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Rise in Telehealth Usage Linked With More Missed Behavioral Healthcare Appointments
New research published recently in JAMA Network Open suggests that an unintended consequence of behavioral healthcare providers ramping up their use of telehealth to conduct visits was a rise in patients missing appointments.
Use of telehealth platforms among behavioral healthcare providers skyrocketed during the COVID-19 pandemic. A study published earlier this year by Trilliant Health found that prior to the onset of the pandemic, utilization of telehealth for behavioral healthcare across major care settings and provider types accounted for less than 1% of visits. By the second quarter of 2022, however, 32.8% of appointments were conducted using telehealth, a 45-fold increase.
Researchers from Northeast Delta Human Services Authority (NDHSA) in Monroe, Louisiana, and the Urban Health Collaborative at Drexel University in Philadelphia, Pennsylvania, conducted a retrospective analysis of electronic health records (EHRs) of patients with behavioral health conditions who visited outpatient clinics in rural Louisiana from May 1, 2022, to January 31, 2023.
The analysis included 9715 appointments (3318 in-person and 6397 via telehealth) involving 1421 patients at least 18 years of age. Of the total patient population studied, 65% were telehealth users. Researchers found that the no-show rate for scheduled in-person appointments was 13%, compared to 17% for telehealth appointments.
“Although the reasons behind no-shows can be multifaceted, difficulty in establishing a therapeutic patient-clinician relationship, loss of nonverbal cues and psychological support, and unfamiliarity with the use of technology may discourage patients from attending telehealth sessions for mental health,” the NDHSA and Drexel researchers wrote.
The study authors noted the main limitation of their research was that it focused on behavioral health clinics serving rural populations and that findings may not be consistent for a broader population that includes different levels of technology available and varied socioeconomic statuses. To that point, the researchers acknowledged that 19% of the study population did not have stable housing, while many lacked a private residence, necessary technology for telehealth appointments (such as internet service and/or sufficient cell phone plan), and stable income.
“Reducing no-shows should incorporate strategies to address unmet social needs along with programs such as sending reminders, offering flexible scheduling, and providing incentives,” the researchers wrote.
References
Trends Shaping the Health Economy: Behavioral Health. Trilliant Health; 2023.
