Rapid growth, persistent challenges in telemedicine adoption among US hospitals

The comprehensive analysis of telemedicine adoption in U.S. hospitals during these years reveals both significant progress and ongoing challenges in the health care sector's digital transformation. The study, published in the Journal of General Internal Medicine, found that the percentage of hospitals offering at least one form of telemedicine service increased from 46% in 2017 to 72% in 2021, with a dramatic surge in patient utilization during the COVID-19 pandemic.

Led by John (Xuefeng) Jiang, Eli Broad Endowed Professor of accounting and information systems at Michigan State University, the research team analyzed data from the American Hospital Association's annual surveys and AHA IT Supplemental Survey, which provides information about electronic medical records, interoperability, health information exchange barriers, reporting, and degree of electronic transition, to explain telemedicine's growth and the obstacles hindering its full potential.

"Our findings demonstrate the rapid acceleration of telemedicine adoption, particularly in response to the COVID-19 pandemic," said Jiang. "However, we also uncovered significant disparities in implementation across different hospital types and persistent challenges in health information exchange that need to be addressed to fully realize telemedicine's benefits."

Key findings of the study include:

• Telemedicine encounters increased by 75%, from 111.4 million in 2020 to 194.4 million in 2021.

• Larger, nonprofit and teaching hospitals were more likely to adopt telehealth services.

• While over 90% of hospitals allow patients to view and download medical records online, only 41% permit online data submission.

• 25% of hospitals identified certified health IT developers, including electronic health record vendors, as frequent sources of information blocking.

The study also revealed that hospitals face significant challenges in exchanging electronic health information, with 85% reporting issues due to interoperability across different vendor platforms.

Joseph Ross, professor at the Yale School of Medicine and co-author of the study, emphasized the need for broader access to telehealth services.

"The lower rates of telehealth service availability in smaller and for-profit hospitals suggests that efforts are needed to ensure these services are broadly available to patients across all hospitals, enabling patients to obtain the care they need," he said.

Ge Bai, former doctoral student in the MSU Broad College of Business and current professor of accounting and health policy at Johns Hopkins University and another co-author, highlighted the potential of telemedicine and the obstacles it faces.

"Telemedicine has the potential to improve hospital care, but our study identified important barriers that are preventing hospitals from reaching this potential," Bai said.

This research builds upon previous work by Jiang, Bai and their colleagues. A related study published in Health Affairs Scholar documented the adoption of electronic health records, or EHRs, in U.S. hospitals over the past decade, highlighting EHRs as a crucial prerequisite for offering telemedicine services. Another recent study by the team, also published in Health Affairs Scholar, revealed that some U.S. hospitals face difficulties in reporting adverse effects of COVID-19 vaccines to health care authorities, further underscoring the challenges in health information management and reporting.

"These studies collectively paint a picture of the ongoing digital transformation in U.S. health care," Jiang said. "While we've seen significant progress in areas like electronic health record adoption and telemedicine implementation, persistent challenges in data exchange and reporting highlight the need for continued improvement in our health information systems."

The researchers suggest that policymakers should focus on addressing these challenges to ensure equitable access to telemedicine services and to facilitate seamless health information exchange among health care providers.

"As we look to the future of health care, it's clear that telemedicine will play an increasingly vital role. Our study not only highlights the progress we've made but also serves as a call to action," Jiang said. "By addressing the disparities in adoption and overcoming technical barriers, we can create a more accessible, efficient and patient-centered health care system. The rapid growth we've observed shows the potential; now it's time to ensure that all patients and health care providers can fully benefit from these technological advancements."