Patients less likely to complete diagnostic testing after telehealth visit compared to in-person visit

A study published in JAMA Network Open on completion rates for high-risk diagnostic tests and referrals found lower rates when tests were ordered during telehealth visits compared to traditional in-person appointments. The study, which examined more than 4,000 patients, underscores the importance of addressing challenges in telehealth to ensure optimal patient outcomes.

The research found that completion rates for telehealth orders stood at 43%, compared to the 58% completion rate for tests and referrals requested during in-person appointments. Also, 57% of tests ordered without any visit at all were completed within the designated time frame.

The study points out that diagnostic errors often stem from the failure to complete necessary tests or referrals, posing safety risks, especially in primary care where the range of potential diagnoses is extensive.

The study focused on three types of high-risk tests: colonoscopy referrals, dermatology referrals for suspicious skin lesions, and cardiac stress tests. Completion rates were assessed within specific time frames – 365 days for colonoscopies, 90 days for dermatology referrals, and 45 days for cardiac stress tests.

The researchers found that patients with telehealth visits were less likely to complete colonoscopies on time, suggesting potential barriers to completion. The lack of staff assistance during telehealth visits, a factor present during in-person visits, may contribute to incomplete test and referral orders, according to the study.

Researchers emphasized the need for additional investments in test tracking and patient outreach, particularly for individuals relying on telehealth care.