• Only 15% of FPs Report Using Telehealth; Training and Lack of Reimbursement Are Top Barriers

    One Pagers | Jan 15, 2016
    Miranda A. Moore, Phd; Megan Coffman, MS; Anuradha Jetty, MPH; Stephen Petterson, PhD; and Andrew Bazemore, MD, MPH

    Telehealth (the use of medical information exchanged from one location to another via electronic communications to improve a patient’s health) has been suggested as a way of improving patient access,1 increasing continuity of care,2 and improving health outcomes3 by extending hours and convenience of care, monitoring and engaging patients remotely, and facilitating specialty consultations.4 However, little is known about primary care clinicians’ implementation of, awareness of, and attitudes toward telehealth.

    In 2014, the American Academy of Family Physicians (AAFP) surveyed 5,000 randomly selected physician members listed in the 2014 American Medical Association Physician Masterfile, receiving 1,557 responses (31%) from FPs.5 After weighting the sample to ensure the estimates computed were representative of FPs across the United States, only 15% of FPs reported using telehealth services in the previous 12 months. On a five-point Likert scale, most FPs agreed or strongly agreed that telehealth improves access to care (78%) and improves the continuity of care (68%) for their patients. FPs indicated that lack of training (54%), lack of reimbursement (53%), cost of equipment (45%), and potential liability issues (41%) are barriers to the use of telehealth. The benefits and barriers to telehealth based on this AAFP survey are listed in Table 1.

    Telehealth use is in the early stages of adoption. Many of the barriers to wider adoption may be addressed by policy changes. Strategies to address the top two barriers identified by this survey include health care stakeholders offering new opportunities for training in the use of tele- health services and payers increasing awareness of their current reimbursement for telehealth services, as well as developing new ways to reimburse the services.

    Table 1. Potential Benefits of and Barriers to Telehealth Based on AAFP Survey of FPs

    Percentage of Respondents*
    Improved Access to Care
    Improved Continuity of Care
    Percentage of Respondents*
    Lack of Training
    Lack of Reimbursement
    Cost of Equipment 45%
    Potential Liability Issues 41%

    AAFP = American Academy of Family Physicians
    * = Weighed percentages based on health Survey of Family Physicians.


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    2. Cherry J. Using telehealth to improve continuity of care. September 29, 2010. Patient Safety and Quality Healthcare. http://psqh.com/using- telehealth-to-improve-continuity-of-care. Accessed October 2, 2015.
    3. Nundy S, Dick JJ, Chou CH, Nocon RS, Chin MH, Peek ME. Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants. Health Aff (Millwood). 2014;33(2):265-272.
    4. Kvedar J, Coye MJ, Everett W. Connected health: a review of tech- nologies and strategies to improve patient care with telemedicine and telehealth. Health Aff (Millwod). 2014;33(2):194-199.
    5. Klink K, Coffman M, Moore M, Jetty A, Petterson S, Bazemore A. Family physicians and telehealth: findings from a national survey. 

    The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP.

    Published in American Family Physician, December 15, 2015. Am Fam Physician. 2016 Jan 15;93(2):101. This series is coordinated by Sumi Sexton, MD, AFP Associate Medical Editor.