Estimating the Proportion of Telehealth-Able United States Emergency Department Visits.

Abstract

STUDY OBJECTIVE We use national emergency department (ED) data to identify the proportion of "telehealth-able" ED visits, defined as potentially conductible by Video Only or Video Plus (with limited outpatient testing). METHODS We used ED visits by patients 4 years of age and older from the 2019 National Hospital Ambulatory Medical Care Survey and applied survey weighting for national representativeness. Two raters categorized patient-described Reasons for Visit (RFV) as telehealth-able (yes, no, uncertain) for both Video Only and Video Plus visits. This categorization was stratified by age (4 to 17 years old, 18 to 35, 36 to 64, and 65 and older). Visit characteristics that were used to remove further nontelehealth-able visits included admission, procedures, diagnostic testing, acuity level, and pain score. RESULTS Our sample included 133.6 million United States ED visits in 2019 for patients aged 4 years or older. Of those, between 3.4% and 8.8% of visits were telehealth-able by Video Only and between 5.0% and 9.7% by Video Plus, considering only the first RFV. Visits by younger patients were more often telehealth-able, with the proportion of telehealth-able visits decreasing with advancing age. Considering all RFVs, between 0% to 6.6% of ED visits were telehealth-able with Video Only and 0.02% to 7.6% with Video Plus. CONCLUSION Between 3% and 10% of United States ED visits may be potentially telehealth-able for patients aged 4 years and older, considering the first listed RFV and ED visit characteristics. Fewer visits may be telehealth-able when all reasons for visits are considered.