EBRI Issue Brief

The Webcam Will See You Now: A Review of Telemedicine During the COVID-19 Era

Apr 1, 2021 11  pages


Telemedicine has evolved from its humble roots as a means of transmitting radiological images over telephone wires to a sophisticated videoconferencing experience for patients. Most recently, the COVID-19 pandemic has contributed to telemedicine usage spiking, as patients sought to avoid hospitals and doctors’ offices. Still, there is scant literature evaluating outcomes for patients using synchronous videoconferencing telemedicine platforms. In a review of current literature on videoconferencing telemedicine as popularly practiced during the COVID-19 pandemic, the Employee Benefit Research Institute (EBRI) examines the factors that could influence wider adoption of telemedicine as well as its effectiveness in affecting patient outcomes. This review finds:

  • Evidence that telemedicine can be effective: One state’s telemedicine system contributed to a reduction in 60-day infant mortality rates and has helped adolescent asthmatics better manage their symptoms. Telemedicine can be as effective as in-person visits, at least for certain types of care, such as managing diabetes or allergies.
  • Evidence that patients found the telemedicine experience compelling. That is, they found telemedicine platforms easy to use, and enjoyed the convenience and time savings that telemedicine offers.
  • Signs that the pandemic has affected usage patterns: One recent study found that since the onset of the pandemic, telemedicine visits increased twenty-three-fold relative to pre-pandemic times.
  • Evidence that some benefits executives at large corporations saw telemedicine as a cost-savings tool, although others wondered whether their workers used telemedicine as a substitute for in-person care or for care that would not have been sought in-person.
  • Two important questions that EBRI aims to answer in future research. To what extent did telemedicine impact outcomes for patients who pivoted to using it to receive care during the COVID-19 pandemic? And will patients continue to use telemedicine as they have during the pandemic, or will they prefer to return to primarily in-person visits?

Telemedicine is a promising means for health care providers to connect with their patients in a way that is more flexible and cost-effective. Patients do not need to travel to receive health care services, which is a boon to many patients, including the elderly and those in rural areas who may live far away from their health care provider. However, as with futuristic innovations like self-driving cars, realizing the full benefits of telemedicine has long been prognosticated to be “just around the corner.” It is now, however, that a confluence of factors have created conditions in which telemedicine is well-positioned to succeed. Reluctance to visit hospitals and doctors’ offices, lower barriers to technology and increasingly prevalent video communication software, reduced regulatory barriers, and buy-in from employers have finally thrust telemedicine into a prominent role in the United States’ health care system.

Still, the extant literature on the impact of telemedicine on outcomes — in particular, telemedicine visits that substituted in-person visits during the COVID-19 pandemic — remains relatively scant. This is not particularly surprising; telemedicine as practiced and popularized during the COVID-19 pandemic is a relatively new phenomenon. In a review of current literature on telemedicine as practiced during the COVID-19 pandemic, EBRI examines the factors that could influence wider adoption and effectiveness of telemedicine in affecting patient outcomes and reducing health care costs.