While generational differences guide preferences for post-pandemic in-person or video visits, as well as primary versus specialty care, telehealth has a significant role to play as health systems formulate their organizational strategies.
The year 2020 was a breakthrough year for telehealth. Now that the pandemic appears to be abating, health systems are seeking the best strategies to move forward with these initiatives and find a way to balance video visits with in-person care.
A consumer survey from the Healthcare Information Management Systems Society (HIMSS) provides significant clues about the road ahead. While there is still a preference for in-person care in the post-pandemic world, video visits have significant appeal, particularly among younger generations and certainly for primary care. Even in specialty care, where in-person visits have an edge, a significant number of patients desire video encounters, with younger people expressing the strongest interest.
Research and analysis for the survey was conducted by HIMSS Market Intelligence in March 2021. The sample included 509 individual consumers who had completed at least one telehealth video visit in the past 12 months. Demographics were balanced to the U.S. population.
"While patients were overall pleased with the care they received from a video-based telehealth visit, healthcare systems are still straddling a generational divide in term of attitudes towards cost and a wiliness to use video telehealth for specialty care versus primary care," Kerry Amato, executive director, health innovation, HIMSS, told HealthLeaders.
"This research illustrates the good news that more than 75% of patients were satisfied with the care they received from a video-based telehealth visit, which means that as healthcare providers are evaluating their post pandemic telehealth strategy, they can count on video being an important component," Amato says. "However, healthcare providers will need to carefully consider the use of video-based telehealth for specialty care versus primary care in their strategy. [Some] 58% of respondents indicated they are not willing to switch their specialty care provider even if offered a 50% discount, but would be willing to switch their primary care provider. That said, it may be useful for providers to initially explore a more robust video-based telehealth strategy around primary care and roll it out to other specialties as adoption increases."
Among all generations, the survey reveals that convenience is the top driver of telehealth use. The biggest barrier: Poor video/audio quality.
The Generational Divide
When choosing what type of primary care visit is preferred post-pandemic, there were differences by generation:
- 70% of Baby Boomers (ages 57-74) prefer in-person encounters; only 27% chose video visits.
- Generation X (ages 41-56) was about evenly split, with 47%% desiring in-person visits and 46% preferring video visits.
- 48% of Millennials (ages 25 to 40) indicated a preference for video visits, followed by 45% desiring an in-person visit.
- Generation Z (ages 18 to 24) expressed the strongest preference for video visits, with 55% choosing that option, and only 34% selecting in-person visits.
- Less than 5% of any generation said they preferred to use messaging or phone calls for primary care visits.
When visiting a specialist, most generations expressed a preference for in-person care post-pandemic, compared to video visits:
- 83% of Baby Boomers (ages 57-74) want to see specialists in person, with only 15% preferring video visits.
- 57% of Generation X (ages 41-56) selected in-person care, with 41% interested in video encounters.
- Millennials (ages 25 to 40) expressed a slight preference for video visits, with 48% choosing video and 46% selecting in-person visits.
- Once again, Generation Z (ages 18 to 24) expressed a strong preference for video visits, with 67% desiring video versus 30% who want in-person care.
- Phone calls or messaging with specialists were low on the preference scale, with only zero to 4% of any generation selecting these options.
The Cost Factor
The survey also explored cost factors. HIMSS reports:
- On average, out-of-pocket costs for patients were higher for in-person appointments ($34.68) compared to video appointments ($29.40).
- Research revealed 67% of respondents expect telehealth to cost less than traditional visits because they are virtual, shorter, and have minimal overhead office expenses.
- About half of patients are willing to change their primary care physicians if offered a discount.
- Younger generations are more tempted to save 50% by changing physicians compared to Baby Boomers.
- Specialty care providers are seen to have a higher value, therefore only one-in-three of those surveyed would be open to changing specialty care providers, regardless of the discount.
- Overall, four in 10 would choose to change providers to save money, while one in five would not want to change providers to save money because they already have a trusted doctor.
The survey also offered some compelling information to health systems as remote care begins to gain traction. The majority of respondents indicated they would be willing to use a health app if asked by their doctor, with more than half preferring an app designed especially for doctor‒patient use. Nearly four out of 10 respondents use a health app, with about 60% sharing the data with their doctors.
“Healthcare systems are still straddling a generational divide in term of attitudes towards cost and a wiliness to use video telehealth for specialty care versus primary care.”
Kerry Amato, executive director, health innovation, HIMSS
Mandy Roth is the innovations editor at HealthLeaders.
With the exception of Baby Boomers, about half of all generations prefer video visits for primary care.
Preference for specialist care via video ranges from 15% to 67%, with younger patients preferring this form of care.
67% of respondents expect telehealth to cost less than traditional visits because they are virtual, shorter, and have minimal overhead office expenses.