Integrating Telehealth Into the Primary Care Workday to Improve Access and Continuity

During the COVID-19 pandemic, primary care practices that had not previously considered telehealth viable were pushed to reconsider it to stay solvent. The pandemic fueled a rapid increase in telehealth to a peak of more than 50% of visits,¹ which has now settled into slightly more than 10%.^2–3 Yet even in this post-pandemic era, telehealth has tremendous potential to strengthen the basic provision of care in small and large practices.

This article describes the benefits of — and workflows for — integrating telehealth into the primary care workday, including tips for conducting effective physical exams via telehealth.

While telehealth-only offerings have grown in recent years, both for general services (e.g., Teladoc or Zocdoc) and for specific conditions (e.g., acne, testosterone, and fertility online sites), integrating telehealth into the primary care clinic improves continuity and access. We have found that telehealth offers a number of practical benefits, including the following:

It reduces cancellations and no-shows. Telehealth allows for ease of access and communication between clinicians and patients, which often keeps patients from canceling or not showing up for appointments despite other demands on their time. Transportation issues are a common reason for last-minute cancellations and we can often salvage these visits by converting them to telehealth.

It improves chronic disease follow-up. Telehealth makes it easier for patients to follow up on their chronic conditions because they can do it from any location — at home, out of town, or at work on their break or lunch hour.

It improves communication about abnormal results. Telehealth allows us to reach patients quickly to personally discuss unexpected abnormal labs or imaging findings and proceed with next steps,⁴ such as further testing or referrals. We often fit in these telehealth visits as other appointment cancellations arise.