Madsen Cathaleen, Banaag Amanda, Koehlmoos Tracey Pérez
Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.
Telemed J E Health. 2021 Dec;27(12):1346-1354. doi: 10.1089/tmj.2020.0474. Epub 2021 Mar 17.
Telehealth in the Military Health System (MHS) has long been an important tool for delivering care in deployed settings. However, the scope of nondeployed telehealth usage in the MHS has not previously been published, making full evaluation difficult. This study aims at addressing this gap by assessing trends over time, demographics, provider types, and diagnoses most associated with telehealth usage in the MHS. Secondary analysis was conducted on health care claims from the MHS Data Repository for all telehealth services provided from fiscal years 2006 to 2018. Telehealth services were identified by using Common Procedural Terminology (CPT) code modifiers GT, GQ, and 95. Patient demographics, provider type, and major diagnostic category were assessed for all telehealth services in both direct (military provided) and purchased (private sector) care. Usage of telehealth services in the MHS rose ∼19-fold, from 2,549 to 48,667 occurrences, from 2006 to 2018. Physicians provided ∼60% of telehealth services overall, and the greatest usage was for mental health diagnoses. Purchased care (PC) showed differences from direct care (DC), including a greater level of expansion, greater inclusion of children and adolescents, and lower usage of telehealth for non-mental health services. Telehealth usage in the MHS has increased substantially from a total 2,549 occurrences in 2006 to 48,667 occurrences in 2018, demonstrating greater acceptance and usage by both DC and PC providers. Future directions include assessing provider types, diagnosis codes, and patient demographics associated with telehealth use, especially in the emerging COVID19 clinical practice environment.
远程医疗在军事卫生系统（MHS）中一直是在部署环境中提供医疗服务的重要工具。然而，MHS中非部署环境下远程医疗的使用范围此前尚未公布，这使得全面评估变得困难。本研究旨在通过评估MHS中远程医疗使用随时间的趋势、人口统计学特征、提供者类型以及与之最相关的诊断来填补这一空白。对MHS数据存储库中2006财年至2018年提供的所有远程医疗服务的医疗保健索赔进行了二次分析。通过使用通用程序术语（CPT）代码修饰符GT、GQ和95来识别远程医疗服务。对直接（军方提供）和购买（私营部门）医疗服务中的所有远程医疗服务的患者人口统计学特征、提供者类型和主要诊断类别进行了评估。从2006年到2018年，MHS中远程医疗服务的使用量增长了约19倍，从2549次增加到48667次。总体而言，医生提供了约60%的远程医疗服务，其中心理健康诊断的使用量最大。购买医疗（PC）与直接医疗（DC）存在差异，包括更大的扩张程度、更多儿童和青少年的纳入以及非心理健康服务的远程医疗使用率较低。MHS中的远程医疗使用量已从2006年的总计2549次大幅增加到2018年的48667次，这表明DC和PC提供者对其接受度和使用率都更高。未来的方向包括评估与远程医疗使用相关的提供者类型、诊断代码和患者人口统计学特征，特别是在新兴的COVID-19临床实践环境中。
