While the use of telemedicine visits within long-term care is significantly down from its pandemic high, it remains above historic levels, particularly for speciality services such as psychiatry, a new study finds. 

Despite these gains in usage, however, telehealth visits within long-term care remain underutilized generally, and could use some additional support, experts said.

Researchers from several Boston universities and medical centers found that from January 2019 to February 2020, telemedicine visits accounted for less than 1% of all health visits for nursing home residents. That number increased to 15% of routine SNF visits and 37% of other outpatient visits in SNFs in early 2020, before dropping again and stabilizing at 2% of routine SNF encounters by mid-2021. Half of all telemedicine visits in 2020 and 2021 were clustered in 18% of nursing facilities. 

In 2019, just three Midwestern states — where a lack of local specialists created high need — had more than 1% of health visits delivered via technology. A year later, all US states were using telemedicine at higher levels. But by the first half of 2022, just one state used telemedicine for more than 10% of nursing facility visits and eight states had  returned to using it less than 1% of the time. 

“Our results should be a wake-up call that telemedicine has not been a ‘field of dreams’ situation where SNFs just come and use the technology without any further systems in place,” said study author Michael L. Barnett, MD, associate professor of Health Policy and Management at Harvard T. H. Chan School of Public Health.

The study showed more LTC residents are using telemedicine for psychiatry visits than ever before, and that it improved access. Older adults remain the least likely group to seek mental health assistance overall: Just 9% of seniors seek mental health treatment, previous studies have shown.

“A policy to encourage continued telemedicine use may facilitate further access to important services as the technology matures,” the researchers wrote in JAMA Network Open