Live video telemedicine is up during 2020, but utilization remains highest among high earners with high levels of education, according to a new Rock Health consumer adoption report.

The research and venture firm surveyed a total of 7,980 from September 4, 2020 to Oct. 2, 2020 in its annual survey. Researchers noted that 2020 was an unusual year for healthcare because of the pandemic.

“Therefore, unlike data from prior years, we believe that 2020 is unlikely to represent a point on a linear trajectory or continuous trend line,” authors of the report wrote. “Rather, the adoption trend in future periods may follow more of a step response path in which a period of overshoot is followed by a new, higher equilibrium that is below the initial 'impulse' delivered by COVID-19.”

There was an uptick in live video telemedicine use from 32% in 2019 to 43% in 2020. While the numbers are up for video calls, live phone calls, text messages, emails and health apps have all seen a decrease from 2019. Researchers propose that these metrics are due overall decrease in healthcare utilization as reported by the Commonwealth Fund.

"This finding (i.e., consumer utilization of some forms of telemedicine fell during the early stages of the pandemic) is initially surprising, particularly in light of widely reported increases of telemedicine utilization among providers. We propose that a Will Rogers phenomenon led to this outcome. Importantly, overall healthcare utilization declined dramatically in the early part of 2020: utilization hit a low point in late March with 60% fewer visits completed than during the same period the prior year," authors wrote. 

The demographics using the telemedicine are concentrated among high earners and those with chronic conditions. The report found that 78% of survey takers that had at least one chronic condition used telemedicine, as opposed to 56% of users without a chronic condition.

Researchers also found that 85% of responders earning a salary of over $150,000 used telemedicine – making it the group with the highest utilization. Education also played an important component. Those with a graduate degree or higher were the most likely to report using the tech (86%).

The survey also found that men use the technology more than women, urban adoption is higher than suburban or rural adoption and that middle-aged adults were the most likely to tap into telemedicine.

Wearable use also grew to 43%, up from 33% in 2019. Some 66% of those using a wearable for the first time during the pandemic said it was to manage a health condition. A total of 51% of all users were managing their health condition.

“Necessity was the mother of adoption, particularly around telemedicine and remote health tracking,” researchers wrote. “However, while more consumers used wearables to track health metrics, it is unclear how well healthcare systems have adapted to this shift in consumer interest in tracking health data, and it is unknown how much patient-generated data is being integrated into healthcare and disease management."

Sixty percent of survey-takers said they searched providers for online reviews, which is smaller than 2019. Some 67% of responders use online platforms to search for health information, which is down from 76% in 2019.

WHY IT MATTERS

There’s no denying that telemedicine came into the limelight during the COVID-19 pandemic. However, what will happen after the pandemic is unknown. This survey demonstrates that users are heavily concentrated in higher income brackets and among the educated, which is a trend seen even before the pandemic.

Researchers note that, while things may even out next year, the regulatory reforms seen over the last year, as well as increase in familiarity with the technology may mean utilization of the technology will still be higher than before the pandemic.

“[W]e believe that the regulatory environment and ongoing pandemic response will support an equilibrium of digital health adoption that is lower than the peak observed once the pandemic first hit, but higher than pre-pandemic levels. The possibility of sustained regulatory reform, in particular, supports a higher post-pandemic equilibrium level,” authors of the report wrote.

THE LARGER TREND

In last year’s Rock Health consumer adoption report, telemedicine and digital tools had about leveled off. In fact, live video chats fell from 2018 to 2019 and wearable usage remained the same.

While several reports have discussed the boom in telehealth last year, reports have also surfaced that the tech can pose inequities. An analysis from Kantar Health found inequalities in telehealth usage across demographic groups.