Prevalence and Characteristics of Telehealth Utilization in the United States

Question What is the prevalence of telehealth use in the US, and what demographic characteristics are associated with it? Findings This survey study of 2555 US adult respondents in an internet-based representative panel about use of telehealth found that only approximately 4% of participants had engaged in videoconferencing visits. While 49% of respondents expressed interest in using videoconferencing in the future, those who were older, identified as Black individuals, or reported lower levels of education expressed less willingness to use videoconferencing. Meaning The findings of this study suggest further efforts may be needed to enhance use of and access to videoconferencing visits among the US population. Importance Telehealth services, which allow patients to communicate with a remotely located clinician, are increasingly available; however, prevalence of telehealth use, including videoconferencing visits, remains unclear. Objective To measure the use of and willingness to use telehealth modalities across the US population. Design, Setting, and Participants This survey study, conducted between February 2019 and April 2019, asked participants about their use of different telehealth modalities, reasons for not using videoconferencing visits, and willingness to use videoconferencing visits. Questions were continuously posed to panel members and closed after 2555 responses were obtained, at which point 3932 panel members had been invited, for a 65.0% response rate. Exposures Demographic characteristics (ie, age, sex, race, rural/urban residency, education level, and income). Main Outcomes and Measures Self-reported use of specific telehealth modalities, reasons for nonuse, and willingness to use videoconferencing in the future. Results A total of 2555 individuals completed the survey with a mean (SD) age of 57.2 (14.2) years; 1453 respondents (weighted percentage, 51.9%) were women, and 2043 (weighted percentage, 73.4%) were White individuals. Overall, 1343 respondents (weighted percentage, 50.8%) reported use of a nontelephone telehealth modality, ranging from 873 respondents (weighted percentage, 31.9%) for patient portals and 89 respondents (weighted percentage, 4.2%) for videoconferencing visits. Although 1309 respondents (weighted percentage, 49.2%) overall answered that they were willing or very willing to use videoconferencing visits, respondents who were Black individuals (OR, 0.58; 95% CI, 0.38-0.91), aged older than 65 years (OR, 0.51; 95% CI, 0.40-0.66), or had less education (high school or less vs advanced degrees: OR, 0.37; 95% CI, 0.25-0.56) were less likely to express willingness. Conclusions and Relevance Despite the focused policy attention on videoconferencing visits, the results of this survey study suggest that other forms of telehealth were more dominant prior to 2020. Targeted efforts may be necessary for videoconferencing visits to reach patient groups who are older or have less education, and payer policies supporting other forms of telemedicine may be appropriate to enhance access. This survey study of participants in an online panel examined willingness to participate in telehealth services to access health services with remote clinicians among participants categorized by sex, age, race/ethnicity, income, and education level.