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CHC 2020 Telehealth Research Study

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Telehealth – the ability of patients to connect with their health care providers via video and phone – has taken off during the COVID-19 pandemic. Community Health Center, Inc. and its research arm, the Weitzman Institute, commissioned Sacred Heart University’s Institute for Public Policy to survey 1,000 Connecticut residents on their views about this emerging, and now essential, technology.

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CHC 2020 Telehealth Research Study

  1. 1. 2020 Telehealth Research Study November 10, 2020Report of Findings © Community Health Center, Inc.
  2. 2. Areas of Investigation The CHC Telehealth Research Study leveraged a quantitative research methodology to address the following areas of investigation: ๏ Devices used for telehealth appointments ๏ Type of telehealth service used and evaluation of the audio and video quality through that service ๏ Aspects individuals liked and disliked about their telehealth experience ๏ Comparison of telehealth to an in-person appointment ๏ Ease of communicating with their doctor through telehealth ๏ Quality of care received through telehealth ๏ Overall satisfaction with the telehealth experience ๏ Likelihood to use telehealth again ๏ Demographic profile of respondents © Community Health Center, Inc.
  3. 3. Slide /© Community Health Center, Inc. 3 Research Methodology Snapshot Methodology Telephone & Digital Target Connecticut Residents No. of Completes 1,001 Quality Assurance Dual-level** No. of Questions 52* Margin of Error 3.02% Incentive None Confidence Level 95% Sample Procured by GreatBlue Research Dates September 11 - October 9, 2020 * This represents the total possible number of questions; not all respondents will answer all questions based on skip patterns and other instrument bias. ** Supervisory personnel, in addition to computer-aided interviewing platform, ensure the data is accurate.
  4. 4. Slide /© Community Health Center, Inc. 4 Respondent Snapshot This slide quantifies select data points to provide context for this research study. The data is not meant to be statistically significant or representative of population contribution, rather to provide an empirical view into the demographic profile of the participants. Gender 35.5 % 63.2 % 1.3 % 1 2 3 Age 5.7% 11.8% 14.1% 15.9% 19.3% 18.2% 11.4% 3.7% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8
  5. 5. Slide /© Community Health Center, Inc. 5 Respondent Snapshot This slide quantifies select data points to provide context for this research study. The data is not meant to be statistically significant or representative of population contribution, rather to provide an empirical view into the demographic profile of the participants. 9.0% 9.5% 5.4% 9.8% 12.2% 8.1% 6.0% 10.8% 29.3% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 9 0.6% 2.2% 15.5% 1.2% 3.3% 14.3% 33.9% 24.3% 4.8% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 9 Income Education
  6. 6. Slide /© Community Health Center, Inc. 6 Respondent Snapshot This slide quantifies select data points to provide context for this research study. The data is not meant to be statistically significant or representative of population contribution, rather to provide an empirical view into the demographic profile of the participants. Ethnicity Children Under Age 18 2.3% 4.6% 13.2% 11.8% 0.6% 66.0% 2.1% 5.8% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 68.7% 11.7% 11.2% 3.1% 1.1% 0.5% 3.7% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7
  7. 7. Slide /© Community Health Center, Inc. 7 Sources of Information on Telehealth More than one-half of all survey respondents, 56.4%, became aware of telehealth via their “healthcare provider,” while one-fifth learned by “word of mouth - family or friend” (20.9%). Telehealth users primarily learned about telehealth via their “healthcare provider” (77.6%), while non-users learned about telehealth through their “healthcare provider” (30.2%) or “word of mouth - family or friend” (30.2%). Readers should note that one-fifth of non-users, 20.8%, were not aware of telehealth prior to the survey. How did you first learn about telehealth? Select all that apply. 56.4% 20.9% 17.1% 10.6% 7.4% 6.7% 77.6% 13.4% 15.3% 2.3% 7.6% 3.6% 30.2% 30.2% 19.2% 20.8% 7.2% 10.5% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 Series1 Series2 Series3 (N=1001)
  8. 8. Slide /© Community Health Center, Inc. 8 Access to Technology Do you currently have access to the following? Nearly two-thirds of all survey respondents, 64.2%, currently have access to both a phone with audio and video with audio. More than one-half of all respondents, 55.4%, reported having either a medical health appointment, a behavioral health appointment, or both types of appointments via telehealth in the past 6 months. Respondents most frequently reported having access to a “smart phone” (60.8%) for telehealth appointments, followed by a “laptop” (48.6%). Readers should note that one-tenth of non-users, 9.6%, do not have access to technology needed for telehealth appointments. Within the past 6 months, have you used telehealth? What types of devices do you have access to for telehealth appointments? Select all that apply. 20.8% 9.1% 64.2% 5.9% 1 2 3 4 43.6% 5.0% 6.8% 44.7% 1 2 3 4 60.8% 48.6% 37.5% 35.1% 31.8% 29.9% 0.4% 4.6% 62.6% 50.9% 40.3% 34.7% 26.5% 27.8% 0.4% 0.5% 58.6% 45.6% 34.0% 35.6% 38.3% 32.4% 0.4% 9.6% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 Series1 Series2 Series3 (N=1001) (N=1001) (N=1001)
  9. 9. Slide /© Community Health Center, Inc. 9 Technology Used for Telehealth Appointment For your telehealth appointments, did you use a phone with audio only, or video with audio? Among those respondents who had a telehealth appointment in the past 6 months, slightly more than one-third, 36.3%, had access to both a phone with audio only and a phone with video and audio for their appointment. More respondents used video with audio (34.5%) than a phone with audio only (27.1%). A “smart phone” (50.5%) was the device most frequently used for a telehealth appointment, followed by a “laptop” (28.5%) or a “cell phone” (24.2%). What type of device did you use for your telehealth appointments? Select all that apply. 27.1% 34.5% 36.3% 2.2% 1 2 3 4 50.5% 28.5% 24.2% 15.3% 13.9% 11.7% 0.9% 47.2% 23.6% 22.5% 15.1% 12.4% 9.2% 1.1% 54.0% 42.0% 28.0% 16.0% 18.0% 18.0% 0.0% 69.1% 50.0% 32.4% 16.2% 20.6% 23.5% 0.0% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 Series1 Series2 Series3 Series4 (N=554) (N=554)
  10. 10. Slide /© Community Health Center, Inc. 10 Rating of Audio and Video Quality Telehealth users provided high ratings for the audio and video connection during their telehealth appointment. More than nine-out-of-ten respondents with a telehealth appointment reported the “telephone / audio connection” (94.5%) was either “very good” or “good,” and a similar frequency of respondents, 92.6%, provided positive ratings for the quality of the “video connection.” How would you rate the quality of the (telephone/audio connection) / (video connection) during your telehealth appointment? 48.0% 44.6% 5.9% 0.5% 1.0% Video connection (N=392) 38.6% 3.5% 0.4% 1.7% 1 2 3 4 5 Telephone / audio connection (N=542) 55.9% Quality (“very good” & “good”)… Telephone / audio connection Video connection Composite 94.5% 92.6% Medical Health Appointment only 94.9% 93.4% Behavioral Health Appointment only 93.9% 84.9% Both Medical and Behavioral Health Appointments 92.5% 93.1%
  11. 11. Slide /© Community Health Center, Inc. 11 Experiences During Telehealth Appointment The strong majority of telehealth users, 91.9%, conducted their appointment at “home,” while less than one-in-ten had their appointment at “work / office” (8.8%), in their “car” (7.2%) or “outdoors” (6.0%). More than two-thirds of telehealth users did not report any issues with “poor telephone signal and dropped calls” (80.7%) or “issues with Wi-Fi connections” (69.1%) for their appointment. Only 5.4% did not feel they had enough privacy and 4.3% did not have enough phone minutes for their telehealth appointment. 16.8% 13.5% 94.6% 71.7% 69.1% 80.7% 5.4% 4.3% 14.1% 5.8% 0.0% 24.0% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 Series1 Series2 Where did you have your telehealth appointment? Select all that apply. 91.9% 8.8% 7.2% 6.0% 0.4% 0.5% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 (N=554) (N=554)
  12. 12. Slide /© Community Health Center, Inc. 12 Likes of Telehealth Roughly three-quarters of telehealth users, 74.4%, reported the aspect they liked most about their telehealth appointment was the fact they “did not have to travel to the provider’s office.” Additionally, spending “less time waiting for the appointment to start” (44.8%) was viewed as another beneficial characteristic of telehealth appointments. Readers should note that 2.3% of respondents indicated they liked their telehealth appointment because they felt “safe from COVID-19.” What did you like most about your telehealth appointment? Select all that apply. (N=554) 74.4% 44.8% 39.2% 30.9% 2.3% 2.2% 1.1% 2.9% 75.9% 42.2% 38.8% 31.9% 2.8% 2.3% 1.1% 3.4% 72.0% 58.0% 38.0% 28.0% 0.0% 0.0% 2.0% 2.0% 66.2% 51.5% 42.6% 26.5% 1.5% 2.9% 0.0% 0.0% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 Series1 Series2 Series3 Series4
  13. 13. Slide /© Community Health Center, Inc. 13 Dislikes of Telehealth Telehealth users indicated they “do not receive hand-on treatment / cannot provide all services” (49.8%) as the aspect they liked least about their telehealth appointment, while nearly one-quarter, 24.0% reported they did not experience any issues. Additionally, 15.2% of respondents indicated a downfall of telehealth appointments was they “found it hard to talk to the provider / felt less personal.” 49.8% 24.0% 15.2% 8.3% 7.2% 6.5% 3.1% 0.5% 52.5% 25.2% 12.2% 6.9% 4.8% 6.0% 1.8% 0.7% 26.0% 18.0% 36.0% 18.0% 20.0% 10.0% 8.0% 0.0% 50.0% 20.6% 19.1% 10.3% 13.2% 7.4% 7.4% 0.0% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 Series1 Series2 Series3 Series4 What did you like least about your telehealth appointment? Select all that apply. (N=554)
  14. 14. Slide /© Community Health Center, Inc. 14 Effectiveness of Telehealth Nearly nine-out-of-ten telehealth users, 88.1%, reported their telehealth appointment was either “very” (52.0%) or “somewhat effective” (36.1%). Less than one-in-ten respondents, 9.8%, reported their appointment was not effective. Those respondents using telehealth for a “Behavioral Health Appointment only” (92.0%) provided increased effectiveness ratings as compared to respondents with a “Medical Health Appointment only” (88.1%) or those having “both Medical and Behavioral Health Appointments” (85.3%). How effective would you say your telehealth appointment was? 52.0% 36.1% 6.7% 3.1% 2.2% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 (N=554) Total Effective (“very” & “somewhat”)… % Composite 88.1% Behavioral Health Appointment only 92.0% Medical Health Appointment only 88.1% Both Medical and Behavioral Health Appointments 85.3%
  15. 15. Slide /© Community Health Center, Inc. 15 Experience with Telehealth Please tell me how much you agree or disagree with each of the following statements, using a scale of “Strongly agree,” “Agree,” “Disagree,” or “Strongly disagree.” 89.7% 84.6% 81.5% 81.1% 76.4% 74.4% 47.3% 8.5% 11.9% 13.2% 15.4% 19.2% 21.8% 12.4% 1.8% 3.4% 5.4% 3.6% 4.5% 3.8% 40.3% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 Series1 Series2 Series3 (N=554) Overall, telehealth users indicated strong levels of agreement with seven (7) statements related to their telehealth experience. More than four-fifths agreed that: • “It was easy to talk to my provider and understand their instructions” (89.7%) • “The quality of care I got from my provider was very good through telehealth” (84.6%) • “I would use telehealth again” (81.5%) • “I received as much time and attention from my provider during my telehealth visit as I would have during an in-person visit” (81.1%)
  16. 16. Slide /© Community Health Center, Inc. 16 Facilitating a Telehealth Appointment Less than one-fifth of all survey respondents reported facilitating a telehealth appointment for a “child” (16.4%), “parent” (11.6%) or “spouse” (8.9%). Among the 164 survey respondents that facilitated a telehealth appointment for their child, the strong majority, 89.0%, indicated they were comfortable with their child having a telehealth appointment. Did you facilitate a telehealth appointment for a family member such as a parent, child or spouse? 11.6% 16.4% 8.9% 84.1% 79.7% 86.9% 4.3% 3.9% 4.2% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 Series3 Series2 Series1 As a parent, were you comfortable with your child having a telehealth appointment? 89.0% 11.0% 1 2 (N=1001) (N=164)
  17. 17. Slide /© Community Health Center, Inc. 17 Preference for Appointment Type While one-third of telehealth users, 33.2%, prefer a telehealth appointment in the future, an increased frequency, 46.0%, would prefer an in-person appointment. To increase the likelihood of using telehealth in the future, nearly one-third of respondents, 32.5%, indicated the need for “access to a quiet / private place,” while nearly one- quarter, 26.0%, reported “access to technology needed for telehealth.” Would you prefer a telehealth appointment or an in-person appointment in the future? What needs would have to be met to make you more likely to use telehealth for a medical appointment in the future? Select all that apply. (N=554) (N=554) 33.2% 31.0% 48.0% 36.8% 46.0% 48.9% 40.0% 32.4% 20.8% 20.2% 12.0% 30.9% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 Series3 Series2 Series1 32.5% 28.0% 26.0% 10.6% 5.4% 4.2% 0.2% 1.1% 7.9% 27.3% 31.0% 24.1% 7.6% 6.9% 4.6% 0.2% 1.1% 8.7% 58.0% 16.0% 34.0% 26.0% 0.0% 0.0% 0.0% 0.0% 2.0% 47.1% 17.6% 32.4% 19.1% 0.0% 4.4% 0.0% 1.5% 7.4% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 9 Series1 Series2 Series3 Series4Medical Health only Behavioral Health only
  18. 18. Slide /© Community Health Center, Inc. 18 Interest in Technology More than two-thirds of telehealth users, 68.0%, reported being either “very interested” (33.2%) or “somewhat interested” (34.8%) in using technology that they own, or was sent to them by their medical provider, to capture health-related information. Respondents that had a “Behavioral Health Appointment only” (78.0%) or “both Medical and Behavioral Health Appointments” (80.8%) via telehealth were more interested in using technology as compared to those respondents having a “Medical Health Appointment only” (64.9%). How interested would you be in using devices to capture your health information by technology that you own or was sent to you by your medical provider (such as a FitBit, Apple Watch, blood pressure cuff, etc.) that would be helpful during a telehealth appointment? 33.2% 34.8% 12.3% 16.1% 3.6% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 (N=554) Total Interested (“very” & “somewhat”)… % Composite 68.0% Behavioral Health Appointment only 78.0% Medical Health Appointment only 64.9% Both Medical and Behavioral Health Appointments 80.8%
  19. 19. Slide /© Community Health Center, Inc. 19 Perceived Benefits of Telehealth Which of the following aspects of telehealth do you perceive to be the most beneficial? Select all that apply. Based on their perception, nearly one-half of non- users, 48.6%, believe telehealth appointments to be “very effective” (13.9%) or “somewhat effective” (34.7%). Perceived benefits of telehealth among non- users primarily included “did not have to travel to the provider’s office” (61.3%), followed by “less time waiting for the appointment to start” (36.2%). Based on your perception, how effective are telehealth appointments? 61.3% 36.2% 26.0% 23.5% 9.2% 3.1% 2.7% 5.1% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 13.9% 34.7% 12.1% 8.3% 31.1% 1 2 3 4 5 (N=447) (N=447)
  20. 20. Slide /© Community Health Center, Inc. 20 Barriers to Using TelehealthThe primary reason why respondents have not yet used telehealth for a medical appointment was because they “have not had the opportunity / need yet to use telehealth” (59.4%), followed by “prefer face to face appointment” (35.7%). More than two-fifths of non-users, 41.6%, reported being “very likely” (14.1%) or “somewhat likely” (27.5%) to use telehealth in the future, while 39.4% are not likely to do so. Why have you not used telehealth? Select all that apply. How likely are you to use telehealth in the future? 59.4% 35.7% 9.2% 5.8% 5.8% 0.9% 7.4% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 14.1% 27.5% 16.6% 22.8% 19.0% 1 2 3 4 5 (N=447) (N=447)
  21. 21. Slide /© Community Health Center, Inc. 21 Changes Needed to Use Telehealth What needs would have to be met to make you more likely to use telehealth for an appointment in the future? Select all that apply. 31.5% 25.7% 19.7% 5.8% 5.6% 3.6% 2.7% 2.5% 2.5% 1.6% 9.8% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 5 6 7 8 9 10 11 Non-users indicated that to become more likely to use telehealth for an appointment in the future, they would need “access to a quiet / private place” (31.5%) or “access to technology needed for telehealth” (25.7%). Nearly one-fifth of non-users, 19.7%, indicated there were no needs that would have to be met that would increase their likelihood of using telehealth in the future. (N=447)
  22. 22. Slide /© Community Health Center, Inc. 22 Insurance and State of Connecticut MandatesMore than one-half of telehealth users, 54.0%, believe insurance companies should reimburse members for telehealth expenses at the full rate for in-person services, while 46.0% believe telehealth services should be reimbursed at a reduced rate. Additionally, more than one-half of respondents, 53.6%, believe the State of Connecticut should require both public and private insurance companies to provide telehealth services as an “optional service” to its members, while one-third, 33.2%, believe telehealth should be offered as a “mandatory service.” Should insurance companies reimburse members for telehealth expenses at the full rate for in-person services or at a reduced rate? Should the State of Connecticut require both public and private insurance companies to provide telehealth services as an option to its members or as a mandatory service?(N=554) (N=554) 54.0% 53.2% 50.0% 61.8% 46.0% 46.8% 50.0% 38.2% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 Series1 Series2 Medical Health only Behavioral Health only 53.6% 57.1% 42.0% 39.7% 33.2% 28.2% 50.0% 52.9% 13.2% 14.7% 8.0% 7.4% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 Series1 Series2 Series3 Medical Health only Behavioral Health only
  23. 23. Slide /© Community Health Center, Inc. 23 Insurance Reimbursement for Telehealth Less than one-half of respondents without a telehealth appointment, 45.9%, believe insurance companies should reimburse members for telehealth expenses at the full rate for in-person services, while 54.1% believe telehealth services should be reimbursed at a reduced rate. Readers should note that more than one-half of telehealth users, 54.0%, indicated that insurance companies should reimburse members at the full rate. Should insurance companies reimburse members for telehealth expenses at the full rate for in-person services or at a reduced rate? 45.9% 54.1% 1 2 (N=447) 54.0% Among Telehealth Users
  24. 24. Slide /© Community Health Center, Inc. 24 COVID-19 Impact on Telehealth Only 4.1% of all survey respondents have tested positive for COVID-19. Among telehealth users, only 15.0% used telehealth prior to the COVID-19 pandemic, while 66.3% used telehealth during the pandemic. Among all survey respondents, more than one-half, 54.7%, anticipate using telehealth after the COVID-19 pandemic. Did you use telehealth prior to the COVID-19 pandemic? Did you use telehealth during the COVID-19 pandemic? Do you anticipate that you will use telehealth after the COVID-19 pandemic? 15.0% 66.3% 54.7% 85.0% 33.7% 45.3% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 1 2 3 Series1 Have you tested positive for COVID-19? 4.1% 92.5 % 3.4% 1 2 3 Prefer not to answer (N=1001) (N=554) (N=554) (N=1001)
  25. 25. Slide /© Community Health Center, Inc. 25 COVID-19 Improved Perception of Telehealth More than four-fifths of all respondents, 86.1%, indicated their perception of telehealth as a result of the COVID-19 pandemic is either “good, and improving” (46.2%) or “good, staying the same” (39.9%). More telehealth users (91.3%) indicated having a positive perception of telehealth as a result of COVID-19 as compared to non-users (79.4%). More than one-fifth of all respondents, 21.7%, indicated their perception of telehealth is based on the belief it “works well / is easy to use / is beneficial.” Please tell me which of the following reflects your perception of telehealth as a result of the COVID-19 pandemic? Please indicate why? 46.2% 39.9% 9.6% 4.4% 56.1% 35.2% 6.5% 2.2% 33.8% 45.6% 13.4% 7.2% 0.0% 25.0% 50.0% 75.0% 100.0% 1 2 3 4 Series1 Series2 Series3 Top Responses… % Works well / is easy to use / is beneficial 21.7% Don’t know / refused 11.5% None / nothing 8.4% Improving over time / becoming more familiar 8.4% Prevents spreading / minimize exposure / safer 6.0% More people using / meets needs / higher demand 5.6% Advanced / developed technology / innovative 5.1% Have not used / no knowledge 4.1% Difficult to evaluate / diagnose / not hand’s on 3.9% Prefer face to face / more personal 3.7% (N=1001) (N=1001)
  26. 26. Slide /© Community Health Center, Inc. Segmented Demographic Findings 26 ๏ 63.0% of respondents with a household income of greater than $150,000 have had a telehealth appointment, compared to only 51.4% of respondents making less than $40,000. ๏ 7.6% of respondents making less than $40,000 do not have access to devices needed for a telehealth appointment, compared to only 2.8% of respondents making $150,000 or more. ๏ More African American respondents had issues with telehealth being “hard to use / had problems connecting” (19.0%) or they “didn’t have a private space for my appointment” (15.2%) compared to Hispanic (8.5% and 7.0%, respectively) or Caucasian respondents (6.4% and 5.6%, respectively). ๏ Hispanic respondents (39.4%) are more likely to prefer a telehealth appointment in the future over an in- person appointment as compared to African American (32.9%) or Caucasian respondents (32.7%). Additionally, those with a household income level of less than $40,000 (47.4%) were most likely to prefer a telehealth appointment rather than an in-person appointment, while those making $150,000 or more were the least likely (29.4%). ๏ However, Caucasian respondents (45.8%) are overall more likely to use telehealth in the future as compared to Hispanic (36.1%) or African American respondents (35.8%). Additionally, respondents making $150,000 or more were more likely (62.5%) to use telehealth in the future as compared to respondents with a household income level of less than $40,000 (31.1%).
  27. 27. Dan Quatrocelli Senior Director, Research dan@GreatBlueResearch.com Catherine Veschi Project Manager catherine@GreatBlueResearch.com Michael Vigeant CEO mjv@GreatBlueResearch.com Courtney Cardillo Data Analyst courtney@GreatBlueResearch.com /GreatBlueRese arch @GBResearch Glastonbury, CT 860-740-4000 © Community Health Center, Inc.

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