Senior man sitting at home using digital tablet for video calling. Mature man having online consultation with doctor.
In-person follow-ups within a week of telehealth visits are a cause of concern, one study notes. (Credit: Luis Alvarez / Getty Images)

Inconsistencies or “fragmentation” of healthcare services between telehealth and traditional clinical options could be driving in-person follow-up visits within a week after as many as 11% of telehealth visits, a new study shows.

The study has a particular focus on Amazon Clinic and its direct-to-consumer services, and takes a critical look at how telehealth could disrupt, rather than enable, adequate care.

Amazon Clinic launched earlier this month in all 50 states. Amazon also launched an AI-based health transcription service, HealthScribe, in July. 

The fact that almost one-ninth of telehealth users are seeking a second opinion in-person is often because the first option proves inadequate, study authors claim. Their investigation was conducted by marketing firm Trilliant Health.

“The efficiencies that the DTC providers offer through their approach should be measured against the waste that they produce when a patient’s illness cannot be addressed inside those closed DTC systems,” the authors write in their report. “Business models rooted in maximizing transactions with individual consumers are seemingly ill-equipped to assist patients with chronic care needs.”

The complexities of certain healthcare conditions are why some clinicians have expressed concerns about relying on telehealth for older adults.

Interestingly, previous studies that highlight the relatively low number of follow-ups after telehealth appointments, have used these data to portray the technology in a positive light, suggesting that telehealth can be an ideal, cost-effective option for specific specialties, such as a nutrition consultation. 

The Trilliant study also acknowledged that telehealth most commonly is used for chronic conditions such as mental health or diabetes, and that a contrast needs to be drawn between certain telehealth providers and those such as Amazon Clinic, which are direct-to-consumer.

And despite the need for a distinction between telehealth options, Amazon’s services do increase care and medication access for specific populations, Trilliant study authors acknowledged. 

These analyses of telehealth come at a time when there is bipartisan support for a Senate bill that would make telehealth access through Medicare permanent. At the moment, such services are set to expire in 2024.