Background: Telehealth in the Military Health System (MHS) has long been an important tool for delivering care in deployed settings . However, the scope of nondeployed telehealth usage in the MHS has not previously been published, making full evaluation difficult . This study aims at addressing this gap by assessing trends over time, demographics, provider types, and diagnoses most associated with telehealth usage in the MHS .
Methods: Secondary analysis was conducted on health care claims from the MHS Data Repository for all telehealth services provided from fiscal years 2006 to 2018 . Telehealth services were identified by using Common Procedural Terminology (CPT) code modifiers GT, GQ, and 95 . Patient demographics, provider type, and major diagnostic category were assessed for all telehealth services in both direct (military provided) and purchased (private sector) care .
Results: Usage of telehealth services in the MHS rose ∼19-fold, from 2,549 to 48,667 occurrences, from 2006 to 2018 . Physicians provided ∼60% of telehealth services overall, and the greatest usage was for mental health diagnoses . Purchased care (PC) showed differences from direct care (DC), including a greater level of expansion, greater inclusion of children and adolescents, and lower usage of telehealth for non-mental health services .
Conclusions: Telehealth usage in the MHS has increased substantially from a total 2,549 occurrences in 2006 to 48,667 occurrences in 2018, demonstrating greater acceptance and usage by both DC and PC providers . Future directions include assessing provider types, diagnosis codes, and patient demographics associated with telehealth use, especially in the emerging COVID19 clinical practice environment.
Index: electronic medical records, military medicine, telehealth, telemedicine