How to get patients to use telemedicine? Charge for parking

What factors predict use of telemedicine? A paper by Reed et al. (2020) uses primary care data from Kaiser Permanente between 2016 and 2018 to find the answer. Note that these results are pre-COVID.

Choosing telemedicine was statistically significantly associated with patient sociodemographic characteristics. For example, patients aged 65 years and over were less likely than patients aged 18 to 44 years to choose telemedicine (RRR, 0.24; 95% CI, 0.22-0.26 for video visit; RRR 0.55; 95% CI, 0.54-0.57 for telephone visit). Choosing telemedicine was also statistically significantly associated with technology access (patients living in a neighborhood with high rates of residential internet access were more likely to choose a video visit than patients whose neighborhoods had low internet access: RRR, 1.10; 95% CI, 1.06-1.14); as well as in-person visit barriers (patients whose clinic had a paid parking structure were more likely to choose a telemedicine visit than patients whose facility had free parking: RRR, 1.70; 95% CI, 1.41-2.05 for video visit; and RRR, 1.73, 95% CI, 1.61-1.86 for telephone visit)

Most of these results are not unexpected, but I would not have previously thought that paid parking increased telemedicine use by 70%! This finding just proves that patients are very responsive to cost sharing. It would be interesting to see how these results would change post-COVID, but it will take some time for those data to read out.