Three researchers from the Naveen Jindal School of Management at The University of Texas at Dallas have received a Best Paper award for their study of the effects of telemedicine on physicians’ decisions, specifically in prescribing antibiotics.
Dr. Tongil (T.I.) Kim, an assistant professor in the Marketing Area; Dr. Shujing Sun, an assistant professor in the Information Systems Area; and Dr. Guihua Wang, a Sydney Smith Hicks Faculty Fellow and an assistant professor in the Operations Management Area, received the award during the 2023 Conference on Health Information Technology and Analytics, presented May 4-6 by the Center for Digital Health and Artificial Intelligence at Johns Hopkins University’s Carey Business School.
“Our research team is unique,” Sun said, “because we work in three different areas. For us to come together for a common interest is uncommon.”
Their paper, “Does Telemedicine Affect Physician Prescriptions? Evidence from Antibiotic Prescriptions,” focuses on antibiotic prescriptions for urinary tract infections (UTIs). According to the paper, antibiotic prescription errors are a widespread issue for patients with UTIs, with a sizeable proportion of antibiotics prescribed being inappropriate.
“In particular, overprescribing antibiotics can increase the risk of long-term antibiotic resistance in the population, which the CDC calls ‘one of the biggest public health challenges of our time,’” Kim said.
Telemedicine visits — the use of computers, smartphones or tablets to replace in-person patient visits at a doctor’s office — increased significantly during the recent pandemic. The study considered questions raised about changes in clinical decision-making as a result of the rapid shift.
Using a unique set of data regarding patient-provider encounters from the United States in 2020 and 2021, the researchers examined the impact of telemedicine on antibiotic prescription errors for UTIs. They considered two types — prescribing antibiotics when it is not recommended by the guidelines and not prescribing them when it is recommended.
“Our research found that the pandemic shifted the way people are receiving care, and we looked at whether doctors have changed their behavior as a result,” Wang said. “Antibiotics have been used by physicians to treat this condition for a long time, but some use too much.”
When comparing office visits with those done via telemedicine, the study found a reduction in overprescription of antibiotics for telemedicine visits.
“We found a significant difference in prescription errors,” Sun said. “The reasons are that doctors can get more information about patient medicines since the patient is at home and can read the name of the prescription and dose from the labels. Doctors also can get more information from caretakers in cases of, for example, treating an elderly person. Having more information helps the doctor better follow the guidelines.”
The study also found that the effect of telemedicine is not uniform across providers and patients. For example, patients with an established relationship with their doctors have a smaller reduction in antibiotic prescription errors. Additionally, physicians with larger practices have a larger reduction in prescription errors via telemedicine.
Implications of the study’s findings include:
- The use of telemedicine may help reduce drug waste and perhaps drug abuse, and potentially decrease associated healthcare costs.
- The study into the effects of providers’ and patients’ characteristics can inform insurer decisions on the allocation of resources to target certain patient and provider segments for telemedicine expansion.
- The study’s results show that, at least in the case of treating UTIs, patient health outcomes in telemedicine doctor visits do not statistically differ from those in office visits.
“As a society, we are still trying to assess the value of telemedicine post-pandemic,” Kim said. “Our study offers a unique insight into its benefit from an angle of prescription errors.”
