Key result
Telehealth video encounters are linked to ~23% fewer medication prescription changes versus in-person visits.
Why the study?
Telehealth expanded greatly during COVID-19 and remains widely used in kidney care, but consensus guidelines on implementing telehealth in ambulatory nephrology care are lacking.
Does telehealth video compared to in-person encounters affect medication prescription changes, orders, and patient instructions in ambulatory nephrology care?
Observational (n=37,728)
No
Does telehealth video compared to in-person encounters affect medication prescription changes, orders, and patient instructions in ambulatory nephrology care?
Relative Risk: 0.77 (95% CI 0.74–0.8)
Telehealth video encounters in ambulatory nephrology are associated with significantly fewer medication changes, orders, and documented patient instructions compared to in-person visits.
Telehealth may advance nephrology care plans similarly to in-person visits; leaves open questions on equity, outcomes, and broader adoption.
Introduction The COVID-19 pandemic greatly expanded the use of telehealth in nephrology, and telehealth remains a popular modality for kidney care. However, there are no consensus guidelines on the implementation of telehealth in ambulatory nephrology care. To examine this field further, we examined the association between clinic encounter modality (in-person versus telehealth) with provider actions to advance patient care plans in one academic nephrology practice. Methods Electronic health records from 26,170 telehealth video and 11,558 in-person encounters from January 2020 to December 2024 were analyzed. Mixed effects models were used to assess the association between encounter modality and medication prescription change rates, order rates, and patient instruction documentation frequency. Results Compared to in-person encounters, telehealth video visits served patients of younger age (60.4 years (SD = 18.1) vs. 66.7 (17.4), p < 0.001) and with less severe kidney disease (estimated glomerular filtration rate 51.9 ml/min/1.73 m 2 (SD = 30.2) vs. 46.1 ml/min/1.73 m 2 (26.6), p < 0.001). Accounting for encounter, patient, and provider characteristics, telehealth modality was independently associated with 23% fewer medication prescription changes (incidence rate ratio (IRR) = 0.77, 95% CI 0.74–0.80), 38% fewer orders (IRR = 0.62, 95% CI 0.57–0.68), and 84% lower odds of patient instructions documentation (odds ratio = 0.16, 95% CI 0.09–0.31) compared with in-person encounters. Conclusion These data suggest that providers use telehealth video and in-person encounters to advance patient care plans differently. Acknowledging these differences will be crucial to establish best practices for telehealth utilization in ambulatory nephrology care and assure ongoing high-quality care delivery.
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Shi et al. (2026) conducted an observational in Kidney disease (n=37,728). Telehealth video encounters vs. In-person encounters was evaluated on Medication prescription change rates (IRR 0.77, 95% CI 0.74-0.80). Telehealth video encounters were associated with 23% fewer medication prescription changes (IRR 0.77; 95% CI 0.74-0.80) and 38% fewer orders compared with in-person visits.
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