{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:07:26Z","timestamp":1789456046106,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002384 (REDCap Use)"],"award-info":[{"award-number":["UL1TR002384 (REDCap Use)"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Telehealth provides remote clinical care for patients using communications technology. The increased use of telehealth during the COVID\u201019 pandemic compels us to better understand telehealth's costs, value, and limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe barriers to access and costs of care for telehealth patients among an outpatient musculoskeletal cohort. This study also evaluates patients' perceptions of telehealth as a means of care delivery during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary academic institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Adult patients attending telehealth visits in an academic physiatry department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>N\/A<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Telehealth\u2010related barriers, costs, and perceptions were assessed using a one\u2010time survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 262 patients (mean age: 59.6\u2009\u00b1\u200915.5\u2009years, median: 62 [\n                      <jats:styled-content style=\"fixed-case\">interquartile range,<\/jats:styled-content>\n                      49\u201372]) completed the survey from November 23, 2020 to February 14, 2021 (completion rate: 28.3%; 262\/926). Comfort levels with technology averaged 8.5\u2009\u00b1\u20092.0 out of 10 (median: 9 [\n                      <jats:styled-content style=\"fixed-case\">interquartile range,<\/jats:styled-content>\n                      8\u201310]), and all but one patient had existing access to the electronic device used for their telehealth visit. Most patients (89.7%) had previously received in\u2010person care for the same issue. Concern about the pandemic was the top reason for receiving telehealth care. For almost all patients, the only costs related to telehealth were direct costs of care. In contrast, patients reported they would have spent an average of $25.14 (median: $10 [\n                      <jats:styled-content style=\"fixed-case\">interquartile range,<\/jats:styled-content>\n                      $0\u2013$40]) on travel if their visit had been in person. Of the 141 patients who were employed or students, 25.5% reported taking time away from work or school to attend the telehealth visit, whereas 85.1% reported they would have needed to take time away from work or school if the visit had been in\u2010person. Satisfaction with telehealth visits averaged 9.1 out of 10 (median: 10 [\n                      <jats:styled-content style=\"fixed-case\">interquartile range,<\/jats:styled-content>\n                      9\u201310]), and 71.6% of patients reported a better impression of telehealth compared to 1\u2009year ago.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings illustrate that telehealth is a low\u2010cost form of health care delivery that has high satisfaction for the patient. This is particularly beneficial in the musculoskeletal patient population who may face additional physical barriers to accessing care in person.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.70086","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T11:13:28Z","timestamp":1769512408000},"page":"997-1004","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceptions, barriers, and costs related to telehealth among outpatient musculoskeletal patients"],"prefix":"10.1002","volume":"18","author":[{"given":"Sara","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhav","family":"Deo","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"},{"name":"Department of Clinical Rehabilitation Medicine Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Rothman","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5099-4627","authenticated-orcid":false,"given":"Joseph","family":"Bonanno","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Kohilakis","sequence":"additional","affiliation":[{"name":"Center for Advancement of Value in Musculoskeletal Care Hospital for Special Surgery  New York New York USA"},{"name":"Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark Alan","family":"Fontana","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New York USA"},{"name":"Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Milani","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"e_1_2_9_2_1","article-title":"Patients, families, and communities COVID\u201019 impact assessment: lessons learned and compelling needs","volume":"2021","author":"Isasi F","year":"2021","journal-title":"NAM Perspect"},{"key":"e_1_2_9_3_1","unstructured":"What is telehealth? How is telehealth different from telemedicine?2019. Available at:https:\/\/www.healthit.gov\/faq\/what-telehealth-how-telehealth-different-telemedicine."},{"key":"e_1_2_9_4_1","unstructured":"CDC.Using telehealth to expand access to essential health services during the COVID\u201019 pandemic.2020https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/telehealth.html"},{"key":"e_1_2_9_5_1","unstructured":"BuisL.Telehealth use among older adults before and during COVID\u201019.2020https:\/\/www.healthyagingpoll.org\/reports-more\/report\/telehealth-use-among-older-adults-and-during-covid-19"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.25291"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43678-023-00605-z"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2022.04.002"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.13029"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.13057"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.13036"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/24.167"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2196\/50090"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_9_16_1","unstructured":"United States Bone and Joint Initiative.The Burden of Musculoskeletal Diseases in the United States (BMUS) Fourth Edition. Available at:http:\/\/www.boneandjointburden.org. Accessed November 1 2024"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001856"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20210621-08"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2021.05.008"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2021.0221"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.12552"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000001600"},{"key":"e_1_2_9_23_1","unstructured":"Centers for Medicare & Medicaid Services.Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments.2024https:\/\/www.federalregister.gov\/documents\/2024\/07\/31\/2024-14828\/medicare-and-medicaid-programs-cy-2025-payment-policies-under-the-physician-fee-schedule-and-other"},{"key":"e_1_2_9_24_1","unstructured":"KFF.Employer Health Benefits Survey.20242024. Available at:https:\/\/www.kff.org\/report-section\/ehbs-2024-summary-of-findings\/"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.70086","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmrj.70086","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.70086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:20:58Z","timestamp":1789453258000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.70086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,27]]},"references-count":23,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/pmrj.70086"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.70086","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,27]]},"assertion":[{"value":"2025-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}