Telemedicine has plugged some healthcare gaps during the COVID-19 pandemic, but many fewer Americans have been receiving important assessments of common cardiac risk factors, according to a troubling study from investigators at Johns Hopkins.1

Researchers reported that while the use of telemedicine surged from almost nothing to 35% between April and June 2020, the number of in-person primary care consultations dropped by more than 21% when compared with the volume of such encounters during the second quarter from previous years.

The data, gathered from an ongoing audit of outpatient care in the United States, also reveal blood pressure monitoring and cholesterol screenings were way down during this period. The frequency of blood pressure monitoring decreased by half, and cholesterol checks declined by 37%.

Because Americans are shying away from routine screenings, investigators are worried about the pandemic causing even more collateral damage, namely undiagnosed cardiovascular disease and other problems usually detected during routine, in-person primary care visits.

In a statement, the lead author of the study, Caleb Alexander, MD, stressed the declines in care reflected in the data are not trivial.2 Preventing strokes and heart attacks is the bedrock of primary care. When left unchecked, this carries implications for emergency medicine providers.


  1. Alexander GC, Tajanlangit M, Heyward J, et al. Use and content of primary care office-based vs telemedicine care visits during the COVID-19 pandemic in the US. JAMA Netw Open 2020;3:e2021476.
  2. Johns Hopkins. Study highlights shortcomings in telemedicine despite large increases in remote consults during COVID-19 pandemic. Oct. 2, 2020.