Presentation (CTI)

OBJECTIVES: Telemedicine can improve productivity of healthcare delivery, but adoption is dependent on user acceptance and digital literacy among physicians. This study examines heterogeneity in remote care adoption among private physicians and compares provision patterns across care delivery modalities.
METHODS: A cross-sectional study used administrative data on private healthcare in Finland from 2019 to 2025, derived from the Social Insurance Institution of Finland (Kela) register. Physicians were characterized by age, gender, and specialty; and provision patterns by daily consultations per physician and initial consultation. Descriptive and statistical analyses were conducted to examine heterogeneity across care delivery modalities (remote, hybrid, in-person).
RESULTS: A total of 15,041 physicians were included, of whom 11,148 (74%) provided remote consultations. Physicians providing remote care increased more than tenfold in early 2020, stabilizing at 5,500-5,800 physicians by 2025. Adoption was lower among older physicians (68% vs. 79% among younger physicians; χ² = 226.6, p < 0.001). Gender was not associated with adoption (χ² = 3.07, p = 0.080); however, male physicians conducted approximately 73% more remote consultations per physician. Remote consultations accounted for 1% to 50% of consultations across specialties. Daily volumes varied across modalities; the highest volume (7 consultations per day) occurred on hybrid working days, compared with 5 for in-person-only and 3 for remote-only. Remote consultations accounted for 12% of initial consultations during 2020-2025, and initial remote consultations comprised 53% of all remote consultations.
CONCLUSIONS: Remote care has become a stable component of the Finnish private healthcare system, but the adoption is heterogeneous across physicians and specialties. Physician-level variation reflects differences in technology adoption and working arrangements, whereas specialty-level variation reflects clinical suitability. Remote services are almost equally often utilized for initial or follow-up care. Differences across care modalities may reflect variation in patient case-mix, and further research incorporating patient-level characteristics is needed.