Waiting to Exhale about Telehealth after COVID-19

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Much of the world is holding its collective breath to see what will happen to telehealth after COVID-19. Continued governmental support for telehealth could reduce administrative and financial burdens that maintain telehealth disparities that render access to care difficult, if not impossible for many citizens, including the underprivileged.

The Accelerator Effect of COVID-19 on Telehealth

Prior to March 2020, weekly telemedicine visits averaged 12,000 nationally. Now that number is more than a million visits per week. These extraordinary gains came from extraordinary circumstances which led Federal and state governments to take extraordinary measures, including more telemedicine reimbursement opportunities, easing of state licensing restrictions; and allowing the use of technologies that are not fully HIPAA-compliant.

 
Regardless, the current COVID-19 emergency will not be permanent. Rollbacks of some emergency measures are already underway, but the extend of those rollbacks is being argued at the legislative level. Many suggestions are now being made for how the many breakthroughs made can be sustained for a vibrant new form of healthcare that significantly includes telehealth after COVID-19.

Support for Telehealth after COVID-19: No Going Back

While uncertainty still exists, it appears from recent events that many telehealth changes will remain in effect.

Dr. Kvedar,  Professor, Harvard Medical School; Senior Advisor, Virtual Care, Mass General Brigham (Partners HealthCare), and ATA President, continued, “I have seen first-hand the many ways telehealth bridges the gap between a critical provider shortage and a growing patient population – a problem that existed prior to the pandemic, and one that will only worsen.” He also said, “However, we need Congress’s support to ensure patients and providers do not go over the telehealth ‘cliff’ as our nation eventually emerges from the pandemic. We must make sure that essential telehealth services do not abruptly end with the public health emergency, especially as we look to reorient our healthcare system to deliver 21st century care.”

Dr. Kvedar’s full testimony before Congress is available here. A recording of today’s full hearing can also be found here.

Making Telehealth Work for The Underprivileged

As part of its COVID-19 response, through the Federal Communications Commission (FCC) the Federal government has invested additional grant funds to improve telehealth infrastructure and programs. The FCC states that a purpose of these grants is to increase access to low-income patients. Still, how inclusive the future of telehealth will be depends on how well telehealth providers address the needs of people who can’t use it because of structural and social barriers.

  • Structural barriers to telemedicine access take physical and social forms. The most significant structural barrier is inadequate access to broadband Internet, which affects practitioners and patients.
  • Social barriers are more subtle because they are often the result of demographic  factors, such as language and cultural norms. For example, even without structural barriers, the availability of telemedicine to a non-English-speaking patient may still of little use. In a state like California, where four in ten residents don’t speak English at home, making medical interpreters available must be part of a comprehensive telehealth solution.

Another social barrier is the effect on inner city residents of limiting the availability of telemedicine to rural areas. The inability of patients to physically get to a hospital or clinic is not confined to the countryside, but is an urban problem, too.

Regulation and Licensing Reform is Only Part of the Answer for Telehealth after COVID-19

Making regulatory and licensing changes permanent is the focus of much of the discussion about the future of telehealth. But we must not forget that invisible barriers make it hard for many already-under-served patient groups to benefit. Only by building telehealth solutions that are culturally competent – along racial, economic, geographic and linguistic lines – can we expect that they will be truly equitable.

 
If you support telehealth after COVID-19, we urge you to make your voice heard with your legislators. Write to your governor and other legislative representatives. The time is now.

Introduction to Telehealth Theory & Practice

Enjoy a fast-moving overview of telebehavioral and telemental health. Understand the key points related to telehealth clinical, legal, ethical, technology, reimbursement, social media and other pivotal issues.

Disclaimer: The Telebehavioral Health Institute (TBHI Telehealth.org) offers information as educational material designed to inform you of issues, products, or services potentially of interest. We cannot and do not accept liability for your decisions regarding any information offered. Please conduct your due diligence before taking action. Also, the views and opinions expressed are not intended to malign any organization, company, or individual. Product names, logos, brands, and other trademarks or images are the property of their respective trademark holders. There is no affiliation, sponsorship, or partnership suggested by using these brands unless contained in an ad. We do not and cannot offer legal, ethical, billing technical, medical, or therapeutic advice. Use of this site constitutes your agreement to TBHI Privacy Policy and Terms and Conditions.

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Brian Hastings
Brian Hastings
2 years ago

Awesome post! Thanks for sharing the knowledge and keep up the good work.

Marlene Maheu, Ph. D.
Marlene Maheu, Ph. D.
Reply to  Brian Hastings
2 years ago

Thank you, Brian.

jancy
jancy
2 years ago

Telehealth is the use of communications technologies to provide health care from a distance

Barbara A Belhumeur, LMHC
Barbara A Belhumeur, LMHC
2 years ago

A factor that is a consideration is the age of the provider. I am an active, 68-year old psychotherapist with a part-time practice and many of my clients have co-existing conditions that puts both of us as provider and client in high-risk for exposure to COVID-19. I feel strongly that the “win-win” of the continuation (permanence) of relaxed telebehavioral services has created a more positive environment for highly compliant clients and a highly available provider. Many scenarios play out in positivity. The use of telephone appointments as a covered service allows those clients who are technically unable or poorly equipped to have continuous and regular sessions without the apprehension of failed technology. My cancellation rate is greatly reduced and rescheduling options are more flexible. The real-time experience of delivering virtual services has been eye-opening. Thank you for this opportunity to share my thoughts.

Marlene Maheu, Ph. D.
Marlene Maheu, Ph. D.
Reply to  Barbara A Belhumeur, LMHC
2 years ago

Barbara,
Thank you for sharing your experience.

Robin Pollitzer, LCSW
Robin Pollitzer, LCSW
2 years ago

I have experienced much more consistency in attendance using telehealth. This improved the effectiveness of treatment.

Marlene Maheu, Ph. D.
Marlene Maheu, Ph. D.
Reply to  Robin Pollitzer, LCSW
2 years ago

Robin,
Good point. Telehealth is fundamentally about creating access to quality care.

Jody Kaufman
Jody Kaufman
2 years ago

Telehealth for Mental Health patients is vital. It is needed and very effective. Depression and Anxiety present barriers for patients to come into office consistently. It’s also very useful when treatment can continue if patient has moved (ie going to college, moving out of area, seniors (everyone ) who have transportation issues.

William O’Brien Psy.D
William O’Brien Psy.D
2 years ago

My patients love telehealth. Thank you so much for your good work.

Marlene Maheu, Ph. D.
Marlene Maheu, Ph. D.
Reply to  William O’Brien Psy.D
2 years ago

William,
Thank you for taking a minute to say something. Your appreciation is appreciated. After 26 years of advocating, researching and training professionals in how to legally and ethically use telehealth, I am heartened to see that telehealth has helped lessen the suffering that surrounds us at this time.

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