Recent Highlights in Telehealth with Rebecca Mishuris, Chief Medical Information Officer, Boston Medical Center and Kyle Faget, Partner, Foley & Lardner

When the COVID-19 pandemic hit, healthcare providers suddenly shifted from infrequent (if any) use of telehealth, to near universal adoption of the modality. One year in, what have we learned, and what is here to stay?

The public health emergency forced providers and regulators to quickly overcome prior barriers that had long impeded adoption of telehealth. While some obstacles were temporarily set aside (e.g., use of HIPAA-compliant platforms), providers voluntarily adapted to more sustainable approaches (e.g., adopting appropriate technology, not only to satisfy longer term regulatory requirements, but also to streamline workflows, EMR interoperability, and provider and patient experience). This widespread and rapid uptake of sophisticated telemedicine suggests that the modality has utility far beyond responding to a time-limited global pandemic, and that the COVID-19 emergency may have forced a component of healthcare reform that was long in the making.

There is much to be learned with respect to the clinical efficacy and safety of telehealth in various scenarios, but there are some early takeaways:

  • Telehealth reduces no-shows. Remote visits make it easier for patients to access care by removing transportation, childcare, and scheduling burdens. This also benefits providers by reducing frustration and improving efficiency in the delivery of care.
  • Where clinically appropriate, telehealth may become more commonplace than in person visits in certain types of medicine. Providers and researchers must closely scrutinize implications on long term outcomes. These findings will be critical in guiding evidence-based driven development of the future regulatory landscape of telehealth.
  • Although telehealth seems to increase access to care, there is reason to worry it may exacerbate health disparities. Individuals without access to internet (and private space) will not benefit from a providers eye’s on the patient (and will not be able to access telehealth at all if non-video visits are not reimbursable). Ensuring that low-income individuals have easy access to secure technology – in private settings – could mitigate any negative impact the expansion of telehealth might have on disparities.

Providers and researchers must closely analyze the impact of telehealth on long term outcomes across not only clinical specialties, but also socio-economic demographics, and inform policy-makers to drive evidence based regulation that allows for telehealth to increase access to care, improve outcomes, and drive down cost, making our healthcare system more sustainable and equitable for all.