What role will telehealth play in a post-COVID world? Patients, health care providers and policymakers are discovering that the question is both complex and critical.
Telehealth: Pros and Cons
A recent virtual roundtable hosted by the Aimed Alliance offered experts and advocates a chance to explore the benefits of telehealth, as well as the unintended consequences.
Participants cited telemedicine’s ease of use and convenience, especially for those whose conditions make it difficult to travel or who live far from their doctor’s office. Some reported that the ability to consult with providers from home reduces the patient’s stress and the burden on caregivers.
Others acknowledged the challenge of accurately diagnosing some diseases without an in-person assessment. Some participants conveyed concerns that an overreliance on telehealth might marginalize people who aren’t technology savvy or who live in rural areas without high-speed internet access.
Balance and Choice
Across the board, participants agreed that telehealth could be a powerful supplement, but not a replacement, to in-person care. There was also consensus that patients and health care providers should drive decisions about when to use in-person care or virtual visits.
“Telehealth is here to stay,” acknowledged David Charles, MD, the medical director of a telehealth program in Tennessee and founder of the Alliance for Patient Access. “But the decision about whether to have an in-person visit or a virtual visit should rest solely with clinicians and their patients.”
This principle was one of several policy recommendations that emerged from the conversation. Others included:
- Encouraging medical societies to create clinical guidelines. These guidelines would help clinicians know when it appropriate for patients to be treated via telehealth versus in person.
- Educating and training providers. Ensuring providers are up-to-speed on best practices for using telehealth technology will promote better remote visits.
- Being mindful of cost sharing. Patients shouldn’t be incentivized to use either telehealth or in-person visits over the other.
- Providing access to audio-only appointments. Retaining an audio-only option is important, but it should be reserved for patients who truly require it, and providers should consider coupling it with an in-person appointment soon after.
These themes also resonated in a recent letter to the Centers for Medicare and Medicaid Services from Patient & Provider Advocates for Telehealth, an advocacy organization dedicated to balanced telehealth policy.
“Telehealth should have a long-term place in the provision of patient-centered care,” the letter explains, “but in-person care remains a cornerstone of clinical practice in the diagnosis and management of chronic conditions.”
“Finding the proper balance between the two is paramount,” the letter notes.
Forty-four groups representing patients and health care providers signed the letter, which addresses telehealth provisions in the recently proposed Medicare Physician Fee Schedule for 2022.
The sentiments and experiences of patients and health care providers provide important underpinnings to current policy discussions. Balanced, commonsense policy can protect patient’s access to care, both virtual and in-person, as the world looks hopefully toward an end to the COVID-19 pandemic.