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The prognosis for post-pandemic telehealth

The technology experienced exponential growth during COVID-19. Now, stakeholders are working to figure out where it fits into the future of health care.

5 min read


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By now, most Americans likely have booked a telehealth visit for a routine medical issue, counseling session or follow-up with a clinician. Whether it’s conducted by phone, video or messaging, telehealth allows people to get care promptly and alleviates logistical barriers.

The technology was around before the COVID-19 pandemic, but the public health emergency caused it to skyrocket as the threat of infection compelled people to isolate. Since then, there have been policy discussions among policymakers and clinicians on how it can be used to improve outcomes and ensure health equity. The Joint Commission announced a new telehealth accreditation program for care organizations that will take effect July 1, and the topic makes regular health care headlines.

Clearly, the technology is here to stay. The National Institute for Health Care Management Foundation convened an online panel of experts earlier this month to discuss where it’s going. Here’s what they said.

Mei Kwong, Center for Connected Health Policy

Mei Kwong offered a high-level view of current telehealth policy and insights on future developments. “To understand telehealth policy in the United States, you need to realize that there’s actually two levels for it. There’s what’s going on with telehealth policy on the federal level and what’s going on on the state level,” Kwong said. By the end of the PHE, states had to decide their long-term telehealth policies, Kwong said. There were discussions about the types of services telehealth could be used for going forward, what would be reimbursed, whether payment for telehealth should be at the same level as in-person care, and where the patient could be located when receiving services.

Licensure to provide remote services and drug prescribing are other important telehealth issues at the state level, Kwong said. Some temporary telehealth policies were implemented to make care easier to access during the pandemic. “The question now becomes what’s going to happen [to the temporary policies], because we are seven months out from the end of the year,” Kwong noted. “As far as I can tell, the federal policymakers have not quite reached a decision on what is going to happen.”

Kwong said policymakers are asking for data on whether telehealth fraud is an issue, whether this type of care is effective or if it reduces health disparities. Studies by the HHS Office of Inspector General have shown little evidence of the widespread fraud and misuse that some predicted. Other research suggests telehealth can lead to better outcomes, such as greater medication adherence and overdose reduction in patients with opioid use disorder.

Saif Khairat, Center for Virtual Care Value and Equity

Health informatics expert Saif Khairat spoke about the new Center for Virtual Care Value and Equity, an initiative at the University of North Carolina at Chapel Hill that will explore two main themes: how to create virtual care that makes effective use of telehealth and other digital modalities, and how to make these services more equitable for patients and financially sustainable for programs and providers. 

“There is a dearth of evidence when it comes to the real-world data in telehealth, specifically understanding what data is being collected at the point of care,” Khairat said. “How can we improve our measurement approaches to ensure we have comprehensive and longitudinal data that could be used for monitoring, evaluation and research purposes?” Khairat noted that a library of real-world data on virtual care visits is being compiled, with the aim of informing improvement efforts.

The center also is working to understand how society can suddenly but effectively switch from in-person to remote care, as it did during the pandemic. It is also developing instruments to help institutions, companies and programs create telehealth platforms that are equitable and sustainable. Khairat said researchers are asking about facilitators and challenges to using telehealth, focusing especially on underserved populations. 

There are plans to interview patients from disadvantaged areas to understand how telehealth can serve them, ensure clinicians don’t spend an inordinate amount of time in front of screens, and provide telehealth training and certification opportunities.

Manuel Arisso, Carelon Behavioral Health

Manuel Arisso discussed how Carelon approaches telehealth as a forward-thinking provider of mental health therapy. It offers services for employee assistance program members, inmates, people with special needs and substance use disorders, and other clientele. Arisso said telehealth provides “a significant opportunity” to help them connect to necessary care and, more importantly, stay with it.

Arisso discussed innovations like self-guided care, digital cognitive behavioral therapy, coaching programs, home-based and hybrid care and other services that can be tailored to individuals’ needs and keep them engaged. Arisso noted that it’s important to think about the “off-ramp” process when a person enters a crisis situation and needs a higher level of care than telehealth can provide. 

The future of telehealth will involve getting a handle on “all the assets we have, the data we have, the opportunity to capture new data points and structure [them] in different ways” to improve clinical outcomes and patient experiences, Arisso said.


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