Telehealth has become a growing area of interest in the health care field as it makes it is easier to reach patients, share information between health care professionals, and cut down on time and costs. The December issue of Health Affairs features research by 11 AcademyHealth members focusing on two main issues: telehealth and accessibility, and new uses for telehealth.
Telehealth and accessibility
For hard-to-reach and underserved populations, telehealth offers an efficient way to interact with health care professionals. It is remote, fast, and easily accessible. According to research from the University of California Berkeley, led by Erin Shigekawa, M.P.H., telehealth is also broadly equivalent to in-person care.
However, while telehealth is becoming more widespread, some patients still face barriers to access. A George Washington University study led by Assistant Professor Jeongyoung Park, Ph.D., M.P.H., found that telehealth is adopted unequally across various socioeconomic groups. While telehealth use has grown rapidly among higher-income working-age adults, Medicaid users, low-income, and rural patients face coverage issues and may not have the same access to telehealth services. In response, researchers recommended state policy measures to remove financial barriers, incentivize health centers and increase patient education.
Research by Jiani Yu and colleagues at the University of Minnesota School of Public Health similarly found that telehealth use depends on coverage policies. Researchers encouraged improving coverage and reimbursement policies to make telehealth more accessible. Along with patients, health centers also face barriers to telehealth adoption. Costs, reimbursement, and technical issues were some of the major barriers found by Health Economist Ching-Ching Claire Lin, Ph.D., Senior Advisor Anne Dievler, Ph.D., M.P.H., and colleagues at the Health Resources and Services Administration (HRSA).
New ways to use telehealth
Last month’s Health Affairs issue also focused on new ways to use telehealth to streamline care and replace some in-person services, reducing time and costs for health providers. A study by AcademyHealth members at the University of Iowa found that telehealth can also be used in in the emergency room. Using telemedicine can mitigate physician shortages in emergency departments, especially in short-staffed rural areas. Tele-triage is another emerging use. Researchers at Kaiser Permanente found that having physicians respond to chest-pain calls was an effective way to manage patient concerns. With easy access to medical records, physicians were able to make shorter calls, more effective recommendations, and reduce future emergency department visits. Using telehealth methods have been shown to be as effective, if not more effective, as in-person treatment. A study of acute respiratory infection diagnosis at Harvard Medical School found direct-to-consumer calls and video-conferencing had treatment outcomes similar to in-person visits.
New research also recommends using telehealth for communication between health centers. A study led by Jordan Albritton, Ph.D., M.P.H., senior statistical data analyst at Intermountain Healthcare in Utah, studied telehealth for skill-sharing. In the case of neonatal resuscitation, the study found that building connections between medical professionals and different health centers was extremely positive. The skill-sharing opportunity, allowed newborns to receive access to higher-level physicians, reduced costs, and improved care. Another AcademyHealth member study from Harvard Medical School recommended expanding telehealth treatments for substance use disorders. Especially in light of the current opioid epidemic, authors noted this area as a prime opportunity to improve and expand care.
While the promise of telehealth is highlighted in throughout the issue, there is also acknowledgement that more research is needed to determine the efficacy of some telehealth interventions and how to increase it. For example, AcademyHealth member Renee Pekmezaris, Ph.D., and colleagues at Northwell Health Department of Medicine found that home telemonitoring of heart failure was generally effective, but efficacy also depended on the time it was used.
Health policy implications
Beyond new uses and approaches to telehealth, AcademyHealth members Sherry Glied, Ph.D., and Jeanne Lambrew, Ph.D., from New York University, discussed potential 2020 health care policy from Democratic candidates. In a joint article, the NYU professors suggest that the Democratic presidential nominee will propose a program expansion — due to a wide variety of factors and recent changes in public opinion — but that it may be difficult to actually launch the plan without controlling both Congress and the White House.
The December issue of Health Affairs features a wide-range of important topics surrounding accessibility, telehealth uses, and implications for health care policy. Congratulations to all AcademyHealth members who contributed to this research and helped find the best ways to improve health care.
Digital technology is being leveraged in exciting ways to improve health and health care. Learn more about the latest in this area by attending Health Datapalooza, AcademyHealth’s meeting for people and organizations creating knowledge from data and pioneering innovations that drive health policy and practice.