Telehealth Lessons Learned During the Pandemic

Telehealth saw a meteoric rise in popularity during the pandemic, with weekly telehealth visits increasing 23 times compared to pre-pandemic numbers. With this rise in popularity comes questions surrounding policy, concerns and what a post-pandemic telehealth world might look like. 

These comments came during a webinar hosted by Carefirst BlueCross BlueShield on Tuesday, June 8th.  

Joining the discussion was Melisa Byrd, Senior Deputy Director and Medicaid Director of the DC Department of Healthcare Finance, Dr. Ateev Mehrotra, Associate Professor of Healthcare Policy and Medicine at Harvard Medical School, Magda Rusinowski, Vice President of Business Group on Health, and Sam Starbuck, Vice President at Privia Health.

 

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Dr. Ateev Mehrotra saystelemedicine has been a lifeline for patients in terms of getting care from their providers.” 

In regards to the success of telehealth, Dr. Mehrotra continued:

“You focus on the telehealth visits, but there have been other ways that people have been interacting. [There have been] huge increases in portal messages and other mechanisms of the consult and every form of telehealth has really expanded quite rapidly during the pandemic.”

Pivoting from success, Moderator Brian Wheeler asked the panel about economic challenges related to telehealth and being able to access telemedicine throughout the pandemic. 

Dr. Mehrotra says ensuring access to telehealth has been “an enormous concern” for stakeholders.

“One area we have seen a huge disparity in is between urban and rural residents. Rural residents are much less likely to have telemedicine visits than urban residents. I think that is key because we already knew our rural communities saw enormous disparity in terms of access and quality.“

In response, Sam Starbuck said: 

“In looking at the data for the number of visits done over the last 12 to 18 months we did not see a disparity between race, ethnicity and gender…the further you get from the DC Metro area the less telehealth utilization you see”.

Rusinowski also discussed how the social determinants of health are interwoven into telehealth access.

“We have to look at things like language barriers, computer literacy, all of those are connected to the utilization of telehealth. If somebody does not have good English proficiency, they are going to feel more comfortable seeing the provider in person. The providers that might be serving those communities might be less able to invest in the infrastructure that is required to actually provide telehealth visits.”

Telehealth usage is up, but what value does it bring? Starbuck used the example of managing the diabetic population as an example of the value of telehealth.

“The example of the diabetic who has chronically been out of control, not because they want to be but because all the hurdles that are in place for them to come to the office, telehealth removes those.”

“From a value perspective, having the greater connectivity for appropriate use cases integrated into the experience and extension of primary care providers, it is a win-win…I think in the transition to value it is critically important in improving patient satisfaction and provider satisfaction and obviously impacting outcomes and quality”.

Dr. Mehrotra says navigating telehealth regulations remains a challenge.

“It is a tremendous issue because you have to deal with many states, all of those different health plans, all of the rules not just for tele-video visits but audio visits, remote patient monitoringhow are you going to navigate all of those?”

“If [plans] are not in a line or congruent, you will see a lot of providers throw up their hands and say ‘forget this, I’m just going back to in person visits’.”