Telehealth use exploded to play an outsized role in helping patients safely access care when the COVID-19 pandemic first hit four years ago, but it is wrong to think of this form of digitally enabled care as a relic of 2020. Indeed, 74% of physicians work in practices that offer telehealth.
Rather, it seems as though every day offers more evidence of how telehealth can help improve access to care, save lives and advance the quality of care in a wide array of physician specialties and clinical conditions.
Supporting telehealth is an essential component of the AMA Recovery Plan for America’s Physicians.
Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.
Read on to explore a recent collection of reporting from the AMA on how physicians and health care organizations are using telehealth in innovative ways that amount to wins for patients, their families and the nation.
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Extends prenatal care to underserved rural areas
- In the past four years, four different labor-and-delivery units have closed across rural northern Minnesota. “It’s created this extreme shortage of places where women can receive obstetric services and gynecologic care,” said Johnna Nynas, MD, an ob-gyn at Sanford Bemidji Medical Center.
- She is delivering babies while also extending her reach deep into the surrounding rural areas using telehealth for prenatal visits. With some patients driving more than two and a half hours to get to the medical center, offering video prenatal visits “just seemed liked the logical thing to do,” she added.
- Based in Sioux Falls, South Dakota, Sanford Health had begun its Baby Beats program prior to the pandemic and its popularity continues to grow.
- Sanford Health also is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
- Learn more with this AMA report, “Future of Health: Advancing the Use of Telehealth Within Medical Specialties” (PDF).
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Offers a lifesaving care option for patients with opioid-use disorder
- COVID-19 emergency era flexibilities that enabled physicians to prescribe medications for opioid-use disorder via telehealth will remain in place permanently thanks to a final rule published by the Substance Abuse and Mental Health Services Administration. The regulation expands access to lifesaving medications for opioid-use disorder and aims to reduce stigma, marking important updates to the regulations that govern opioid treatment programs.
- “Prescribing buprenorphine through telehealth visits provides the opportunity to reach remote and underserved communities and patients who may be unable to travel daily to in-person appointments because of distance to the OTP [opioid treatment program], cost, child care, employment and other factors,” said Bobby Mukkamala, MD, who chairs the AMA Substance Use and Pain Care Task Force and serves on the AMA Board of Trustees.
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Finds a home in the world of physical medicine and rehab
- Access to a physician with specialty or subspecialty training moves the needle on improving patient outcomes in the physical medicine and rehabilitation field—and telehealth is a means for providing needed access to specialty care. So says Mary Alexis Laccarino, MD, a physiatrist with a specialty in neurological rehabilitation, who outlined the evidence on the beneficial use of telehealth in concussion treatment and management.
- The AMA has created a plethora of resources to help guide physician practices through the successful implementation of telehealth and remote patient monitoring.
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Delivers high-quality psychiatric care to more patients
- Child and adolescent psychiatrist Robert Findling, MD, detailed how telepsychiatry has evolved since the pandemic hit. “In many ways, acculturating to this was not an option, but once it happened, people learned what they liked and didn’t like, got better at things they weren’t as comfortable with, and then it became part of our armamentarium so that when greater flexibility occurred, people were comfortable offering people options.”
- Virtual care has allowed Dr. Findling and his health system colleagues to reach patients in rural Virginia that they previously couldn’t deliver care to. In addition, letting patients decide whether to come in or schedule a virtual visit—unless a hands-on evaluation is a medical necessity—has allowed the health system’s no-show rates to remain “remarkably low.”
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Reduces greenhouse gas emissions
- One large health system linked its 2020 growth in telehealth virtual visits to a reduction in the emissions of greenhouse gases equal to the emissions created annually by 1,200 homes. Researchers with Northwest Permanente calculated telehealth’s impact on reducing patients’ vehicle traffic and the corresponding reduction in greenhouse gas emissions to 10.5 tonnes of carbon dioxide or equivalent greenhouse-gas emissions (CO2-eq) in 2020 from 19.6 tonnes CO2-eq in 2019.
- Northwest Permanente also is a member of the AMA Health System Program.
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Helps private practice physicians flourish
- “After being in this for nine years and having confronted many obstacles to survival, I remain happy in my private practice,” said AMA member Roxanne Tyroch, MD, discussed how telemedicine helps her reach more patients in the El Paso, Texas, area.
- “What I like is that people can see me on their lunch break,” she said of telemedicine. “They don't have to waste the time driving down, look for a parking space or wrestle with traffic. They can see me on the weekend or evening even when I don't have staff. Patients with physical limitations and transportation hardships are well served by telemedicine.”
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Enables neurologists to offer convenient care
- Can neurology examinations be done using telemedicine? Neurologist Neil Busis, MD, detailed how the four elements of virtual motor evaluations can be adapted to virtual care. For example, with functional testing, the physician can ask a remote patient to stand up from a chair without using their hands.
- “You can examine most things you need to examine in most cases by using these kinds of principles,” said Dr. Busis, who chairs the American Academy of Neurology telehealth subcommittee.
Despite these and other advancements, a commercial payer patchwork is holding back the promise of telehealth and digitally enabled care. Four major areas where payers fall short are:
- Lack of coverage alignment across commercial payers, Medicare and Medicaid.
- Inconsistent coverage policies within the commercial market.
- Inconsistent levels of transparency for coverage policies within the commercial market.
- Time lag for determining coverage policies within the commercial market.
Learn more with this Leadership Viewpoints column by AMA President Jesse M. Ehrenfeld, MD, MPH, on how extending telehealth parity will advance patient care.
Visit AMA Advocacy in Action to find out what’s at stake in supporting telehealth and other advocacy priorities the AMA is actively working on.
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