September 18-24 is Telehealth Awareness Week, the American Telemedicine Association’s campaign to highlight the ways technology can enhance, accelerate, and improve health care outcomes for patients at every stage of their care journey.
Telehealth utilization surged during the earliest months of the COVID-19 pandemic. Even though utilization has declined as in-person care re-opened, there remains elevated use of telehealth compared to before the pandemic. In many ways, the growth in access to digitally-based care has been a silver lining during the public health crisis. Positive consumer stories, coupled with new data coming from the analysis of care patterns and outcomes during the pandemic, demonstrate the potential impact on outcomes for those who can remotely access care.
Telehealth demonstrated positive results particularly in the context of addressing behavioral health. Arguably, behavioral health providers had the least capacity to deliver digital care prior to the pandemic. The Public Health Emergency (PHE) and other state and federal regulatory actions removed some of the barriers to remote access to care that had stymied the growth of behavioral health services delivered via telehealth. Thus, behavioral health providers were able to rapidly move care delivery online or over the phone.
These rapid changes laid fertile ground for a new understanding of the power of digital care delivery. A recently published JAMA study found that access to telehealth services for those receiving Medication Assisted Recovery was associated with better retention in treatment. Further, the study indicated that access lowered the risk of overdose. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Evidence-Based Resource Guide on Telehealth notes the potential telehealth delivery holds to solve any number of challenges that plague the behavioral health field, including workforce shortages, treatment compliance, attendance – and even better ability to assess the life circumstances of clients who may be logging in from home.
With outcomes pointing to the efficacy of remote care, providers, system leaders, and regulators need to continue to protect an environment where patients and providers can fully utilize digital solutions to support health. Permanent, ubiquitous access is not a guarantee. Signs indicate that the PHE will end in the coming months. In an attempt to extend many of the PHE’s provision after it ends, the House passed – and the Senate is currently considering – the Advancing Telehealth Beyond COVID-19 Act. The Centers for Medicare & Medicaid Services (CMS) and other federal agencies are also releasing guidance on the transition away from the PHE. However, the guidance doesn’t fully protect or sustain the flexible regulations that permitted the expansion of remote behavioral health care. The Drug Enforcement Administration (DEA) plays a role in continuing to allow prescribers of medications used to treat addiction to prescribe without an in-person visit requirement.
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The ability to continue to access telehealth services is also contingent on state policy. An inconsistent patchwork of state-level regulations around licensure and coverage impedes delivery of digital care across state borders – where the patient is in one state but the provider is in another. While some states have moved to adopt affirmative telehealth policies, some states have rolled back regulations in ways that have hampered the delivery of telehealth for substance use disorders (SUD).
Aligning federal and state regulations to support the continuation of telehealth services remains a critical area of attention for industry and community advocates. There are also ways other stakeholders can advance the permanent availability of telehealth as an integral part of primary and behavioral health care delivery.
- Center the voice of consumers. While not every patient will choose to access care via telehealth, every patient should have the option. Solutions and service providers should encourage patients who value and benefit from access to digital care to share their experiences within their social networks and with policymakers.
- Share the data. Early in the pandemic, my work brought me in contact with SUD and mental health providers who could speak anecdotally about the power observed in allowing patients to access treatment remotely. With two years behind us in this rapid expansion to digital care utilization, now is the time for providers, industry leaders, and solutions creators to share the outcomes that point to the efficacy of not only their solutions, but the concept of improved care through digital options writ large.
- Fully integrated digital solutions along the care journey. In behavioral health, telehealth is not only a tool in clinical treatment. Digital solutions now exist for long-term peer recovery support services, linking individuals in recovery to remote peer recovery coaching and support meetings. Additionally, SUD treatment needs to be as integrated with primary care in the digital space – as has been called for in the brick-and-mortar system – to reduce the number of doors (in real life, or digitally) a person has to walk through to receive truly whole-person care.
- Embrace Telehealth as one of the “multiple pathways to recovery.” It is well past time that the value and impact of telehealth as a legitimate method of delivering care be accepted as a standard of care. Providers should have at their disposal all of the tools necessary to meet patients where they are – and patients should have access to tools that make interacting with health care providers seamless, easy, and affordable.
As Telehealth Awareness Week comes to an end, I remain hopeful that our policymakers will find ways to make permanent the flexibilities crafted during the pandemic, to ensure individuals continue to access quality care whenever, wherever, and however they wish.
For more information on the power of telehealth and ways you can champion its use, visit https://telehealthawareness.org/