It’s Time for Senate Action on Telehealth
Since the COVID-19 pandemic began, telehealth has seen a massive growth in popularity. What started as a necessity due to lockdowns has morphed into a permanent desire for change in healthcare. And, due to Hurricane Ian we have been using telemedicine with our Direct Primary Care practice in Florida and found the flexibility incredibly helpful during our recent disaster response especially for our patients in rural areas that were cut off by flooding. However, Congress has not yet made the changes needed to allow telehealth care to permanently continue for all Americans after the pandemic ends.
A new study reminds us of the high-quality care that telehealth provides. Researchers at the Mayo Clinic found that diagnoses made over telehealth matched in-person diagnoses 86.9% of the time. That number was even higher for psychiatry visits (96%). While there has been a past focus on telehealth for primary care, this study highlights that specialty doctors can also benefit. In fact, non-primary care specialties had an even higher likelihood of telehealth and in-person diagnoses matching.
This reinforces prior research showing the success of telehealth. A study out of Japan, for instance, similarly concluded that telehealth “can provide the same level of diagnostic accuracy as” face-to-face visits.
This study highlights that telehealth is not always a replacement for in-person visits; thus, if officials are ever considering future lockdowns or limits on what types of patients can receive in-person medical care, they must not be too restrictive.
In evaluating patients between March and June 2020, the study’s authors noted that during those months of intense lockdowns, virtual diagnoses for conditions that require “confirmation through traditional physical examination, neurological testing, and pathology” were less likely to be identical with in-person diagnoses. This is common sense.
In medicine, it is critical to ensure that all options are on the table so patients and doctors can evaluate the circumstances and choose what works best. Sometimes, in-person treatment works well and is needed. Other times, telehealth can work even better. An August 2022 report found that Medicare beneficiaries with Opioid-Use Disorder who used telehealth had better outcomes than those who did not.
Telehealth has provided greater access to healthcare for the elderly. In 2020 alone, Medicare patients had 52.7 million telehealth visits, a 63-fold increase from 2019.
These benefits should extend beyond the COVID-19 pandemic. In 2021, study in the Journal of Telemedicine and Telecare concluded that “Even before COVID-19, many seniors faced practical challenges, such as transportation, which has prevented them from keeping follow-up appointments, or in some cases visiting a provider at all. Alternative delivery models, like telehealth, remain our most promising option.”
Medical professors at the University of Kentucky report that “telehealth has the potential to decrease the healthcare inequity in rural populations.” New England researchers write that U.S. physicians have found telehealth to make healthcare delivery “more flexible, value-based, and patient-centered.” It can allow people to save time away from work, reduce traveling to the doctor, as well as travel-related expenses.
In addition to saving time for many, it provides access to care for those without transportation. For this reason, a team at the University of North Carolina asserted that “permanent policy changes that remove geographic and location requirements, widen the range of services eligible for telehealth appointments, and allow for telephone use will help make telehealth a more viable solution for individuals facing transportation barriers to accessing health care.”
The evidence for telehealth is clear and unambiguous leaving no excuse for congressional inaction. In a rare moment of bipartisan clarity, the House passed H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act, with a vote of 416-12 in July. The bill would extend the temporary telehealth coverage for Medicare patients through the end of 2024. There is much to gain, but the Senate has been slow to act. With midterm elections looming, many senators seem more focused on campaigning than passing critical legislation.
In mid-September, over 370 organizations signed a letter to Senate leaders urging them to pass the legislation preserving Medicare coverage of telehealth care. From the American Medical Association to Cleveland Clinic, Johns Hopkins Medicine, and the Federation of American Hospitals, practitioners and providers see the importance of maintaining telehealth.
It is critical that the Senate pass this extension and that Congress goes further to make these changes permanent, lasting well beyond 2024. We must call the Senate to action and hold them accountable.
We should trust science and research to guide our policy. The facts in this case are clear: telehealth works.
Dr. Lee Gross is the owner of Epiphany Health & president of Docs 4 Patient Care Foundation
