A report from The Nicholson Foundation outlines how lessons learned from the accelerated application of telehealth in New Jersey during the COVID-19 pandemic can help the state become a national leader in its ongoing use to improve healthcare delivery—a position it had been moving toward even before the start of the public health emergency.
The authors of Moving Telehealth Forward in New Jersey say achieving that goal will require changes that include: eliminating the digital divide; establishing a private-public entity to advocate for statewide adoption of pertinent telehealth laws; educating healthcare providers working with vulnerable populations about privacy and confidentiality laws that apply to telehealth; and adequately reimbursing providers for telehealth services that replace or complement in-person visits.
A collaboration between Knight Consulting, LLC and The Nicholson Foundation, the report notes that telehealth use had been building for decades. However, its use in the United States had been mostly seen in rural areas until the COVID-19 pandemic necessitated a safer alternative to in-person visits to doctors and other healthcare providers. During the pandemic, telehealth use increased exponentially among all economic groups, but its distribution was uneven: Populations with limited access to healthcare services before the pandemic, also benefited less from telehealth during the pandemic.
The report also found that the rapid increase in telehealth use during the pandemic was largely facilitated by federal and state waivers that quickly relaxed telehealth regulations and made it possible to meet the growing demand for virtual visits during the pandemic. These waivers expanded both the types of providers eligible for telehealth reimbursement and the number of sites where services could be accessed, most notably from patient homes. Reimbursement rates also were increased to be comparable to in-person visits, and penalties for failing to comply with privacy and confidentiality rules were dropped.
The report notes that the increased use of telehealth resulting from all of these changes contributed to more efficient healthcare delivery, but not everyone benefited equally. Vulnerable populations were more likely to feel the effects of the pandemic than other groups, and were generally less likely to receive timely healthcare services, including through telehealth. Disparities in availability and affordability of, among others, high-speed internet and adequate broadband services contributed to this gap in service delivery. The report’s authors suggest that temporary policy changes must be made permanent, and strategic investments in telehealth infrastructure must be made, in order to capitalize on the advances in telehealth experienced during the pandemic.