Published March 3rd, 2021 at 6:00 AM
Here’s one positive side effect of the COVID-19 pandemic: telehealth is here to stay.
When COVID-19 hit the United States nearly a year ago, the American health care system had to scramble to safely provide care to their patients.
As a result, nearly half of Kansans have used telehealth in the last year, according to a new survey from the REACH Health Foundation and United Methodist Health Ministry Fund.
Now that the telehealth option is broadly available, health care providers think telehealth may revolutionize health care.
“I think with telehealth visits we are really just on the cusp of some really awesome things,” said Dr. Jessica Gillespie-Gebhards of Olathe Health.
The survey found that 48% of Kansans have used telehealth in the last year. Moreover, 86% of the 800 polled said they support expanding or maintaining telehealth options in the future. According to a Kansas Health Institute (KHI) issue brief, at its peak in April-May of 2020, 43% of primary care visits were done through telehealth.
Kansans said the three greatest benefits of telehealth care are to avoid the spread of COVID-19, quick and easy access to health specialists and eliminating the need for traveling.
Video calls were the most common form of connection for telehealth, with 38% of Kansans saying they used their computer to do a video call. Another 29% of poll respondents said they used the telephone to conduct their appointment.
Dr. Gillespie-Gebhards said that 90% of her appointments are on video calls. She says the expansion of telehealth in the last year has helped her stay connected with her patients.
Health care providers were able to provide telehealth care to their patients at such a high rate due to the rollback of restrictions from insurers at the beginning of the pandemic.
“The lifted restrictions decreased the cost burden of telehealth,” said Mike Jensen, chief strategy officer of Olathe Health. “The necessity was already there.”
Now some in the field are worried that those restrictions will come back at the end of 2021.
“I think those who live in smaller communities and especially in rural areas that would like access to a second opinion or specialist, those are game changing kinds of opportunities,” said Brenda Sharpe, president and CEO of REACH Healthcare Foundation. “I don’t think Kansans want to go back to the way it was before the pandemic.”
There are currently three bills being considered in the Kansas legislature that would ensure increased telehealth access that Kansans have enjoyed during the last year.
House Bill 2206 will update definitions within the existing telemedicine act that would allow Kansans to continue doing telemedicine in their homes. An important change would be to the definition of an “originating site,” or where the patient is receiving care. The new bill proposes a definition change that would allow for homes to be included as an originating site.
House Bills 2066 and 2209 would allow physicians and psychologists respectively to provide out-of-state care through telemedicine. That is something Dr. Gillespie-Gebhards has been doing frequently during the last year.
“I do telehealth appointments all of the time with patients who are in their 20s, 30s and 40s who are really willing to use technology to see the doctor and don’t necessarily have to have that in-person visit,” she said. “I’m seeing a lot of college aged students who are at Arkansas, or Oklahoma or Iowa that I would have otherwise had difficulty, or not been able to see regularly.”
Making life easier for providers and patients will allow telehealth to keep growing as an option for Kansans, who overwhelmingly support its growth.
“I think we need to be grounded by the fact that Kansans want to have the option of telehealth,” said David Jordan, president and CEO of United Methodist Health Ministry Fund. “It’s clear that consumers want this and don’t want to go backwards. I think the hope is that the folks involved in the debate, whether it be policymakers, payers or providers, try to take that into account as they have this discussion.”
A population that could benefit the most from expanded telehealth are those in rural areas. The REACH/United Methodist survey found that 42% of rural Kansans have used telehealth, and that 79% of rural Kansans favor using telehealth as an option over in-person visits.
A core reason for that support is due to reduced travel time. Some residents must drive more than 30 miles to see a physician or psychologist. Telehealth allows rural Kansans to not have to plan their whole day around going to the doctor.
“We’ve heard about multiple farmers that can’t make it into town for a doctor’s appointment, but may pull their tractor off during harvest to do a telehealth consultation,” Jordan said.
Dr. Gillespie-Gebhards has some patients that drive more than an hour and a half to see her for checkups. She says she has seen an increase in the usage of telehealth from people who live further away from her office.
That convenience was evident in the survey as well, as eliminating the need for travel was the greatest benefit from telehealth according to rural poll responders.
However, there is a slight catch in getting telehealth access to rural populations: broadband availability.
According to a new study from KHI, more than half of the Medicare and Medicaid eligible population in the state don’t have access to broadband or a device to connect them to the internet.
In the REACH/United Methodist survey rural respondents overwhelmingly voiced concern about rural broadband access. The survey found 73% of rural residents think broadband in their communities is worse than that in metropolitan areas. Fully 88% believe that expanding broadband would allow Kansans to better communicate with the doctor through telehealth, and 81% support the legislature focusing on expanding broadband in the state.
“There have definitely been times where I started a telehealth visit where I’m seeing them, and they are seeing me then the connection keeps dropping, and do have to convert it to a phone visit,” Dr. Gillespie-Gebhards said. “Sometimes with quick service visits, if I know it’s going to drop, I’m like ‘let me do a quick exam, take a look at you over before we have to convert to the phone.’ ”
When telehealth has been used in rural communities, it has been effective so far. Jensen said that instead of waiting for things to get to the worst possible point before seeing a doctor, telehealth has encouraged people to see the doctor before a problem becomes serious.
“If they don’t have a vehicle and have limited transportation options, or if they’re low-income workers who are hourly, then they don’t have sick time to take off for preventative care and other appointments,” Sharpe said. “We think that this is an issue that is top of mind and beneficial for both rural and urban communities.”
Jacob Douglas covers rural affairs for Kansas City PBS in cooperation with Report for America.