Eighty percent of providers using telehealth in Virginia have seen improvements in their patients’ continuity of care, and 87% feel confident in the quality of care they’re able to offer patients via telehealth, according to a new survey conducted by the Virginia Telehealth Network of more than 10,500 active license healthcare professionals throughout the state.

These are just some of the impressive results from the new survey. Healthcare IT News sat down with Virginia Telehealth Network's Mara Servaites, executive director, and Robin Cummings, special projects director, to dig into the results and find out the status of telemedicine in the state.

Q. Your survey has discovered fascinating things about Virginia providers' feelings about continuity of care and quality of care they’re able to offer patients via telehealth. Why do you think this is?

Cummings: We tracked both of those points from the first survey into the second. We saw growth in the areas of providers agreeing or strongly agreeing that telehealth is an effective tool for providing care. They feel confident in the quality of care they offer via telehealth and have seen improvements in their patients’ continuity of care.

Servaites: Part of that is a “practice makes perfect” scenario, and as people have gotten used to telehealth, they've also embedded better workflows within their practices, and so have their collaborating providers. We’re seeing a “rising of all ships” as people get more used to the modality and as documentation and workflows improve.

Q. What have you learned about providers' plans to increase or decrease telehealth usage now that the public health emergency has ended? And why do you think this is?

Cummings: We saw some reduction in reliance on telehealth now that operations are returning to pre-COVID normal, and I think it’s really interesting that we are seeing growth in providers saying telehealth offers them flexibility in their scheduling, and that it's allowing them to see more patients.

It’s again getting to that normalization place of what makes sense for a provider and his or her patients. A virtual practice is not going to necessarily work for all providers and that's okay.

Servaites: We’re beginning to get to a place that maximizes telehealth usage, while also acknowledging that sometimes this isn't the right modality for this particular service or for this patient.

One of the other things that could impact long-term use of telehealth is around reimbursement, specifically with the PHE expiring, that is creating a lot of chaos and a lot of misinformation. We are hearing concern from the healthcare community that telehealth may no longer be a reimbursable service and that even providers who have been doing telehealth for a long time may no longer be reimbursed – while not true, the feeling of lack of permanence creates that anxiety around long-range planning for providers.

Cummings: And while there have been extensions of the PHE and many of the related provisions, providers are still trying to figure out their new normal. What can we do and not do in this space? Where might our reimbursement be at risk? How do we need to change our policies and practices to meet emerging requirements?

Q. What does the survey show about telemedicine addressing patient care barriers and seeing more patients? What do these results say about telehealth in Virginia?

Servaites: The survey showed barriers we know exist and that continue to exist. A lot of that is more around the technology side and connectivity side. One of the largest cited areas that could improve the patient experience with telehealth is internet connectivity.

Cummings: Yes, improvement in internet connectivity would improve the overall patient experience with telehealth – particularly for populations who may be limited in technology access and digital literacy.

One of the areas of growing need we captured in the follow-up survey is the need for enhanced access to interpreter services. While telehealth is allowing providers to grow their patient panels, they are also seeing increased need for supports to provide better care for their patients.

Q. The survey says providers are taking on new patients beyond their local community. What does this mean? And is there a health equity angle here?

Cummings: There’s always been a struggle around the distribution of healthcare providers. Telehealth can expand provider networks to reach underserved rural and urban areas, particularly in specialties where there just aren’t enough providers to be physically present in all communities.

Where there's still a lot more work to be done is around making sure that the telehealth piece is accessible to all communities, and we’re excited to see creative problem-solving for confidential telehealth access – like healthcare providers partnering with local libraries and clinics.

The other thing that we hear, particularly in the mental and behavioral health space, is that there are instances where patients in small communities feel more comfortable having a provider located more distantly from them, that they aren’t someone they're going to run into in the grocery store. You might be more candid with somebody you know you won’t see around town.

Servaites: When providers are looking at serving patients beyond their local community, it’s important to be aware of what laws and regulations still exist for serving patients across state lines. They need to get clarity around what they're allowed to do legally, and certainly what their malpractice coverage will allow them to do.

They also need to regularly find out the location of the patient. Where is the patient calling in from? What's the address? If there was an emergency, how would you be able to, you know, call for help for that individual? But then it also is going to let you know, “has my patient traveled across state lines and am I now serving my patient over a state line?”

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