Asian senior male and daughter video call with doctor in living room. Elderly old mature grandfather sitting on table with young granddaughter, using computer laptop consult with general practitioner.

There is no question that telehealth was a game-changer during the pandemic. Going forward, more research needs to be done to determine the best way to use it. That’s the assessment of Phillip Rodgers, MD, co-director of the University of Michigan’s Clinical Palliative Care Program and an advisor to the American Academy of Hospice and Palliative Medicine.

Phillip Rodgers, MD

“Both patients and their families have come to rely on telehealth,” Rodgers told McKnight’s Home Care Daily Pulse. “For palliative care providers, telehealth has been extremely valuable in terms of expanding our reach so that we can care for the patients we serve.” 

The Centers for Medicare & Medicaid Services provided waivers during the COVID-19 pandemic that allowed providers to use telehealth in lieu of in-person visits.

The Consolidated Appropriations Act passed by Congress at the end of last year extended telehealth flexibilities until the end of 2024. CMS will also allow hospice providers to continue using HIPAA non-compliant technology through the end of August. However, the future of telehealth beyond 2024 remains murky for providers. 

Telehealth’s positive impact

There is plenty of evidence to point to its benefits — particularly among older and poorer people, Rodgers noted. A study by the Department of Health and Human Services Assistant Secretary for Planning and Evaluation Office of Health Policy found telehealth was a boon to underserved populations during the public health emergency. The study found telehealth use was highest among Medicaid beneficiaries (29.3%), Medicare beneficiaries (27.%), Blacks (26.8%) and those with incomes below $25,000 (26.7%).

Those numbers would seem surprising given the challenges those groups have faced accessing technology and broadband services. However, Rodgers explained telehealth flexibilities during the PHE have allowed for audio-only telehealth visits, enabling patients to speak with clinicians by phone. Rodgers speculated that is one flexibility that could eventually end.

“We expect those audio-only services to be narrowed and some of that might be appropriate,” Rodgers added. “That’s unfortunate because we have found that patients with Medicare and Medicaid have really leaned into telehealth.” 

Palliative care benefits 

Expanding telehealth services could reduce barriers to accessing palliative care, especially in rural areas where there are few providers who practice that specialty, according to Rodgers. A 2021 study published in JAMA Network called telehealth “a new pathway for bringing palliative care specialists to rural areas.”

Rodgers said social services and behavioral health services are invaluable tools in palliative care that should be available to a wider audience through telehealth. 

“The burden of having to go in and sit in a waiting room is really ripe for research to understand if we can do better via telehealth for certain types of services than we have for generations with office visits,” he said.