The pandemic brought about a rapid expansion of telehealth. In response, the National Committee for Quality Assurance, the Alliance for Connected Care, and the American Telemedicine Association brought together experts from across the industry to form The Taskforce on Telehealth Policy (TTP). The taskforce looked at the future of telehealth, specifically considering the quality of care and safety standards. In mid-September, they released a report outlining recommendations for policymakers to consider.
The TTP suggested that telehealth is a natural evolution into the digital age, not a new type of care, and this type of care delivery can be critical in advancing a well-coordinated, patient-centered, value-optimized healthcare system. Based on the review of data during the pandemic, the taskforce believes there is evidence to support the argument that telehealth can be successfully integrated into our healthcare system, and should not be limited as it was prior to the pandemic.
The TPP consisted of three subgroups, which each provided recommendations. Following are some highlights from each subgroup.
Patient Safety and Program Integrity
- Telehealth can enhance safety by preventing care delays, reducing exposure to illness, and minimizing travel necessary for office visits.
- Safety standards should be the same, not different for telehealth. Minimum standards should be identified and integrated into existing standards.
- Emerging tools, like artificial intelligence, can help detect fraud, waste, and abuse. The existing fraud, waste, and abuse protection systems in place should be extended to telehealth.
- Patient privacy should be protected.
Data Flow, Care Coordination and Quality Measurement
- Telehealth is a natural evolution into the digital age, not a new type of care.
- Quality measures should be adapted, rather than reinvented, for telehealth.
- Telehealth platform certification should be required on data sharing, care coordination, and privacy.
- Leverage telehealth to improve care coordination. Move toward care coordination document sharing among all team members (within and outside of telehealth) to remove silos and improve care coordination.
- Pilot digital patient experience surveys.
Effect on Total Cost of Care
- No excess cost or utilization has been observed thus far during COVID-19 because of telehealth. The mix of care weighed toward telehealth, but overall numbers were steady.
- Behavioral health is an exception. While utilization increased, there is potential to improve both costs and outcomes by reducing untreated behavioral conditions that can result in physical health needs.
- Other ways telehealth shows promise for improving costs:
- Fewer missed appointments.
- Fewer skilled nursing facility patient transfers to hospitals and emergency departments.
- Increased use of transitional care management that results in fewer readmissions.
- Anecdotally, when asked what they would have done without telehealth, patients indicated they would have gone to the emergency department or urgent care.
The taskforce offered other overarching recommendations, including addressing technology gaps to ensure equity; resuming full HIPAA privacy enforcement; considering access for the hearing or visually impaired; permanently lifting telehealth restrictions as encounters meeting appropriate standards of care; and providing guidance on any new policies.
Read the full TTP report at https://www.ncqa.org/programs/data-and-information-technology/telehealth/taskforce-on-telehealth-policy/.
