Perspectives 10.06.2020

Telehealth Expands Health Care Options for Low Income Populations

Jean Mah, Scott Davidson, Heidi Costello, Warren Brodine, President and CEO of Eisner Health
Cell phones and other kinds of mobile devices and communications technologies are of increasing importance in the delivery of health care.
Photographer Daniel Sone; National Cancer Institute on Unsplash

COVID-19 has forced everyone to adapt to a “new normal.” Seemingly overnight, dining tables became offices, bedrooms became classrooms, and external video cameras became hard to find. COVID-19 significantly disrupted the health care industry. This disruption fueled immense innovation among health care providers. Suddenly, there was an overwhelming need to ensure continuous health care and guarantee patients’ and families’ needs were being met. During this incredibly difficult time, health care providers overwhelmingly adopted telehealth systems to virtually care for patients.

Telehealth opens up the lines of communication between provider and patient, allowing for more streamlined, personalized care when you need it the most. Telehealth is beneficial for patients. It allows patients the opportunity to easily speak with their health care teams to receive quick answers to their health care questions. Telehealth is also beneficial for health care providers. It offers a continuous approach to care, promoting more frequent communication between provider and patient and encouraging the adoption of health care solutions that are most advantageous for the patient.

COVID-19 has accelerated change in health care and beyond. Yet, as we emerge from the COVID-19 pandemic, will telehealth become the new norm, or will it simply be thought of as a temporary replacement to in-person appointments? On October 21, 2020, the federal government’s COVID-19 Public Health Emergency expires. If this emergency declaration is not extended, it means providers can’t bill for all Medicaid visits. This may force providers to discontinue telehealth services altogether.

We believe telehealth is the future of health care because it allows access to important health care services for all patients. This is especially advantageous for low-income patients. Here’s why:

Low-income patients want telehealth solutions

Eisner Health, a nonprofit community health center with 16 locations in Los Angeles County, provides patients with medical, dental, optometric, behavioral health, OB/GYN and pharmacy services, regardless of income. The team at Eisner Health has seen the benefits of telehealth among its more than 50,000 low-income patients.

In its Q2 survey of both Spanish-speaking and English-speaking patients, 80 percent of all patients expressed wanting telehealth as an option for future visits. Additionally, 95 percent of patients were “satisfied” or “very satisfied” with their last telehealth visit.

“Clearly the need is there among our patients for increased telehealth opportunities,” said Warren Brodine, President & CEO of Eisner Health. “As a health care provider, we need certainty. We want to be able to offer the same modality of care regardless of payer source. We also want to develop a physical building that can serve all patients with enhanced capabilities to facilitate the telehealth visits that our patients desire.”

Timely visits precipitate more visits:

No one likes to sit in a doctor’s office for longer than needed. Telehealth visits are more timely visits, which make going to the doctor that much more convenient. Suddenly, a 15-minute telehealth visit with your doctor actually takes 15 minutes. This is especially important for low income patients.

Often, low income patients rely on public transportation to get to and from the doctor. When their doctor is running behind schedule and the appointment takes longer than expected, that could mean missing the one bus that gets them back to home. Low income patients most often work in hourly jobs. Taking time off of work to visit the doctor is not only problematic, but it also means fewer hours they are getting paid for working.

Telehealth makes visiting the doctor more convenient. This breaks down the health care barriers and encourages people to take control of their health by engaging in more preventive care. Increased preventive care reduces health care costs for everyone and leads to healthier communities.

By looking holistically at health care and realizing the immense capability telehealth has in streamlining the care model, we can begin to reinvent the entire health care system to benefit all patients.

A digital divide still exists

Brodine is quick to point out that the typical “low income” patient isn’t what we often imagine. “They aren’t all homeless. We’re seeing an increased hidden homeless problem due to these tough economic times, where people are experiencing homelessness and are hiding in plain sight,” said Brodine. “They most often reside in urban populations where the cost of living is high. They tend to live in racial and ethnic communities and within congregate and multi-family settings. These low income patients are our essential workers in grocery stores, convenience stores, child-care facilities and restaurants who are relied upon to stay open to provide necessary services in the midst of a pandemic.”

But, there’s still a digital divide. Low-income residents likely don’t have smartphones, and if they do, they have the most basic phone plans that don’t come with data plans. This means they can’t stream video visits with their doctor unless they also have access to high speed WiFi. This WiFi coverage might not be readily available or dependable where they live or work.

Telehealth changes the care model:

Providers must think differently about their approach to health care. “We are constantly asking our team to go beyond the typical health care delivery models and think bigger,” said Brodine. “How can we bring the services to the patient? How can we collaborate with other providers so it’s more convenient for the patient?”

By looking holistically at health care and realizing the immense capability telehealth has in streamlining the care model, we can begin to reinvent the entire health care system to benefit all patients.

Additionally, medical schools and residency training programs must look at telehealth as central to care delivery. What does the sustainability future model look like for training the future provider? By bringing new concepts to medical schools, like a telehealth training center, we are providing much needed tools and resources to ensure our future doctors and health sciences professionals learn the skills necessary to work with this new technology.

As we continue to battle COVID-19 across the globe, we are all learning to adjust to this new normal. This is especially true for providers, who were forced to be more innovative than ever before. Telehealth is one example of this innovation in action. Telehealth has disrupted the healthcare landscape in a good way, making care available to more patients, regardless of payer source. Let’s make sure we keep it that way and embrace this innovation as a change agent for future growth in the health care industry.