Viewpoint: How to solve telehealth's shortcomings

Although many have argued telehealth is a cost-effective way to expand healthcare into underserved communities, Ateev Mehrotra, MD, and Lori Uscher-Pines argue that additional strategies are needed to reach this goal.

Dr. Mehrotra (an associate professor of healthcare policy and medicine at Harvard Medical School in Boston) and Ms. Uscher-Pines (a policy researcher at the RAND Corp.) provided an overview of their research in a Health Affairs blog post. Based on their analysis, they found that between 10 percent and 20 percent of remote dermatology appointments and 38 percent of remote retinal screening appointments required in-person follow-up care.

Unfortunately, patients referred for follow-up care sometimes stayed on wait lists for multiple months. Therefore, they argue that, for telehealth to be successful, there needs to be a way to account for this issue.

One suggestion is for telehealth providers to add in-person services; they note that the dermatology telehealth program has added physical offices for follow-up care. Another suggestion is to encourage more specialists to require telehealth appointments prior to in-person visits, so that in-person visits are prioritized for those who need it most.

"We must experiment with more comprehensive strategies that combine telehealth and the necessary in-person care so that we are digitizing a better, more efficient and more equitable healthcare system," they write.

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