UNSTRUCTURED
Objective
To examine the effect of the Covid-19 policy expansions on telehealth access among vulnerable populations including uninsured, seniors, and rural patients.
Data Sources
Primary data collection of telehealth visits between January 21- April 19, 2020.
Data Collection
Study data was collected through the online platform and extracted from the institutional data warehouse for processing and analysis.
Study Design
We conducted a cross-sectional analysis of virtual visits through a state-wide telehealth center embedded in a large academic healthcare system. Primary outcomes of this study were changes in health access among vulnerable populations and changes in provider staffing to stabilize the telehealth practice.
Principal Findings
A total of 2132 telehealth visits were conducted, 1530(71.8%) patients were female, 1561(73.2%) were between the ages 18-50, 1576(74%) were uninsured, and 1225(57.5%) were from rural regions. A significant increase in access among senior (p<0.05), uninsured (p<0.001), and rural (p=0.001) patients, and video visits (p<0.001) occurred in response to the telehealth expansion.
Post-expansion, the daily average number of telehealth visits and wait times increased by 229% and 436% respectively, which required an increase in telehealth providers by 228% to meet patient demands. The predictive model expected 394% increase in virtual visits through June, 2020 (95% CI: 2892-8579).
Conclusions
Recent telehealth policy expansions appear to expand access to vulnerable populations such as senior, uninsured, and rural patients while decompressing hospitals and emergency rooms and maintaining positive patient experiences. While the policy expansion displayed effectiveness, additional measures are needed. These include the need for regulations around virtual visits unintended consequences, certification of telehealth software, and guidelines for workforce training.