Telehealth is a way to expand access to health care, but it’s not a panacea

Telehealth services have the potential to increase access to health care for rural Vermonters, older Vermonters, and others who face challenges in finding transportation to an appointment. I am excited about the potential expansion of telehealth in rural Vermont.

However, I believe that, as we work to expand access to telehealth, we should keep three main considerations in mind:

• First, telehealth should never diminish the value placed on local, community-based health care providers throughout rural Vermont. Telehealth should be a tool to enhance the relationship between a provider and a patient, not a replacement for face-to-face care. In addition, there is value to providers who are physically located within the communities of the patients they serve. This leads to a better understanding of the patient, and is also necessary for those health needs that cannot be addressed remotely. The expansion of telehealth services should never be an excuse to stop prioritizing the health care provider workforce needs of rural America.

• Second, care must be taken to ensure that the expansion of telehealth does not increase social isolation. This is particularly true for older Vermonters, who already face higher risks of mental health problems and suicide due to social isolation. For some older Vermonters who live alone, doctors’ appointments may be an important source of social interaction.

• Finally, telehealth access is available only to the extent that communities have strong enough internet service to take advantage of these opportunities. With the expansion of telehealth services, there will be a link between broadband availability and access to health care. We must be vigilant in ensuring that the same measures taken to expand access to health care do not actually create further disparities.

The bill that we passed out of committee requires insurance companies to reimburse providers for one specific type of telehealth: store and forward. In store and forward, digital media such as photos or video clips are securely sent between two providers or between a provider and a patient. An example of store and forward would be if your primary care provider sent a picture of your rash to a specialist to find out whether you required a referral. If the referral was not needed, this would save you an unnecessary and expensive trip to the specialist.

The hope is to reduce health care costs by avoiding unnecessary appointments, and to reduce wait times with specialists by incentivizing specialists to determine beforehand which patients’ conditions actually require their expertise.

This week, the Legislature is on break for town meeting. When we reconvene, the telehealth bill will be on the floor of the House. I plan to stand up and speak about some of the challenges and opportunities of telehealth for rural areas, and to encourage a thoughtful, intentional and measured expansion of these services going forward.

I welcome any feedback or comments, on this or a different issue (730-0604; lrogers@leg.state.vt.us). I am proud to live in such an engaged community, and I greatly appreciate each of your phone calls, emails, in-person meetings, and visits to the Statehouse.

Rep. Lucy Rogers, a Democrat from Waterville, also represents Cambridge in the Vermont House of Representatives.