Q&A: Maintenance of telehealth services necessary in case of future ‘mass health events’

Key takeaways:

• Use of telehealth for neurological care has decreased since the early stages of the COVID-19 pandemic.
• Improvements in telehealth are needed to reduce utilization gaps.

A recent study in Neurology Clinical Practice has uncovered disparities in telehealth utilization for neurologic conditions among older individuals as well as those from underserved populations.

Healio spoke with lead study author Marisa McGinley, DO, of the Mellen Center for Multiple Sclerosis at the Cleveland Clinic, to expand on the study’s findings.

Healio: What specific factors sparked your examination of telemedicine utilization for certain neurologic conditions?

McGinley: We were overall encouraged by the significant increase in utilization of telemedicine during the COVID-19 pandemic, but with any new health care delivery method, we wanted to identify any emerging disparities that need to be proactively addressed. Telemedicine is clearly going to remain a meaningful part of health care, which is why it is imperative we understand barriers and preferences patients face when accessing telemedicine options. This study was a first attempt to better understand utilization that can be used to inform optimizing telemedicine models.

Healio: What in the study’s findings did you find surprising or alarming?

McGinley: Most of our results were not surprising, but they demonstrated our concern that utilization of telemedicine for neurological care has decreased compared to the early pandemic. While this is not surprising as many stay-at-home orders limited in-person care options in 2020, the decreased utilization raises the concern that there are other additional factors beyond preferences driving care back to the office. Ultimately, we want patients to get the best care possible, but also want to ensure that care options are not limited that can drive health disparities.

Healio: What did you find to be cause for positivity or optimism?

McGinley: There are two aspects of our findings that I found most encouraging.

First, although telemedicine use decreased in the later pandemic period it was still significantly higher than pre-pandemic use. This is encouraging that many of the regulatory and payor changes that occurred have continued allowing for more broad accessibility of telemedicine visits.

Second, we were encouraged that our rural patients utilized telemedicine just as much as our urban patients. Rural communities have a significant access need for neurological care. The observation that rural patients are utilizing telemedicine indicates this may be a promising health care delivery method to improve neurological care access in these areas.

Healio: What can the data breakdown of peri-pandemic telemedicine usage tell clinicians about utilization during future mass health events?

McGinley: I think the data generated for this study and others shows the utility of telemedicine to be scaled up to meet the needs of health care systems during global health events. It also illustrates the value of maintaining an infrastructure to support high volume telemedicine care. Early in the pandemic many institutions needed to develop the necessary IT infrastructure to provide the volume of virtual care needed.

As we move further from the pandemic, it is important that health care systems continue to invest in maintenance of these telemedicine systems to be prepared to manage high volumes in future mass health events.

Healio: What plans are in place for Cleveland Clinic to address or close the socioeconomic gaps revealed in the research?

McGinley: Health disparities including socioeconomic gaps are not unique to telemedicine and it will be crucial moving forward to better understand the unique barriers underrepresented patient populations have to receiving health care including virtual care. At Cleveland Clinic we are using these data along with several other studies to identify populations with disparities in both virtual care and access to health care overall. We are aiming to work with these populations to better understand barriers and facilitators to care and develop targeted interventions.

We look forward to developing equitable care options that use telemedicine to improve access to neurological care in all communities.

Reference:

McGinley MG, et al. Neurol Clin Pract. 2024;doi:10.1212/CPJ.0000000000200407.

For More Information:

Marisa McGinley, DO, can be found at: https://my.clevelandclinic.org/staff/22853-marisa-mcginley.