According to new RAND Corporation report, the rapid adoption of telehealth helped safety net clinics in California maintain consistent levels during the pandemic.
However, the use of audio-only care has persisted in the clinics longer than in other types of healthcare settings. Researchers say the higher rates of audio-only telehealth in safety net settings raises questions about the quality of care and equity for low income patients, since the quality of care for audio-only telehealth has not been established.
RAND researchers examined the experiences of 45 FQHCs in California that provide care for lower income people. Many of the clinics are located in rural areas of the state. All of the clinics received support to expand telehealth services from the Connected Care Accelerator program launched in 2020 by the California Health Care Foundation.
The project’s goal was to help health centers navigate the transition to telehealth during the pandemic and support them to be able to access primary care and behavioral health services with the delivery of virtual visits.
Researchers evaluated the clinics’ experiences with telehealth by analyzing data on in-person and telehealth visits, interviewing health center leaders, and surveying health center providers and staff.
The study found that overall visit volumes remained about the same from the pre-pandemic to the pandemic study periods, with the share of audio only and video visits dramatically increasing during the pandemic particularly for behavioral health.
Health centers that delivered numerous video visits and replaced audio only visits with video visits over time had some common promising practices that could aid other clinics, according to the report.
These practices included adding telehealth navigator programs, assessing patients’ digital literacy, providing one-on-one training for patients, setting targets for video visit volume, and offering real time technical support.
Researchers say increased efforts are needed to study the impact of audio only visits on the quality of medical case, as well as where it fits into a hybrid model of care where patients receive a mix of telehealth and in-person visits.
The report “Experiences of Health Centers in Implementing Telehealth Visits for Underserved Patients During the COVID-19 Pandemic: Results from the Connected Care Accelerator” is available at https://www.rand.org.