The Potential and Challenges for Telehealth to Improve Access to - - PowerPoint PPT Presentation

The Potential and Challenges for Telehealth to Improve Access to Care

Penny Mohr

Senior Advisor, Emerging Technology and Delivery System Innovation Research Initiatives Healthcare Delivery and Disparities Research Patient-Centered Outcomes Research Institute (PCORI)

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Penny Mohr

• Has nothing to disclose.

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Growth in Outpatient Telehealth Services in Private Insurance

Source: Harvey JB et al. Utilization of Outpatient Telehealth Services in Parity and Non-Parity States, 2010-2015. Telemedicine and eHealth Published online 30 May 2018; https://doi.org/10.1089/tmj.2017.0265

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Potential and Challenges for Telehealth to Improve Access to Care

• Introduce panel
• To learn about PCORI’s investment in telehealth research and obtain

some early insights into completed results.

• To provide an overview of both the potential and the challenges of

using telehealth to improve access to care from the perspective of two PCORI-funded investigators.

• To identify the challenges of using telehealth to improve access to

care and outcomes for rural residents.

• To explore what evidence is needed by payers for making coverage

decisions for telehealth

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Session Chair

Penny Mohr, MA  Senior Advisor, Emerging Technology and Delivery System Innovation Research Initiatives, Healthcare Delivery and Disparities Research  Patient-Centered Outcomes Research Institute (PCORI)

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Addressing Childhood Hearing Loss in Rural Alaska through Telemedicine

Susan Emmett, MD, MPH  Assistant Professor of Surgery and Global Health  Duke University

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Effect of a home- based exercise intervention

• f wearable

technology and telephone coaching

• n walking

performance in peripheral artery disease

Mary McDermott, MD  Jeremiah Stamler Professor of Medicine  Northwestern University Feinberg School of Medicine

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Discussant

Kristine Sande, MBA  Associate Director  Center for Rural Health  University of North Dakota School of Medicine & Health Sciences

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Discussant

Victor Yung-Tao Wu, MD, MPH  Chief Medical Officer  TennCare

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PCORI’s Telehealth, Telemedicine, and mHealth Portfolio

$381 MILLION

SUPPORTING

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COMPARATIVE CLINICAL EFFECTIVENESS RESEARCH STUDIES IN TELEHEALTH

As of August 2019 Projects may be classified as more than one type

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Number of Telehealth Projects by Primary Disease/Condition

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Number of Telehealth Projects by Primary Disease/Condition

Mental and Behavioral Health Nutritional and Metabolic Health Cardiovascular Health As of August 2019

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Number of Telehealth Projects by Primary Disease/Condition

Cancer Rare Disease Reproductive and Perinatal Health As of August 2019

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Purpose of telehealth intervention

• A Focus on Promoting Self-efficacy and Knowledge

Framework adapted from American Telemedicine Association and Bashshur et al. The taxonomy of telemedicine. Telemedicine and eHealth. 2011 with stakeholder input.

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Our Telehealth Projects Target Underserved Populations

N=40, as of August 2019. Categories are not mutually exclusive

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The focus is on improving patient/caregiver well being

Outcome Targets for Telehealth Studies

Framework adapted from: Edmunds et al. An Emergent Research and Policy Framework for Telehealth. eGems 2017; 5(2): available at: An Emergent Research and Policy Framework for Telehealth

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When Will Results from Telehealth Studies Likely Be Available?

Average duration of telehealth projects (N=84): 3.7 years

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Findings from Completed Studies (N=17)

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Advancing the State of Evidence for Decisionmakers About Telehealth

PCORI Stakeholder Workshop (May 24, 2018) Key message: patient/clinician experience and context are critical

• Need to understand long-term adherence
• Patient and provider experience that contributes to adoption/lack of interest and

sustained use or discontinuation​

• Tracking use and outcomes beyond the study period​
• Report out contextual factors that make the telehealth

component work

• Type of support personnel needed
• How they interact with the care team
• Type of training needed
• Requirements for integration with the EHR

Included 22 participants representing patients, clinicians, payers, health systems, policymakers, and telehealth advocacy

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Learn More

• www.pcori.org
• info@pcori.org
• #PCORI2019
• www.YourURL.url

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Questions?

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Thank You!