Juan J. Andino, MD, on key concerns surrounding the future of telehealth

In this video, Juan J. Andino, MD, MBA, shares key concerns for the future of telehealth as Congress weighs a decision surrounding the extension of telehealth flexibilities. Andino is an assistant professor of urology at the University of California, Los Angeles.

Video Transcript:

The main thing is the expiration, and then what's going to happen? Patients have become used to this. If somebody has been having that telehealth relationship, and then all of a sudden, January 1, 2025, they're told by a clinic or by a hospital system, "Hey, sorry. We know you know this surgeon, doctor, what have you. They know your history. They've taken care of you. But now we're not going to get paid if they provide that health care to you, so you're not going to be able to maintain that relationship." That's going to be extremely sad and disappointing for patients and physicians alike.

The other aspects of the waivers and the things that remain in flux and that are not fully fleshed out are going to be things like interstate telehealth. There was a period during the pandemic where you could provide telehealth across state lines. Those waivers expired because the pandemic has been under better control, and that has not been part of the flexibilities that have been extended. But that's an ongoing conversation that's a little bit controversial. There are some people who are very pro in the oncology space. You can probably make an argument that's probably one of the most important areas, because there are centers of excellence. There are things like radical cystectomy, retroperitoneal lymph node dissections, [where] patients are going to get better outcomes if they go to a place that focuses and specializes in those types of high-risk surgeries. That's one of the components, the interstate telehealth.

The other part that there's been a lot of discussion around is phone visits or audio-only visits. Historically, telehealth has been primarily reimbursed or covered if it's a synchronous video, but we know that not every patient is going to have access to broadband internet, smartphones, computers, laptops, what have you. There is some worry that if you only reimburse video and in-person the same, that we may create a new digital divide [for] the folks who live in more rural areas, and there's a number of studies that have shown that minority patients may be less likely to be able to use video and rely on phone visits. If those types of encounters are not considered equitable or not reimbursed in the same way, that could unintentionally lead to some down the road consequences of a portion of our patients have better access to care, but now this other group actually has worse access because they either have to come in-person, or they're not getting those opportunities to connect.

This transcript was AI generated and edited by human editors for clarity.