{"id":5084034,"date":"2021-06-21T00:00:00","date_gmt":"2021-06-21T04:00:00","guid":{"rendered":"https:\/\/ctlatinonews.com\/telemedicine-a-blessing-for-some-inaccessible-for-others\/"},"modified":"2021-06-21T00:00:00","modified_gmt":"2021-06-21T04:00:00","slug":"telemedicine-a-blessing-for-some-inaccessible-for-others","status":"publish","type":"post","link":"https:\/\/latinonewsnetwork.com\/ctln\/2021\/06\/21\/telemedicine-a-blessing-for-some-inaccessible-for-others\/","title":{"rendered":"Telemedicine A Blessing For Some, Inaccessible For Others"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">When the pandemic began, LaVita King of Bridgeport worried about how she would continue to see her behavioral health therapist and primary care physician at Southwest Community Health Center.<\/p>\n\n\n<p class=\"wp-block-paragraph\">She lives close enough to walk to the federally qualified health center but didn\u2019t feel comfortable leaving her home in those early days, let alone venturing into a medical office. But she\u2019s been able to access care through phone and video chats.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cFor me, it\u2019s been such a lifesaver, such a blessing,\u201d said King, 69. \u201cOtherwise, I would not have been able to talk to my behavioral health therapist for this whole entire time. The fact that I could speak with her on the phone every week\u2014and then we figured out a way that we could actually see each other on video\u2014it\u2019s just a blessing.\u201d<\/p>\n\n\n<p class=\"wp-block-paragraph\">Telehealth has helped connect patients to providers over the past year. It has been particularly crucial in keeping federally qualified health center (FQHC) patients, many of whom are people of color and on Medicaid, connected to medical care during the pandemic.<\/p>\n\n\n<p class=\"wp-block-paragraph\">But while telehealth has brought some health care benefits and kept those already receiving services connected to their providers, national reports by&nbsp;<a href=\"https:\/\/www.rwjf.org\/en\/library\/research\/2021\/01\/from-safety-net-to-solid-ground-one-in-three-adults-used-telehealth-during-the-first-six-months-of-the-pandemic-but-unmet-needs-for-care-persisted.html\" target=\"_blank\" rel=\"noopener\">Robert Wood Johnson Foundation<\/a>&nbsp;and Health Affairs show that the technology has done little to reach new patients, and those with limited English proficiency had low rates of telehealth use.<\/p>\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n<p class=\"wp-block-paragraph\">A larger share of Hispanic-Latino and Black Americans did not have access to the internet at home. There were also significant differences by age, with 28% of Black seniors and 24% of Hispanic-Latino seniors lacking internet access at home (compared to 18% of all seniors), <a href=\"https:\/\/www.healthsystemtracker.org\/chart-collection\/how-might-internet-connectivity-affect-health-care-access\/#item-start\" target=\"_blank\" rel=\"noopener\">reports<\/a> Health System Tracker.<\/p>\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n<p class=\"wp-block-paragraph\">FQHCs are community-based health care providers that receive federal funds to provide primary care services in underserved areas. They must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes patients.<\/p>\n\n\n<p class=\"wp-block-paragraph\">According to Ken Lalime, CEO of the&nbsp;<a href=\"https:\/\/www.chcact.org\/\" target=\"_blank\" rel=\"noopener\">Community Health Center Association of Connecticut<\/a>, 62% of FQHC patients in Connecticut are on Medicaid, 10% are on Medicare and 15% are uninsured. Most, around 90%, have income that\u2019s twice the federal poverty level, and more than half don\u2019t speak English as their first language. There are 17 FQHCs in Connecticut.<\/p>\n\n\n<p class=\"wp-block-paragraph\">FQHCs saw their number of patient visits plummet as soon as the COVID-19 pandemic hit, Lalime said. Providers wondered how they would reach their at-risk patients and get them the care they needed. Telehealth quickly emerged as the answer.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><em><strong>\u201cJust because we built it doesn\u2019t mean that folks will come. What most data are showing across the country is that [telehealth] made access more readily available for people who already had access.\u201d<\/strong><\/em><\/p><cite><strong>Tekisha Dwan Everette,<\/strong><br \/><strong>executive director of Health Equity Solutions<\/strong><\/cite><\/blockquote>\n\n\n<p class=\"wp-block-paragraph\">On March 10, 2020, Gov. Ned Lamont issued an executive order that, among other things, allowed Medicaid to cover telehealth visits. On May 10, 2021,&nbsp;he signed legislation into law&nbsp;that extends that provision for another two years.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cTelehealth meant everything for people getting access to care in the pandemic,\u201d said Jill Zorn, senior policy officer at the&nbsp;<a href=\"https:\/\/universalhealthct.org\/\" target=\"_blank\" rel=\"noopener\">Universal Health Care Foundation of Connecticut<\/a>. \u201cFrom a health care perspective, not being able to see your doctor was a real problem. Having [insurers, including Medicaid] pay for telehealth was huge. If there\u2019s any good thing that came out of the pandemic, this is one of them.\u201d<\/p>\n\n\n<p class=\"wp-block-paragraph\">When COVID shutdowns began, FQHCs in the state saw patient visits drop by up to 80%. Once the state allowed telehealth, some centers conducted as much as 80% of their visits that way, and over the past year or so, about 50% of all FQHC visits have been telehealth visits, Lalime said. The number of telehealth visits is starting to drop now, he said, as patients feel more comfortable scheduling in-person visits.<\/p>\n\n\n<p class=\"wp-block-paragraph\"><strong>\u2018A Game Changer,\u2019 But Not For All<\/strong><\/p>\n\n\n<p class=\"wp-block-paragraph\">Via telehealth, King has continued her care plan, gotten referrals for any tests or scans she needs, and ensured her prescriptions stayed up to date.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cAll of the things that I needed to have done because I have access to my providers through telemedicine, I\u2019ve been able to have those things done,\u201d she said.<\/p>\n\n\n<p class=\"wp-block-paragraph\">Staff at&nbsp;<a href=\"http:\/\/swchc.org\/\" target=\"_blank\" rel=\"noopener\">Southwest Community Health Center<\/a>&nbsp;in Bridgeport had long been interested in telehealth, but it was never feasible before because Medicaid wouldn\u2019t cover the expense, said the center\u2019s president and CEO, Mollie Melbourne.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cTelehealth was a game-changer for us. It really helped us retain that connection with our patients,\u201d Melbourne said. She added that it was essential for patients receiving mental or behavioral health services and those with chronic illnesses.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cTechnology was a challenge [early on] but the concept of telemedicine, they fell right into. The patients seem to love it, especially for behavioral health,\u201d Melbourne said. \u201cAnd once we got over the technological hurdles, the providers really enjoy it.\u201d<\/p>\n\n\n<p class=\"wp-block-paragraph\">Telehealth eliminates various barriers to care, including the need for transportation, said Joanne Borduas, CEO of&nbsp;<a href=\"https:\/\/www.chcact.org\/center\/community-health-wellness-center-of-greater-torrington\/\" target=\"_blank\" rel=\"noopener\">Community Health &amp; Wellness Center<\/a>, which has locations in Torrington and Winsted.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cWe have no public transportation at all\u201d in the area, she said. \u201cIt\u2019s a challenge as it is, without a pandemic, trying to keep our patients coming back and staying connected with them. The ability to stay connected to them is so critical to their health and wellness,\u201d she said.<\/p>\n\n\n<p class=\"wp-block-paragraph\">Without telehealth, Borduas said, \u201cwe probably would have seen an enormous increase in adverse outcomes. What that would have caused is just this cycle throughout the pandemic of [patients] having their needs met in the emergency room. We were very happy that we were able to use telehealth.\u201d<\/p>\n\n\n<p class=\"wp-block-paragraph\">Telephone telehealth, in particular, has been a lifeline for many, she said.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cNot all of our patients have the ability or the money to buy computers, so the ability to do video telemedicine was challenging,\u201d she said. \u201cThe telephone-only component was really a lifeline for many of our patients; it became such a huge component.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Telehealth has brought various benefits but also new challenges.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cThere were definitely some growing pains,\u201d Lalime said. \u201cTo get it rolling, it took patient education and system education. Connecticut responded fairly quickly to this, but it was not instantaneous. It took some time.\u201d<\/p>\n\n\n<p class=\"wp-block-paragraph\">The Community Health Center Association is studying the impact of telehealth and how well it worked during the pandemic, he said.<\/p>\n\n\n<p class=\"wp-block-paragraph\"><strong>\u2018The Key To Equity?\u2019 Not So Fast<\/strong><\/p>\n\n\n<p class=\"wp-block-paragraph\">While telehealth likely helped centers recoup the patients they had lost in the pandemic\u2019s early days, early data show it hasn\u2019t improved overall access to care, said Tekisha Dwan Everette, executive director of the advocacy group&nbsp;<a href=\"https:\/\/www.hesct.org\/\" target=\"_blank\" rel=\"noopener\">Health Equity Solutions<\/a>.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cJust because we built it doesn\u2019t mean that folks will come,\u201d she said, noting many FQHC patients lack access to the broadband internet needed for video visits. \u201cWhat most data are showing across the country is that [telehealth] made access more readily available for people who already had access.\u201d<\/p>\n\n\n<p class=\"wp-block-paragraph\">She\u2019s encouraged by proposals to expand broadband access in the state, she said, but other questions remain. As centers consider telehealth\u2019s role, they need to examine whether they are using it to be truly equitable. They need to assess whether it\u2019s accessible to patients across various races and age demographics, for instance, and whether primary care is fully embracing it, she said.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cEverybody thinks this is the key to equity\u2014which it can be\u2014but when they start to look at their data, they realize it isn\u2019t,\u201d she said. \u201cI think we can do it right; I don\u2019t necessarily think we did it right.\u201d<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><em><strong>\u201cFrom a health care perspective, not being able to see your doctor was a real problem. Having [insurers, including Medicaid] pay for telehealth was huge. If there\u2019s any good thing that came out of the pandemic, this is one of them.\u201d<\/strong><\/em><\/p><cite><strong>Jill Zorn, senior policy officer at the Universal Health Care Foundation of Connecticut<\/strong><\/cite><\/blockquote>\n\n\n<p class=\"wp-block-paragraph\">FQHCs will be able to use telehealth for at least the next two years, but leaders hope it is here to stay.<\/p>\n\n\n<p class=\"wp-block-paragraph\">\u201cThere are some things, we all know, that simply can\u2019t be done over telemedicine,\u201d Melbourne said. \u201cBut I see it as a critical tool. I hope it does not go away.\u201d<\/p>\n\n\n<p class=\"wp-block-paragraph\">Borduas said, \u201cThere will always be a place for telemedicine. We\u2019re going to prepare to do this forever. That technology will be embedded in everything we do going forward.\u201d<\/p>\n\n\n<p class=\"wp-block-paragraph\">Telehealth will never fully replace in-person care, Lalime said, but \u201cit\u2019s part of the toolkit. Over the next couple of\u00a0years, I think it\u2019s going to evolve. It\u2019s a very exciting time.\u201d<\/p>\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n<p class=\"wp-block-paragraph\">Cover Photo: Darcy Cusano, an advanced practice registered nurse at the Community Health &amp; Wellness Center in Torrington, meets with a telehealth patient. <\/p>\n\n\n<p class=\"wp-block-paragraph\"><em>Publisher\u2019s Note:\u00a0<a href=\"http:\/\/ctln.local\/\" target=\"_blank\" rel=\"noopener\">CTLN<\/a>\u00a0and\u00a0<a rel=\"noreferrer noopener\" href=\"http:\/\/c-hit.org\/\" target=\"_blank\">c-hit.org<\/a>\u00a0collaborate to best serve the Connecticut Hispanic, Latino community.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When the pandemic began, LaVita King of Bridgeport worried about how she would continue to see her behavioral health therapist [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","ghostkit_customizer_options":"","ghostkit_custom_css":"","ghostkit_custom_js_head":"","ghostkit_custom_js_foot":"","ghostkit_typography":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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