Telehealth at forefront of broadband discussions

The rise of telehealth during the pandemic has meant fewer patients miss their therapy sessions. (Dreamstime/TNS)

While the state continues to plan how best to tackle increasing broadband access, some health care providers and partners are engaging in steps to facilitate telehealth for Missouri's unserved and underserved populations.

The state Special Interim Committee on Broadband Development met Monday afternoon to hear from various stakeholders, including MU Telehealth, Health Forward Foundation and BJC Healthcare, about their current broadband efforts and potential telehealth opportunities as the state looks to expand access.

With federal, state and local governments, as well as private industries, looking to fund broadband development around the state, health care providers and partners are working to understand how telemedicine can fit into the equation.

Michele Thomas, chief medical information officer for BJC Medical Group, said BJC began a pilot program for video visits with two providers in early 2020, but within weeks the pandemic forced all 600 providers into video visits.

"That experience really led us to understand that telehealth is now really a vital part of the physician's toolkit in engaging patients and giving them the care that they need," Thomas said.

Telehealth has provided new opportunities for home-bound patients, college students away from home and busy parents, she said.

By increasing access to primary care providers and specialists, Thomas said telehealth helps ensure patients receive care when they need it.

A witness from SSM Health also said increased access to telehealth could mean increased access to specialized care as patients could see doctors not located in their area.

Rachel Mutrux, senior program director of telehealth at University of Missouri Extension, said the Missouri telehealth network has worked to improve rural access to quality healthcare for more than 20 years and broadband has remained a barrier.

Mutrux said the pandemic changed the concept of telehealth as it removed the previously common practice of video conferencing from clinics.

"We know now that providing telehealth right into the patient's home works and works very well," Mutrux said.

During the pandemic, Mutrux said the Missouri telehealth network created the Hotspots for Health program to provide around 10,000 internet hotspots to patients, clients and health care providers to conduct video visits.

She said the main benefits were an increase to health care access for patients and easier access to medical records and service expansion for medical providers.

Additionally, SSM Health has plans to develop more telemedicine sites throughout the state.

McClain Bryant Macklin, director of policy and strategic initiatives with the Health Forward Foundation, said a public and private partnership could be an avenue for addressing broadband development needs.

The Health Forward Foundation provided a $50,000 grant to MU Extension and KC Digital Drive to support digital and telehealth equity.

"Our dollars are going toward a curriculum for community health workers to ensure they themselves are not in the divide and to teach them digital literacy skills," Macklin said.

The curriculum ranges from uploading a patient's medical records to connecting a blood pressure cuff to a smartphone via Bluetooth.

Macklin said the program is also designed to move beyond basic care navigation and into the world of health promotion.

Thomas recommended the Legislature take steps to ensure all Missourians have access to telehealth services - like codifying the public health emergency waivers, investing in broadband infrastructure and joining the Interstate Medical Licensure Compact.

The compact is an agreement with 30 other participating states that allows for a more streamlined license pathway for out-of-state physicians who have patients in Missouri.

Thomas said this compact could also increase the number of physicians available during an emergency.

She also recommended the state adopt audio-only consults for patients with existing relationships with providers.

"I don't expect phone visits to become the norm, I don't expect them to become our go-to type of visit, but they can be very helpful in certain situations," Thomas said.

She pointed to behavioral health as an area that might benefit from audio-only consults as some patients forgo treatment because they are uncomfortable with video visits and leaving their home.

"I think these items that I'm discussing are the basic preliminary steps that will move our Missouri health care system toward evidence-based, efficient and equitable telehealth services," Thomas said.