Chair Matthews and members,
My name is Matt Dean, and I am a senior policy fellow with the Heartland Institute. The Heartland Institute is a 37-year-old independent, nonpartisan, nonprofit organization whose mission is to discover, develop and promote free-market solutions to social and economic problems. Heartland is6 headquartered in Illinois and focuses on providing national, state and local elected officials with reliable and timely research and analysis on important policy issues.
In 2020, as nonessential medical procedures were postponed in hopes of slowing the spread of the coronavirus, telehealth (which is also sometimes referred to as telemedicine) was forced to immediately scale up to provide connections between patients and providers who were separated by lockdown orders.
After nonemergency visits resumed, many patients justifiably feared coming to hospitals and clinics as the virus raged across America. Protecting frontline emergency workers became the highest priority of policymakers who were given models showing a pandemic rivaling or eclipsing the worst pandemics in US history. Telehealth visits became the alternative to bringing millions of sick and healthy people together. Now, state laws are being considered to replace temporary emergency use of expanded telehealth with state-specific laws tailoring their future use. Rural Americans stand to gain the most access.
TELEHEALTH BEFORE AND AFTER COVID-19
Telehealth is the use telephones, tablets and computers to remotely connect medical providers with each other or to patients. Telehealth is most commonly defined as video and audio telecommunication, but some legislation expands that to telephonic communications as well. Telehealth began in surgical suites and emergency rooms to bring the expertise of specialty physicians to complex surgeries and procedures. Over time, telehealth was expanded to replace some face-to-face primary care visits for the convenience of the patient. Patients in remote areas, or those who lacked the ability to travel could see their doctor or mid-level provider from their home.
Through 2019, telehealth grew slowly beyond early adopters. Then came COVID-19, and telehealth was given a trial by fire. In just a few short months, telehealth services skyrocketed from just 2.8% of all healthcare services, to over 70% of services in the first 90 days of 2020. Federal and state emergency executive orders immediately sidelined restrictions on telehealth. Telehealth utilization has expanded from 11 percent of US consumers using telehealth in 2019 to 46 percent of consumers now using telehealth to replace cancelled healthcare visits.
Turf wars between providers, that for over a decade to restrict the growth of telemedicine, were declared over. Suddenly, providers were forced to make it work. The success of telehealth has been recognized as one of the positive outcomes of the tragedy of the pandemic. Patients enjoyed the convenience of being able to see their doctor from home. Physicians could prioritize face-to-face visits for only those visits that could not be done remotely. It was clearly more convenient for both in many instances.
Heartland supports the efforts to make permanent the emergency telehealth measures put in place during the early days of the pandemic. Telehealth was designed to expand access, and the numbers certainly speak for themselves. According to a recent survey from the Covid19 Healthcare Coalition, 80% of patients express satisfaction with their experience, and more than 70% anticipate utilizing telehealth after the pandemic.
After peaking in April 2020, patients are returning to in-person visits, but also about 25% are choosing to replace in-person visits with telehealth. Current utilization of telehealth services has stabilized at nearly 40 times the pre-pandemic volume.
Telehealth can never replace in person doctor visits. Mental health consults are greatly expanded through telehealth. Importantly, it is sometimes preferable to have a face consultation with a mental health provider, and telehealth can better allow those providers to prioritize office visits for those patients who need to be seen.
Lastly, telehealth can provide fast, direct access and limit unnecessary travel and contact for frail elderly, or other patients with preexisting conditions. Its simply more convenient and less costly for patients. Last year, 3.6 million Americans didn’t go to the doctor because of transportation issues, just think of the ways
The results have shown that telehealth can be a great addition to care for more people and if delivered in the right way, can free up clinic time and resources for those who need to be seen and treated in person.
Thank you.
Nothing in this testimony is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this and other topics, The Heartland Institute’s website provides a great link to many policy resources.
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