Viewpoint: Audio phone visits with medical providers remain crucial connections to delivering equitable healthcare, say Johns Hopkins medicine experts

Newswise – Writing in the November 17 issue of New England Journal of Medicine, two telemedicine experts and a historian at Johns Hopkins Medicine say audio-only phone visits are a critical link to healthcare providers for patients who don’t have access to video visit options. Insurance coverage put in place during the pandemic for certain types of audio-only visits, they say, should continue, and without it healthcare providers risk worsening disparities in the care people experience. often marginalized.

Much like the remote work environments that have become commonplace, telehealth is here to stay, say the trio of researchers.

However, as the potential of telehealth has become more visible during the pandemic, they say, not all patients have equal access to devices and internet access for remote care. Audio-only phone visits for certain types of medical care, not just follow-up calls or reminders, became eligible for Medicare and Medicaid reimbursement early in the pandemic.

In their report, the researchers documented that more than 240,000 out of more than 1.4 million total telemedicine visits to Johns Hopkins Medicine over the past two years were audio-only visits. Of all telemedicine visits at Johns Hopkins Medicine, 16% were conducted via audio only, including 28% mental and behavioral health care visits and 17% oncology visits.

Additionally, the researchers report an increase in audio-only visits among people who identify as black and those whose primary language is Spanish. Nearly 60% of telemedicine visits with adults over 65 in zip codes near predominantly black and urban neighborhoods near Johns Hopkins Hospital were conducted as audio-only visits. According to the researchers, reliance on audio-only tours was also high in some rural Maryland counties.

“Choosing between audio-only and other forms of telehealth shouldn’t be a situation,” says Jeremy Greene, MD, Ph.D., William H. Welch Professor of Medicine and Medical History and Director from the Department of History of Medicine at Johns Hopkins University School of Medicine. “Everyone should benefit equally from the suite of telemedicine options available to healthcare providers.”

Greene authored the report with Helen Hughes, MD, MPH, medical director of Johns Hopkins Medicine’s Office of Telemedicine and assistant professor of pediatrics at Johns Hopkins University School of Medicine, and internist and pediatrician Brian Hasselfeld, MD, who serves also Senior Medical Director of Digital Health and Innovation for Johns Hopkins Medicine.

“It has been exciting to see telemedicine become part of routine care across the country in response to the pandemic, but it is clear that many patients cannot access telemedicine visits via video,” says Hughes. “Until significant progress has been made to make digital tools more accessible to everyone, audio-only visits are an important and simple tool for connecting patients to their providers when clinically appropriate for certain types of care.

Researchers say healthcare providers should continue to build equity and simplify telehealth systems.

“As healthcare practitioners, we should ask ourselves if the modality of care can handle the problem at hand and if we can be trained appropriately to understand the limitations of that modality,” says Greene, also a primary care provider. at Johns Hopkins.

For those who say audio-only visits are ripe for fraud and waste, Greene says the risks apply to all modes of healthcare.

“If insurance funding were removed for audio-only visits, a significant portion of the population would lose the only form of telemedicine available to them,” Greene says.