• 32,059%: Increase in telehealth behavioral health visits between March and July 2020, compared to March – July 2019

• 12,681%: Increase in telehealth medical visits between March and July 2020, compared to March – July 2019

As Idahoans, we share a sense of pride that we live in such a beautiful state with rich and varied recreational, professional, and cultural opportunities. However, being a large mostly rural state not only brings many great benefits, it also brings a few challenges.

One challenge we face is access to affordable, quality healthcare. Idaho’s rapid population growth in urban areas, a shortage of healthcare professionals, and the difficulty of access to frontier areas create widespread barriers to healthcare access. To address these challenges, the Department of Health and Welfare (DHW) and our partners formed a Telehealth Task Force. The Task Force successfully developed recommendations to advance telehealth in Idaho, to ensure that Idahoans have convenient access to quality care, no matter where they live. These findings and recommendations are part of an effort to develop a more coordinated, broad approach to telehealth adoption.

The evolution of telehealth in Idaho

Telehealth is the use of electronic information and technology to provide healthcare when the patient and provider are not in the same place. The increased availability of telehealth is an important evolution in healthcare access today. For many healthcare appointments, an in-person interaction with a healthcare provider is not clinically necessary, and telehealth can meet the patient’s healthcare needs. Telehealth is consistently shown to be a cost-effective, safe, secure, and convenient option for patients and providers. Using telehealth services, patients can receive care, consult with a provider, receive information about a condition or treatment options, arrange for prescriptions, and receive a diagnosis.

Idaho’s unique challenges make telehealth an ideal solution to ensure Idahoans have access to affordable, quality healthcare. However, financial, legal, and organizational barriers have historically slowed the adoption and use of telehealth in Idaho.

COVID-19 has had a devastating impact on the health and lives of Idahoans, and it has forced many areas of healthcare to adapt. One of the significant developments has been the elimination of state and federal restrictions. This new flexibility has enabled providers to safely connect with patients they otherwise would not have seen. Overall, there has been a 17,075% increase in telehealth visits between March and July 2020, compared to the same period in 2019.

Advancing telehealth in Idaho: Telehealth Task Force recommendations

In July 2019, the Healthcare Transformation Council of Idaho (HTCI), endorsed by the Health Quality Planning Commission, established the Telehealth Task Force, which included DHW Medicaid staff. In October of 2020, the Telehealth Task Force, planned and facilitated by the DHW Division of Public Health, completed work to develop recommendations on strategies to increase telehealth adoption and utilization in Idaho. The Task Force developed several key recommendations, which were approved by the HTCI, including:

• Support consumer understanding and trust of telehealth service options and adopt the term “virtual care” to include a broader array of technology-enabled services. One challenge that comes hand-in-hand with innovation is that stakeholders develop their own language to describe new ways of doing things. This can lead to confusion between different parties if they are talking about the same thing but using different words. Common language can unify the understanding of different kinds of telehealth services and promote shared understanding. For example, the task force recommends using the term “virtual care” as an umbrella term that includes telemedicine, telehealth, mHealth, eConsults, eVisits, video visits, remote patient monitoring, etc.
  
• Coordinate the evolution of virtual care by establishing a Virtual Care Advisory Board. Virtual care (including telehealth) is a complex and quickly evolving field. Stakeholders and decision makers need to be closely coordinated, which can be accomplished by creating a long-term Virtual Care Advisory Board. The board could provide leadership for the expansion of virtual care, and guide and identify opportunities for its advancement in Idaho.
  
• Ensure all Idahoans have access to reliable internet by supporting the Department of Commerce’s broadband initiative. In rural communities, one of the most significant challenges for Idahoans in accessing telehealth services is a lack of access to reliable, high-speed internet and technology. Support of the broadband initiative would help improve access to broadband in rural and underserved homes and communities.
  
• Help address longstanding payment and reimbursement challenges through collaboration between payers, providers, and key stakeholders. Prior to the public health emergency, the payment model caused significant barriers for healthcare providers to offer telehealth services. More focused efforts on improving reimbursement opportunities through payment policy changes and consistent billing and coding practices would provide incentives to offer and expand telehealth services.
  
• Permanently adopt the temporary waivers that fast-tracked telehealth availability during the COVID-19 public health emergency. Without permanent legislative and regulatory changes, it is possible that when the public health emergency ends, it may once again become more difficult to access telehealth services. The Task Force recommends the review of several waivers for possible permanent adoption. This review should also consider and address any negative impacts to patient privacy and security, to fully address patient safety.

These Telehealth Task Force recommendations are now being considered by various communities, stakeholders, and healthcare providers across Idaho. The widespread use of telehealth during the COVID-19 public health emergency has resulted in a new appreciation for how Idaho can use telehealth in a variety of healthcare settings. The crisis has highlighted gaps for the state to address unlocking the full potential of telehealth in Idaho. Supporting telehealth services helps ensure healthcare access for all Idahoans, providing them with choices regarding their care.

We are honored to work with our partners toward our mission of strengthening the health, safety, and independence of Idahoans. The Telehealth Task Force worked diligently to develop an actionable set of recommendations to advance telehealth in Idaho. Members included St. Luke’s Health System, Boise State University, Regence Blue Shield, Idaho Medical Association, Idaho Office of Broadband, and private sector businesses.

You can learn more about telehealth in Idaho, and read the full telehealth recommendation report, on the Healthcare Transformation Council of Idaho website. You can also follow the DHW’s work toward our mission and read more about our Strategic Plan on our website.

Have a safe and healthy weekend, and remember to: Wear your mask, keep six feet of distance between yourself and others, wash your hands often, cover your coughs and sneezes, and get your vaccine when it’s your turn!