AMA Adds Digital Literacy to its Telehealth Adoption Gameplan

The American Medical Association is adding equity to its recipe for successful telehealth expansion.

The organization’s House of Delegates approved a new policy during its June Special Meeting that promotes efforts to include digital literacy in connected health programs, with a goal of reducing barriers to care that have traditionally plagued underserved populations.

“It is essential for physicians to serve as leading partners in efforts to improve access to telehealth services in historically marginalized and minoritized communities,” David H. Aizuss, MD, a member of the AMA Board of Trustees, said in a press release. “More of our patients used telehealth during the COVID-19 pandemic, and we should take advantage of this opportunity to ensure all our patients are able to benefit from being able to access and use telehealth services – regardless of their background or geographic location.”

“So many people have been stuck on the sidelines as telehealth has grown during the COVID-19 pandemic,” he added. “We must make sure they are not left behind as telehealth moves forward. We must recognize that broadband internet access is a social determinant of health.”

The action comes alongside several similar efforts to use telehealth to address those barriers to care, ranging from social and cultural differences to broadband access to a lack of resources to access care via telehealth. This includes the Telehealth Equity Coalition, which was unveiled by the American Telemedicine Association and the National Health IT Collaborative for the Underserved (NHIT) at the ATA’s EDGE conference in February.

“We know that telehealth can have an impact, certainly in underserved and rural communities,” NHIT CEO Luis Belen said in February. “But where should we prioritize it?”

The AMA has some ideas on that.

According to the new AMA Equity Plan, the organization will, over the next three years:

• Support efforts to measure and strengthen digital literacy, especially for “historically marginalized and minoritized populations;”
• Encourage healthcare providers and telehealth vendors to design platforms and programs that address barriers to access for these populations, including culture, language, technology accessibility and digital literacy;
• Support efforts to design telemedicine and mHealth tools, including voice-activated technology, to address access issues faced by older adults, people with vision impairment and those with disabilities;
• Encourage providers and payers to invest in initiatives designed to improve access to care for these populations, including improving physician and non-physician provider diversity, offering training and technology support for equity-centered participatory design and launching new and innovative outreach campaigns to inform and educate communities about telehealth.
• Support new physician practice eligibility guidelines for programs that assist in the purchase of telemedicine equipment to help improve broadband access and the use of smart devices by underserved populations;
• Support efforts that prompt payers to allow their contracted physicians to use telehealth;
• Oppose payer strategies that incentivize telehealth through either cost-sharing or the use of physicians in a preferred network;
• Advocate that provider reimbursements be “fair and equitable” no matter whether the services are provided via audio-only telehealth, audio-visual telehealth or in-person; and
• Recognize broadband connectivity as a social determinant of health.

Aside from the policy, the Special Meeting also accepted a report from the AMA’s Council on Medical Service that addresses concerns with telehealth licensure, a long-standing and nagging barrier to telehealth expansion.

The report notes that providers were able to increase their use of telehealth during the COID-19 public health emergency due in large part to federal and state emergency measures, some of which allowed them to treat patients via telehealth in other states. Those measures are temporary, however, and the organization is worried that care will be affected if nothing is done to support telehealth across state lines when the PHE ends.

To that end, delegates at the Special Meeting voted to:

• Continue supporting state efforts to expand physician-licensure recognition across state lines, as outlined in the AMA’s policy on telemedicine coverage and payment;
• Modify its existing policy on telehealth licensure to exempt physician-to-physician consults; and
• Modify that policy to allow physicians who are caring for a patient in another state through an established relationship and in-person visits to continue providing that care via telehealth as long as it’s part of the ongoing or modified care plan.