Telehealth Policy: Timeliness vs. Geography

In a recent Health Affairs blog, researchers from Thomas Jefferson University and Princeton University argued that Medicare’s telehealth policies need to focus on timely access, not geography.

The biggest misperception in telehealth is that its only purpose is to connect residents of Elk Mountain, Wyoming with specialists in Boston or Chicago. “Geography fails to accurately capture the relationship between supply (providers) and demand (patients),” the researchers concluded.

“While rural America has access problems because there aren’t enough doctors, urban America has access problems because there aren’t enough [timely] appointments.”

For those without access to telehealth, the problem is two-fold: long wait times to even get an appointment, plus long commute times for both rural and urban patients. Some studies have shown that rural Medicaid patients have an easier time getting timely appointments than their urban counterparts.

The researchers emphasized that there’s no difference between making a long trek through the Rockies to see a doctor or taking slow public transit in a big city. The key issue is lack of timely access to a physician – a problem that telehealth solves for both rural and urban patients.

mHealth Intelligence recently reported that University of Florida Health in Jacksonville has received a $2.2 million grant to adapt a rural telehealth platform to treat HIV patients in the sprawling Jacksonville metro area, where public transit is sometimes slow and unreliable.

“We propose that appointment timeliness be used to frame the discussion around healthcare, as this approach better captures the relationship between the supply of health providers and demand for their services – independent of geography,” said the researchers.

Since Health Affairs is heavily read by healthcare policy gurus, the debate about timeliness versus zip code will no doubt take on new urgency. That will help shatter the stereotype of telehealth being solely a solution for rural patients.