CTeL Fall Summit: Q & A with RAND Telehealth Researchers

DTC telehealth is spreading rapidly, but high quality research on important aspects of this innovative healthcare delivery model remains limited. Two researchers at the forefront of attempts to close the gap are Lori Uscher-Pines, PhD, MSc, and J. Scott Ashwood, PhD, from RAND Corporation. They will share their very latest research findings with Summit attendees on November 17 in the session “Research Report: The Impact of DTC Telehealth on Utilization and Spending.”

In this “sneak-peek” Q & A with CTeL, Drs. Uscher-Pines and Ashwood discuss their telehealth research and share their views on both the critical research needs for telehealth and the challenges of conducting such research.

Q
You have been researching telehealth for several years now. Can you tell us a bit about your research?
A
Our group at RAND has conducted several studies on the impact of DTC telehealth on access, quality, and costs. Our most recent study explored whether DTC telehealth visits substitute for more costly sites of care (e.g., EDs and doctors’ offices) or represent new utilization. Our goal was to use medical claims data to assess the cost implications of offering DTC telehealth services.

Q
What research questions or topics are high on your agenda for future work relating to telehealth?
A
Because DTC telehealth is so new and the offerings are evolving, we need more research across the board. We are particularly interested in identifying and addressing the barriers that underserved populations face in using telehealth services.  It is important to ensure that the benefits of telehealth are shared by all and variation in access and demand for services does not exacerbate existing disparities. We also want to assess the potential as well as the limitations of telehealth in overcoming health care workforce shortages.

Q
In your view, is telehealth receiving adequate research attention?
A
No! Important decisions about the reimbursement and regulation of these services are being made in the absence of data. With any innovation in healthcare delivery, it takes some time to grow the evidence base, but we can’t afford to wait years to assess the quality, cost, and access implications of these services that are available to millions of Americans and to guide the implementation of DTC telehealth during an era of delivery reform.

Q
What do you think are the critical research needs for telehealth right now?
A
We need additional research on the cost implications of different types of telehealth with different patient populations. This research is critical if the ultimate goal is to expand reimbursement of telehealth services. We also need to explore how DTC telehealth services and reimbursement can be structured to limit induced demand (e.g., for conditions that would resolve on their own without intervention) while providing value to patients.

Q
Are there any special challenges to conducting research on telehealth?
A
It can be difficult for independent researchers to identify telehealth visits, especially DTC visits, in traditional data sources, like medical claims databases. To do this kind of research, you often need to partner with a telehealth provider or payer.

 

J. Scott Ashwood, PhD, is an Associate Policy Researcher at RAND Corporation. He has extensive experience with empirical studies of health care economics, access to care, quality measurement, and behavior. Some of his recent project work includes developing an evaluation plan for a nationwide mental health demonstration focused on Medicaid populations, estimating the economic impact of statewide mental health interventions in California, estimating the relationship between access to primary care physicians and use of preventive services, and analyzing the impact of health care quality measurement on provider behavior.

Lori Uscher-Pines, PhD, MSc, is a Policy Researcher at RAND Corporation. She specializes in innovations in healthcare delivery and has spent the last several years conducting quantitative and qualitative research on the impact of telehealth on access, quality, and costs. Some of her recent work includes assessing the quality of care in DTC telehealth visits, exploring the role of teledermatology in increasing access to dermatologists in underserved communities, assessing the VA’s capabilities for telehealth, and evaluating the impact of a novel telehealth program that uses physician volunteers to increase access to care in safety net clinics via telehealth.

 

Learn more about the latest research on DTC telehealth. Register now for the Fall 2016 CTeL Telehealth Summit.

 

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