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onecarevt.org
OneCare Vermont Telehealth Survey
March 2020
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Responses received from all Vermont Health Service Areaso 55% of responses from
Burlington Health Service Area (HSA)
o At least 5% of responses were from each of the other HSAs
No significant variations throughout the network
OneCare Telehealth Survey
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92% of respondents utilized audio/video services in the past 60 days
80.9% of respondents utilized audio only (telephone) services
Many audio/video platforms: Zoom = 73.6% FaceTime = 27.7% Doximity = 22.8%
Experience with facilitators for telehealth visits: Patient’s family members/friends/neighbors 73% Skilled Nursing Facility staff 24.2% Community Health Worker 16.7% Congregate Housing Staff 11.3%
Would practice benefit from telehealth connectivity equipment packages? Yes 54.5% No 11.4% Undecided 33.5%
Should telephone-only services continue to be reimbursed post COVID-19? Yes 82.8% No 7.1 % Undecided 10.5%
Telehealth Survey Highlights
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Barriers for Providers Lack of staff time/ability to coach patients 55.7% Reimbursement concerns 51.3% No video platform 39.8% Workflow design 39.7% Billing/Coding issues 39.2% Training of office staff 30.4%
Telehealth Survey Highlights: Barriers
Barriers for Patients Lack of technical understanding/support/comfort 86% No broadband service 75.5% Financial barriers (smart phone, computer, tablet) 59.6% No cell service 59.4% Perception that telehealth is not as high quality 36.5% No interest 27.9% Privacy concerns 18% Lack of deaf/hearing impaired services access 15.5% Lack of interpreters for non-English speakers 11.1%
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Telehealth Survey Themes
Majority of all providers support continuation of reimbursement for telephone-only visits for those unable to engage in video visits
Important option for those lacking transportation or living hours away from medical services
Some patients prefer telemedicine services to in-person visits; others declined these visits
Providers noted reduction in cancellation and no-show rates and promising us of this option during winter storms
Providers identified many intended post-COVID-19 telehealth uses
Covid-19 has dramatically advanced the use of telehealth services
Providers and patients found Telehealth essential during COVID-19 pandemic
There are significant barriers to utilization
Reimbursement and coding -additional burden on clinical offices
Work particularly well for Behavioral Health visits
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Post COVID-19 Telehealth Services Identified
Chronic condition management (68.5%)
Medication management (67.6%)
Non-urgent acute (sick) visits (44.4%)
Behavioral health (43.5%) Screening services, (Depression
screening 38%) Adult Well Visits (26.7%) Adolescent care (10.5%) Medicare Annual Wellness Visits
(24.1%) Well child visits (8.6%)
Consultation with Specialists Wound Care Endocrine follow up visits Assessing need for ED or clinic
visit Post-op visits Obstetric visits
gestational diabetes preconception counseling contraceptive counseling
Stable MAT patients Care of Vermonters who are
out of state Smoking cessation counseling
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OneCare Vermont Support of Telemedicine
Support of expanded statewide broadband/cell connection policy initiatives – Dept. of Public Service
Cooperation with VPQHC Statewide Telehealth Workgroupo Grant funding applications – video and peripheral
device equipment and broadband service expense
o Explore payer funded initiatives
o Data literacy education efforts
Input to Department of Financial Regulation policy on post-pandemic telemedicine benefits & reimbursement
Explore models for use of facilitators of telemedicine interaction
Explore methods for clinical and social determinant prioritization of patient engagement
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What types of telehealth services have you provided (or your patients received) in the past 60 days? (check all that apply)
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If you selected audio/visual above, which platforms have you utilized? (select all that apply)
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What barriers to telemedicine have you noted from the provider of care perspective? (check all that apply)
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What barriers to telemedicine do you perceive from the patient perspective? (check all that apply)
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Have you designated a specific point person in your office to educate and support patients in telemedicine?
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Do you have a process for obtaining feedback from patients about their satisfaction/experience using telehealth services?
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What types of facilitators of telemedicine interactions have you utilized? (check all that apply)
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Rate your future willingness to use the types of facilitators in question 7? (1-5 low to high willingness)
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Would your practice benefit from having telehealth connectivity equipment packages (cell/broadband-enabled smartphone with camera or computer tablet with camera) that could be loaned to your patients for upcoming telemedicine visits?
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How interested would you be in participating in such a program if funding for such equipment was identified? (1-5 low to high interest)
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Are there other internet access opportunities in your community for those without broadband access in their home?
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Would an education session on telehealth be helpful to you?
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What time of day is your preference for a one hour education session?
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In your opinion, should telephone only services continue to be reimbursed at parity or near parity with video and in-person visits after the COVID-19 public health emergency?
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What telehealth services do you plan to provide after the COVID-19 public health emergency? (select all that apply)
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Which of the following do you identify as your Health Service Area?
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Please identify your clinical role.