False equivalence?
Dr. Soares said researchers have attempted to assess the evidence of telehealth benefits in such situations as ADHD, cognitive behavioral therapy, and parent training.
“There is a paucity of published studies that specifically look at different conditions and compare in-person to telehealth visits, but these are ongoing in autism diagnostics and other areas by several SDBP members,” he said. “Stay tuned.”
Dr. Keder added that telehealth will never replace in-person visits, but the availability of this new option gives developmental pediatricians flexibility in strategies in treating and evaluating patients.
“Both are helpful and viable models. In the pandemic, we were forced out of necessity to embrace telehealth,” he said. “Because of this, we are seeing the power and benefits telehealth offers. Now many families like a mixture of alternating in person with telehealth visits.”
The policy statement cites research that finds patients are highly satisfied with telehealth and that telehealth may cost less than in-office visits.
The report stresses that equitable access to devices needed for telehealth visits is a concern because there is disproportionate access to required technology, especially in rural and underserved communities. The Federal Communications Commission has provided grants to eligible families to offset the cost, in part, for a laptop, desktop computer, or tablet. However, more is still needed, the group said.
The position paper calls for:
- Equitable access to the infrastructure and technology for telehealth, including greater access to broadband services in rural and underserved areas.
- Increased access to devices needed to connect children with neurodevelopmental disorders with critical health care services.
- Reimbursement of interpretation services for the people who are deaf and/or have limited English proficiency.
- Mitigation of geographic barriers to accessing DBP care.
- Permitting patients to access telehealth from their home or whichever physical location provides opportunities for safe and timely care, especially for established patients.
- Ensuring more engagement by state medical licensing boards to join the Interstate Medical Licensing Compact to provide care by telehealth when there is already an insufficient geographic distribution of that type of provider in a state, as is being conducted in the field of psychology.
- Ensuring ongoing reimbursement.
- Parity in reimbursement for telehealth in-person visits.
- Increased funding for research looking into outcomes, quality, and effectiveness of telehealth services at the federal and state levels.
“Our organization can work with families to educate lawmakers, insurance administrators, and organizational leaders about the value that telehealth holds in the care of their child and family,” Dr. Soares said. “We can also conduct research to add to the evidence based around the topic to further the science around telehealth outcomes and equivalency to in-person settings.”
“With the current workforce shortage in DBP and behavioral health it is more critical than ever to maintain access to care,” Dr. Keder added. “The pandemic has provided an opportunity to better harness the amazing power of telehealth to allow for access to equitable care for families. We hope that this statement moves legislators, leaders, and voters to continue to advocate for ongoing telehealth at both the state, federal, and organizational levels.”
Dr. Benton, Dr. Keder, and Dr. Soares have disclosed no financial conflicts of interest.
A version of this article first appeared on Medscape.com.