Telehealth Policy, Practice, and Education: a Position Statement of the Society of General Internal Medicine.

{"article_title":"Telehealth Policy, Practice, and Education: a Position Statement of the Society of General Internal Medicine.","author":"\"Chen, Anders , Ayub, Mariam H , Mishuris, Rebecca G , Rodriguez, Jorge A , Gwynn, Kendrick , Lo, Margaret C , Noronha, Craig , Henry, Tracey L , Jones, Danielle , Lee, Wei Wei , Varma, Malvika , Cuevas, Elizabeth , Onumah, Chavon , Gupta, Reena , Goodson, John , Lu, Amy D , Syed, Quratulain , Suen, Leslie W , Heiman, Erica , Salhi, Bisan A , Khoong, Elaine C , Schmidt, Stacie\"","journal_title":"Journal of general internal medicine","issn":"1525-1497 ; Electronic","isbn":"","publication_date":"20230801","volume":"38","issue":"11","first_page":"2613","page_count":"8","accession_number":"37095331","doi":"10.1007\/s11606-023-08190-8","publisher":"Springer","doctype":"Journal Article; Research Support","subjects":"Internal Medicine","interest_area":["Internal\/Family Medicine"],"abstract":"Telehealth services, specifically telemedicine audio-video and audio-only patient encounters, expanded dramatically during the COVID-19 pandemic through temporary waivers and flexibilities tied to the public health emergency. Early studies demonstrate significant potential to advance the quintuple aim (patient experience, health outcomes, cost, clinician well-being, and equity). Supported well, telemedicine can particularly improve patient satisfaction, health outcomes, and equity. Implemented poorly, telemedicine can facilitate unsafe care, worsen disparities, and waste resources. Without further action from lawmakers and agencies, payment will end for many telemedicine services currently used by millions of Americans at the end of 2024. Policymakers, health systems, clinicians, and educators must decide how to support, implement, and sustain telemedicine, and long-term studies and clinical practice guidelines are emerging to provide direction. In this position statement, we use clinical vignettes to review relevant literature and highlight where key actions are needed. These include areas where telemedicine must be expanded (e.g., to support chronic disease management) and where guidelines are needed (e.g., to prevent inequitable offering of telemedicine services and prevent unsafe or low-value care). We provide policy, clinical practice, and education recommendations for telemedicine on behalf of the Society of General Internal Medicine. Policy recommendations include ending geographic and site restrictions, expanding the definition of telemedicine to include audio-only services, establishing appropriate telemedicine service codes, and expanding broadband access to all Americans. Clinical practice recommendations include ensuring appropriate telemedicine use (for limited acute care situations or in conjunction with in-person services to extend longitudinal care relationships), that the choice of modality be done through patient-clinician shared decision-making, and that health systems design telemedicine services through community partnerships to ensure equitable implementation. Education recommendations include developing telemedicine-specific educational strategies for trainees that align with accreditation body competencies and providing educators with protected time and faculty development resources.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=37095331&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Chen A, Ayub MH, Mishuris RG, Rodriguez JA, Gwynn K, Lo MC, Noronha C, Henry TL, Jones D, Lee WW, Varma M, Cuevas E, Onumah C, Gupta R, Goodson J, Lu AD, Syed Q, Suen LW, Heiman E, Salhi BA, Khoong EC, Schmidt S","Journal_Info":"Publisher: Springer Country of Publication: United States NLM ID: 8605834 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1497 (Electronic) Linking ISSN: 08848734 NLM ISO Abbreviation: J Gen Intern Med Subsets: MEDLINE","Publication_Type":"Journal Article; Research Support, N.I.H., Extramural; Consensus Statement","Published_Date":"2023-08-01","Source":"Journal of general internal medicine [J Gen Intern Med] 2023 Aug; Vol. 38 (11), pp. 2613-2620. Date of Electronic Publication: 2023 Apr 24.","Languages":"English","Electronic_ISSN":"1525-1497","MeSH_Terms":"COVID-19* , Telemedicine*, Humans ; United States ; Pandemics ; Internal Medicine ; Policy","Subjects":"Humans, United States, Pandemics, Internal Medicine, Policy, COVID-19, Telemedicine","Title_Abbreviations":"Journal of general internal medicine","Volume":"38"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"37095331","RelevancyScore":"890","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"889.762634277344"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=37095331&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=37095331&authtype=shib&custid=ns346513&group=main&profile=eds"}