In today’s blog I will review a Rehabilitation & Community Providers Association (RCPA) member survey regarding telehealth impact since the Covid-19 crisis began. (Click here to see the full report). For anyone who has done a member survey, you know that response rates of 25 – 35 providers is not uncommon … which is to say, low numbers. Well, for this survey, RCPA was able to garner responses from more than 300 individuals, representing 125 member organizations from drug & alcohol, to adult and children’s mental health, to rehabilitation and intellectual disability programs, to residential services … it’s really an impressive review of the Pennsylvania services landscape. (Obviously, some people seem to be spending more time in front of their computers in order to answer surveys lately … ;P) The results are really interesting, and worth reviewing.
Covid has opened the door to telehealth in unprecedented ways. Right off the bat, the survey captures the radical change that behavioral health is currently undergoing: with 69% of providers reporting they did not do any telehealth before the Covid-19 emergency declaration, and now a full 99% reporting doing at least some form of tele-health.
Providers credit telehealth to helping them improve access. A full 78% of providers credit telehealth with improving patient access, and a slightly smaller percentage of providers (53%) report that they have been able to decrease the time from referral to first day of service (a holy grail metric of access in behavioral health) thanks to telehealth.
Most barriers to telehealth are technological and regulatory. According to the RCPA provider survey, the number one barrier to delivering telehealth services (46%) is the client’s access to adequate technology (including a client’s limited internet access and limited phone minutes, etc..) The next biggest barrier is the antiquated and inane requirement for a client to have a wet signature in the chart for every delivered service (17% of respondents cited this as a concern.) Clinical barriers were not experienced as so important by survey respondents with such things as client resistance (12%), impact on session length (7%), and difficulties in measuring client progress (6%) identified as barriers much less often than the technological and regulatory barriers.
Many staff like telehealth. The most common “positive benefit” providers reported about telehealth is improvements in “work/life balance.” Honestly, in our high burnout field, it is rare to see such a uniformly agreed improvement in work/life balance! Further, some providers reported improved productivity through telehealth, presumably because stacking hours in tele-meetings can just be easier than the vagaries of making everyone in a clinic get to their right place on time.
Most providers would like to see tele-health be maintained in one way or another after the covid-19 crisis ends. A full 99% of survey respondents endorsed ‘Yes’ to the statement: “Should telehealth continue to be a viable, reimbursable service once COVID-19 is over?” Such uniformity is rare in our field, but it makes sense in light of the results the rest of the survey shows: providers are having an easier time with their work, access is improved, and everyone’s safety is being maintained through social distancing. The barriers that remain are technological and regulatory – and this is where the advocacy work begins.
Questions remain, including the most important: How are clients doing with the transition? The RCPA survey was limited to providers, so we don’t really have a sense for how clients are feeling about the tele-transition. The survey did ask one question whether providers feel their clients are engaged and having a positive experience with telehealth, to which 53% responded in the positive. This is heartening, but we of course would like to know more: What do clients like about telehealth, and what don’t they like? Are there some populations that tele-health is better for, while some for whom it is worse? Are there some interventions that work well in a tele-manner, and some that work worse?
And when those reports come out, we here at CDR will be reviewing them and sharing them. Since the data is out there, we just need to remember to look at it, and act together based on the facts.