onecarevt.org

OneCare Vermont Telehealth Survey

March 2020

onecarevt.org 2

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

onecarevt.org 3

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

onecarevt.org 4

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%

onecarevt.org 5

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

onecarevt.org 6

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

onecarevt.org 7

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

onecarevt.org 8

What types of telehealth services have you provided (or your patients received) in the past 60 days? (check all that apply)

onecarevt.org 9

If you selected audio/visual above, which platforms have you utilized? (select all that apply)

onecarevt.org 10

What barriers to telemedicine have you noted from the provider of care perspective? (check all that apply)

onecarevt.org 11

What barriers to telemedicine do you perceive from the patient perspective? (check all that apply)

onecarevt.org 12

Have you designated a specific point person in your office to educate and support patients in telemedicine?

onecarevt.org 13

Do you have a process for obtaining feedback from patients about their satisfaction/experience using telehealth services?

onecarevt.org 14

What types of facilitators of telemedicine interactions have you utilized? (check all that apply)

onecarevt.org 15

Rate your future willingness to use the types of facilitators in question 7? (1-5 low to high willingness)

onecarevt.org 16

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?

onecarevt.org 17

How interested would you be in participating in such a program if funding for such equipment was identified? (1-5 low to high interest)

onecarevt.org 18

Are there other internet access opportunities in your community for those without broadband access in their home?

onecarevt.org 19

Would an education session on telehealth be helpful to you?

onecarevt.org 20

What time of day is your preference for a one hour education session?

onecarevt.org 21

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?

onecarevt.org 22

What telehealth services do you plan to provide after the COVID-19 public health emergency? (select all that apply)

onecarevt.org 23

Which of the following do you identify as your Health Service Area?

onecarevt.org 24

Please identify your clinical role.