A recent Minnesota Department of Health study into telehealth showed widespread benefits for patients and providers, prompting changes to telehealth in Minnesota.
The Minnesota State Legislature requested this recent telehealth study from the Minnesota Department of Health to research the overall impact of the 2021 Telehealth Act across the state.
Telehealth is a technology service that offers immediate healthcare to patients without going to the doctor’s office. Telehealth is usually offered through video chats like Zoom.
The study found that telehealth expands access to care easier and faster without increasing healthcare costs. Additionally, the study found that most Minnesotans are satisfied with telehealth care and telehealth only fell short when technical issues occurred.
Besides the benefits, the Minnesota Department of Health study recommended ensuring telehealth is more equitable in the future, especially for those lacking digital literacy and access to technology.
The research
The studies looked into the impacts of telehealth on patients and healthcare providers.
Tyler Winkelman, former inaugural president of the Minnesota Electronic Health Record Consortium, said for the telehealth study, the Consortium gathered data from 11 health systems throughout the state to gain a diverse overview of who is using telehealth and why.
“This is a way to generate findings that are useful for policy while sort of keeping all of the health information private with each of the health systems,” Winkelman said.
Paul Drawz, a former president of the Minnesota Electronic Health Record Consortium, said they receive data from healthcare centers by sending codes requesting data, ensuring that patients’ privacy is maintained. Drawz added that the data comes back in counts, such as how many people used telehealth in a specific city.
“We can write one set of code, extend it out to the sites, and they send us back results,” Drawz said. “We never send us information on an individual. We only get results.”
Some of the 11 healthcare systems within the telehealth study include Fairview Health Services and Allina Health.
Winkelman said the Consortium’s data collection and consolidation started during the COVID-19 pandemic and has gained more funding to increase system efficiency since. Instead of taking up to 12 months to collect information, Winkelman said it now takes around a couple of months for the Consortium’s data gathering.
“It’s still a lot of people, power and time,” Winkelman said. “But it’s much faster than when we first started because of some of these infrastructure investments by the state health department.”
Stephanie Devitt, founder of consulting company SDK Communications, said SDK has a few different roles in the project like interviewing patients and providers or helping the Minnesota Department of Health organize the report. Devitt said they interviewed 92 patients for about 30 to 40 minutes each about their experiences with telehealth.
Devitt said SDK aimed to understand how large healthcare systems integrated telehealth post-pandemic versus how community-based providers used telehealth to serve smaller communities impacted by health inequalities.
“Those types of things are what we were trying to understand from providers,” Devitt said. “When do you encourage telehealth? When do you allow it? When do you not encourage it? On the patient side, we just wanted to understand their preferences and the impacts of telehealth and health equity.”
Devitt said SDK found that telehealth helped some patients overcome transportation barriers, stress with going to the doctor in person and avoiding stigma in some communities about being seen at certain clinics.
“We talked to a Federally Qualified Health Center who serves a population where there’s a lot of stigma around mental health and people they knew needed help were refusing,” Devitt said. “So it became available by telehealth and they didn’t have to be seen walking in the clinic.”
Devitt added SDK found telehealth helped some people find care providers that matched their racial identity, which can help create a more comforting environment. Additionally, Devitt said many people taking care of elderly loved ones appreciate telehealth because it allows them to join appointments virtually.
Winkelman said it is important to recognize that healthcare systems like Fairview and others do not typically interact with public health departments to improve patient care on such a large scale.
“This is a good example of healthcare systems and public health collaborating to, ultimately, hopefully lead to better policies for patients,” Winkelman said.
Devitt said SDK worked with a variety of clients throughout this study to understand how the differences in access to digital devices influence people’s ability to connect with resources, including telehealth. Ensuring people have access to digital healthcare goes deeper than broadband, it means having the financial ability to have digital healthcare access.
“We’ve learned a lot through our work about how important telehealth is to helping people get access to care that they otherwise wouldn’t get,” Devitt said.
The impact of telehealth
Associate Director of Mental Health at Boynton Health Cecilia Bloomquist said when she started her career in the psychotherapy field in 2012, telehealth was not widespread until COVID-19.
“The accessibility is incredible,” Bloomquist said. “Because you can expand so many options there. It’s been quite amazing to see this shift.”
Drawz said he noticed an increase in telehealth use from 2015 to 2020, but the COVID-19 pandemic accelerated the trend. Drawz said it was not until then that many healthcare providers saw telehealth as a valid way to provide quick and widespread care.
Bloomquist said Boynton offers telehealth and in-person care for students. Boynton’s primary care team treats a variety of conditions via telehealth alongside mental health therapy and counseling options, group therapy, affinity groups, and psychiatry services, Bloomquist added.
“We actually think about this more case by case,” Bloomquist said. “Providers are making recommendations according to what the person is dealing with and what they have available.”
Drawz said the report shows that telehealth care provides the same quality care as an in-person visit for most individuals. Telehealth can be an accessible option for people who can not physically go to the doctor’s office.
“Some people just can’t get out of their home,” Drawz said. “We do have to pay attention to digital literacy. Not all communities have access to broadband. And so it’s important to keep those things in mind as we advocate for telehealth.”
Bloomquist said she believes telehealth is a highly accessible option for students and providers alike because of its flexibility for busy schedules.
“People really appreciate the opportunity to work in this hybrid model,” Bloomquist said. “It does help providers.”
Devitt said the question for the state legislature is whether telehealth expansion provisions remain and where changes need to be made post-pandemic. Devitt added it is important to be cognizant of how the different types of healthcare insurance — Medicare, Medicaid or commercial insurance — will be also influenced by the federal government’s decisions on telehealth, not just the state’s.
“One of the things that’s going to matter a lot is whether or not telehealth is reimbursable in the metro area after the start of the year at the federal level,” Devitt said. “That’s something in addition going on that just will influence how providers make their choices.”