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Telehealth is essential for N.H. health equity

By Jay Couture and Tess Stack Kuenning - Guest Columnists | Jun 20, 2020

Over recent months, the COVID-19 pandemic has exposed the need to improve access to telehealth services across New Hampshire. During this challenging period, and at all times, individuals and families face significant hurdles to accessing in-person health care, including physical, geographic, and economic challenges. As we’ve seen throughout this crisis, telehealth, in which a patient has access to a health care provider via telephone or videoconferencing, goes far to eliminate many of these barriers and increase access to needed health care services for thousands of Granite Staters.

We write today on behalf of the NH Healthcare Consumers & Providers COVID-19 Coalition, a collaborative group that consists of more than 50 health care and social service organizations, advocacy and consumer groups, who recognize telehealth as a powerful tool for health equity. Together, we call on state policymakers to permanently expand access to telehealth, continue to help us overcome COVID-19, and support the health and wellness of our state into the future.

This week, the New Hampshire State Senate addressed this critical issue when they voted overwhelmingly in bipartisan support of House Bill 1623, which proposes to make permanent the supports for telehealth that were enacted temporarily by an Executive Order issued by Governor Sununu. This bill, which now moves back to the House of Representatives for approval, will ensure Granite Staters have continued access to medical, behavioral health and other needed care through phone and videoconferencing, beyond this pandemic.

Under COVID-19, health care and behavioral health providers had to switch the delivery of services from a traditional in-person model to telehealth in a matter of weeks, with the goal of ensuring no gaps in care and enhancing existing services. It is safe to say that this has been both transformational and successful, for patients and providers alike.

Throughout this crisis, telehealth has helped keep patients and staff safe and has allowed health care providers to reserve their personal protective equipment (PPE) for testing patients and staff at-risk for the virus. Telehealth services have offered similar benefits for dental providers, who are at high risk because of exposure to aerosols and droplets and who must thoroughly disinfect the operatory between patients.

With New Hampshire still in the midst of ongoing mental health and addiction crises, telehealth has also resulted in expansion of critical behavioral health services. For many experiencing mental illness or Substance Use Disorder (SUD), it has helped to alleviate obstacles to receiving care, including trauma and anxiety that can be triggered when entering a medical office. Many organizations, for the first time, are seeing a 0% no-show rate for behavioral health services. Patients who come in every week or month, like cancer patients or those receiving Medication-Assisted Treatment for SUD, have shared that telehealth means they do not miss as much time for work. Providers note it is critical for caring for older patients and others in need who do not have access to reliable transportation.

In these ways, telehealth goes far to support health equity, which is a guiding priority and a core value of our COVID-19 Coalition. We believe all Granite Staters must have access to the highest level of care, no matter where they live or the level of their income. With its potential to overcome workforce and access barriers, telehealth, and HB 1623 specifically, can reduce health disparities for aging and underserved populations, as well as reduce patients’ costs and burdens associated with lost work time, transportation and childcare. Telehealth gives patients living in rural areas access to more providers and allows them to receive care in their own communities, instead of traveling long distances. For example, patients can engage in live video visits with providers for both acute and chronic issues.

In addition, the convenience of telehealth may also drive many patients to seek care they might have avoided if relying only on in-person appointments. This increased utility of health services is in the best interest of patients and aligns with the preventive model of primary care that strives to keep people healthy.   

Simply put, telemedicine is the future of health care here in New Hampshire and across the world. The current COVID-19 pandemic has created the urgency, the rationale, and the framework for improving and expanding telehealth in our state, and the time to act is now. We strongly urge the House of Representatives to vote affirmatively for HB 1623. The health of Granite Staters depends on telehealth.

Jay Couture, President and CEO of Seacoast Mental Health Center in Portsmouth, is president of the NH Community Behavioral Health Association, which is comprised of New Hampshire’s ten community mental health centers. Tess Stack Kuenning is president and CEO of the Bi-State Primary Care Association, which represents 14 New Hampshire community health centers.

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