Health Care Service Innovations Propelled by the Pandemic Offer Permanent Promise, Journal Papers Show

While posing potential and realized disruptions to a range of health services, the COVID-19 pandemic also drove the accelerated development of promising and responsive health service delivery innovations, two papers published this month in Clinical Infectious Diseases show.

The policy papers, Advancing Digital Health Equity and Innovations in HIV Care Delivery During the COVID-19 Pandemic: Policies to Strengthen the Ending the Epidemic Initiative, describe how measures to limit the spread of the novel coronavirus accelerated the realization of long-needed improvements in health care access and recommend their continued support and expansion.

Advancing Digital Health Equity describes the rapid rollout and uptake of innovations that saw the percentage of Medicare-paid visits that were conducted electronically rise from 0.1% — about 2,000 visits a week — in February to 43% of Medicare-paid visits — 1.3 million visits per week — in April. The paper also highlights the need to address the digital divide for populations already at greater risk for health disparities, including older, Black and Hispanic individuals, individuals with lower incomes and individuals with less education.

Innovations in HIV Care Delivery During the COVID-19 Pandemic documents policy changes necessitated by the pandemic, including expanded telehealth, that were critical to facilitating access to HIV care and prevention. Other policies, such as home delivery of prescription drugs and streamlined access to Ryan White Program services, prevented disruptions in PrEP and in HIV treatment.

Permanent policy changes and continued support for innovations that include the expanded use of telemedicine, reduced barriers to prescription medicines and fewer administrative hurdles to accessing Ryan White Program services will be critical to drive the health system transformation needed to end HIV as an epidemic in the U.S. In building on these innovations, steps must be taken to address the digital divide, including equitable and ongoing reimbursement models for telehealth visits and measures to ensure innovations are accessible. In addition, to address continuing shortages of infectious diseases and HIV providers in some areas, policies are needed to allow physicians and advanced practice providers to offer telehealth services across state lines.

 

Brian R. Wood, M.D., of the University of Washington is the corresponding author of Advancing Digital Health Equity. Wendy S. Armstrong, M.D., of Emory University School of Medicine is the corresponding author of Innovations in HIV Care Delivery During the COVID-19 Pandemic: Policies to Strengthen the Ending the Epidemic Initiative.