The pandemic has turned many aspects of life upside down, but it has also pushed us to adapt and embrace new ideas. In healthcare, the expanded use of telehealth has changed the game.
State and federal lawmakers eased telehealth restrictions relatively early in the pandemic to facilitate critical health interactions without exposing more people to the virus. In New Hampshire, Governor Sununu passed Emergency Order 8, allowing individuals with opioid use disorder (OUD) to enter medication-assisted treatment (MAT) through telehealth. It removed the attendance requirement for MAT, which was a major barrier for many people seeking care, and greatly increased access to life-saving treatment. For example, my company saw more members than ever before—up to 96 percent—attend their initial medical evaluation, with most starting opioid use disorder medication within hours of arrival.
Last June, however, the order expired, reinstating the in-person appointment requirement and eliminating telehealth as an option for people with OUD to establish care. As a result, wait times for appointments have increased, engagement in care has decreased, and the number of overdoses has returned to pre-Covid-19 levels.
The impact of telehealth: how virtual services expand access in communities
The impact of telehealth is simple: it allows more people to access care exactly when they want it. And this is especially vital for addiction treatment, especially MAT.
Often, when people seek treatment for a substance use disorder (SUD), the window of opportunity is very short. In fact, it’s so short that we lose 25 out of every 100 people who come to us for help when their care is delayed by requiring them to attend an in-person visit versus starting treatment the same day via telehealth. Many of those seeking care do not have the necessary resources to attend an in-person visit, such as child care, transportation, flexible work schedules…and cannot wait for care. Virtual services remove these barriers and allow people to immediately start MAT with life-saving drugs such as buprenorphine. This reduces the risk of overdose and death while playing a critical role in health equity.
A New Hampshire success story
The move to make telehealth a permanent part of MAT services was and is urgent. In fact, it can be a matter of life or death for some.
Fortunately, New Hampshire passed an amendment last month, HB 503, to permanently expand access to telehealth for MATs in the state. Policy changes like this require strong interaction between providers, community members, and legislators, quantitative and anecdotal data, and listening to the voices of those most affected, but often the least represented.
Senator Tom Sherman, a physician and longtime advocate for telehealth, has been instrumental in moving this change forward by collaborating with SUD providers to bring this critical issue to light and create a compelling case for expanding telehealth:
“We’ve seen the powerful impact of telehealth on several other aspects of healthcare, and it was time to expand it to addiction treatment. Beyond what the pandemic has shown us, we stand behind the mountains of data proving that MAT is one of the safest and most effective approaches to substance use disorder, and we believe that the more people who have access to it because of telehealth, the better.”
State Sen. Jeb Bradley was another key supporter:
“We must continue to support those in our communities who struggle with substance use and mental health issues, and that includes providing them with the resources and support they need.” This amendment is an important step in facilitating access to appropriate and important treatments.
Despite the enormous amount of work being done at the state level, time is still of the essence. The end of the federal emergency order, which supersedes state regulations and could come as soon as October, would reinstate the attendance requirement for MATs, reversing progress in telehealth across the country unless federal regulations are amended.
Changing the game for good
Working together, we have the power to ensure that life-saving treatment can reach everyone who needs it. Telehealth is one of the most basic, basic ways. We must continue to push for broader expansion of telehealth for MAT and call on our federal leaders to do what is right…change the game forever and make telehealth a permanent solution. Lives depend on it.
Photo: sorbetto, Getty Images