J Am Board Fam Med
-
One of the most vulnerable groups is older persons who seek medical care (patients), especially those who are cognitively impaired with limited access to technology or knowledge of its use. ⋯ Physicians working collaboratively with community agencies for in-home technology-enhanced visits led to positive outcomes for this vulnerable older population.
-
National telehealth policy thus far has focused on broadening access to service, specialties, and originating sites. Yet telehealth policy can further equity by providing system-level change needed to reduce structural determinants that hamper telehealth access in historically marginalized, low income, and limited English-speaking populations. The authors propose policy solutions for states and CMS to help address these structural determinants of telehealth care. A telehealth "ecosystem" grounded in the following core components would ensure equitable access to care: use of technology inclusive of economically marginalized patients, access to the technology and broadband for completing virtual visits, and concrete support for patients as they develop their digital and telehealth skills.
-
Family physicians who are self-identified members of Black, Hispanic, and American Indian/Alaska Native racial groups are more likely to practice in disadvantaged areas but also tend to have narrower scopes of practice when compared with White family physicians, despite holding the same certification. Considering the established benefits of comprehensive primary care, these results suggest the need for policies incentivizing and supporting broader scopes of practice in disadvantaged areas.
-
Given the absence of guidelines for use of virtual visits for primary care delivery, a framework is needed to inform the most appropriate use of virtual visits. ⋯ After further validation, we expect that this framework may guide future research and practice: it may be valuable for clinical practice redesign, for designing evaluations of the outcomes of virtual visits, for outcomes research, for patient education, for triage, and possibly for reimbursement considerations.
-
After years of slow progress, the COVID-19 pandemic forced a rapid adoption of telehealth and telemedicine. The transition was not uniform across demographic groups, reflecting social determinants of health. ⋯ The focus on research on the COVID-19 pandemic is turning increasingly toward the long-term impact of the pandemic. Reports on Medicare wellness visits, drug safety, medical abortion, and the differences in scope and location of practice by race and ethnicity of family physicians can also be found in this issue.