J Health Care Poor Underserved. 2020;31(4):1546-1556. doi: 10.1353/hpu.2020.0116.
Telehealth allows information-sharing and clinical care at a distance via telecommunication and information technologies. While telehealth promises to increase access for underserved populations (particularly those in rural areas), roadblocks are slowing widespread availability. These roadblocks have created disparities that are most acute in rural areas, and for racial minorities, the elderly, and those with low levels of educational attainment. The success of telehealth relies on having reliable, high-quality broadband access, facilitating interstate licensing for providers and parity in reimbursement for telehealth. However, due to various structural barriers, telehealth is not being adopted as quickly in rural areas, where it is most needed. We describe broadband access by state, state adoption of the Interstate Medical Licensure Compacts (IMLCs), which facilitates the practice of telehealth across states, and state adoption of telehealth parity laws. We discuss each of these in turn and provide policy recommendations.
远程医疗通过电信和信息技术实现远程信息共享和临床护理。虽然远程医疗有望增加服务不足人群(特别是农村地区人群)的可及性,但障碍却在减缓其广泛普及。这些障碍造成了在农村地区以及在少数民族、老年人和受教育程度较低的人群中最为严重的差异。远程医疗的成功依赖于可靠、高质量的宽带接入,为提供商提供州际许可,并实现远程医疗报销的均等化。然而,由于各种结构性障碍,远程医疗在最需要的农村地区并没有被迅速采用。我们按州描述宽带接入情况、各州对州际医疗许可契约(IMLCs)的采用情况,这些契约有助于在各州之间开展远程医疗实践,以及各州对远程医疗均等化法律的采用情况。我们依次讨论了每一个方面,并提出了政策建议。