Facilitated Telemedicine’s Potential for Vulnerable Patient Populations, with Andrew Talal, MD

Although the rise of telemedicine has greatly increased access to quality health care for many, certain barriers persist among individuals in underserved populations.

Increasing telemedicine entry points is essential for providing equitable care to these patients, many of whom have limited access to or low trust in the technology necessary to participate in virtual health care. Facilitated telemedicine offers a potential approach to address these concerns by linking patients to an in-person health care staff member who helps them connect with an off-site clinician, affording them the same care as a standard telemedicine appointment by providing them with the additional tools and resources required for this modality.

Andrew Talal, MD, professor in the department of medicine at Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, and a team of investigators explored the use of facilitated telemedicine integrated into opioid treatment programs for increasing access to hepatitis C virus (HCV) treatment, with results showing faster initiation of direct-acting antiviral (DAA) therapy and greater cure rates versus referral to an off-site hepatitis specialist.

In an interview with HCPLive, Talal explained how the concept for this model came to fruition, noting the high prevalence of HCV among individuals enrolled in opioid treatment programs. Additionally, he pointed out that in New York, frequent in-person appointments were required for these individuals to receive methadone at the time of the study, an opportunity he recognized for integrating HCV treatment in the form of facilitated telemedicine.

However, Talal emphasized its benefit spans beyond HCV: “I think it's important to realize that facilitated telemedicine could be used for other conditions for underserved or vulnerable populations where they may not be able to operate the equipment, they may have linguistic difficulty understanding… where you need somebody who can serve either as a facilitator for the interaction or as a person to answer questions to be identified as the point person.”

He attributed some of the success of his study to the “empathy and trust conveyed through this medium,” describing initial skepticism as to whether or not people in the opioid treatment programs would trust an outside provider. However, he said it was not an issue and in fact, they rated their satisfaction with telehealth equally as high as they did for in-person evaluation.

In another interview segment, Talal described plans to conduct future research in other states outside of New York and highlighted other opportunities to leverage facilitated telemedicine through opioid treatment programs.

Reference

^{Brooks, A. Facilitated Telemedicine Through Opioid Treatment Program Increases HCV Treatment Access. HCPLive. April 3, 2024. Accessed April 5, 2024. https://www.hcplive.com/view/facilitated-telemedicine-through-opioid-treatment-program-increases-hcv-treatment-access}