Report: What Pennsylvania can do to improve telehealth

(The Center Square) – While telehealth greatly expanded during the pandemic, state legislators have been slow to update the law to make it a permanent option.

An analysis from the Reason Foundation that compared all 50 states found that Pennsylvania’s telehealth actions have been a mixed bag. Though some progress has been made, more remains to be done.

“It is hard not to notice that states have shown a surprising lack of urgency in making comprehensive updates to their telehealth laws,” wrote Josh Archambault, a senior fellow at the Cicero Institute and Pioneer Institute, and Vittorio Nastasi, director of criminal justice policy for the Reason Foundation.

The vigorous haste of state leaders early on to adapt to the pandemic eventually faded away.

“Most of the emergency actions taken early on in the pandemic were only temporary,” Archambault and Nastasi wrote. “When state public health emergency declarations ended, and executive orders were withdrawn, many of the new flexibilities were lost. While some states recognized the benefits of regulatory flexibility and have adopted permanent reforms, a surprising number have only made minor tweaks to their laws, and most only benefit one kind of service or provider.”

The report compared states on whether their laws let patients access telehealth in many forms, whether they can start using telehealth in any form, barriers to interstate telehealth services, and the kinds of providers patients could access with telehealth.

Pennsylvania did well on letting patients start using telehealth by any mode they’d like – such as beginning with a text, email, or video call. The report gave Pennsylvania a green rating.

For interstate telehealth, however, Pennsylvania got a yellow rating. The state has a registration process for out-of-state providers, but it’s limited to certain types of physicians or providers.

“Too many states and medical boards have made it time-consuming, expensive, or prohibited providers from seeing patients outside their home state,” Archambault and Nastasi noted. “Pilots don’t lose their skills when they cross a state line, and neither do health care professionals.”

Pennsylvania did worst for limiting independent practice, earning a red rating in the report due to its prohibition on nurse practitioners working without a doctor’s oversight. Though a number of western states, and three of Pennsylvania’s neighboring states allow NPs to work independently, the commonwealth has yet to embrace the change, as The Center Square previously reported.

Though legal changes have been slow in coming, lawmakers have shown a willingness to expand funding for telehealth. A commission formed to advise state legislators on how to spend $100 million for behavioral health recommended improvements to telehealth infrastructure, for example.

To take advantage of the benefits of telehealth, though, the report argues more must be done.

“Immediate action will be needed to avoid disrupting patient access to providers they gained during COVID, as other options may not exist in their community,” Archambault and Nastasi wrote. “For many patients, cutting off remote access to care is the difference between them receiving care in this manner versus no care at all.”