Remote Health: Optimizing the Delivery of Sexual Health Care

Abstract

R emote health care, including telehealth or telemedicine, has slowly evolved since the 1800s with the advent of the telegraph and telephone. 1 Telehealth is the use of electronic information and telecommunication technologies to provide care when an individual and his/her/their health care provider are not in the same place at the same time. 2 For the purpose of this supplement, "remote health care" includes all the different modalities health care providers can use to remotely interact, diagnose, treat, and monitor their patients. Remote care takes a broader perspective to consider how new communication technologies can complement in-person communication in public health clinics. Promising uses of new technology include assessing symptomatic patients via telephone triage, offering remote testing and diagnosis (e.g., laboratory, pharmacy/ retail clinic, at-home/mail-in) via self-collection of specimens and self-tests, Internet or text-based appointment reminders and test results (i.e., remote patient monitoring), or video appointments. In general, remote care encounters can occur synchronously (phone or video session) or asynchronously (patient communication separated in time and space through messaging platforms). 3 At its core, remote health is human-centric; it satisfies a patient's clinical needs, at his/her/their convenience, and removes barriers to the patient's health improvement. However, as with the introduction of any new technology or service, unintended consequences arise. 4 State-specific regulatory issues, payment and reimbursement, privacy, and confidentiality concerns, among others, have posed substantial challenges to scaling up remote health care in our nation. 5 The SARS-CoV-2 (COVID-19) pandemic forced the US health care system to modernize its approach to delivering clinical care that did not involve in-person clinician assessments.The COVID-19 response challenged the medical community to ensure continuity of services and care for people required to stay home in isolation, quarantine, or physical distance. In February 2020, the Centers for Disease Control and Prevention (CDC) released guidance advising health care providers and persons in areas affected by the COVID-19 pandemic to implement physical distancing practices and recommended that clinical services be offered through virtual means (e.g., telehealth). 6 Trends in telehealth encounters in October and November 2020 revealed that telehealth appointments were offered to approximately 64% of Medicare beneficiaries, whereas only 18% had been offered telehealth by their provider before the pandemic. 7 What was once not widely accepted or common among the medical community and insurers quickly became daily practice. Physicians who reported using telehealth nearly quadrupled from 22% in 2019 to 80% in 2020. 8 These findings indicated that continuing telehealth policy changes might provide increased access to acute, chronic, primary, and specialty care during and after the pandemic. 6 Our nation's health care system has faced overwhelming and...

Creating a Sexually Transmitted Infection Disease Intervention Workforce for the 21st Century

“…31 The COVID-19 pandemic accelerated the use of telehealth with a more flexible regulatory and reimbursement environment. 32 Although it may not yet be known how much of the flexibility around telehealth may remain after the pandemic, its use likely could be helpful for STI disease intervention activities.…”

“…For instance, one study used telehealth via video conferencing to show MSM how to collect specimens and then to deliver STI test results to the participants 31 . The COVID-19 pandemic accelerated the use of telehealth with a more flexible regulatory and reimbursement environment 32 . Although it may not yet be known how much of the flexibility around telehealth may remain after the pandemic, its use likely could be helpful for STI disease intervention activities.…”