Digital is the answer to the health care workforce problem

Two major developments about the challenging state of health care recently received in-depth public scrutiny.

Their apparent overlap indicates at least a partial solution to a problem Massachusetts shares with most other states.

During the Massachusetts Association of Health Plans conference last week, Gov. Charlie Baker said that given the chronic shortage of staff, the health care industry needs to re-think how it provides services.

In October, the Massachusetts Health and Hospital Administration estimated that there were approximately 19,000 full-time vacancies in the Commonwealth’s hospitals.

Baker said staffing issues also affect health care payments. Short-staffed rehabilitation and long-term care facilities cannot take new patients from hospitals, leaving patients stuck waiting for their next treatment facility to open.

Tim Foley, executive vice president of 1199SEIU, which represents more than 70,000 health-care workers, said the staffing shortage is a “whole-system issue” in hospitals, nursing homes, home care and other care facilities, requiring A “whole system” is required. Solution.”

“Some of these jobs are not going to be replaced; We need to come together and think about new care delivery models, Foley said.

A study just came to light of the feasibility of one such alternative delivery model, telehealth, which apparently was not discussed at that health planning conference.

The use of telehealth as a routine method for seeking care has exposed a digital divide across different socioeconomic strata, according to a new report from researchers and health-planning organizations.

As defined by the Health Resources Services Administration, telehealth uses electronic information and telecommunication technologies to support long-distance clinical health care, patient and professional health education, public health, and health administration .

Noting the long-standing health disparities that the COVID-19 pandemic brought to light, the Massachusetts Association of Health Plans commissioned the study at the start of the pandemic to research the unequal acceptance of telehealth use, MAHP’s Advocacy & Engagement Elizabeth Leahy said.

Researchers concluded that after analyzing data from 1.8 million health plan members from January 2019 to December 2021, the state’s oldest and youngest residents, as well as low-income, minority and rural populations, went to the doctor most often. Let’s go

For seniors, low use of telehealth may be due to a combination of technology barriers and the routine and comfort of meeting their doctor in person, said Nathalie McIntosh, senior director of programs and research at Massachusetts Health Quality Partners.

The researchers talked to some people — including seniors and English language learners — who don’t have cellphones or, if they do, don’t know how to use the video feature, McIntosh said. “The audio telephone visits were really helpful” for these populations, he said.

For younger adults who did not use telehealth, McIntosh said this was not a matter of digital literacy, but rather an indicator of limited access to primary care providers in general.

“To do a telehealth visit, you really need to have a normal source of care, because it’s a scheduled visit,” she said.

Except for a few cities and towns in the Pioneer Valley, where telehealth was used in more than 43% of visits, telehealth use was greater in greater Boston and other densely populated areas of eastern Massachusetts, and lower in central and western Massachusetts.

An encouraging development offering a potential solution to the overall health-care provider shortage, telehealth was widely used across the state for behavioral-health care, conducting an average of 75 to 80% of all mental-health visits each month. it was done.

This higher percentage likely reflects recent reimbursement reforms as a result of a law signed by the governor in January 2021, which mandates permanent payment parity for tele-mental health services.

Health care staffing shortages can be substantially reduced by focusing on ways to increase telehealth services among primary care physicians, older patients, and young adults with socioeconomic challenges.

For the MAHP/Harvard study, researchers recommended that health plans increase screening for digital affordability and streamline enrollment in underutilized public benefit programs to make internet and devices more affordable, as well as community-based organizations Build referral partnerships with others who can provide digital literacy. Training.

As our governor and former CEO of Harvard Pilgrim Health Care warned, the medical industry may never return to its pre-pandemic state.

It may not be a panacea, but encouraging telehealth as a way to address the prospect of permanent staff shortages would be penicillin for this chronic condition.

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