House Bill 1980 HD2 SD2, a bill making its way through the state Legislature with broad support from both patients and providers, will significantly expand access to health care for Hawaii’s kupuna low-income, limited-English-proficient and rural residents. The bill recognizes the use of telehealth modalities including audio-only (telephone) as reimbursable patient visits with their health care providers.
For the sake of all Hawaii residents, the House of Representatives should follow the Senate’s lead and pass this important measure.
The pandemic spurred revolutionary advancements in telehealth. Vulnerable patients met safely with doctors using smartphones, tablets and computers. Over the last two years, we have learned that the use of telehealth technologies — especially those that include family members in virtual visits with providers — has the potential to result in better access to care, reduced transportation barriers, and improved outcomes for the care recipients.
Not all telehealth visits involved video. Some patients — particularly those in rural, underserved communities with limited internet access and those who struggle with the use of technology — benefitted greatly from audio-only access to telehealth services.
Audio-only delivery served a critical function during the pandemic by assuring open lines of communication and improving access for marginalized groups.
While Hawaii’s initial emergency declaration included coverage of audio-only telehealth interactions, this flexibility has since expired. And because Hawaii’s limited broadband access continues to serve as a barrier to accessing two-way audio-visual communication, the most vulnerable among us — including those in the rural and underserved communities — may be left unable to access the benefits telehealth can provide.
Audio-only interactions have an abundance of support. The Centers for Medicare and Medicaid Services (CMS) determined that one-third of its telehealth encounters during the pandemic were conducted by telephone. The RAND Corp. found that telephonic interactions were a literal “lifeline” for hospitals and medical facilities that lacked the infrastructure to deliver audio and visual services. Many states have changed their policies to allow for audio-only telehealth, and the Department of Health and Human Service and CMS recently made telephonic/audio-only treatment a permanent feature of certain telehealth services eligible for Medicare coverage.
We know audio-only works to deliver much-needed care to Hawaii’s vulnerable communities. Making audio-only a permanently acceptable option for the delivery of care in Hawaii is both critical and common sense.
We urge Hawaii’s House of Representatives to pass HB 1980 HD2 SD2 without delay.
