What Telehealth Gets Right and What's Missing: A National Multistakeholder Study of Access and Sustainability.

INTRODUCTION Increasing access to high-quality health care in the United States is a national priority. Telehealth has been shown to support this goal. However, its benefits remain unevenly distributed, and the perspectives of those most directly involved in its delivery and use are needed to guide effective sustainment and expansion. This study aimed to obtain patient, practitioner, and policymaker/administrator perspectives regarding the impacts of telehealth on increasing health care access and to identify recommendations for improving accessibility and sustainability.

Methods

Semistructured interviews were conducted with patients, practitioners, and policymakers/administrators with experience using or overseeing virtual care modalities across multiple US states. Interviews were audio recorded and transcribed, and inductive thematic analysis was performed to code the interviews and extract themes.

Results

A total of 62 participants completed interviews (40 patients, 15 practitioners, and 7 policymakers/administrators). Stakeholders reported that telehealth can expand access in rural and medically underserved areas, reduce barriers to care for high-priority populations, and improve efficiency. However, these benefits are not equally accessible to all. Stakeholders identified both beneficial effects and persistent barriers, as well as actionable recommendations to improve the accessibility and sustainability of telehealth.

Discussion

Scaling telehealth effectively will require broadband investment, community-based access points, device access, digital-literacy support, user-friendly platforms and onboarding, and workflows that mitigate clinician burden and burnout.

Conclusion

These findings point to actionable policy initiatives to expand accessible, sustainable telehealth.