Panelists Discuss Impact of Policy on Telehealth at Harvard Law School Webinar

Harvard Law School’s Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics hosted a virtual panel Thursday on the impact of policy changes on the use of telehealth.

The discussion — titled “Achieving Telehealth’s Potential: The Federal Policy Landscape for Interstate Telehealth Practices” — was moderated by Carmel D. Shachar, an HLS lecturer and the executive director of the Petrie-Flom Center.

Four panelists spoke at the event, including Massachusetts Medical Society Director for Advocacy and Government Relations Leda Anderson, Sirona Strategies Partner Krista Drobac, U.S. Department of Veterans Affairs Deputy Director for Clinical Services Leonie K. Heyworth, and Rutgers University adjunct assistant professor Craig Lipset.

During the webinar, the panelists discussed the role of telehealth in modern medicine, particularly as its services have increased since the onset of the Covid-19 pandemic.

“What we know about telehealth is that it is an amazing extender for access to care,” Shachar said. “States — I think — took a look at how they could build a more flexible clinician workforce, especially with the pandemic not being evenly distributed across the country but sometimes coming in waves in the northeast or the southwest, for example.”

Still, as pandemic restrictions have eased, Shachar said policies enabling the large-scale use of telemedicine are now being rolled back.

“What we’re finding now as we come to the end of the federal public health emergency, which is one of the legal structures that has really allowed for this regulatory shift during the pandemic, is that, if anything, things are being walked back to pre-pandemic — that we’re going back to a very state-focused system,” Shachar said.

State medical boards — which are responsible for licensing, regulating, and disciplining physicians — play an important role in setting standards that promote health care quality, the panelists said.

“There’s value in the role of state medical boards in serving the public and keeping patients safe and ensuring quality medical care, by setting standards for the quality of care,” Anderson said.

But while physician licensing boards may standardize the quality of care, they can also limit access to virtual health services, according to Drobac.

“You are breaking the law if you practice in a state and are not abiding by the practice rules that have been set out by the medical board in that state,” Drobac said. “The idea that a medical board could police this better if they continue to require licensing, I think is false.”

“People are either going to do it anyway, or they’re going to get in their car and drive to a state where it’s legal,” Drobac said of medical practitioners.

The Veterans Affairs health care system — which allows its physicians to provide care across state borders — could serve as a model for integrating telehealth into nationwide systems, Heyworth said.

“And so really now what we’re looking at — looking forward to the expansion phase — is to be able to say, ‘How can this impact the type of care that we can deliver? How can we best leverage our capacity?’” she said. “‘How can we use that to improve quality of care, by leveraging that specialty expertise that might exist in some pockets and not another?’”