How Can California Expand Telehealth to Improve the Lives of Children with Special Health Care Needs?
For most of his childhood, Ethan and his mother often had to drive six hours from their home in Redding, California, to Los Angeles to meet with a psychiatrist for his autism treatment. Today, Ethan, now 19 years old, drives just 10 minutes to a clinic in Redding where he meets with the very same psychiatrist via a live video conferencing system.
Telehealth, using technology to provide health care and support services at a distance, has the potential to improve care for the 1.4 million children in California who, like Ethan, have special health care needs. These children often require multiple specialists, coordinated health care, and related services on an ongoing basis. In both rural and urban areas of the state, Children with Special Health Care Needs (CSHCN) often find their health care needs unmet for a variety of reasons, such as provider shortages, lack of access to specialists, lack of affordable transportation, and a number of other barriers. But with the increased use of video conferencing, remote patient monitoring through smartphones, and other technology applications, we can break down those barriers and make it possible for more children to get care they may otherwise go without, right in their own communities.
Recognizing the potential of telehealth, The Children’s Partnership, the UC Davis Children’s Hospital, and the Center for Connected Health Policy, with support from the Lucile Packard Foundation for Children’s Health, set out to understand how telehealth is currently being used to meet the needs of California’s CSHCN and identify where policy constraints to wider adoption exist. After conducting a literature review, online surveys, and interviews with key stakeholders, including providers and California Children Services (CCS) administrators, we were able to uncover both the best practices of how telehealth is implemented and the difficulties in bringing it to scale.
The majority of providers surveyed, namely pediatric physicians, thought telehealth has potential to bridge gaps in care for CSHCN, but over 50 percent felt that issues of time, reimbursement, and equipment limited its use. Of the 39 CCS program administrator respondents, 32 out of 39 would be interested in state-sponsored training to learn more about telehealth.
It was clear from our interviews and surveys that many are eager for an expansion of telehealth that could help families get their children the care they need in a timely manner and at an affordable cost, regardless of where they live. CSS, health care providers, family advocates, children’s advocates, philanthropists, and other stakeholders all have a role to play to make telehealth for CSHCN a reliable option throughout California. Through expanded outreach to families and providers, and increased incentives for participation, we hope to have more success stories like Ethan’s, so instead of driving hours to multiple doctors’ appointments, children can spend their time reaching their potential.