全球智库信息集成服务系统

The COVID-19 pandemic prompted greater use of telehealth in the MHS, and most behavioral health providers were open to using video telehealth in the future

• Interviewees almost universally noted a dramatic shift from in-person care to audio-only or video telehealth or to a combination of in-person and telehealth modalities at military treatment facilities early in the pandemic.
• Most providers were not using video telehealth, but more than three-quarters expressed an interest in using it in the future.
• Nearly all providers were using audio-only telehealth, but only about one-quarter indicated that they were open to continuing to use it.
• More than half of interviewees said they thought patients liked telehealth, citing the greater convenience over in-person visits.

MHS behavioral health staff cited a variety of concerns and barriers to using telehealth

• Most concerns and barriers cited were related to technology and included insufficient internet bandwidth and equipment, difficulty accessing telehealth platforms while teleworking, a lack of technical support, concerns about reliability and data security, and provider and patient learning curves.
• About half of interviewees expressed concerns about using telehealth—particularly audio-only telehealth—to treat high-risk patients or patients with high symptom severity, citing difficulty assessing symptoms and patient risks.
• Administrative barriers were another commonly cited barrier to expanded telehealth use, including unclear guidance and policies and a perceived lack of high-level support.

The COVID-19 pandemic prompted sweeping changes to behavioral health care delivery in the Military Health System (MHS), which turned to telehealth to minimize disruptions and ensure continuity of care for service members. Four to seven months into the pandemic, MHS behavioral health staff at ten military treatment facilities shared their experiences using telehealth and their perspectives on its utility, barriers to its wider integration in the MHS, and concerns about its use in the post-pandemic future.

Telehealth use was previously low across the MHS, but it increased dramatically with the onset of the pandemic. At the time they were interviewed, nearly all providers who treated service members with posttraumatic stress disorder, depression, or substance use disorders were using audio-only telehealth in some capacity. Although most were not using video telehealth, three-quarters expressed an openness to using it in the future. However, the widespread integration of telehealth in the MHS will need to include efforts to overcome technical and administrative barriers and to address provider concerns about telehealth modalities for behavioral health care delivery—for example, the need for clinical guidance on using telehealth with specific types of patients, and provider and patient orientation on using telehealth technology.

• Chapter One

  Introduction

• Chapter Two

  Methods

• Chapter Three

  Use of Telehealth Following the Onset of the COVID-19 Pandemic

• Chapter Four

  Organizational Factors Associated with the Use of Telehealth

• Chapter Five

  Clinical Factors Affecting the Use of Telehealth

• Chapter Six

  Staff Reflections on Patient Satisfaction and the Importance of Provider and Patient Orientation to Telehealth

• Chapter Seven

  Telehealth with Service Members Located Remotely from MTF Care

• Chapter Eight

  Summary and Recommendations

• Appendix

  Interview Guide