As part of our ongoing special edition series on the future of telehealth, we’re honored to feature this guest-authored piece by Laurie Buis, PhD, M.S.I., a nationally recognized expert in digital health innovation and evaluation. In this article, Dr. Buis outlines seven critical areas where research is urgently needed to ensure telehealth continues to evolve as a sustainable, equitable, and effective mode of care: clinical care, administration, education and training, policy, technology and innovation, patient experience, and ethics. These priorities reflect a growing understanding that while telehealth rapidly expanded during the pandemic, long-standing challenges persist.
This piece is part of the Special Edition in the Journal of Telemedicine and eHealth, focused on advancing the next decade of telehealth research and implementation.
You can read the full article here.
by Laurie Buis, PhD, MSI
Despite decades of evidence suggesting promise for supporting synchronous clinical encounters between patients and providers, telehealth had not been integrated widely into routine clinical care until the pandemic necessitated its rapid expansion. During the pandemic, regulatory policies were temporarily adjusted to facilitate telehealth’s deployment, underscoring its impact in providing healthcare access amidst service disruptions. This transformation highlighted telehealth as a pivotal tool for healthcare delivery, capable of connecting patients to care teams remotely. An Agency for Healthcare Research and Quality (AHRQ)-funded Think Tank convened in August 2024 to discuss telehealth’s trajectory and future in a post-pandemic world, drawing experts across various fields to Michigan State University. The three-day event advanced collaboration and among other activities, this Think Tank convene a subgroup tasked with charting areas where additional telehealth research is needed. This subgroup established seven key areas where research is needed: clinical opportunities, administrative opportunities, education and training, policy formulation, technology and innovation, patient characteristics and experience, and ethics.
Clinical Care: During the pandemic, telehealth programs scaled quickly across clinical disciplines. Research is needed now to optimize its use. Efforts should focus on identifying appropriate use cases for telehealth, refining clinical workflows, and possibly creating new healthcare roles to maximize telehealth’s potential.
Administration: Administrative hurdles have impeded telehealth adoption for decades and despite rapid expansion during the pandemic, these administrative hurdles still remain. Research on issues such as cost, data utilization, and leadership are still needed. A comprehensive understanding of how telehealth can be incorporated into administrative functions can foster more efficient healthcare delivery.
Education and Training: As telehealth becomes integral to healthcare, educational practices for providers and patients alike must evolve. Research is needed to determine the best methods for integrating telehealth training into medical curricula and continuing education. Patient education is equally crucial to ensure individuals can effectively utilize telehealth services.
Policy: Although policy changes during the pandemic expanded telehealth access, permanent adjustments remain uncertain. Current and timely research is needed now to evaluate how these changes affect telehealth adoption and efficacy, as well as health outcomes, in order to inform future policy decisions.
Technology and Innovation: Although expansion of virtual visits expanded greatly during the pandemic, there remains a lot of untapped potential for technology to enhance virtual care. Research is needed to explore emerging technologies, such as remote patient monitoring and other integrations of patient-generated data, to complement virtual care. As telehealth technologies advance, research must also address the user experience, ensuring it accommodates diverse patient needs and literacy levels for effective engagement.
Patient Characteristics and Experience: The pandemic exposed gaps in addressing patient-related factors like digital literacy and systemic biases. Future research should focus on enhancing patient awareness and acceptance of telehealth, tailoring solutions to varied community needs, and using innovative education methods.
Ethics: Ethical considerations around data usage, privacy, and stewardship are paramount. Research is needed to explore how to responsibly collect and use patient data while ensuring transparency and patient trust. Probing whether sufficient data supports conclusive results without sacrificing ethical standards is critical.
The overarching message from the Think Tank is that while significant strides have been made in telehealth implementation and adoption, longstanding challenges that the field of telehealth has been addressing for decades still remain. Addressing these challenges requires a sustained focus on these seven research themes, ensuring telehealth continues to evolve as a powerful adjunct in healthcare delivery. This aligns with a broader endeavor to reconcile accumulating knowledge with a continuous pursuit of enhanced healthcare solutions.
Telemedicine Research
Comfort Providing Gender-Affirming Care and Preferences for Consultative Support Among Rural Pediatric Primary Care Providers
Full citation: Sequeira, G. M., Kidd, K. M., Slekar, A., Kahn, N. F., Costello, L. M., Negrin, I., Huzurbazar, S., & Narumanchi, J. (2024). Comfort Providing Gender-Affirming Care and Preferences for Consultative Support Among Rural Pediatric Primary Care Providers. Telemedicine and e-Health, 30(6), e1798–e1804.
https://doi.org/10.1089/tmj.2023.0537
This study surveyed 51 pediatric primary care providers (PPCPs) in rural West Virginia to assess their comfort providing gender-affirming care and their preferences for different types of consultative support from specialists. The majority of PPCPs agreed that timely access to specialist consultation would increase their comfort, especially with behavioral health referrals and creating affirming environments.
Younger providers (<10 years in practice) and those trained in pediatrics expressed greater comfort and found specialist support more impactful—particularly when initiating or managing gender-affirming medications. Among the four support modalities tested (tele-education, electronic consultation, telephone consultation, and telemedicine), telemedicine and electronic consults were seen as most practical and helpful.
The study highlights how tailored consultative models can support rural providers, especially those with less experience. It underscores the importance of increasing access to specialist guidance to meet the needs of gender diverse youth in underserved areas.