Provision of telemental health before and after COVID-19 onset.

OBJECTIVES: To examine the organizational characteristics associated with telemedicine services provided by mental health care organizations before and after onset of the COVID-19 pandemic in the United States. STUDY DESIGN: Using 2019-2020 National Mental Health Services Survey data, we assessed changes in provisions of telemedicine services by mental health care facilities before and after onset of the COVID-19 pandemic. METHODS: We estimated multivariable logistic regression models comparing pre- vs postpandemic changes in prevalence of telemedicine offered by mental health care facilities. We incorporated mental health care organizations' characteristics, including facility type, accepted payment, geography, and language service provisions, as well as state-level policies, such as payment parity laws, shelter-in-place laws, and number of COVID-19 cases. RESULTS: Mental health care facilities had 4 times the odds (odds ratio [OR], 4.3; 95% CI, 4.09-4.61)​​ of telemedicine provision post pandemic in 2020 compared with prepandemic in 2019. In 2020, facilities that accepted Medicaid (OR, 1.3; 95% CI, 1.11-1.49) and Medicare (OR, 1.3; 95% CI, 1.14-1.39) were more likely to provide telemedicine than those that did not. Facilities that offered American Sign Language (OR, 1.3; 95% CI, 1.16-1.43) and non-English language services (OR, 1.3; 95% CI, 1.15-1.44) were more likely to provide telemedicine than facilities that did not. Facilities located in states with payment parity laws (OR, 1.2; 95% CI, 1.11-1.36) were more likely to offer telemedicine than states without. CONCLUSIONS: Telemedicine availability in mental health facilities has expanded post COVID-19 pandemic, but telemedicine provision has been uneven across organizational and state-level factors. Expansion of regional investments and payment parity might be necessary to ensure equitable provision of telemedicine.

Family Caregivers' Experiences With Telehealth During COVID-19: Insights From Michigan.

Telehealth can benefit older adults during COVID-19. The purpose of this study was to understand benefits and barriers to telemedicine visits for older adults from the perspectives of family caregivers. A cross-sectional, online survey was conducted across the state of Michigan with family caregivers (n = 90) who responded to open- and closed-ended questions. Perceived benefits of telemedicine included access and rapport; barriers included the appropriateness of telemedicine for certain health care needs. Telemedicine is a likely to remain beyond COVID-19 and can facilitate access to and continuity of care. There are barriers, however, that must be addressed, especially among older patients.