You probably don’t need us to remind you that in 2020, the United States declared the COVID-19 pandemic to be a public health emergency (PHE) — but now it’s looking like we’re finally in the clear, after three years of masking, social distancing, and working from home.
That’s not to say the pandemic’s over or that we no longer need to worry about COVID-19 — just that the state of emergency is over.
Last month, the United States officially ended the PHE that was put in place more than three years ago. Among other aspects of daily life, the PHE had a profound impact on healthcare and how we access it — as such, the PHE ending is also likely to have an equally profound impact on telehealth.
“[The Department of Health and Human Services] and the leadership across the Department remain focused on protecting the health and well-being of all Americans, particularly those at highest at risk, including seniors and immunocompromised people, making sure we don’t leave the uninsured behind, and monitoring the latest subvariants so we’re prepared and ready to manage the risks of the virus moving forward,” secretary of health and human services Xavier Becerra said in a statement on May 11, when the PHE officially ended.
In response to the PHE, doctors and other healthcare providers adopted several telehealth measures and practices to allow patients and healthcare workers to stay safe in the face of COVID-19.
The US Department of Health and Human Services first declared a PHE in response to COVID-19 in late January 2020. But it wasn’t until about a month and a half later that things began to hit the fan. In mid-March of that year the number of people diagnosed with COVID started rising fast — in response, businesses began to close their doors, students attended class on their laptops, and the video communications platform known as Zoom became a household name.
During the PHE, virtual doctor’s appointments and other forms of telehealth became more prominent — this was possible because the PHE relaxed certain HIPAA requirements and allowed patients to file insurance claims for more telehealth services. And in the language services domain, remote interpreting became an even more important method of delivering services than before. The shift to telehealth meant healthcare providers had to rely on remote interpreting technology more than ever before.
It certainly stands to reason that this change should have had a positive impact on patients with limited English proficiency (LEP). Instead, it seems that telehealth was often less accessible to patients with LEP than those without. From problems with digital literacy to inaccessible user journeys, many patients with LEP struggled to receive the care they needed during the PHE.
As we transition into this post-PHE era, here’s what healthcare providers — telehealth or otherwise — should know about accessing language services and providing equitable care to patients with LEP.
The PHE and Language Access
Throughout the COVID-19 pandemic, language barriers have posed challenges to effective healthcare delivery for individuals with LEP. Even before the pandemic, healthcare providers have had to take measures to break language barriers for patients with LEP.
But the pandemic and the shift to telehealth under the PHE made things even tougher. Insufficient digital literacy, lack of access to digital requirements like broadband internet among certain populations with LEP, and occasionally erroneous or misleading translations of important public health information made it harder for patients with LEP to access telehealth. And as a result, research suggests that populations with LEP were more likely to suffer adverse consequences from COVID-19 than other groups.
These disparities shed some much-needed light on the importance of language access in healthcare. Ultimately, the PHE created a motive for healthcare providers to develop programs and innovative solutions to address language access barriers and ensure equitable healthcare for all.
How the PHE Ending will Affect Telehealth
With the end of the PHE last month, many healthcare providers will be less likely to rely upon certain telehealth practices. And some things that were allowed under the PHE — for example, a relaxation of HIPAA that let providers who were covered by Medicare to use WhatsApp and FaceTime — will no longer be allowed.
Likewise, the end of the PHE also means that doctors are no longer able to prescribe controlled substances to patients via telehealth alone. Patients will be required to come in for an in-person visit with the doctor before any such prescriptions can be written or filled.
While video doctors’ appointments will certainly stick around, they’ll likely become less common than they were during the pandemic — especially since fewer telehealth visits will be covered by insurance, requiring many patients to default to onsite visits to the doctor. This means patients with LEP could potentially have to travel longer distances to meet with a doctor who speaks their language. Healthcare providers will still be able to use remote interpreting technology to get connected with an interpreter, in the event that a patient needs an interpreter. Demand for in-person interpreting may increase, however, as doctors begin to shift away from telehealth appointments and technologies.
Additionally, healthcare providers may need to reevaluate their language access practices to ensure that they meet the needs of patients who are coming into the office or hospital. In-person appointments introduce additional layers — for example, interacting with the receptionist at the front desk — that could cause friction if language access isn’t adequately considered.
Summary
About a month into this new chapter, it’s critical that healthcare providers consider ways in which the end of the PHE might impact the accessibility of telehealth services. Here are some things for healthcare providers to keep in mind during this critical junction:
- The PHE had a profound impact on the way we interacted with healthcare systems, making remote visits with the doctor much more commonplace than they once were.
- While telehealth should have made healthcare more accessible to patients with LEP, research suggests that individuals with LEP suffered greater consequences during the pandemic.
- With the PHE ending, we’ll likely see a shift back to regular, in-person health appointments.
- In these early days of the post-PHE era, it’s critical to revisit language access practices to ensure that patients with LEP are well-accommodated in both telehealth and in-person settings.
As we transition into this new phase of the pandemic, Avantpage is proud to provide consulting, translation, and interpreting services to healthcare providers all across the country. If you need to work on revising your language access plan for the post-PHE era, don’t hesitate to contact us at [email protected] or (530) 750-2040 for more information about our services.
