Facilitated Telemedicine Boosts Healthcare Access

TELEMEDICINE has immense potential to improve healthcare access by overcoming geographic and temporal barriers. Its implementation for underserved populations requires careful consideration of digital literacy, broadband connectivity, and patient-provider trust. By integrating health equity principles, telemedicine can address long-standing disparities in care while expanding the reach of essential services.

Facilitated Telemedicine Drives OTP Treatment Success

A pragmatic randomised controlled trial (RCT) examined the effectiveness of facilitated telemedicine for hepatitis C virus (HCV) treatment within opioid treatment programmes (OTPs). People with opioid use disorder (OUD) have the highest incidence of HCV, making targeted interventions critical. The trial found that 90.3% of participants receiving facilitated telemedicine achieved a sustained virologic response (SVR), compared with 39.4% in the usual care offsite referral group. Participants reported satisfaction equivalent to in-person healthcare interactions, demonstrating the acceptability of telemedicine in real-world settings.

Key factors underpinning successful implementation included the presence of a site liaison, high case manager (CM) onsite presence, and low CM turnover. Integration of CMs into OTP workflows promoted engagement, frequent communication, and cross-disciplinary collaboration. Additional organisational supports, such as low provider-patient volume and onsite phlebotomy, facilitated timely treatment initiation and improved access. The duration between initial visit and HCV treatment initiation was significantly shorter with telemedicine (mean 49.9 days) compared to referral (mean 123.5 days).

Organisational and Patient-Centred Factors

Facilitated telemedicine aligns with the missions of OTPs and state agencies, promoting patient-centred care. Improved staff knowledge of addiction, HCV, and health systems enhanced advocacy and supported patients throughout treatment. Warm handoffs, open communication channels, and involvement in group sessions fostered trust and engagement. Features such as CM attendance at staff meetings, site MD involvement in recruitment, and flag alerts strengthened collaboration and problem-solving.

This study illustrates that facilitated telemedicine can successfully integrate into routine care for underserved populations, improving both clinical effectiveness and patient satisfaction. By addressing organisational and implementation challenges, telemedicine offers a scalable model for delivering equitable healthcare and accelerating uptake of life-saving treatments such as HCV antivirals.

Reference

Talal AH et al. Opioid treatment program-integrated facilitated telemedicine for hepatitis C treatment: a hybrid effectiveness-implementation analysis. BMC Complement Med Ther. 2025;25(1):377.