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La telesalud ha ayudado a conectar a los pacientes con los proveedores durante el año pasado. Ha sido particularmente crucial para mantener a los pacientes de centros de salud calificados a nivel federal (FQHC), muchos de los cuales son personas de color y tienen Medicaid, conectados a la atención médica durante la pandemia. Pero si bien la telesalud ha traído algunos beneficios de atención médica y ha mantenido a los que ya reciben servicios conectados con sus proveedores, los informes nacionales de la Fundación Robert Wood Johnson y Health Affairs muestran que la tecnología ha hecho poco para llegar a nuevos pacientes, y aquellos con un dominio limitado del inglés tenían bajos tasas de uso de telesalud. Los FQHC son proveedores de atención médica comunitarios que reciben fondos federales para brindar servicios de atención primaria en áreas desatendidas. Deben cumplir con un estricto conjunto de requisitos, incluida la prestación de atención en una escala de tarifas variable basada en la capacidad de pago y operar bajo una junta directiva que incluye a los pacientes. Según Ken Lalime, director ejecutivo de la Asociación de Centros de Salud Comunitarios de Connecticut, el 62% de los pacientes de FQHC en Connecticut tienen Medicaid, el 10% tienen Medicare y el 15% no tienen seguro. La mayoría, alrededor del 90%, tiene ingresos que duplican el nivel federal de pobreza, y más de la mitad no habla inglés como primer idioma. Hay 17 FQHC en Connecticut. Los FQHC vieron caer su número de visitas de pacientes tan pronto como golpeó la pandemia de COVID-19, dijo Lalime. Los proveedores se preguntaban cómo llegarían a sus pacientes en riesgo y les brindarían la atención que necesitaban. La telesalud surgió rápidamente como la respuesta.
El 10 de marzo de 2020, el gobernador Ned Lamont emitió una orden ejecutiva que, entre otras cosas, permitió a Medicaid cubrir las visitas de telesalud. El 10 de mayo de 2021, promulgó una ley que extiende esa disposición por otros dos años. “La telesalud lo significó todo para las personas que tuvieron acceso a la atención durante la pandemia”, dijo Jill Zorn, oficial senior de políticas de Universal Health Care Foundation de Connecticut. “Desde la perspectiva del cuidado de la salud, no poder ver a su médico fue un problema real. Que [las aseguradoras, incluido Medicaid] pagaran por telesalud fue enorme. Si algo bueno salió de la pandemia, este es uno de ellos«. Cuando comenzaron los cierres de COVID, los FQHC en el estado vieron caer las visitas de pacientes hasta en un 80%. Una vez que el estado permitió la telesalud, algunos centros realizaron hasta el 80% de sus visitas de esa manera, y durante el año pasado aproximadamente, alrededor del 50% de todas las visitas de FQHC han sido visitas de telesalud, dijo Lalime. La cantidad de visitas de telesalud está comenzando a disminuir ahora, dijo, ya que los pacientes se sienten más cómodos programando visitas en persona.
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“No todos nuestros pacientes tienen la capacidad o el dinero para comprar computadoras, por lo que la capacidad de realizar telemedicina por video fue un desafío”, dijo. “El componente de solo teléfono fue realmente un salvavidas para muchos de nuestros pacientes; se convirtió en un componente tan grande«. La telesalud ha traído varios beneficios, pero también nuevos desafíos. «Definitivamente hubo algunos dolores de crecimiento«, dijo Lalime. “Para ponerlo en marcha, fue necesaria la educación del paciente y la educación del sistema. Connecticut respondió con bastante rapidez a esto, pero no fue instantáneo. Tomó algún tiempo.« La Asociación de Centros de Salud Comunitarios está estudiando el impacto de la telesalud y qué tan bien funcionó durante la pandemia, dijo. Para mas información Fuente: C-HIT.
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