AUA Urology Advocacy Summit 2023: Not Just Phoning It In: Why Telehealth Is Vital in a Modern World

( Dr. Lisa Finkelstein and Dr. Kara Watts provided a presentation on the utility of telehealth services, one of the focuses of the 2023 AUA Summit. The public health emergency declared during the pandemic expanded allowances for telehealth services, but these changes were temporary. The presentation identified five legislative priorities that will be addressed during the Congressional Hill visits.

The first referred to eliminating the originating site requirement. When telehealth was initially designed prior to the pandemic, the focus was to allow for increased access to physicians in rural and underserved areas; there were designated sites that patients were required to travel to in order to perform their visit. During the pandemic, this originating site requirement was waived, and patients were permitted to perform the telemedicine visit from their homes. Dr. Watts stressed the difficulty for elderly, disabled, and lower income patients to organize transportation – these patients would all benefit from permanent allowance for virtual visits from home.

Next, Dr. Watts outlined that the AUA has been advocating for payment parity, which refers to the reimbursement for in personal versus digital visits. She highlighted several resources that are required for telehealth visits, such as technological support, funding for a HIPAA-compliant program, and digital supplies. Dr. Finkelstein underscored that telehealth does require an investment in infrastructure to ensure that visits are able to be performed. As the third priority, both speakers covered the need to support audio-only visits, given that many patients have barriers to video capabilities. Internet access varies, and audio-only visits allow for equity in access to high quality telehealth care.

Next, Dr. Finkelstein summarized the opportunity for an in-person healthcare provider, often medical students and nurses, to be virtually supervised by a physician as they examine and/or provide care to patients in person. She provided several examples of virtual supervision of medical students, including at her Alma Mater in Philadelphia. Lastly, the physicians covered interstate licensure as the last legislative telehealth priority. As a practitioner in rural America, Dr. Finkelstein underscored the importance of the interstate licensure to allow for patients to access telehealth services across state lines, especially in the context of the ongoing shortage of urologists in rural areas.

In conclusion, Dr. Watts and Dr. Finkelstein both stressed the timeliness of the telehealth related “asks” that are set to expire once Omnibus flexibilities end of January 1, 2024.

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Presented by:
  • Lisa Finkelstein, DO, St. John’s Health; Jackson Hole, WY
  • Kara Watts, MD, Montefoire Medical Center; Bronx, NY
Written by: Ruchika Talwar, MD, Urologic Oncology Fellow, Vanderbilt University Medical Center, @RuchikaTalwarMD during the 2023 AUA Annual Urology Advocacy Summit, Washington, DC, February 27 – March 1, 2023

  • Odukoya EJ, Andino J, Ng S, Steppe E, Ellimoottil C. Predictors of Video versus Audio-Only Telehealth Use among Urological Patients. Urol Pract. 2022;9(3):198-204. doi:10.1097/UPJ.0000000000000301
  • Andino JJ, Zhu Z, Surapaneni M, Dunn RL, Ellimoottil C. Interstate Telehealth Use By Medicare Beneficiaries Before And After COVID-19 Licensure Waivers, 2017-20. Health Aff (Millwood). 2022;41(6):838-845. doi:10.1377/hlthaff.2021.01825