AUA Urology Advocacy Summit 2024: Establishing Telehealth’s Permanent Place in Healthcare: What’s Left to Accomplish

( The American Urological Association’s Annual Advocacy Summit in Washington, DC in late February 2024 featured a session focused on Telehealth in Urology. Dr. Helen Bernie began the session by outlining how the COVID-19 pandemic accelerated the widespread use of telehealth care. Prior to declaration of the Public Health Emergency, telehealth reimbursement and application were limited and varied greatly based on payor. In 2020, the Centers for Medicare and Medicaid removed the originating site requirement, allowed for audio-only visits, and removed co-pays for telemedicine visits. This allowed for rapid adoption of telehealth care despite limitations on in-person care.

Dr. Bernie explained that currently, in the post-pandemic era, she heavily utilizes telehealth for follow up care in scenarios where an in-person examination may not be necessary. She emphasized the importance of having time set aside for virtual visits, utilizes a “virtual scribe,” and adequate administrative support. Dr. Bernie also outlined how telehealth is convenient for both patients and providers, allowing patients to forgo long trips to her office, potentially obviating the need for transportation services, decrease commute costs, and in her specific practice, potentially allowing patients to discuss sensitive topics such as sexual health from the comfort of their own home. In urology, where workforce strain affects rural areas significantly, telehealth may allow for expanded access in areas that do not have urology care available.

Second, Brian Lewis, a patient advocacy leader and kidney cancer patient, emphasized how telehealth services enhance access to patient care. Lewis shared stories and testimonials on how telemedicine care for second opinions from centers of excellence without long commutes, particularly for patients in rural areas.

Next, Dr. Juan Andino presented his thoughts on why telehealth is worth continuing outside of the pandemic-related flexibilities. He cited decreased travel time, decreased cost for patients, and increased convenience for patients. Additionally, from the physician perspective, there is high satisfaction with telehealth care. Analyzing pre-pandemic data, Dr. Andino presented a series of studies from the University of Michigan analyzing video visits as a substitute for in-person clinic visits, demonstrating increased convenience through decreased travel time, decreased lost wages, and high satisfaction rates. He stated that virtual visits serve as a high-quality option for both follow up and new patient visits. Dr. Andino emphasized that the current telehealth allowances are set to expire at the end of 2024 unless Congress takes legislative action.

Lastly, Mr. Martin Gerwirtz provided the patient perspective on prostate cancer and telehealth. He shared his own experience with telehealth, particularly as an active surveillance patient with low risk prostate cancer. He specifically underscored the ability for patients to elicit second opinions and specialized opinions, particularly when only an imaging review is required (i.e. MRI). 

Presented by: Juan Andino, MD, Member, AUA Urology Telehealth Task Force; Helen Bernie, MD, North Central Section; Martin Gewirtz, Active Surveillance Patients International; Bryan Lewis, KidneyCan 

Written by: Ruchika Talwar, MD, Urologic Oncology Fellow, Vanderbilt University Medical Center, during the 2024 AUA Advocacy Summit, Feb 26 to Feb 28, 2024