The Role of Telehealth in PAH Management: Benefits, Barriers, and Solutions.

Abstract

Telehealth utilization increased during the coronavirus disease-2019 (COVID-19) pandemic, which encouraged remote patient management. The identification of optimal strategies to enhance telehealth and address barriers to its use for patients with pulmonary arterial hypertension (PAH) may improve patient outcomes. Physicians (n = 11) and advanced practice providers (n = 6) based in the United States with experience with telehealth in PAH were recruited to a double-blinded modified Delphi panel (two survey rounds and a virtual consensus meeting). Consensus was defined as ≥ 80% of panelists rating their agreement or disagreement using a 9-point Likert scale. A consensus in agreement was reached that telehealth is the use of virtual or remote methodologies to interact with, monitor and assess patients and deliver health care. Telehealth methodologies may be used in PAH for returning visits, diagnostic test follow-up and medication management; telehealth is convenient, enables additional visits, and provides patient access to care. There are barriers to telehealth such as socioeconomic status, patient digital literacy, visual and/or hearing impairments, developmental disabilities, geographical location, and reimbursement. Solutions to improve patient access to telehealth include health insurance reimbursements, financial resources for healthcare professionals (HCPs), and improved connectivity infrastructure for patients. There are benefits, barriers and solutions for telehealth in general, and more research is required to evaluate the impact on PAH care. Further research and insights from the present study may improve PAH management and telehealth services. Improvements in telehealth care and delivery may allow better monitoring of patients with PAH and assist in more equitable PAH care.