Our New Virtual World of Care

This past spring, when the COVID-19 pandemic struck, people in need of behavioral health services were blindsided.

While in-person treatment programs were considered essential services and continued, many people, especially those at higher risk, stayed away. Even more, outpatient services and other supportive services were unable to offer people the help that they needed. This had a major impact on many people seeking substance use disorder services and mental health services, including children, many of whom receive services at school.

Technology to the rescue. Telemedicine is the use of electronic information and telecommunications technologies to support long-distance clinical health care, including behavioral health. Technologies include videoconferencing and telephone.

However, a number of state and federal laws and rules limit the use of telemedicine for Medicaid services, meaning that telemedicine services were unavailable to many of the people who needed care the most.

From the very beginning of the peacetime emergency, the Minnesota Department of Human Services went to work with providers, advocates and the federal government to waive a number of state and national laws and rules to allow providers to be reimbursed for these services. Changes that in normal times would have taken months or years to make, happened in weeks, with the changes applying retroactively as well. In the example of children receiving services in schools, this meant that the kids could receive services even if they were distance learning.

What happens to telemedicine after the pandemic?

To find answers to the study, we have, and continue, to conduct focus groups with health care providers in MinnesotaBut our job isn’t done. Now the question is: What happens after the pandemic? The waivers end shortly after the declared emergency ends. Do we go back to how we did business before?

That’s what we need to find out. A statewide telemedicine study is taking advantage of the emergency waivers due to the COVID-19 emergency to study the effectiveness of telemedicine.

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To find answers to the study, we have, and continue, to conduct focus groups with health care providers in Minnesota. The groups seek to answer:

  • How was telemedicine used before the pandemic in primary health care, mental health care and substance use disorder treatment settings?
  • How is telemedicine used during the pandemic in these health care settings?
  • Is telemedicine effective?
  • What barriers do health care providers and patients face?

Thus far, the study has found that:

  • Some patients who would otherwise not access care due to their illness, travel distance, lack of transportation, lack of child/senior care or level of motivation can more easily access services in the comfort of their home. Telemedicine made it easier to access services and easier to involve other family members in health care services.
  • Telemedicine improves equity in access to health care for minority groups.
  • Telemedicine made it easier to access services and easier to involve other family members in health care services.
  • Telemedicine freed up time to serve more people in need of services, since health care staff could provide services from one location, eliminating drive time between provider sites.
  • Attendance was improved by fewer no-shows and late arrivals.

That’s just a start. The study will continue, and we will continue to learn how best to get more people the care that they need.

Through a careful, methodical, clear-eyed approach to understanding this issue, and by working with partners such as providers and advocacy organizations, we can make wise, cost-effective decisions for the future of telemedicine in Minnesota.


Paul Fleissner is the Director of the Behavioral Health Division at the Minnesota Department of Human Services.

Last Updated on January 11, 2021

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