Landscape for Telehealth under COVID-19

The purpose of the Landscape for Telehealth under COVID-19 project was to help PCORI better understand where there are new opportunities for comparative effectiveness research within telehealth, especially after the major shift towards telehealth visits during the COVID-19 pandemic. As part of this work, NORC worked closely with PCORI to complete a rapid landscape review of peer-reviewed and grey literature on changes to telehealth-related policy, care delivery, and outcomes as a consequence of the COVID-19 pandemic. NORC also assembled a small group of telehealth experts to serve on a technical expert panel (TEP); the TEP was convened several times to provide additional insight on where PCORI might target its future research and telehealth investments.

The NORC team was guided by three major framework components: policy context, health system delivery, and outcomes. Due to the abbreviated timeline, we conducted a pragmatic review that focused on literature published between January 30, 2020 and October 16, 2020; incorporating key resources provided by PCORI and TEP members. To remain within the narrow scope of pandemic-related changes, the team excluded any work that didn’t meet specific definitions of telehealth/telemedicine, didn’t focus on expansion or use of telehealth during the pandemic, and/or did not cover at least one of the three major framework components. The final landscape review report provided a synthesis of telehealth trends over the course of the COVID-19 pandemic; potential health disparity implications of telehealth; areas in need of further research, and potential areas of future focus for PCORI.

Following the submission of the landscape review report, the team held TEP discussions to provide additional insights on areas for future PCORI focus. The seven member TEP group represented academic, industry, and patient-centered advocacy backgrounds. NORC conducted a series of one-on-one interviews with each member and convened a group meeting to engage in group dialogue about areas where additional evidence for telehealth use may be warranted. NORC turned the individual interviews and TEP group meeting into a comprehensive summary document and a transcript. The summary document describes the implications for research priorities in telehealth, suggestions for next steps that PCORI may take to engage in this field, and recommendations for any subsequent rapid evidence review in priority research areas.

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