Part 2: Telepsychiatry’s Future: COVID-19’s Public Health Emergency End Explained

As of May 11, 2023, though, that public health emergency declared during the COVID-19 pandemic will come to an end, as announced by the Biden administration. The state of emergency cleared the path for telehealth’s rapid expansion of use across the country. How will the end of the public health emergency affect clinicians and patients who embraced virtual health care?

Psych Congress Network connected with Edward Kaftarian, MD, founder and executive chairman of Orbit Health Telepsychiatry, to hear more about the implications of this policy decision for telehealth providers.

In Part 2 of this video interview series, Dr Kaftarian describes how, in his expert opinion, he anticipates access to care will change following the end of the public health emergency and how clinicians can mitigate the risk posed to patients during this period of transition. He also shares lots of resources where provides can find more information about telehealth specific to their practice’s location.

Missed Part 1 of this video? Find it here! For more expert insights on practicing psychiatry in a virtual setting, visit our Telehealth Excellence Forum.

Edward Kaftarian, MD: Hi, my name is Dr. Edward Kaftarian. I'm a psychiatrist and also on the steering committee for Psych Congress. I'm the executive chairman and founder of Orbit Health Telepsychiatry.

So unfortunately, access to care is going to be affected because of the end of the public health emergency. With increased telehealth restrictions, it's going to be harder and harder to provide telehealth to patients unless you meet certain requirements and exceptions to the rules. And so I think what's going to happen is it's going to have a cooling effect to some degree on telehealth access. Now, the telehealth industry has grown so much since the beginning of the pandemic that I think that telehealth will continue to expand despite the government's efforts to cool it down and the unintended consequences of ending the public health emergency. So I do think that there's going to be a lot of pressure on the government to continue some of the flexibilities that were in place, but I do believe that we're going to have a little bit of a dip right after the pandemic in terms of our ability to provide telehealth services in a way that's compliant with the regulations.

And so once we go through that phase, there's going to be so much pressure on the government that I think there will be special acts of Congress and special regulations that the Biden administration and other administrations will put into place in order to meet this need. But I do believe that the end of the public health emergency will have a detrimental effect on telehealth. That being said, I think that telehealth is here to stay, and there's no government effort or regulatory problem that will not eventually be addressed because people do need telehealth, and it's going to especially impact people that can't leave their homes, such as people who are disabled and some elderly people who are relying on telehealth. There's going to be a huge backlash if these people cannot get care, and rightfully so, because we do have an obligation as a society to provide care to people who need it and to make providers and patients meet up with each other in person is honestly an obsolete and ridiculous kind of requirement.

So hopefully government agencies, regulatory bodies will get up to speed on this and put in exceptions to some of the regulations that inhibit the access of care.

So first of all, there are so many rules and regulations that can affect providers. It's always good to have expert legal help, and there are a number of law firms that specialize in telehealth and a number of attorneys that are very knowledgeable in telehealth rules and regulations. So I would first make sure that you have qualified help with that. Now, if you want to do some informal research on your own, each state can differ in their rules and regulations. I would first go to the telehealth resource centers. So there are a number of resource centers for telehealth online, and they're regionally organized. So for example, California has its own regional telehealth center. There's Northeast, there's Southeast, so go to telehealth resource centers. You can just Google it and you'll see where to go. And that provides a whole host of updates on rules and regulations of telehealth.

You also can look at the American Psychiatric Association. They have a toolkit that goes over some of the rules and regulations and provides updates to providers. I would recommend that if you're seeing a patient in a particular state, that you're familiar with what the medical board requires in that state. So let's say that I'm a provider providing care to a patient in California, I would want to go to the California Medical Board website. And some of the websites are more detailed than others, and some of the medical boards are more restrictive than others. For example, Louisiana has a lot of restrictions on telehealth, so if you are a provider providing care to a Louisiana patient, you want to make sure that you're up-to-date on the rules and regulations that the medical board requires.

Now, other places you can go include the American Telemedicine Association, which has some toolkits and resources that you can look at, but I would also encourage you to go to the website for Orbit Health, which has some resources there. And then finally, and most importantly, I would check Psych Congress Network. So Psych Congress Network has lots of tools and discussions and videos on regulations and rules.

In the end, just practice safely and common sense often carries the day, but you definitely want to make sure that you're up-to-date with the laws and the regulations around telehealth.

Edward Kaftarian, MD, is found and executive chairman of Orbit Health Telepsychiatry. Dr Kaftarian is a nationally recognized psychiatrist and leader in the field of telepsychiatry and healthcare technology. Trained at the world-renowned Johns Hopkins Hospital, he is board-certified in psychiatry, forensic psychiatry and addiction medicine. Dr Kaftarian has served in a variety of executive roles within the California prison system, including chief psychiatrist, senior psychiatrist, medical director, and director of pharmacy. He is the founder of California’s Statewide Prison Telepsychiatry Program, which is the largest correctional telepsychiatry program in the world.