Telehealth has transformed access to care for patients with opioid use disorder (OUD), allowing clinicians to provide critical treatment without requiring patients to travel to a facility. However, a recent survey published in Health Affairs highlights that barriers to telehealth access remain a significant challenge, particularly for video-based visits. Despite widespread adoption of telehealth, there is still no consensus on the best approach to address digital equity issues, making the development and implementation of effective OUD telehealth strategies essential to ensure all patients can receive high-quality care.
Widespread but Uneven Adoption of OUD Telehealth Strategies
The survey examined OUD providers’ use of both video-based and audio-only telehealth visits, as well as their attitudes toward these modalities and the strategies they employ to help patients overcome technological barriers. Conducted in two waves—December 2020 and March 2022—the research shows that 77% of clinicians reported using at least one strategy to support patients facing challenges with video visits.
Group practices were significantly more likely to implement OUD telehealth strategies than solo practitioners, who often lack the staff and resources to provide technical support. This discrepancy highlights the need for targeted assistance for smaller practices, which may struggle to offer effective telehealth support without outside help.
Common OUD Telehealth Strategies to Improve Access
While the survey found no single strategy was used by a majority of respondents, three approaches emerged as the most common methods for improving access to video-based telehealth:
- Providing educational materials (38.5%) – Clinicians offered step-by-step guides or instructions to help patients navigate video platforms.
- Real-time technical assistance (32.3%) – Some providers assigned staff to assist patients during visits, ensuring the technology worked properly.
- Alternative video chat platforms (32.3%) – Providers sometimes switched platforms to accommodate patients’ device limitations or personal preferences.
These strategies are at the core of effective OUD telehealth strategies, but the lack of a consistent, widely adopted approach underscores the need for additional resources, training, and guidance for clinicians. Community stakeholders can play a pivotal role in supporting these efforts by connecting patients with local resources and technical assistance.
Audio-Only Visits: A Necessary but Limited Solution
Many clinicians consider audio-only visits a practical solution to digital equity barriers. Millions of patients may lack access to devices, reliable broadband, or the digital literacy required to participate in video visits. Audio-only sessions allow these patients to receive some level of care, but they are generally seen as less effective than video-based or in-person visits.
Key survey findings highlight these perceptions:
- 61% of providers believe video visits are as effective as in-person care.
- 31.5% of providers believe audio-only visits are as effective as in-person care.
- 69.7% of clinicians stated video chats provided better care than audio-only visits, up from 63.5% in the December 2020 survey.
Research also indicates that patients tend to have lower satisfaction and comprehension during audio-only visits, reinforcing the importance of implementing OUD telehealth strategies that help patients access video-based care whenever possible.
Trends in Telehealth Utilization
The survey revealed a decline in overall telehealth use for OUD treatment between December 2020 and March 2022. Telemedicine visits dropped from 56.7% of all OUD visits in 2020 to 41.5% in 2022. Audio-only visits remained relatively stable, representing roughly one-third of telehealth sessions, with 28% of visits conducted via audio-only in March 2022.
About two-thirds of clinicians used audio-only visits sparingly or not at all:
- 29% of clinicians did not use audio-only visits at all.
- 37% used audio-only visits for just 1–10% of telehealth visits.
These trends show that while audio-only visits are a necessary safety net, most clinicians prefer video visits whenever possible. Implementing effective OUD telehealth strategies can help maximize the use of higher-quality video sessions.
Bridging the Digital Divide
The report emphasizes that dedicated efforts to bridge the digital divide can make video visits a viable, sustainable alternative to audio-only sessions. Solo practitioners, in particular, may benefit from additional resources, community partnerships, and training to implement OUD telehealth strategies that ensure patients can access video visits successfully.
Looking Ahead
Telehealth will continue to play a central role in OUD treatment, but addressing digital equity is critical. While many providers are taking steps to support patients, the lack of a standardized approach and the lower adoption rates among solo practitioners highlight areas for improvement.
Investing in resources, guidance, and community collaboration can help ensure all patients—regardless of technological limitations—can access the care they need. By prioritizing digital equity and focusing on effective OUD telehealth strategies, providers can deliver care that is accessible, sustainable, and high-quality, ultimately improving outcomes for individuals with opioid use disorder.
