healthcare disparities

Professor Awarded $720K to Evaluate an Equity-Focused Telehealth Model

Megan Cole Brahim leads the collaboration with Ariadne Labs, C3, and Massachusetts FQHC Telehealth Consortium, supported by grants from the Donaghue Foundation and the Robert Wood Johnson Foundation.

Megan Cole Brahim, assistant professor of health law, policy & management, has received two awards totaling $719,573 to evaluate an equity-focused telehealth delivery model for Medicaid-enrolled patients with chronic conditions.

The awards are from the Donaghue Foundation and the Robert Wood Johnson Foundation. Cole leads the project with June-Ho Kim, a faculty member with the Primary Health Care program at Ariadne Labs, which is a joint center for health systems innovation at Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health. They will also collaborate with Community Care Cooperative (C3), a statewide Medicaid accountable care organization made up of 18 federally-funded community health centers across Massachusetts.

“Our goal is to generate an evidence base for providers and policymakers in Massachusetts and across the US as they make decisions about what telehealth might look like post-COVID, and how it can be used to improve quality, equity, and value of care for the most vulnerable,” Cole says.

As of 2019, less than a quarter of the country’s federally qualified health centers (FQHCs, which are health centers that receive federal grant funding) were using any type of telehealth to provide real-time virtual care directly to patients. By June of 2020, 98 percent were using telehealth in some capacity.  

“Post-COVID, telehealth can be used to improve access to primary and specialty care for patients who previously faced barriers making it to in-person visits,” she says. “Patients may no longer need to take a day off from work or take three buses across town to make it to an appointment. At the same time, patients with inadequate access to technology or internet, or who require interpretation services, may not experience these same benefits—that is, unless the telehealth delivery model tries to bridge these gaps.”

Over the next two years, Cole and Kim will lead research using data from electronic records, insurance claims, and patient surveys to evaluate how telehealth has affected the quality, cost, and equity of care for patients with chronic diseases, including how the effects of telehealth may have varied by race, ethnicity, and language. They will gather insights directly from patient representatives and FQHCs leadership to better understand experiences and develop best practices.

In addition to C3, they will also work with the Massachusetts League of Community Health Centers—which, with C3,  co-leads the Massachusetts FQHC Telehealth Consortium of 35 FQHCs.

“Through this partnership, we’re thrilled to bring together the wide array of strengths and resources of the three organizations to accelerate innovation at a time of rapid change around the COVID-19 pandemic,” says Kim, who is also an instructor in medicine at Harvard Medical School and an attending physician at Brigham and Women’s Hospital.

“In particular, we want to transform the care for patients living with the physical and financial burdens of chronic illness and those who face barriers due to their lower income, race, and language,” he says. “Telehealth is a promising but unproven tool. This project is about trying to better utilize that tool to make healthcare truly meet patients where they are, both literally and figuratively.”