OUD Providers Fail to Find Consensus on Addressing the Digital Divide

There is still no consensus regarding opioid use disorder (OUD) providers’ approach to addressing digital equity issues preventing patients from accessing telehealth.

A survey report published in the health policy journal Health Affairs found that 77% of OUD clinicians used one or more strategies to address barriers to video-based telehealth visits. However, solo practitioners were much less likely to use any strategy. Researchers also found that no one strategy was in use by the majority of respondents. 

The survey assessed the use of video chat and audio-only telehealth, attitudes toward audio-only telehealth and strategies used to address barriers to video visits across two waves of surveys: one conducted in December 2020 and the other in March 2022.


“It is promising that the majority of clinicians in our sample, particularly those in group practices, were implementing one or more digital equity strategies to support patients who faced barriers to video visits,” the report states.

The lack of a widespread strategy suggests “the need to provide more resources and training, as well as guidance” on the place that providers and other community stakeholders hold in facilitating telehealth via video chat. 

The three most common strategies used, regardless of practice setting, to help people access video chat visits were providing educational materials (38.5%), real-time technical assistance (32.3%) and offering to use an alternative video chat platform (32.3%).


The report doesn’t include exact use rates for all settings and digital equity strategies. However, solo practitioners were less likely to implement any of the strategies researchers assessed compared to group practices.

“Clinicians in solo practice are particularly in need of additional resources and community partners to implement the more impactful strategies, as they may lack the staff to offer needed supports,” the report states.

Previous research indicates that many providers see audio-only visits as a solution to digital equity issues. However, the report affirms that many providers see audio-only visits as inferior to video chat visits or in-person visits.

“Because millions of patients might not have the devices, digital literacy, or broadband capacity to participate in video visits, clinicians have two options: offer audio-only visits that may be perceived as lower quality or implement digital equity strategies to support patients in accessing video visits,” the report states.

The report also mentions previous research that finds patients have lower satisfaction and comprehension on audio-only calls.

The report specifically finds that 61% of providers find that video chat visits are as effective as in-person care — compared to 31.5% for audio-only visits — and that 69.7% of clinicians said video chats provided better care than audio-only.

The share of clinicians saying video chats provided better increased from the December 2020 survey’s finding of 63.5%.

Regardless of telehealth visit type, utilization decreased between the two waves of surveys. Overall telemedicine use dropped from 56.7% of all OUD visits in December 2020 to 41.5% in March 2022.

Audio-only visits as a share of OUD telehealth visits hovered near one-third in both surveys, making up 28% of telehealth visits in the March 2022 survey.

About two-thirds of clinicians surveyed didn’t use audio-only telehealth visits at all or very little. About 29% didn’t use audio-only at all while 37% used audio-only visits for 1% to 10% of telehealth visits, the report states.

“With dedicated efforts to bridge the digital divide, video visits can replace seemingly inferior, as well as less sustainable, audio-only visits,” the report states.

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