Study highlights need to expand telehealth services in Puerto Rico
Findings reveal virtual care’s potential to improve access and efficiency.
The results of a new study on the adoption of health information technology, prepared for the Puerto Rico Medicaid office, emphasize the need to expand telehealth services across the island.
Currently, only 37% of doctors in Puerto Rico are affiliated with organizations offering telehealth services, and just 5.7% of those who do not provide it plan to implement it within the next 12 months, according to the study conducted by Bridgewater Group.
“There is an enormous opportunity to address, through the strategic and humanized use of telehealth, many of the challenges of availability and access to health services that currently affect our patients and medical providers,” said María Fernanda Levis, president of health consulting firm Impactivo.
“In Puerto Rico, we have successful models that demonstrate how technology can enhance human capabilities, achieving extraordinary results for patients and relieving the workloads faced by many of our physicians,” she added.
The study’s findings were presented at the first Digital Health and Telehealth (DHTH) Conference in Puerto Rico, convened by the Southeast Telehealth Resource Center (SETRC) of the Health Resources and Services Administration (HRSA) and Impactivo.
The conference showcased various models of care integrating telehealth, including mental health care, prenatal care and chronic condition management.
“As a Telehealth Resource Center, we are dedicated to empowering communities through accessible and innovative solutions,” said Suleima Salgado, principal investigator and Puerto Rico/U.S .Virgin Islands Telehealth Liaison for the SETRC. “We are committed to working together to build sustainable telehealth programs and increase access to care and digital literacy in rural and underserved communities.”
An example of telehealth’s impact is the Optimized Virtual Care (OVC) program at the Castañer General Hospital. This initiative, which is one of only 22 programs selected nationally by the federal government, has transformed health care delivery in rural communities, including Castañer, Adjuntas and Jayuya.
The program combines home visits by nurses and community health workers with virtual consultations between patients and doctors. It also facilitates transportation for patients needing in-person care.
Findings from the program show that participants achieved better control of chronic conditions, such as a 4% improvement in hypertension management and a 6% improvement in diabetes control, compared to nonparticipants. Participants also reported reduced stress and better mental health after a year in the program.
Financially, the OVC program yielded substantial savings. High-cost, high-need patients enrolled in the program incurred 73% lower medical expenses than similar patients outside the program. The savings stem from reduced hospitalizations and emergency room visits, underscoring the program’s ability to improve health outcomes while cutting costs.
“The results of this program demonstrate how telehealth can simultaneously improve patient health, financial efficiency, and satisfaction for both physicians and other health care professionals. Its success lies in using technology to enhance human interactions in health care, rather than adding additional administrative burdens,” Levis said.
The experience of Castañer General Hospital illustrates how patient-centered telehealth and digital health programs can drive innovation, efficiency and sustainability by providing enhanced support to physicians.
The program alleviated the burden on medical providers by leveraging community health workers, addressing participants’ social determinants of health and aiding in the management of chronic conditions.
Nevertheless, the Medicaid office’s study paints a mixed picture of technology adoption in Puerto Rico that shows the need for greater investment and regulatory stability. While Federally Qualified Health Centers (FQHCs) have broadly adopted electronic health records (EHRs) and other health information technologies (HIT), many private practices and hospitals face significant barriers.
These challenges include costs, infrastructure limitations and system interoperability issues, which restrict the expansion of tools like electronic records and telehealth.
The widespread use of EHR systems in FQHCs has largely been driven by federal incentives and reporting requirements.
“The challenges of our health system are a human problem that can be addressed through technological innovation,” Levis said. “Telehealth is an essential tool for strengthening the health network, improving patient outcomes and reducing costs.”
