As one of the 3 key legislative asks for the annual AUA Advocacy Summit, telehealth remains top of mind for urologists and all physicians and providers. During the COVID-19 pandemic, there was a massive uptake in telehealth as a result of regulatory flexibilities and improved regulatory landscape allowing patients to seek out new patient evaluations.¹ Patients, physicians, and providers have become accustomed to using telehealth as a substitute for in-person care.² Because of the Consolidated Appropriations Act signed by President Biden, many of the telehealth flexibilities at the federal level have been extended until December 31, 2024. Without congressional action, telehealth regulation and reimbursement could return to pre-pandemic levels—severely restricted, without allowing new patient evaluations, and not reimbursing physicians for the medical decision-making they are providing for patients.

Dr Helen Bernie kicked off the session by highlighting one of the existing pieces of legislation, the Connect for Health Act, and how the language in this bill would support the many flexibilities that patients and providers alike have become used to. Most critically, it would permanently remove all geographic restrictions on telehealth and allow patients to do telehealth visits from home and other nonclinical sites for Medicare beneficiaries. She also shared her own personal experience with telehealth for sexual medicine and male infertility. As she is a key specialist in a large state, many of her patients travel to her from all over Indiana. Telehealth has allowed her to provide high-quality care while removing geographic and financial barriers to patients—until an in-person exam or a surgical intervention is needed.

Next, Bryan Lewis as a kidney cancer survivor and president of KidneyCAN shared the patient perspective. He shared his own story and that of many other kidney cancer patients. Telehealth is allowing patients to seek out expert opinions at centers of excellence, removing geographic barriers. During the public health emergency, some of this even took place across state lines, though this flexibility is no longer available except for in specific circumstances (ie, Veterans Affairs health system, specific state laws, or physician licensed in multiple states).

To build on these patient testimonials, Dr Juan Andino provided an overview of the newest data that emerged during the pandemic as a result of public health emergency flexibilities. For the first time, new patient consultations were studied, and these showed even greater cost and time savings, highlighting the ability to eliminate previous barriers to accessing specialty care, especially with known workforce shortage issues. Additionally, physician satisfaction and positive perception of telehealth has skyrocketed. The data shown, with many of the studies included in a recent mHealth publication,³ highlighted the positive impact of telehealth in providing the same level of quality care.

Finally, Martin Gewirtz, a prostate cancer patient, certified advocate, and board director of Active Surveillance Patients International, closed out the session by sharing additional patient testimonials on the role telehealth has played in managing cancer and health, such as allowing specialists to review laboratory results and imaging obtained locally to determine an appropriate course of action.

As part of an educational curriculum to prepare AUA Summit attendees to meet with the offices of lawmakers, this session provided a comprehensive overview of telehealth: where we were prior to 2020; the regulatory and reimbursement changes that have allowed for appropriate expansion of telehealth services; and the real-world, day-to-day impact that connecting patient and physician or provider through telehealth can have on facilitating care.

At the time of this submission, the future of telehealth remains in limbo. While there is bipartisan support for ensuring telehealth remains a tool for connecting with patients, an election year and myriad other political battles make it difficult to understand when and how Congress will tackle this issue of telehealth. Thankfully, the AUA in partnerships with patient and provider organizations continues to advocate for continued use of telehealth and reimbursing providers for the care delivered. But we need all your help—as the year comes to a close, keep an eye out for opportunities to communicate with your local representatives to ensure that congressional action is taken to allow us to deliver and receive care in a modern medical system.