World Health Organization risk drinking level reductions as treatment outcomes in PTSD and substance use disorder trials.

Telehealth use in the US increased dramatically during the COVID-19 pandemic enabled largely by regulatory changes that expanded public and private insurance coverage for video- and phone-based delivery of healthcare services []. Although telehealth utilization has dropped since the peak of the pandemic, usage and patient acceptance remains higher than pre pandemic levels as indicated by national trends [] as well as data from specific health systems [] and geographic communities []. Available evidence also allays some concerns about telehealth potentially duplicating in-person health visits. Research shows that telehealth substitutes for rather than duplicates certain types of in-person visits such as consultations for common acute outpatient conditions [], primary care visits [, ] especially when the patient has an existing clinical relationship with the provider [], and visits with specialists that do not require in-person hands-on care such as genetics, nutrition, mental health, diabetes care []. Additionally, analysis of federal claims data and electronic health records from large, integrated health system in the US suggests that telehealth does not appear to increase downstream emergency department visits [, ], and does not trigger non-essential return visits or follow ups across primary and specialty care [, ]. Studies have also found telehealth to be clinically useful and cost effective in chronic disease management [, ] and for improving access to continuity of behavioral health services []. The continuing utility and promise of telehealth have prompted bipartisan legislation to incrementally extend pandemic telehealth provisions beyond the initially approved timeline. Notably, professional bodies such as the American Medical Association and the American Hospital Association strongly support permanent expansion of telehealth access [, ]. With some pandemic telehealth provisions becoming permanent and others being extended, telehealth is emerging as a viable option for healthcare delivery in the post-pandemic world []. As we develop systems and practices to routinize telehealth, it is important to ensure that existing health disparities are not exacerbated. One group that is particularly vulnerable to telehealth challenges includes patients with Limited English Proficiency (LEP). This group includes individuals whose primary language is not English and who have limited ability to read, write, speak, and understand English []. In 2021, 25.7 million individuals in the US were deemed to have LEP, comprising 8% of the overall population aged five years and older []. Despite federal regulations mandating equitable healthcare access for patients with LEP, this group experiences significant challenges even with conventional in-person healthcare [, ]. Communication barriers in the absence of bilingual providers and professional interpreters contribute to high rates of misdiagnosis, over or under treatment, adverse events, and treatment-related complications, resulting in poor health outcomes and low patient satisfaction [–].