Telehealth — remote doctor visits for non-emergency treatment — has spiked dramatically since the start of the pandemic. The American Medical Association is throwing its support behind legislation that would expand funding and reduce regulations on telehealth, by letting anyone access telehealth services no matter where they are. And legislators on both sides of the aisle have called on congressional leaders to expand access.

PwC’s Health Research Institute put out a report late last year, saying telehealth will be huge in 2021, but there are roadblocks, especially around equity. I spoke with Karen Young, PwC’s Health Industries Leader. The following is an edited transcript of our conversation.

Karen Young: The number one issue, obviously, was they had technical issues. A lot of people feeling uncomfortable being on video, and certainly from a race perspective, we saw a lot of disparities with the Latinx and Black community not being comfortable on video. And so how do you get them to be more comfortable, having a video conversation with their physician? Also, ongoing follow-up and care visits were down when you did use telehealth. So those ancillary services need to be worked out in order for this to be a sustainable platform.

Molly Wood: What are the best ideas right now to address that fundamental discomfort, the camera shyness?

Young: What we’re seeing organizations focus on is, are [patients] looking at somebody like themselves? Because they don’t trust going to somebody that’s not from their community. They don’t trust going to somebody who might not look like them and be Black or Latinx. And so organizations are focused on that demographic to say, how do we get more people into positions of physicians and providers, that individuals and consumers and patients will start to be more and more comfortable when they’re looking at somebody that’s like them?

Wood: Certainly it’s a lot of companies that are operating under this model. But I wonder where do insurance companies fit in, because I know that, for example, they stopped covering copays midway through the pandemic?

Young: Yeah, absolutely. And we would say that is probably one of the most significant challenges right now as far as reimbursement. And so we’ve got data that shows 52% [of health executives] would say reimbursement is one of the most significant elements of telehealth. And so to solve for reimbursement, you’re going to need policy, you’re going to need support, whether it’s governmental or commercial insurance, so the payers are going to have to come to the table along with the providers understanding the benefits of telehealth and the long-term care costs to an individual.

Wood: What about the tools that clinics and doctors and clinicians are using? In some cases, their consumer tools, right? Like are there privacy concerns for patients?

Young: We often talk about the supply chain challenges that we saw because of the physical supply chain of getting PPE during this pandemic, scaling up for needs across medicines or even vaccines. And now, organizations have quickly pivoted to what is their risk and governance and security around their virtual supply chain. And as they build out these platforms, have they taken all the necessary precautions to protect patient data, electronic health records, access, and certainly when you start to put a lot of these elements into the cloud, those risks are there and organizations are assessing their governance and their processes and around those risks.

Wood: How big a priority do you think it is? I mean, knowing that hospitals and health care facilities have been a huge target in cyberattacks and everybody has aging infrastructure.

Young: It’s one of the top priorities. In many of our clients that we speak to, especially board members, it’s one of the top three items on a board member agenda, whether it’s physical or virtual cyberthreats, security risk, and specifically across the health industry group, it is one of their number one risks that they focus on.

Wood: I mean, it sounds like you’re describing some pretty steep challenges, from inequality to insurance reimbursement to broadband access. But PwC is still confident that there’s going to be growth in this industry in 2021?

Young: Absolutely. I think what we’re seeing is, the opportunity has never been greater. The pandemic has allowed the timing of succeeding and failing to happen over the past 12 months to determine what’s working, what’s not working and what’s needed. And so we’ll continue to see the uptick of telehealth, the scalability of it, the consistency of telehealth. And those experiences, I think, will continue to grow and the consumers and patients will continue to demand it.