Background: Hepatitis C virus (HCV) elimination requires treatment access expansion, especially for underserved populations. Telehealth has the potential to improve HCV treatment access, although data are limited on its incorporation into standard clinical practice. Methods: We conducted a cross-sectional, e-mail survey of 598 US HCV treatment providers who had valid email addresses and 1) were located in urban areas and had written >20 prescriptions for HCV treatment to US Medicare beneficiaries in 2019-20 or 2) were located in non-urban areas and wrote any HCV prescriptions in 2019-20. Through email, we notified providers of a self-administered electronic 28-item survey of clinical strategies and attitudes about telemedicine for HCV. Results: We received 86 responses (14% response rate), of which 75 used telemedicine for HCV in 2022. Of those 75, 24% were gastroenterologists/hepatologists, 23% general medicine, 17% infectious diseases, and 32% non-physicians. Most (82%) referred patients to commercial laboratories, and 85% had medications delivered directly to patients. Overwhelmingly, respondents (92%) felt that telehealth increases healthcare access, and 76% reported that it promotes or is neutral for treatment completion. Factors believed to be "extremely" or "very" important for telehealth use included patient access to technology (86%); patients' internet access (74%); laboratory access (76%); reimbursement for video visits (74%) and audio-only visits (66%). Non-physician licensing and liability statutes were rated "extremely" or "very" important by 43% and 44%, respectively. Conclusions: Providers felt that telehealth increases HCV treatment access. Major limitations were technological requirements, reimbursement, and access to ancillary services. These findings support the importance of digital equity and literacy to achieve HCV elimination goals.

Dr Kapadia reports grants to his institution from Gilead Sciences Inc unrelated to the current study. Dr. Patel is part of the Speakers Bureau for Gilead Sciences. Dr. Talal reports grants to his institution from Gilead Sciences, Merck, and Abbott Laboratories. He has also served on advisory committees and as an advisor to Gilead Sciences, Novo Nordisk, and AbbVie. All other authors report no conflicts of interest.

This work was supported in part by R01 DK123205 (to MS, MTW, EW, AHT), K01 DA048172 (to SNK), a Patient-Centered Outcomes Research Institute (PCORI) Award (IHS-1507-31640) (to AHT) and the Troup Fund of the Kaleida Health Foundation (to AHT). The opinions expressed in this work are those of the authors, and do not necessarily reflect the views of the funding agencies or the US Government.

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