Lori Uscher-Pines

Senior Policy Researcher; Research Quality Assurance Manager

Washington Office

Education

Ph.D. in health policy and management, Johns Hopkins University; M.Sc. in international relations/security studies, London School of Economics; B.A. in international relations, University of Pennsylvania

One Page Bio

Media Resources

This researcher is available for interviews.

To arrange an interview, contact the RAND Office of Media Relations at (310) 451-6913, or email media@rand.org.

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Overview

Lori Uscher-Pines is a senior policy researcher at the RAND Corporation. She is also the research quality assurance manager for RAND Social and Economic Well-Being. Her research interests include telehealth, maternal and child health, mixed methods research, and emergency preparedness. Her current projects include assessing the impact of various forms of telehealth such as telemental health and telestroke on quality and access to care. She is also conducting an evaluation of the implementation of telehealth programs in safety net settings and conducting a digital trial evaluating the effectiveness of virtual breastfeeding support via mobile app. She is a mixed methods researcher who has authored over 100 peer-reviewed publications.

Uscher-Pines earned her Ph.D. in health policy and management from the Johns Hopkins Bloomberg School of Public Health and her M.Sc. in international relations from the London School of Economics. Before coming to RAND, Uscher-Pines completed a post-doctoral fellowship at Johns Hopkins University, National Center for Preparedness and Catastrophic Event Response.

Research Focus

Commentary

Moving on from Telehealth-by-Desperation: What Will Make Telehealth Stick
During the COVID-19 pandemic telehealth has helped to maintain continuity of care for millions of Americans, preserve personal protective equipment, and facilitate social distancing. But that does not mean that telehealth will be embraced by patients and providers in the long run.
Aug 18, 2020 Health Affairs Blog
Coronavirus, Telemedicine, and Dustbusters
Telemedicine has been with us for decades. And yet it hasn't transformed health care in the way that ATMs have transformed banking or cordless vacuums have transformed household cleaning. But the coronavirus pandemic could forever change how telemedicine is used.
Mar 16, 2020 The RAND Blog
Coronavirus Outbreak Intensifies: Q&A with RAND Experts
Cases of the coronavirus have now spread to several dozens of countries, infecting thousands and thousands of people across the globe. With concerns about the disease rising, we asked a group of RAND researchers to answer a wide range of questions about the crisis.
Mar 5, 2020
Parental Leave Would Cause a Boom in Breastfeeding
Doctors recommend exclusive breastfeeding for the first six months of a baby's life. This provides health benefits to both mother and child and saves health care costs. Paid maternity leave can boost breastfeeding rates, but few U.S. firms offer it.
Apr 17, 2017 The Hill
Telehealth Alone Won't Increase Health Care Access for the Underserved
Telehealth can bring care into communities that have limited access to providers or facilities. But it must be integrated into a well-functioning system that can address the added needs that telehealth generates.
Dec 16, 2016 Health Affairs Blog
Are County Masking Requirements the Future of Influenza Prevention?
If it doesn't seem that state laws as currently written can help increase the number of health care workers vaccinated against influenza, then what can? There is evidence that imposing consequences for vaccination refusal, including the requirement to wear a surgical mask, can help.
Nov 20, 2013 The RAND Blog
Applying What Works to Reduce Non-Urgent Emergency Department Use
It is likely that communities with low rates of non-urgent ED use not only have better access to primary care, but patients who are educated about appropriate care seeking and convenient alternatives for acute care, writes Lori Uscher-Pines.
May 22, 2013 The RAND Blog
Why Aren't Americans Listening to Disaster Preparedness Messages?
Given the recent spate of highly publicized disasters, why don't more Americans pay attention to the advice of public health officials? The messages they are getting are largely based on unverified assumptions, not hard evidence. Equally concerning, these assumptions may inadvertently hinder preparedness.
Jun 29, 2012 The RAND Blog

Publications

Journal Article
What Drives Greater Assimilation of Telestroke in Emergency Departments?
Although many emergency departments (EDs) have telestroke capacity, it is unclear why some EDs consistently use telestroke and others do not. We compared the characteristics and practices of EDs with robust and low assimilation of telestroke.
2020
Journal Article
Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic
During the COVID-19 pandemic, visit volume at a sample of FQHCs declined modestly for primary care visits and remained stable for behavioral health visits because telehealth visits replaced in-person visits.
Feb 4, 2021
Report
Telehealth After COVID-19: Clarifying Policy Goals for a Way Forward
The use of telehealth has increased during the COVID-19 pandemic. What role can telehealth play in a post-pandemic world? The authors of this Perspective discuss how the ongoing use of telehealth services could affect the realization of policy goals.
Jan 22, 2021
Journal Article
The Transition to Telehealth During the First Months of the COVID-19 Pandemic: Evidence from a National Sample of Patients
As the COVID-19 pandemic disrupted in-person medical care, emergency regulatory changes were implemented to promote use of telehealth.
Jan 8, 2021
Journal Article
Treatment of Opioid Use Disorder During COVID-19: Experiences of Clinicians Transitioning to Telemedicine
In the context of the pandemic, buprenorphine prescribers quickly transitioned to providing telemedicine visits in high volume; nonetheless, there are still many unknowns, including the quality and safety of widespread use of telemedicine for OUD treatment.
2020
Journal Article
Prevalence and Characteristics of Telehealth Utilization in the United States
This article measures the use of and willingness to use telehealth modalities across the U.S. population.
Dec 3, 2020
Journal Article
The Use of and Experiences With Telelactation Among Rural Breastfeeding Mothers: Secondary Analysis of a Randomized Controlled Trial
The objective of this study was to identify maternal characteristics associated with the demand for and use of telelactation and to describe visit characteristics.
2019
Journal Article
Use of Virtual Breastfeeding Support Among Underserved, Rural Mothers
To assess predictors of utilization and telelactation visit characteristics, we merged and analyzed data from two sources: visit-level data supplied by the telelactation vendor and longitudinal surveys of women in the intervention group at four timepoints.
2019
Journal Article
Feasibility and Effectiveness of Telelactation Among Rural Breastfeeding Women
This article evaluates the feasibility and impact of telelactation via personal electronic devices on breastfeeding duration and exclusivity among rural women.
Nov 13, 2020
Journal Article
Use of Tele–mental Health in Conjunction With In-Person Care: A Qualitative Exploration of Implementation Models
Exploration of implementation models for tele–mental health.
Oct 2, 2020
Journal Article
Health Center Implementation of Telemedicine for Opioid Use Disorders: A Qualitative Assessment of Adopters and Nonadopters
Although use of telemedicine for the treatment of opioid use disorders is growing, there is limited research on how it is actually being deployed in treatment. We explored how health centers across the U.S. are using it.
Sep 18, 2020
Report
The Case for a Telemedicine Coordinator: Lessons Learned from the Sustainable Models of Telemedicine in the Safety Net Initiative
This brief report offers lessons learned about telemedicine staffing and the coordinator role from the experience of nine community health centers in California that participated in the Sustainable Models of Telehealth in the Safety Net initiative.
Jul 29, 2020
Report
Costs of Maintaining a High-Volume Telemedicine Program in Community Health Centers
RAND researchers describe telemedicine-related costs incurred by health centers participating in the Sustainable Models of Telehealth in the Safety Net initiative.
Jul 29, 2020
Report
Experiences of Community Health Centers in Expanding Telemedicine
Researchers evaluated the experiences of health centers that participated in the Sustainable Models of Telehealth in the Safety Net initiative, which aimed to support the growth of telemedicine.
Jul 29, 2020
Report
Promising Practices for Telemedicine Implementation
RAND researchers describe practices identified by health centers participating in the Sustainable Models of Telehealth in the Safety Net initiative that could support the growth and sustainability of telemedicine programs in safety-net settings.
Jul 29, 2020
Journal Article
Adoption of Telemedicine Services by Substance Abuse Treatment Facilities in the U.S.
Telemedicine for treating Substance use disorder (SUD) use is growing steadily among treatment facilities; however, uptake is uneven and relatively low. As such, telemedicine may be an under-utilized tool to expand access to care for patients with SUD.
Jul 28, 2020
Journal Article
Treating Patients With Opioid Use Disorder in Their Homes: An Emerging Treatment Model
Treating OUD in the home via telehealth is expanding under COVID, but it is not clear what will happen post pandemic.
May 29, 2020
Journal Article
Feasibility of Social Distancing Practices in US Schools to Reduce Influenza Transmission During a Pandemic
We assessed the feasibility of implementing other social distancing practices in K-12 schools as a first step in seeking an alternative to preemptive school closures.
May 22, 2020
Journal Article
Suddenly Becoming a "Virtual Doctor": Experiences of Psychiatrists Transitioning to Telemedicine During the COVID-19 Pandemic
The COVID-19 pandemic has driven a dramatic shift in how psychiatrists deliver care. Findings highlight that although psychiatrists express some concerns about the quality of these encounters, the transition has been largely positive for both patients and physicians.
May 19, 2020
Draft
Opportunities and Challenges in Using Online Learning to Maintain Continuity of Instruction in K–12 Schools in Emergencies
Explores the use of online instruction in K-12 schools during prolonged school closures and preparedness when it occurs with little warning.
Apr 16, 2020
Journal Article
School and Preparedness Officials' Perspectives on Social Distancing Practices to Reduce Influenza Transmission During a Pandemic: Considerations to Guide Future Work
The objective of this qualitative study was to explore the perspectives of school and preparedness officials on the feasibility of implementing a range of social distancing practices to reduce influenza transmission during a pandemic.
2019
Journal Article
Enhancing Community Preparedness: An Inventory and Analysis of Disaster Citizen Science Activities
Disaster citizen science, or the use of scientific principles and methods by "non-professional" scientists or volunteers, may be a promising way to enhance public health emergency preparedness and build community resilience.
Oct 30, 2019
Report
Experiences of Medicaid Programs and Health Centers in Implementing Telehealth
Telehealth is underutilized by safety-net providers due to a range of policy, organizational, and logistical barriers. This research facilitates state-to-state learning to inform both Medicaid policy and Medicare policy and provide lessons learned.
Mar 8, 2019
Journal Article
Geographic Access to International Board-Certified Lactation Consultants in Pennsylvania
Most children in Pennsylvania live within 30 miles of an international board-certified lactation consultant; however, this is true for a smaller percentage of children in rural counties.
Aug 24, 2018
Journal Article
Virtual First Responders: The Role of Direct-to-Consumer Telemedicine in Caring for People Impacted by Natural Disasters
Using telemedicine in a disaster can tap a pool of out-of-state providers, thus expanding the response workforce quickly and cost-effectively.
Jun 4, 2018
Journal Article
Expanding The Paradigm of Occupational Safety And Health: A New Framework For Worker Well-Being
Defining, promoting, and evaluating worker well-being is a complex undertaking requiring partnerships and commitments across employers, individuals, and communities.
May 22, 2018
Journal Article
School Practices to Promote Social Distancing in K-12 Schools: Review of Influenza Pandemic Policies and Practices
Little information is available to schools to develop policies and procedures on social distancing during a flu pandemic. Additional research is needed to assess the feasibility and effectiveness of these policies and procedures.
May 4, 2018
Journal Article
Rapid Growth In Mental Health Telemedicine Use Among Rural Medicare Beneficiaries, Wide Variation Across States
The use of mental health telemedicine among rural Medicare patients varies dramatically across states and is highly concentrated both in terms of who receives and who provides this care.
Jun 6, 2017
Journal Article
The Emergence and Promise of Telelactation
Telehealth services to support lactation may hold particular promise, but additional research is needed to determine whether the benefits outweigh potential challenges.
Jun 2, 2017
Journal Article
Variation in Dermatologist Visits by Sociodemographic Characteristics
Medicaid enrollees are less likely than those with private insurance to see a dermatologist or receive care for a skin condition, suggesting that efforts need to be made to increase access to skin specialists.
Apr 26, 2017
Journal Article
Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending
Direct-to-consumer telehealth may increase access by making care more convenient for certain patients, but it may also increase utilization and health care spending.
Mar 28, 2017
Journal Article
Antibiotic Prescribing for Acute Respiratory Infections in Direct-to-Consumer Telemedicine Visits
Patterns of antibiotic prescribing behavior show that both telemedicine and office-based clinicians over-prescribed antibiotics to treat acute respiratory infections, but telemedicine clinicians tended to prescribe broad-spectrum antibiotics.
2015
Journal Article
Leveraging Telehealth to Bring Volunteer Physicians Into Underserved Communities
Organizations that use telehealth to address safety net clinic needs by recruiting retired or semi-retired doctor volunteers can help improve access to physicians in underserved areas while enriching the professional lives of clinicians.
Mar 16, 2017
Journal Article
The National Adult Immunization Plan: Strengthening Adult Immunization Through Coordinated Action
Addressing persistent structural and policy barriers to adult immunization will benefit all Americans.
2016
Report
Lessons Learned from the MAVEN Project Pilot: Using Physician Volunteers to Increase Access to Care via Telehealth
The Medical Alumni Volunteer Expert Network (MAVEN) Project created a corps of experienced volunteer physicians to provide telehealth consults to providers in safety-net clinics. This evaluation of the program can inform quality-improvement efforts.
Dec 9, 2016
Research Brief
Building a More Sustainable U.S. Blood System
Describes trends affecting the U.S. blood system, presents insights into its sustainability, and offers recommendations for how policymakers can ensure the safety and sustainability of the blood supply.
Nov 28, 2016
Report
Toward a Sustainable Blood Supply in the United States: An Analysis of the Current System and Alternatives for the Future
This report aims to describe the U.S. blood system, identify and discuss potential threats to the functioning and sustainability of the blood system, and describe recommendations with the potential to improve the sustainability of the blood system.
Nov 21, 2016
Journal Article
The Promise of Direct-to-Consumer Telehealth for Disaster Response and Recovery
This paper discusses several potential uses of direct-to-consumer telehealth during disaster response and recovery while noting the logistical, legal, and policy challenges that must be addressed to allow for expanded use.
Sep 12, 2016
Journal Article
Using Insights from Behavioral Economics to Strengthen Disaster Preparedness and Response
Behavioral economics has achieved positive results in decision-making contexts similar to those surrounding disaster preparedness and response, and therefore the low cost and potentially high impact of behavioral economics-based interventions warrant further investigation.
Jun 2, 2016
Journal Article
Effect of Teledermatology on Access to Dermatology Care Among Medicaid Enrollees
Offering teledermatology appeared to improve access to dermatology care among Medicaid enrollees and played an especially important role for the newly enrolled.
May 19, 2016
Report
Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans
The Department of Veterans Affairs health care system, with broad resources and capabilities, provides timely and high-quality care to most, but not all, patients. Meeting veterans' needs over the next five years will require additional capacity.
Dec 31, 2015
Journal Article
Access and Quality of Care in Direct-To-Consumer Telemedicine
Direct-to-consumer (DTC) telemedicine serves millions of patients; however, there is limited research on the care provided.
Nov 20, 2015
Tool
Community Resilience: Learn and Tell Toolkit
This toolkit is intended to teach people about community resilience so that they can then teach others. It has information and exercises, which individuals and organizations can use to communicate with their staff and service populations.
Apr 22, 2015
Tool
The Hungrier Games: Disaster Resilience Skills for Youth
This guide contains an introduction to the key principles of community resilience. It is intended for high school youth (ages 14--18). The introduction is presented through youth-friendly talking points and the use of a scavenger hunt game.
Apr 22, 2015
Journal Article
The Relationship Between Influenza Vaccination Habits and Location of Vaccination
Medical settings are still best at capturing individuals who are not in the habit of getting regular influenza vaccinations.
Dec 23, 2014
Infographic
Building Blocks for a Resilient City
This infographic illustrates how communities can withstand and recover from disasters by building resiliency.
Aug 18, 2014
Journal Article
Equity in the Receipt of Oseltamivir in the United States During the H1N1 Pandemic
We assessed the relationship between individual characteristics and receipt of oseltamivir (Tamiflu) in the United States during the H1N1 pandemic and other flu seasons.
Jun 1, 2014
Infographic
Road to Resilience: Building Stronger, More Sustainable Communities
This infographic illustrates how communities can become more resilient as they plan ahead for potential disasters.
May 23, 2014
Journal Article
Analysis of Teladoc Use Seems to Indicate Expanded Access to Care for Patients Without Prior Connection to a Provider
Despite the potential benefits of telehealth applications, little is known about their overall impact on care. Teladoc appears to be expanding access to patients who are not connected to other providers.
Feb 1, 2014
Journal Article
Barriers and Facilitators to Pediatric Emergency Telemedicine in the United States
Pediatric emergency telemedicine shares challenges with other telemedicine applications, but reimbursement is relatively less significant, and workflow disruption is relatively more significant in this setting.
2014
Journal Article
On Call at the Mall: A Mixed Methods Study of U.S. Medical Malls
The decline of the traditional U.S. shopping mall and a focus on more consumer- centered care have created an opportunity for medical malls.
Nov 1, 2013
Journal Article
Household Preparedness Is Not Enough: The Challenges and Opportunities in Assessing Community Readiness for Disasters
This study aimed to identify existing measures of partnership, self-sufficiency, and social connectedness, as well as gaps and opportunities in the measurement of community preparedness and resilience.
Sep 1, 2013
Journal Article
The Challenges and Rewards of Engaging a Skeptical Public
The aim of this commentary is to discuss both the challenges and the rewards of engaging a public that wants to weigh evidence prior to taking action in an emergency, rather than defer to expert judgment.
Mar 1, 2013
Journal Article
Emergency Department Visits for Nonurgent Conditions: Systematic Literature Review
About 37% of ED visits were for nonurgent conditions. Patients using EDs inappropriately tended to be younger, found EDs more convenient, had an ED referral by a physician, or had negative perceptions about providers who might be alternatives to ED care.
2013
Journal Article
The Promise and Pitfalls of Community Resilience
This commentary describes the potential promise and pitfalls of the concept of community resilience and recommends strategies to overcome its limitations.
2013
Journal Article
A Qualitative Analysis of the Impact of Healthcare Personnel Influenza Vaccination Requirements in California
Using qualitative methods, we explored the implementation of California's 2007 influenza immunization requirements of hospital-based health care personnel (HCP).
2014
Journal Article
Bioterrorism and Biological Threats Dominate Federal Health Security Research: Other Priorities Get Scant Attention
Federal support for health security research is heavily weighted toward preparing for bioterrorism and other biological threats, providing significantly less funding for challenges such as monster storms or attacks with conventional bombs.
Dec 1, 2012
Journal Article
Growth of Retail Clinics in Vaccination Delivery in the U.S.
Retail clinics play a growing role in delivering vaccinations to Americans, and vaccinations constitute a substantial share of retail clinic business.
Jul 1, 2012
Journal Article
Citizen Preparedness for Disasters: Are Current Assumptions Valid?
Despite extensive messaging about the importance of citizen preparedness and countless household surveys purporting to track the preparedness activities of individuals and households, the role individual Americans are being asked to play is largely based on conventional wisdom.
Jun 1, 2012
Research Brief
A Shot in the Arm for Adult Vaccination
Vaccine-preventable diseases take a heavy toll on U.S. adults despite the widespread availability of vaccines. Office-based providers can do more to promote adult vaccinations but need clearer guidance and a better business case to offer them.
May 16, 2012
Report
A Blueprint for Improving the Promotion and Delivery of Adult Vaccination in the United States
Vaccine-preventable disease continues to take a heavy toll on adults despite the widespread availability of effective vaccines. This report identifies the barriers to adult vaccination and recommends strategies to improve its promotion and delivery.
Jan 11, 2012
Journal Article
Influenza Vaccination Coverage Among Health-Care Personnel — United States, 2010-11 Influenza Season
This article reports on the results of a survey of health care workers to determine whether they had received an influenza vaccine in April 2011.
Aug 1, 2011
Research Brief
Building Community Resilience to Disasters: A Roadmap to Guide Local Planning
Examines ways in which communities can improve their ability to withstand and recover from adversity.
Feb 22, 2011
Report
Building Community Resilience to Disasters: A Way Forward to Enhance National Health Security
Provides a roadmap for federal, state, and local leaders who are developing plans to enhance community resilience for health security threats and describes options for building community resilience in key areas.
Feb 22, 2011
Research Brief
Seasonal Flu Vaccination: Why Don't More Americans Get It?
RAND researchers found that less than half of U.S. adults received flu vaccinations in 2010. Strategies to increase flu vaccination rates should include stronger efforts to address public skepticism and negative perceptions.
Feb 14, 2011
Journal Article
Racial and Ethnic Disparities in Uptake and Location of Vaccination for 2009-H1n1 and Seasonal Influenza
This article describes findings from a group of experts assembled to help improve the science of patient safety..
2011
Report
Seasonal Influenza Vaccine Use by Adults in the U.S.: Detailed Survey Data Tables for the 2009-2010 Vaccination Season
This detailed data from a survey of adults age 18 and over of seasonal influenza vaccine uptake informs public health officials and other stakeholders about seasonal influenza vaccination of adults during the 2009-2010 vaccination season.
Jun 16, 2010
Report
Seasonal Influenza Vaccine Use by Adults in the U.S.: A Snapshot from the End of the 2009-2010 Vaccination Season
This overview of the results of a survey of adults age 18 and over informs public health officials and other stakeholders about seasonal influenza vaccination of adults during the 2009-2010 vaccination season.
Jun 15, 2010
Draft
Understanding Community Resilience in the Context of National Health Security: A Literature Review
This review lays a foundation for upcoming analyses that will provide a working definition of community resilience, identify activities for building resilience, and offer associated metrics.
Jan 11, 2010
Journal Article
Awareness of Government Seasonal and 2009 H1N1 Influenza Vaccination Recommendations Among Targeted US Adults: The Role of Provider Interactions
Despite comprehensive media coverage of the H1N1 pandemic, awareness of government influenza vaccination recommendations among adults is low. Provider-based vaccination counseling may help increase awareness of federal vaccination recommendations.
2010
Journal Article
Healthy Young and Middle Age Adults: What Will It Take to Vaccinate Them for Influenza?
Starting in 2010, healthy adults age 19-49 will be recommended for annual influenza vaccination. Boosting rates of vaccination in this population will require new and untraditional strategies aimed at encouraging first-time vaccination.
2010
Journal Article
Neighborhood and Individual-Level Violence and Unintended Pregnancy
Finds that neighborhood-level violence and other individual-level violence indicators may be important when examining factors related to unintended pregnancy among young, urban women.
2010
Journal Article
Perceived Seriousness of Seasonal and A(H1N1) Influenzas, Attitudes Toward Vaccination, and Vaccine Uptake Among U.S. Adults: Does the Source of Information Matter?
Information campaigns made more adults concerned about a pandemic, but didn't reassure them sufficiently about H1N1 vaccine safety and effectiveness that they got the vaccine.
2010
Journal Article
Research Priorities for Syndromic Surveillance Systems Response: Consensus Development Using Nominal Group Technique
This paper describes an expert panel process that identified a set of fundable and practically feasible research priorities in the field of syndromic surveillance.
2010
Report
Seasonal Influenza Vaccine Use by Adults in the U.S.: Detailed Survey Tables, Mid-November 2009
This detailed data from a survey of adults age 18 and over on their uptake of the seasonal influenza vaccine will inform public health officials and other stakeholders on progress toward vaccinating adults prior to the end of the vaccination season.
Dec 7, 2009
Report
Seasonal Influenza Vaccine Use by Adults in the U.S.: A Snapshot as of Mid-November 2009
This overview of the results of a survey of adults age 18 and over of seasonal influenza vaccine uptake will inform public health officials and other stakeholders on progress toward vaccinating adults prior to the end of the vaccination season.
Dec 7, 2009

Multimedia

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The Global Spread of COVID-19
Mar 4, 2020