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Lawmakers Want a Full Study of Telehealth During the COVID-19 Crisis

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Mobile healthcare, telemedicine, telehealth, BYOD

 

By Eric Wicklund

A bill before Congress calls on the Health and Human Services Department and the Government Accountability Office to produce separate studies on how telehealth has been used to address the coronavirus pandemic.

 

– While Congress is under mounting pressure to extend telehealth coverage past the coronavirus pandemic, some lawmakers want to make sure the evidence is there to support those moves.

A bill introduced in the House last week calls on both the Health and Human Services Department and the Government Accountability Office to conduct separate studies of telehealth use and outcomes during the ongoing emergency. Known as the KEEP Telehealth Options Act, the bill aims to give lawmakers a detailed accounting of the connected health landscape.

(For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.)

“COVID-19 has unexpectedly pulled us into a demonstration of how effective and important telehealth options are for older Iowans or those who live farther from a health center,” Rep. Cindy Axne (D-IA), who co-sponsored the bill with Rep. Troy Balderson (R-OH), said in a press release. “What we have now is a golden opportunity to document how telehealth services were implemented and where improvements can be made so we can chart a path to keeping these options available for patients who won’t stop needing them when this pandemic is over.”

This isn’t the only bill to call for a telehealth study. Earlier this month, Rep. Robin Kelly (D-IL) unveiled the Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020 (HR 7078), which would reportedly call on HHS to study telehealth use during the emergency and report back to Congress one year after the emergency has ended.

This latest bill gives HHS six months to finish its study and report back to Congress. It calls on the agency to analyze actions taken during the COVID-19 emergency to enhance telehealth coverage for Medicare, Medicaid and the Children’s Health Insurance Program (CHIP), including new services and providers who qualify for reimbursement and analyses of telehealth use by rural, minority, low-income and elderly populations, telemental health services and the impact on public health.

The bill gives the GAO seven months to complete its study and report back to Congress, and calls on the agency to focus on the efficiency, management and successes and failures of expanded telehealth access, as well as any increase in fraudulent activities.

While telehealth has generally been cast in a positive light in how it’s been used to help the healthcare industry address care during the pandemic, critics have maintained that there haven’t been enough studies to prove its value. Prior to the pandemic, many telehealth bills in Congress

Idaho Gov. Little signs executive order easing telehealth restrictions permanently

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Idaho Gov. Brad Little on Monday signed an executive order to make the loosened restrictions around telemedicine permanent.

The announcement comes as Idaho’s caseload of newly confirmed coronavirus continues to grow. As of Saturday, more than 3,500 Idahoans had tested positive for the virus, and on three straight days last week — Thursday, Friday and Saturday — new cases exceeded 100 each day.

Earlier this year, Little’s office announced that multiple regulations regarding health care via telecommunications and licensing of medical professionals would be waived due to the pandemic. The governor waived 125 other regulations last month in order to get health care workers, such as retired workers, relicensed to expedite the response to an increasing COVID-19 caseload.

Due to the restrictions being lifted, there were about 117,000 telehealth visits from March to May. By comparison, there were only 3,000 telehealth visits in the same time frame of 2019.

“Our loosening of health care rules since March helped to increase the use of telehealth services, made licensing easier, and strengthened the capacity of our health care workforce, all necessary to help our citizens during the global pandemic,” Little said. “We proved we could do it without compromising safety. Now it’s time to make those health care advances permanent moving forward.”

During a press conference, Little referenced the executive orders he signed when he first took office in January 2019.

New Bill Would OK Telehealth Anywhere For 6 Months After COVID-19 Emergency

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Mobile healthcare, telemedicine, telehealth, BYOD

By Eric Wicklund

A bill introduced this week would enable providers to use telehealth to treat patients in any location up to 180 days after the emergency, bypassing site restriction and interstate licensing guidelines.

– A new bill before Congress aims to allow providers unfettered use of telehealth for six months after the end of the COVID-19 emergency.

Introduced this week by Senators Marsha Blackburn (R-TN) and Ted Cruz (R-TX), the Equal Access to Care Act would allow licensed providers to use telehealth in any state to treat patients in any location for up to 180 days after the end of the national emergency.

(For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.)

“The location of the provision of such services shall be deemed to be the (state in which the provider is located) and any requirement that such physician, practitioner, or other provider obtain a comparable license or other comparable legal authorization from the (state in which the patient is located) with respect to the provision of such services (including requirements relating to the prescribing of drugs in such secondary State) shall not apply,” the bill states.

“Telehealth has proven to be an effective tool for providing patients access to health care, including during and prior to the COVID-19 pandemic,” Blackburn said in a press release. “Removing bureaucratic red (tape) will result in more services in more places by more providers so that Americans can get care without the risk of exposing themselves to COVID-19 in a doctor’s office or hospital.”

“Expanding healthcare access in the communities hit hardest by the coronavirus pandemic is crucial to our nation’s recovery,” added Cruz, who’d first announced plans to submit the bill in April.This bill will remove bureaucratic barriers that for too long have stood in the way of effective telemedicine, and will help ensure the American people have their healthcare needs met – regardless of where they live or where their doctor is licensed – and equip our healthcare providers with the capacity they need to treat patients and ultimately defeat this virus.”

The bill would bypass two particular sticking points in telehealth adoption: site-based restrictions and licensing.

State and federal regulators – especially the Centers for Medicare & Medicaid Services – have long regulated where telehealth can be delivered, most often restricting those sites to healthcare facilities and rural areas. With the onset of the pandemic, many states and CMS have enacted emergency measures to expand access to new sites, such as the patient’s home, community health centers, clinics and skilled nursing facilities.

Some states are moving to make those rules permanent, and Congress is under increasing pressure to address that issue as well.

The licensure issue is trickier. Telehealth advocates have long argued that there should be an easier way for a provider to treat a patient in another state, either through an interstate licensure process or license portability – or even one national license. But interstate licensure compacts have been slow to gain broad acceptance, and critics say each state should have the authority to regulate who delivers healthcare in that state.

The one exception is the Department of Veterans Affairs, whose physicians were granted approval to treat veterans in any location via telehealth with passage of the Veterans E-Health & Telemedicine Support (VETS) Act in 2017.

VA Sees a Surge in Veterans Using Telehealth to Access Healthcare

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Mobile healthcare, telemedicine, telehealth, BYOD

 

By Eric Wicklund

Due to the COVID-19 emergency, veterans are logging onto the VA Video Connect app more than 120,000 times a week to access care, a 1,000 percent increase in traffic compared to a typical three-month span.

 

– Veterans used telehealth to access care more than 120,000 times a week during the height of the coronavirus pandemic, according to the Department of Veterans Affairs.

That’s more than a 1,000 percent increase over the usual traffic recorded on the VA Video Connect mHealth app, officials said. The three-year-old platform, touted as one of the nation’s best connected health programs, typically sees 10,000 visits a week.

(For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.)

“As we near the three-year anniversary of the launch of VA Video Connect, even during these challenging times, VA has and continues to maintain access to high-quality health care for Veterans,” VA Secretary Robert Wilkie said in a press release announcing the statistics. “As the service becomes more popular, VA remains committed to providing a seamless user experience to ensure Veterans have access to care where and when they need it.”

With many of the nation’s 2.6 million veterans living in remote locations, dealing with mobility or transportation issues or simply hesitant to travel to the nearest hospital, the nation’s largest health system has been moving to embrace connected health. The number of veterans accessing healthcare through telehealth jumped 17 percent from 2018 to 2019, while virtual visits made through the VA Video Connect app jumped 235 percent.

That popularity has caught the eye of a couple Senators who say the VA could use more support.

Roughly one month ago, Senators Kelly Loeffler (R-GA) and Kyrsten Sinema (D-AZ) introduced a bill aimed at expanding the ranks of care providers licensed by the VA to use telehealth.

The bill, called the VA Mission Telehealth Clarification Act, expands on the landmark VA Mission Act, signed into law in June 2018, which greatly expanded the VA’s telemedicine and mHealth network by, among other things, giving VA care providers the authority to treat veterans in any location.

A companion bill was filed in the House in June 2019 by US Rep. Earl “Buddy” Carter (R-GA), who noted the original act allowed only doctors to deliver care.

“This meant that only doctors could provide services through telehealth, not students, interns, residents or fellows,” he said. “This is a major problem especially for interns, residents and fellows who have graduated medical school and are training to become full time doctors because they are not able to get the necessary experience in telehealth at the VA until the time they become fully licensed.”

With their bill, Loeffler and Sinema put the emphasis on hardships caused by COVID-19.

“Increasing telehealth access for Arizona veterans will help keep them safe during the Coronavirus pandemic and make health care more accessible today and into the future,” Sinema said in a press release.

In his announcement, Wilkie said the VA is taking steps to expand veteran access to healthcare through telemedicine and mHealth technology. The agency has distributed more than 26,000 tablets to veterans and is working with wireless carriers like Verizon, T-Mobile and Sprint to ensure access without incurring data charges.

Senate HELP Committee weighs the future of telehealth

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Of the 31 changes federal policymakers have enacted so far to ease access to virtual care, senators wondered: How many should be made permanent?

ince the start of the COVID-19 pandemic, federal policymakers have enacted 31 changes to enable greater access to telehealth. In a hearing this week, members of the Senate Committee on Health, Education, Labor and Pensions asked how many of those changes should be made permanent – and how to make sure the most vulnerable won’t get left behind.

“Today we have the opportunity to consider how we can deploy telehealth to expand access to healthcare for everyone,” said Sen. Tina Smith, D-Minn.

Smith called attention to the nationwide calls for action sparked by the police killing of her constituent, George Floyd, and urged her colleagues to consider how telehealth can be a vehicle for health equity.

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Telehealth Gives a Free Health Clinic a Lifeline to its Patient Population

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Mobile healthcare, telemedicine, telehealth, BYOD

By Eric Wicklund

The Order of Malta Clinic of Northern California is using a new telehealth platform to improve access and care for thousands of residents in and around Oakland – many of whom have no other access to care.

– A community health clinic in Oakland that offers free healthcare to underserved populations is discovering just how important telehealth can be when payment and reimbursement are taken off the table.

The Order of Malta Clinic of Northern California, launched in 2008, saw some 4,500 uninsured and underinsured patients last year – and that number is growing, due to the coronavirus pandemic and a resulting surge in unemployment. With the crisis reducing in-person care to emergencies, the clinic has ramped up a telemedicine platform recently put in place with assistance from Kareo.

(For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.)

“We’ve become a lifeline for people whose only access to care is through us,” says Dr. Michael Matly, the clinic’s managing director. “We’re providing care that they wouldn’t get.”

The clinic, part of a global order that has been providing free healthcare for about 900 years, offers free care, including testing, preventive healthcare and access to dozens of specialists, to a population of roughly 300,000 in the Bay Area. It’s funded solely through an annual fundraising event and donations.

Up until COVID-19, that care had been delivered strictly through the downtown site or a mobile clinic introduced in 2018. Now, much of that care comes through the telephone.

“It’s been a huge relief for them,” says Dr. Thomas Wallace, who volunteers four days a week at the clinic and, at 89 years, is its senior staffer. “With the clinic being closed, we need this opportunity to stay in touch with them and see how they’re doing.”

Working through an electronic health record platform and laptops, the clinic’s roughly 50 volunteers can coordinate care for patients on a connected health platform, ordering tests, prescribing medications and updating medical records. The platform is currently audio-based, but the clinic is working to launch a video visit service soon.

“I think video is going to allow us to see more patients,” says Matly. “Phones are good for many of our patients, but to be able to actually see them will give us new opportunities.”

“The key is giving them access to care,” he adds. “This is a population that has always been vulnerable,” many of which have little or no insurance, are multilingual, perhaps homeless, have emigrated here from other countries, and are unsure or untrusting of the health system.

“In the COVID-19 age, people don’t want to go to the hospital,” Matly says. “This population is even more vulnerable now.”

“Before the transition to telemedicine, it was disturbing not being able to communicate with our patients,” Wallace noted in a recent press release announcing the Kareo partnership. “During a time of social distancing and following the shelter-in-place mandate, this is a window of hope to a community that is desperately in need of regular medical attention.”

Matly says the clinic staff are “learning new skillsets” through telehealth, and the clinic itself is forging partnerships with the likes of Twitter and the Mayo Clinic to expand its reach and offer new resources, even some eConsults. They envision someday using mHealth devices and platforms to capture more data, perhaps even expand care management into the home.

Once the crisis has passed, Matly and Wallace don’t expect patients to come flocking back to the clinic or mobile unit. But with a telehealth program in place, the clinic can reach out to those patients, as well as making inroads to new patients and new communities. Care delivered through a phone, online or via video is infinitely better than no care at all.

“We’re excited to see where this leads,” says Wallace.

FCC Announces 11th Batch of COVID-19 Telehealth Program Awards

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Mobile healthcare, telemedicine, telehealth, BYOD

By Eric Wicklund

As Congress asks for more transparency from the agency, another 62 telehealth projects are approved for funding, bringing the total to $128.23 million for 367 programs in 45 states and Washington DC

– The Federal Communications Commission has approved another 62 applications from healthcare providers for funding from the COVID-19 Telehealth Program.

With its 11th set of applications, the FCC has awarded $128.23 million from the $200 million program to 367 connected health programs in 45 states and Washington DC.

(For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.)

The announcement comes as the FCC faces increasing scrutiny from Congress over the program, which was launched out of the CARES Act at the end of March.

In a letter to FCC Chairman Ajit Pai last week, US Reps Frank Pallone Jr (D-NJ) and Michael Doyle Jr. (D-PA) called for the agency to provide weekly updates, beginning this week, on the number of applications received for funding from the $200 million program, as well as those approved for funding, those not approved for funding and the amount of money dispersed to healthcare providers.

“While the FCC has posted weekly updates of funding awards, we are troubled by the lack of transparency regarding the health care providers who have applied but have not yet received an award,” Pallone, chair of the Commerce and Energy Committee, and Doyle, chair of the Subcommittee on Communications and Technology, wrote. “We have heard reports that many health care providers are facing issues obtaining funds, particularly those serving tribal lands.”

“Similarly, health care providers report they have been unable to receive funding for some important telehealth equipment that we believe should be covered under the law,” they added.

The COVID-19 Telehealth Program is not a grant program. To receive disbursements, healthcare providers will be required to submit an invoicing form and supporting documentation to receive reimbursement for eligible telemedicine and mHealth expenses and services.

The latest group of approved applications, as usual, includes a mix of large and small providers, from clinics and programs to hospitals and health systems, all looking for support to expand telemedicine and mHealth technology platforms to meet the demand caused by the coronavirus pandemic.

This list includes Miami’s Baptist Hospital, Florida’s Citrus Health Network, the Hearts for Hearing Foundation in Oklahoma City, Detroit’s Henry Ford Health System, the Hospital for Special Surgery in New York City, Maimonides Medical Center in Brooklyn, Marshfield Medical Center in Wisconsin, Cleveland’s Metrohealth System, the Oregon Health and Science University in Portland, the Providence St. Joseph Health Consortium in Washington, Thomas Jefferson University Hospitals in Philadelphia, University of Colorado Health, here hospitals in the UPMC network and the West Virginia United Health System.

Bipartisan senators call for making telehealth expansion permanent post-coronavirus

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A group of 30 senators from both sides of the aisle on Monday urged leadership to make permanent the expansion of telehealth services that has been undertaken during the coronavirus pandemic.

The letter to Senate Majority Leader Mitch McConnell (R-Ky.) and Senate Minority Leader Charles Schumer (D-N.Y.) calls for provisions from the CONNECT for Health Act included in previous COVID-19 legislation be extended after the public health emergency is over.

“Americans have benefited significantly from this expansion of telehealth and have come to rely on its availability,” said the lawmakers led by Sens. Brian Schatz (D-Hawaii) and Roger Wicker (R-Miss.). “Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic.”

Telehealth has grown in popularity during the coronavirus pandemic as a safer alternative to in-person visits.

The services help doctors work with patients diagnosed with COVID-19 without putting themselves at risk.

It also helps providers care for high-risk patients who might contract the disease if forced to leave their homes for medical visits.

Advocates say enhanced telehealth capabilities could result in improved service with lower fees even beyond the pandemic.

“Doing so would assure patients that their care will not be interrupted when the pandemic ends,” the senators wrote. “It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment.”