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Telehealth Strategies

To Tackle the Digital Divide, A Program Teaches Seniors How to Use Telehealth

By News

A pilot program in South Carolina is addressing the digital divide by teaching seniors in rural counties how to use telehealth technology.

By Eric Wicklund

July 26, 2021 – A pilot program in South Carolina is tackling the digital literacy divide with a program that teaches seniors how to use telehealth technology.

Supported by the South Carolina Department on Aging and the national non-profit Rural Local Initiatives Support Corporation (Rural LISC), the program equips seniors in rural communities with a tablet and free cellular service for up to a year. The seniors attend classes on digital literacy at local community centers, building a comfort level with devices that are fast becoming a portal to connected health in underserved communities.

“It is our hope that this pilot program will be a model of one approach to closing the digital divide in South Carolina,” Kathy Schwarting, CEO of Palmetto Care Connections (PCC), told the South Carolina-based Statehouse Report.

PCC, a state-wide non-profit connected health organization that co-chairs the South Carolina Telehealth Alliance with the Medical University of South Carolina (MUSC), conducted the program, which involved roughly 100 seniors in rural Barnwell and Allendale counties. The pilot program will expand to three more counties soon, with hopes of becoming statewide.

“They loved it,” Schwarting said of the seniors, who learned how to use tablets not only for virtual visits with their care providers but also for communicating with family and friends, playing games and accessing other online resources.

Digital literacy – or a lack thereof – is considered a social determinant of health, and a considerable barrier to telehealth adoption in rural and remote parts of the country. People won’t use telehealth if they’re not comfortable with the technology, and if they can’t afford or access it easily, they have little opportunity to become familiar with it.

The shift to telehealth during the coronavirus pandemic cast the digital literacy gap in a harsh light, and prompted healthcare organizations and telehealth advocates – including the American Medical Association and the Telehealth Equity Coalition, launched this past February – to study how to address that gap.

“With the pandemic we’re creating a bigger digital divide,” says Luis Belen, CEO of the National Health IT Collaborative for the Underserved (NHIT), a public-private partnership launched in 2008 to engage underserved populations in the use of health information technology. “We need to start having conversations that focus on creating equity.”

Another health system tackling the divide is Jefferson Health. After receiving funding last year to expand its telehealth network to address COVID-19, the Philadelphia-based network created a task force to make sure those expanded resources would be used.

“You can’t just hand someone a device and expect they’re going to be on a telehealth visit the next day,” said Kristin Rising, MD, MS, an associate professor and director of the Center for Connected Care. “Many people aren’t comfortable using telehealth. You have to find out why … and help them.”

“Telehealth has the potential to decrease our digital divide,” she added. “But we need to know how to use it first.”

Source: mHealth Intelligence

Congress Eyes Seniors’ Access to mHealth Tools for Diabetes Care Management

By News

By Eric Wicklund

– A pair of Senators has re-introduced proposed legislation aimed at give seniors better access to mHealth and telehealth tools for diabetes care management.

The Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act, filed earlier this month by Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH), takes aim at the growing field of connected health devices and platforms for those living with diabetes. It would improve Medicare coverage for such things as implantable continuous glucose monitors, insulin dosing systems, mHealth apps and platforms and the artificial pancreas.

According to the American Diabetes Association, some 34.2 million Americans are living with diabetes, including 7.3 million who are undiagnosed. Of that number, 14.3 million, or 26.8 percent, are seniors.

Healthcare innovators have made significant strides in recent years in developing mHealth and telehealth tools that allow those living with diabetes to monitor their health and collaborate with their care providers. The technology allows providers and patients to manage care around the clock, adjusting medications to address trends, avoid serious health concerns like hypoglycemia and hyperglycemia and improve long-term clinical outcomes.

“Technological advances make diabetes easier to manage,” Collins said in a press release. “The market arrival of cutting-edge diabetes technologies, however, does not immediately benefit patients if older Americans are unable to afford them. I have heard from numerous seniors who, when transitioning from employer-provided insurance to Medicare, were shocked to learn that the technologies they have relied upon for years to manage their diabetes are no longer covered. … Our bill would help ensure that outdated Medicare coverage criteria does not impede access to technologies that will improve care and reduce costs to the health care system as a whole.”

The bill, which was introduced in 2019 by Collins and Shaheen but failed to make it out of committee, would create a task force within the Health and Human Services Department to propose policies on coverage and payment for innovative diabetes technologies and services for seniors. It would report annually to the HHS Secretary and Centers for Medicare & Medicaid Services Administrator on:

  • Existing Medicare benefit categories under which innovative diabetes technologies and services should be covered;
  • Changes to Medicare statute and changes to regulations and sub-regulatory guidance for existing benefit categories that would be necessary to accommodate coverage and payment of innovative diabetes technologies and services;
  • The elimination of other unnecessary burdens that impede access to innovative diabetes technologies and services;
  • Proposals for a new benefit category for covering certain technologies and services that cannot otherwise be covered through changes to regulations and sub-regulatory guidance for existing benefit categories and specifications for the new benefit category and
  • Proposals to streamline interagency administrative processes through greater FDA and CMS collaboration that would facilitate prompt approval or clearance and coverage of innovative technologies and services for patients with diabetes.

Source mHealth Intelligence

FCC’s COVID-19 Telehealth Program Reboots in 2 Weeks

By News

The Federal Communications Commission will accept applications for the second round of the COVID-19 Telehealth Program from April 29 to May 6.

By Eric Wicklund

April 16, 2021 – Healthcare providers interested in taking part in the Federal Communications Commission’s COVID-19 Telehealth Program will have seven days to submit applications, beginning on April 29.

The FCC made the announcement on Thursday, setting the stage for a second round of funding for projects aimed at boosting access to connected health services during the coronavirus pandemic through better broadband resources.

“For over a year, health care providers have fought on the front lines of this pandemic and have had to rapidly innovate to support the health and well-being of all Americans,” Acting FCC Chairwoman Jessica Rosenworcel said in a press release. “Telehealth has been at the forefront of this effort and I’m pleased to announce that additional support is just around the corner.”
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“The FCC is dedicated to moving quickly to review and approve applications for this funding to support health care providers and patients across the country,” she added.

Congress appropriated $200 million in the CARES Act to launch the program in 2020 through the FCC’s Wireline Competition Bureau. FCC issued awards to 539 applicants before running out of money in July, but was criticized in some corners for a lack of transparency in the program.

Another $249.95 million was set aside in the Consolidated Appropriations Act of 2021 to create a second round. At the same time, FCC officials revised the application and award process.

  • It will establish a system for rating applicants, with more attention paid to hardest-hit and low-income areas as well as projects that failed to gain approval in the first round, those in healthcare provider shortage areas and Tribal communities.
  • It will ensure “equitable nationwide distribution of funding so that each state, territory, and the District of Columbia will receive funding since the program’s inception.” Last year’s program funded projects in 47 states, Washington DC and Guam but sent no money to Hawaii, Alaska or Montana.
  • It will set a deadline for applications, rather than reviewing programs as they are submitted, so that all projects can be reviewed at the same time.
  • It will award funding in two phases, so that approved projects can be funded quickly and the rest have an opportunity to provide more information to qualify for the second phase.

The filing window will run from Thursday, April 29 to Thursday, May 6.

The money is designated for “telecommunications services, information services, and connected devices necessary to enable telehealth during the COVID19 pandemic.”

The COVID-19 Telehealth Program isn’t a grant program, but a reimbursement program. To receive disbursements, healthcare providers are required to submit an invoicing form and supporting documentation to receive reimbursement for eligible telemedicine and mHealth expenses and services.

HHS Unveils Telehealth Grants to Address Rural Maternal, Obstetrics Care

By News

HHS is kicking off Black Maternal Health Week by offering three four-year grants, totaling $12 million, to projects aimed at boosting maternal health outcomes among underserved populations in rural America.

By Eric Wicklund

– Federal officials are making $12 million available for three projects that aim to approve maternal and obstetrics care for underserved populations in rural America, and they expect telehealth to be part of the program.

The Notice of Funding Opportunity from the Health Resources and Services Administration’s (HRSA’s) Federal Office of Rural Health Policy comes as federal officials kick off Black Maternal Health Week. The HRSA’s Rural Maternity and Obstetrics Management Strategies (RMOMS) program, which will offer the three award recipients grants of up to $1 million annually for four years, aims to boost outcomes in rural and underserved population by testing new models of connected care.

“Improving maternal health outcomes – particularly among Black women – is priority for the Biden administration and for the Department,” Health and Human Services Secretary Xavier Becerra, said in a press release issued Monday. “Expanding access to health insurance coverage, preventative care and investing in rural maternity care is one step forward. With the American Rescue Plan, President Biden gave states tools to combat the racial disparities in pregnancy-related deaths by providing an easier pathway for states to ensure mothers access to the care they need after birth. Continuous health care coverage reduces health care costs and improves outcomes.”

In an HRSA release highlighting the RMOMS grant program, officials said the three award recipients would have four years to plan and launch programs that improve maternal obstetrics care in rural communities. Those programs would have four areas of focus: risk-appropriate care approaches in rural regions; continuum of care through network approaches; telehealth and specialty care; and financial sustainability.

“The program will allow awardees to test models in order to address unmet needs for their target population, which could include populations who have historically suffered from poorer health outcomes, health disparities and other inequities,” the release says.

Applicants must be part of a network serving HRSA-designated rural areas that includes at least two rural hospitals or critical access hospitals (CAHs), at least one federally qualified health center (FQHC), at least one Level II and/or Level IV facility (as defined by the American College of Obstetricians and Gynecologists), locally and/or regionally available social services in the continuum of care and the state Medicaid agency.

The HRSA will host a webinar on the program on April 22. Applications are due by June 4.

HHS isn’t the only organization taking a hard look at racial and ethnic disparities in maternal health outcomes. Two months ago, Congress saw the introduction of a package of 12 bills called the Black Maternal Momnibus Act of 2021.

Among other things, the package of bills calls on the Centers for Medicare & Medicaid Services to consider payment models that improve the integration of telehealth services into maternal healthcare programs and establish grant programs for models of care that include access to broadband internet and remote patient monitoring services and programs that use mHealth tools to address social determinants of health.

Other bills in the package, which is endorsed by more than 190 organizations, would make targeted investments in programs that address social determinants of health, fund community-based organizations and programs that might use connected health tools and platforms to address issues like substance abuse, pre- and post-partum mental health, veteran care and building the perinatal workforce, and improve data collection efforts and quality measures to improve health outcomes and access to care.

In addition, several of the 14 applicants selected in January’s first round of the Federal Communications Commission’s Connected Care Pilot Program aim to use funding to launch or expand connected health programs that address high-risk pregnancies and maternal health outcomes.

“As maternal mortality rates continue to drop around the world, they are rising in the U.S., leaving behind devastated families and children who will grow up never knowing their moms,” US Rep. Lauren Underwood (D-IL), who co-founded and co-chairs the Black Maternal Health Caucus and is one of the co-sponsors of the Black Maternal Momnibus Act, said in a press release. “This crisis demands urgent attention and serious action to save the lives of Black mothers and all women of color and birthing people across the county.”

Amazon Announces Nationwide Telehealth Platform, Open to Other Businesses

By News

The retail giant announced today that its telehealth platform, previously available only to employees and their families in Washington, would roll out nationwide this summer and be offered to other businesses.

By Eric Wicklund

– Amazon has announced the nationwide launch of its telehealth platform, with plans to expand the service from its own employees to other companies.

The Washington-based retail giant announced today that its Amazon Care service, until now limited to employees and their families in its home state, is now available for other Washington companies, and that the platform will be expanded to Amazon employees and other companies throughout the country beginning this summer.

Finally, the company announced that it would offer in-person care to Washington DC, Baltimore and other cities in the near future.

The long-rumored announcement puts Amazon securely in the middle of the retail telehealth sandbox, with a virtual care platform that could appeal to a wide range of businesses. It is expected to compete in a crowded connected health space with vendors like American Well and Teladoc, as well as with payers and health systems offering their own branded programs.

“By supplying Amazon Care as a workplace benefit, employers are investing in the health and well-being of arguably their most important asset: their employees,” the company said in a press release. “Amazon Care enables employers to provide access to high quality medical care within 60 seconds for employees, including options for care around the clock through messaging or video. Amazon Care gives instant access to a range of urgent and primary care services, including COVID-19 and flu testing, vaccinations, treatment of illnesses and injuries, preventive care, sexual health, prescription requests, refills, and delivery, and much more.”

Amazon unveiled the platform roughly 18 months ago, offering virtual care through an mHealth app and on-demand house calls for employees and their families in Washington. In doing so, the company helped to elevate the direct-to-consumer telehealth market, where retail companies like Google, Microsoft and Apple were beginning to compete with Walmart, Walgreens, Rite Aid, CVS and health systems to capture the attention of consumers who didn’t have primary care providers or who were looking for more convenient ways to access on-demand services.

The coronavirus pandemic has only added to the urgency, pushing more services online and away from hospitals, doctors’ offices and other healthcare sites.

“Amazon Care addresses a wide spectrum of patient needs through its primary care and urgent care offerings,” the company said in its press release. “Patients can access preventive care such as annual vaccinations, health screenings, and lifestyle advice. The service also supports patients’ wellness needs, including nutrition, pre-pregnancy planning, sexual health, help to quit smoking, and more. For immediate needs, patients can use Amazon Care to assess and treat illnesses and injuries on demand.”

The announcement could spur a new round of retail healthcare offerings or telehealth partnerships, such as the recently announced merger of Doctor On Demand and Grand Rounds.

“This is a very exciting chess move from Amazon Care,” Taqee Khaled, head of strategy and a healthcare consultant for the consulting firm Nerdery, said in an e-mail to mHealthIntelligence. “A lot of folks will look at this on the outside and not realize how extensively Amazon has been preparing for this moment by obsessively striving to serve their own people exquisitely well. In their iterative process, where fast failure is not just expected but encouraged, they have tried and failed as much – or more – than they’ve succeeded. Along the way, they probably learned a lot and tabled several things for future use toward external competitive advantage.”

“That they’re ready to go national with this is a fearsome prospect for other platforms – and commences what will likely be the digital healthcare equivalent of a Hundred Years War,” he added. “To date, many startups and maturing companies play in this space. … But Amazon perfecting the last mile, pharmaceutical management, virtual care, and – yes, expect it – brick and mortar, may truly mean ‘the end (of traditional health systems) is nigh.”

Lawmakers Resubmit Telehealth Bills Targeting Kids’ Health, COVID-19 Effects

By News

By Eric Wicklund

Two more telehealth bills have returned to Capitol Hill after failing to make it through last year’s session. One takes on kids’ health and other calls for an HHS study of how telehealth has effected care delivery.

– Two more telehealth bills have resurfaced on Capitol Hill, joining a growing package of legislation aimed at improving connected health coverage and access after the coronavirus pandemic.

US Reps. Lisa Blunt Rochester (D-DE) and Michael Burgess, MD (R-TX) last week reintroduced the Telehealth Improvement for Kids’ Essential Services (TIKES) Act (HR 1397), which aims to boost telehealth coverage through state Medicaid and Children’s Health Insurance Program (CHIP) services.

While no text is available for this bill, Rochester and Burgess, who first submitted the bill last October, said last year that it would “provide guidance and strategies” to help states integrate telehealth in Medicaid and CHIP programs and mandate telehealth studies from both the Government Accountability Office (GAO) and the Medicaid and CHIP Payment and Access Commission (MACPAC). It would build upon a 25-page CMS toolkit unveiled in April 2020 that’s designed to help states expand telehealth coverage under Medicaid and CHIP to deal with the pandemic.

“Amidst the pain and suffering that our nation has endured throughout the COVID-19 pandemic, a major takeaway has been the advantage of telehealth,” Burgess said then. “There is a convenience factor to not having to take time to physically transport yourself to the doctor’s office and have your child sit in a waiting room with other potentially sick patients. This bipartisan legislation will improve utilization of telehealth by requiring the Centers for Medicare and Medicaid Services (CMS) to provide guidance to states on how to make the most of telehealth options in their Medicaid and CHIP programs. Additionally, it directs studies to gather data that can help inform future telehealth policy.”

Also making a return appearance in Washington is the COVID-19 Emergency Telehealth Impact Reporting Act (HR 1406), which would have the Health and Human Services Department collect data on telehealth use during the pandemic and analyze how these technology platforms have affected care delivery.

“Telehealth is undoubtedly the future of health care, especially for the rural communities that I am privileged to represent,” US Rep. John Curtis (R-UT), who co-sponsored the bill submitted last July and this year’s version with US Reps. Peter Welch (D-VT) and Doris Matsui (D-CA), said in a press release last year. “Ultimately, Congress’ objective should be to make many – if not at all – of these regulatory changes permanent. Our bill is a significant step in that direction because it will ensure we are keeping patients’ health and reducing the costs of care through value-based medicine as our top priorities as we consider expanding telehealth services throughout the country.”

With the COVID-19 pandemic in full force last year, Congress saw several bills aimed at improving coverage for and access to telehealth services both during the after the public health emergency, but none of those bills made it out to a vote. With a new administration and Congress in place this year, the hope is that some – if not all – of these bills making a return will be approved, either individually or in some sort of package.

Just last week, the Senate saw the reintroduction of the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act (S 340) and the Telehealth Modernization Act (S 368 and HB 1332).