Celebrating 2021 National Rural Health Day Southwest Telehealth Resource Center Dec. 1, 2021 Since 2010 the National Organization of State Offices of Rural Health has designated the 3rd Thursday in November as National Rural Health Day to celebrate the rural leaders and champions in rural communities. This year the Arizona Telemedicine Program and the SWTRC joined with the Arizona Rural Health Association and the Arizona State Office of Rural Health to kick it off in Arizona with a “2021 Mid-Year Rural Health Policy Roundup” webinar by Alan Morgan, CEO of the National Rural Health Association. Since 2010 the National Organization of State Offices of Rural Health has designated the 3rd Thursday in November as National Rural Health Day to celebrate the rural leaders and champions in rural communities. This year the Arizona Telemedicine Program and the SWTRC joined with the Arizona Rural Health Association and the Arizona State Office of Rural Health to kick it off in Arizona with a “2021 Mid-Year Rural Health Policy Roundup” webinar by Alan Morgan, CEO of the National Rural Health Association. This webinar streamed live to a national audience on November 15th and the recording and presentation slides are available at: https://telemedicine.arizona.edu/webinars/previous for on-demand playback. Each year the National Organization of State Offices of Rural Health selects a Community Star from each of the 50 states. The 2021 Community Star report, https://en.calameo.com/read/0045723395dc12ef8ac48, includes stories of how each Community Star is working to improve life in their rural community. Congratulations to all of the 2021 Community Stars! Matthew Probst, PA-C Chief Quality Officer and Medical Director El Centro Family Health Mathew Probst is the Chief Quality Officer and Medical Director for a Federally Qualified Health Center located Northeast of Albuquerque, New Mexico. Under his leadership, Mr. Probst was able to implement initiatives at the start of the pandemic which resulted in his county having one of the lowest fatality rates and one of the highest vaccination rates in the county. Read more about why Mr. Probst was featured in an award-winning documentary named The Providers: https://en.calameo.com/read/0045723395dc12ef8ac48 < Previous News Next News >

HHS to put $35M toward telehealth for family planning Kat Jercich November 29, 2021 The agency plans to use the funds to award about 60 one-time grants to Title X family planning providers, who must apply by February of next year. The U.S. Department of Health and Human Services announced that it would make $35 million in American Rescue Plan funding available for Title X family planning providers to strengthen their telehealth infrastructure and capacity. Title X family planning clinics help to insure access to a broad range of reproductive health services for low-income or uninsured individuals. "I’ve seen first-hand the critical role that telehealth plays in serving communities, particularly to protect so many families from COVID-19," said HHS Secretary Xavier Becerra in a statement about the grant availability. "As providers transitioned from providing in-person primary care to offering telehealth services, we were able to test, vaccinate, and act as lifelines to communities disproportionately hit by the pandemic," he said. "Increasing our investment and access to telehealth services remains critical." WHY IT MATTERS The Office of Population Affairs funds 71 Title X family planning service grantees and supports hundreds of subrecipients and thousands of service sites around the country. Family planning includes a broad range of services related to reproductive health, including contraception, sexually transmitted infections and pregnancy testing. Although abortion care can be co-located with family planning services, Title X funds cannot be used to pay for it. Although some services require in-person treatment and exams, others can be carried out via telehealth – as evidenced by grantees' use of virtual care to help their patients during the COVID-19 crisis. Still, facilities may not have adequate technology available. "During the global COVID-19 pandemic, family planning programs have accelerated the use of telehealth," said Dr. Rachel Levine, assistant secretary for health, in a statement. "These ARP funds will facilitate the delivery of quality family planning services and reduce access barriers for people living in America who rely on the health care safety net for services," she added. HHS plans to use the funds to award about 60 one-time grants to active Title X grantees. Organizations must apply by February 3, 2022, and notices of awards will be announced before the project start date of May 1, 2022. THE LARGER TREND Even as the government has moved to shore up telehealth infrastructure via funding, the question of virtual care's future continues to hang over Congress. Despite requests from hundreds of advocacy organizations, legislators have so far failed to take action to permanently safeguard telehealth after the end of the COVID-19 public health emergency – what some activists have referred to as "the telehealth cliff." "We recognize there are many unknowns related to the trajectory of the COVID-19 pandemic over the next 12 to 24 months," said American Telemedicine Association CEO Ann Mond Johnson in October. "However, we implore Secretary Becerra to provide as much predictability and certainty as possible to ensure adequate warning before patients are pushed over this looming cliff." ON THE RECORD "The pandemic has laid bare the important role that telehealth can play in our nation’s healthcare service delivery, and we are profoundly grateful for the opportunity to support continued investments in telehealth for the nation’s family planning safety net," said Jessica Swafford Marcella, HHS deputy assistant secretary for population affairs, in a statement. < Previous News Next News >

Citing Medicaid misery, 25 governors push for PHE's end in April Molly Gamble December 21, 2022 In a letter sent to President Joe Biden this week, 25 governors ask for the end of the COVID-19 public health emergency in April. HHS last renewed the federal PHE in October for another increment of 90 days — until January 11 — with the pledge to provide states with 60 days' notice if it decided to terminate the declaration or allow it to expire. Since those 60 days came and went without notice, states are operating under the assumption the PHE will be renewed for another 90 days and expire in April, unless extended again. "We ask that you allow the PHE to expire in April and provide states with much needed certainty well in advance of its expiration," the governors urged Mr. Biden in their Dec. 19 letter. The governors claim the PHE hurts states, largely through the Medicaid flexibilities costing states "hundreds of millions of dollars." Under the continuous coverage requirement of the Families First Coronavirus Response Act, state Medicaid agencies are barred from disenrolling people during the PHE — unless they request it — in exchange for an enhanced federal match. HHS estimates up to 15 million people will be disenrolled from Medicaid and the Children's Health Insurance Program when the PHE ends. "While the enhanced federal match provides some assistance to blunt the increasing costs due to higher enrollment numbers in our Medicaid programs, states are required to increase our non-federal match to adequately cover all enrollees and cannot disenroll members from the program unless they do so voluntarily," the governors wrote to Mr. Biden. "Making the situation worse, we know that a considerable number of individuals have returned to employer sponsored coverage or are receiving coverage through the individual market, and yet states still must still account and pay for their Medicaid enrollment in our non-federal share." The governors sent their letter a day before Congress released its omnibus spending bill, which contains working language for states to be able to start evaluating Medicaid enrollees' eligibility as of April 1 in a redetermination process that would take place over at least 12 months. The measure also calls for phasing down the enhanced federal Medicaid funding through December 31, 2023, though states would have to meet certain conditions during that period. The American Hospital Association advocated for the latest extension of the PHE in October, noting that the majority of the hospital members it polled said they still depend on the flexibilities provided by the PHE waivers to deliver care. The letter was initiated by Chris Sununu, governor of New Hampshire, and signed by the following: Kay Ivey, Alabama Mike Dunleavy, Alaska Asa Hutchinson, Arkansas Doug Ducey, Arizona Ron DeSantis, Florida Brian Kemp, Georgia Brad Little, Idaho Eric Holcomb, Indiana Kim Reynolds, Iowa Charlie Baker, Massachusetts Tate Reeves, Mississippi Mike Parson, Missouri Greg Gianforte, Montana Pete Ricketts, Nebraska Doug Burgum, North Dakota Mike DeWine, Ohio Kevin Stitt, Oklahoma Henry McMaster, South Carolina Kristi Noem, South Dakota Bill Lee, Tennessee Greg Abbott, Texas Spencer Cox, Utah Glenn Youngkin, Virginia Mark Gordon, Wyoming See original article: https://www.beckershospitalreview.com/finance/citing-medicaid-misery-25-governors-push-for-phes-end-in-april.html?utm_medium=email&utm_content=newsletter < Previous News Next News >

The value of telehealth and the move to digitally enabled care — 3 insights Becker's Hospital Review In Collaboration with American Medical Association Nov. 1, 2021 During the pandemic, healthcare organizations embraced telehealth to ensure they could provide access and high quality care to their patients. Now, nearly two years later, organizations are contemplating how best to move forward, including how to safeguard and optimize opportunities to move towards digitally enabled care. During the pandemic, healthcare organizations embraced telehealth to ensure they could provide access and high quality care to their patients. Now, nearly two years later, organizations are contemplating how best to move forward, including how to safeguard and optimize opportunities to move towards digitally enabled care. During Becker's 6th Annual Health IT + Revenue Cycle Virtual Conference, the American Medical Association sponsored a roundtable discussion on this topic. The AMA's Lori Prestesater, Vice President of Health Solutions, and Meg Barron, Vice President of Digital Health Innovations, talked with healthcare executives from around the country about their digital health successes and challenges. Three insights: 1. Providers want virtual care to continue as long as their key concerns are addressed. "Physicians are enthusiastic about digital health technologies," Ms. Barron said. "However, that enthusiasm is directly tied to a solution's ability to help them take better care of patients or reduce their administrative burdens." Four key concerns consistently expressed by physicians when evaluating digital solutions are whether a solution works and has an evidence base, how providers will be compensated, what liability and privacy issues exist, and how implementation and change management will occur. 2. One of the major advantages of telehealth is improved access. Access can be widely defined; virtual technology has made significant inroads in improving access in multiple ways: COVID-19 access. The department chair of a hospital in the Northeast noted that telehealth helped them provide quick access and treatment to patients during the pandemic. "It worked extremely well in this emergency situation," he said. "Patients would call in and report symptoms, and we could make decisions about their care. We provided pulse oximeters and followed up via telehealth." Specialty access. A CMO from a Midwestern health network — who is the father of a daughter with a chronic illness — shared his personal experience with specialty care from multiple systems. "I can't imagine how my daughter could receive specialty care without telehealth. Care that was previously siloed can now be accessed nationally, if not internationally." Behavioral health access. A chief population health officer from a health system in the Midwest said telehealth access to mental health services was a big success. "Patients found the pandemic very rough, and many needed some behavioral health services, but they didn't necessarily want to try to see somebody because of the stigma associated with it," she said. "Being able to offer telebehavioral health services to our patients, and frankly, even to our employees, was a great success." 3. Challenges such as patient hesitancy, bandwidth issues and measurement of value remain. Although patients are generally positive about telehealth, some have found it difficult to onboard to telehealth platforms. One provider in the Northeast said younger patients love the ability to text and connect virtually, but elderly patients often prefer in-person visits for the human connection. Also, many healthcare organizations have faced connection issues. A West Coast CMO explained, "We have 24 hospitals, and many of them are in rural areas. We really struggled with bandwidth." Finally, measuring the value of these technologies remains a challenge. Ms. Prestesater pointed out that it can be a "many-year equation to evaluate the value for a chronically ill patient." AMA has a recently released Return on Health value framework that can help an organization quantify the comprehensive value of virtual care. Although some participants warned that virtual care may not be less expensive, it can be hard to quantify savings from things like avoiding emergency care. A Midwest hospital executive said, "Home-based care has led to a substantial reduction in visits to the emergency room and days in the hospital for us. The problem in the whole equation is it's hard to measure something that doesn't happen." < Previous News Next News >

The challenges of telemental health, and how they can be overcome Bill Siwicki June 14, 2022 Mental healthcare may be among the more intuitive specialties to deliver via telemedicine – but privacy demands, technology difficulties and the need for safe places deter some from taking advantage. Of all the medical specialties impacted by telemedicine during the course of the pandemic, perhaps the one with the most wholesale and lasting effects is behavioral and mental health. Mental health appointments do not typically involve any collection of vitals or specimens, nor do they absolutely require a face-to-face meeting, although therapists can observe physical cues from the whole body in person. Just talking via video, or even just audio, is enough. We talked with Dr. Janice Johnston, chief medical officer and cofounder of Redirect Health, a telehealth technology and services company, to get her expert observations regarding: The biggest ways telehealth is changing America's treatment of mental health. What impact increased telehealth accessibility has had on mental health treatment. The challenges telehealth presents in treating mental health. The improvements that can be made to telehealth for the treatment of mental health. Q. What are the biggest ways telehealth is changing the U.S.'s treatment of mental health issues? A. Before COVID-19 and historically in the U.S., there has been a negative stigma around receiving mental healthcare. While there have been a lot of movements and campaigns attempting to try and stamp out the stigma, many people have been deterred from seeking professional help due to a lack of coverage in healthcare plans, high copays and fear. As telehealth widens, the availability of mental health services continues to grow and is more accessible than ever. Gone are the days of driving to appointments and sitting in a waiting room, with the feeling that all eyes are on you. Social networks also have created a platform for mental health activists and we are seeing, in real time, an increase in people looking for treatment or routine mental care. COVID-19 accelerated the need for more access and new ways of treating mental health, such as telehealth. As a result of the COVID-19 pandemic, we also have seen many major insurance companies offer permanent or temporary plan benefits that include mental health services. Telehealth has made it easier for insurers to include these benefits in their plans with less out-of-pocket costs for patients. In many cases, insurance providers even waived the entire cost for visits when using telehealth. While most people don't want to be thought of or treated differently because they choose to seek mental health treatment, the stigma around it can make them feel judged, and they avoid choosing care. Telehealth has made it possible for people to now access care from the privacy of their homes, making the decision to seek care much easier and more comfortable. Being able to speak with a mental health professional from home has provided patients the ability to choose a setting that provides the most comfort, making the process of opening up and sharing concerns with a new person much easier. Q. What impact has increased telehealth accessibility had on mental health treatment in the U.S.? A. The COVID-19 pandemic forced changes for Americans across the country that have affected mental wellbeing, such as working from home, quarantine enforcements, lack of spending time with friends and family, and feeling isolated. This led to a surge in mental health issues with most non-emergency medical treatments shut down due to safety concerns and quarantine enforcements. Telehealth was a necessity we didn't see coming, and the pandemic accelerated this service due to the timely needs that were arising. With the higher demand for mental healthcare, telehealth has been the answer for many. People living in rural communities or underserved areas, specifically, experience limited access to specialty healthcare services, especially mental health. One of the key impacts of increased telehealth accessibility is that these communities have been able to turn to telehealth as an option when they may not have had an alternative. Different from rural or underserved communities, many urban populations see that finding in-person care isn't the difficult part, but affording it and getting to their appointment can be. Another key impact of increased accessibility is that telehealth tends to be a much more cost-effective option, as in-person care can regularly be more than double the cost. Think of all the money and time wasted having to take off work, which can result in lost wages, needing to hire a babysitter, or paying for gas when commuting to and from appointments. With telehealth, patients are able to afford their scheduled appointment at a time that is convenient and works for them. Additionally, while most offices provide services in standard office hours, many telemental health services provide care before and after work hours as well, so patients have more scheduling flexibility. There also are a lot of cultural barriers and health inequities that many minority communities experience that may deter them from seeking mental healthcare. During the pandemic, these communities experienced a rise in telemental health usage. While there are several reasons why this rise has occurred, we have seen that telehealth has been able to combat some of the barriers these groups have had to overcome. For one, telehealth affordability has made services much more accessible to minority groups or lower income individuals, enabling them to include mental healthcare into their budgets. Additionally, minority groups have experienced higher rates of depression and anxiety, only exacerbated by the pandemic, so the demand from these communities, along with the decrease in negative stigma around mental care through telehealth, has driven them to these options. Lastly, telehealth allows those with language barriers in the U.S. to have access to a broader group of mental health professionals who can provide a better understanding of their cultural backgrounds, partnered with the ability to speak in their preferred language. Q. What are some of the challenges telehealth presents in treating mental health issues, and instances when in-person care must be sought? A. While telehealth has expanded access to mental healthcare for so many across the country, there are still limitations that may lead some to favor in-person care. First, privacy. While many patients prefer telehealth so they can have their appointment in the privacy of their homes, there are situations where people may not have that same privacy in their home. Some people may live in multi-generational homes where others are home and in earshot, or they could share a room with others with privacy not immediately available. This may leave patients taking their calls from their car, which is not always comfortable or preferred. As a result, people in these settings may prefer care in person. Second, safe places. While some people prefer their care virtual for a variety of reasons, others feel that virtual mental healthcare is cold and distant, and favor in-person care in order to feel more engaged with their mental health provider. Sometimes being removed from their normal home setting can help create a safe place for the patient to discuss their mental health concerns. This is especially a factor with live support groups, which can be more engaging and easier in person than virtually. Many times, live support groups are used for people looking to overcoming addictions, and being able to separate them from their traditional setting can be helpful for pulling them out of their environment, even momentarily. And third, technology. Some individuals may not understand the technology behind apps or websites that provide mental health services. They may not know how to access video links or use their phone to connect to a provider, which could result in a sub-par session, where they do not feel comfortable or at ease. Patients also do not want to see time consumed or wasted during their appointment because of technical struggles and may prefer to see their providers in person to avoid the hassle of these situations. Q. What improvements can be made to telehealth specifically for the treatment of mental health issues? A. We can look to the current challenges of the telehealth space to find where to start with improving the telehealth experience for everyone. For starters, creating wider access to the internet allows telehealth to reach more people who may not have any options available to them today. In fact, the Biden administration recently secured commitments from 20 leading internet service providers to either reduce prices or increase speeds to serve low-income households. This is a great step in the right direction. Better cellular and internet speeds allow for more telemental health experiences to be held over video, and not telephonically, where mental health professionals can better assess their patient through both verbal and nonverbal cues. With all the advancements and changes we have seen in technology in just the last few decades, there is a lot for patients and providers to keep up with. Education is key to making sure telehealth sticks around and continues to rise in its availability. Many providers are willing to learn new technology, but need to be trained by the people that thoroughly understand the ins and outs of these systems. As new standards of care are set by technological advancements, providers and patients alike need to be provided the education to keep up with these evolving standards. It is important for those implementing new systems to deliver the proper education providers need to learn the technology, as well as assist their patients. Another thing to consider is how to assist patients with disabilities through telehealth. There are laws in place in the U.S. to ensure equality in care for those with and without disabilities, and therefore considerations need to be made in telehealth situations as well, such as providing additional instructions or scheduling longer appointment times. Sometimes added support or modifications need to be made to technology systems in order to support these patients as well. Telehealth systems should meet accessibility requirements and should provide resources that are available in multiple formats, like audio recordings or large text sizes. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. For more information: https://www.healthcareitnews.com/news/challenges-telemental-health-and-how-they-can-be-improved < Previous News Next News >

Closing 2022 with New Telehealth G-Codes for HHAs, Uncertainty for Telehealth Startups, Plus State & Federal Telehealth Developments (and much more!) CCHP December 13, 2022 New G-Code Reporting Requirements for HHAs under CY 2023 CMS PPS Rule The Centers for Medicare and Medicaid Services (CMS) has finalized new G-codes to report use of telecommunications technology under the home health benefit for Home Health Agencies (HHAs) under their finalized Calendar Year (CY) 2023 Home Health Prospective Payment System (PPS) Rate Update. HHAs are asked to voluntarily start reporting on January 1, 2023, and the requirement to report would kick in July 2023. CMS notes that in 2020 the home health benefit was temporarily altered due to COVID-19 (and made permanent in 2021) requiring any provision of remote patient monitoring or other services furnished via a telecommunications system to be included in the plan of care. The telecommunication service, however is not allowed to substitute for a home visit ordered by the plan of care or for purposes of eligibility or payment. Reporting of the new G-codes will allow CMS to analyze the characteristics of beneficiaries utilizing services remotely and have a broader understanding of the social determinants that affect who benefits most from these services. The codes HHAs will be asked to submit are detailed in a Medicare Learning Network (MLN) document, and include: G0320: Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system G0321: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system G0322: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (for example, remote patient monitoring) For more details on the G-codes and reporting expectations, see the full MLN Guidance and the full text of the finalized CY 2023 Home Health PPS Rate Rule. Falling Investment for Telehealth Startups A recent article in Politico [subscription required] brings to light the stark decrease in investment in telehealth companies in 2022 (compared to 2021), as the pandemic subsides and a recession likely kicks in. In fact, while telehealth funding for digital health in the US peaked in 2021 with $11 billion dollars, that has fallen to only $3 billion by the third quarter of 2022. The effects of this slow down in capital is bound to ripple across the industry. As a result, many startups are laying off workers and focusing on just a few key offerings. Adding to the uncertainty of the future for these companies is how telehealth policies will impact them moving forward as state and federal governments shift from pandemic era temporary policies to often stricter permanent telehealth requirements with greater oversight. Cerebral, a digital mental health company, for example is currently under federal investigation for over-prescribing ADHD medication. This is the type of occurrence other telehealth companies may take note of and may shape the way they think about the future of their products and services in order to avoid such situations. Additionally, consumer demand has shifted post-pandemic. While consumers were enthusiastic about utilizing telehealth for most forms of healthcare in order to avoid crowded doctors’ offices and hospitals at the height of the pandemic, they now prefer to use it for check-ins with their doctors, mental health visits and addiction treatment, according a survey by the American Medical Association. This necessitates a shift for many telehealth start-ups, and according to Megan Zweig, COO of Rock Health, many companies are struggling with this. For more information, read the full Politico article [subscription required]. World Health Organization Telemedicine Implementation Guidance In November the World Health Organization (WHO) released a telemedicine implementation guide based on knowledge and learnings the WHO has gathered since releasing their first report on telemedicine in 2010. The set of recommendations within the new guide is aimed at optimizing the implementation of telemedicine services by providing an overview of key planning, implementation and maintenance processes to inform an investment plan and support countries across different stages in developing telehealth solutions. The guide contains three phases to developing a successful telehealth program, including (1) a situational assessment; (2) planning the implementation; and (3) monitoring and evaluation, and continuous improvement. There are a total of eleven steps within the three phases, including tasks such as performing a landscape analysis, establishing standard operating procedures, developing a budget and determining monitoring and evaluation goals, as well as an adaptive management plan for improvement. Several case studies from different countries, including India, Cabo Verde, Indonesia, Qatar and Mali are also provided in the annex section of the document. Download the full telemedicine implementation document from the WHO’s website for all the detailed steps outlined in their recommended procedures for telemedicine implementation. See full article: https://mailchi.mp/cchpca/closing-2022-with-new-telehealth-g-codes-for-hhas-uncertainty-for-telehealth-startups-plus-state-federal-telehealth-developments-and-much-more < Previous News Next News >

Telehealth 2.0: How Providence is taking its platform to the next level Laura Dyrda June 13, 2022 Telehealth became the prevailing mode for medical providers to see patients during the early days of the pandemic, and while use has leveled off in many areas, virtual care has become a permanent part of the healthcare ecosystem. Hospitals and health systems across the U.S. are now building telehealth, remote patient monitoring and hospital-at-home programs as part of their growth strategies. Patients also prefer telehealth as a convenient way to see their clinicians when an in-person visit isn't necessary. Most health systems have built a functioning telehealth program, but what opportunities are there to refine these programs for a better patient and clinician experience? Todd Czartoski, MD, chief medical technology officer at Renton, Wash.-based Providence, joined the Becker's "Digital Health + Health IT" podcast to talk about where the health system's virtual care program is headed. Click here to subscribe to the podcast and keep an eye out for Dr. Czartoski's episode. Note: Response below is edited lightly for clarity. Question: Where do you see telehealth becoming a better tool for clinicians and patients? How is virtual care at Providence evolving? Dr. Todd Czartoski: Over the last two years, our organization has done just over 4 million [telehealth] visits. For perspective, in 2019 we did 67,000 visits, and in one year we were doing 70,000 visits a week in April and May of 2020. That was a huge shift. Now, turning the lights on and being able to walk into the room is one thing, moving furniture around and optimizing the flow is another. A lot of our focus in the last couple years has been improving the experience for the provider, clinic staff and for the patient. We have really gotten it down to where the basic technical components of [telehealth] work pretty darn well, and we don't have a lot of issues with the connectivity piece. We've added interpreter services, and we've added in the ability to talk to more than one person at a time so you can have a family member in a different part of the country join the visit. Those types of things have been important add-ons, in addition to waiting room functionalities where you can add a survey or information tailored to the patient while they're waiting to see their provider in the virtual waiting room. Those are the things you're going to see continuing to evolve and emerge as additional capabilities. The support staff for the physician or provider's clinic also see their function and role evolving. If you think about a traditional clinic, a lot of those roles require putting patients in the room, checking their vitals, ordering labs or getting patients a follow-up appointment. Some of these things still exist, and some are going to be automated or done as part of a telehealth visit. That's where some of the opportunities are arising to continue to optimize the experience for the patients, staff and provider. You're going to see big trends overall here. Telehealth as a video visit, as a functionality, is somewhat limited. What we've learned is that whether you're a behavioral health specialist, a primary care provider or a subspecialty surgeon … all of those specialist visits can be done safely and effectively with telehealth. It's opened the door for looking at what else could we do beyond just a face-to-face visit. Specifically, the door has been opened for home monitoring. We have a remote patient monitoring solution that we built for COVID-19 home monitoring specifically, and because of the success of that, we've monitored over 30,000 patients up to two weeks who either confirmed or were under suspicion of having COVID-19. That opens the door for what we could do in terms of other types of home monitoring for COPD, diabetes, hypertension or whatever the case may be. That's a big area for growth and development. Finally, moving services outside the hospital, hospital-at-home, is a big initiative for us. We've been working on it for a long time and we're seeing some success. We're rapidly deploying that across our ecosystem and a lot of other health systems are as well. It really checks a lot of the boxes for patient experience; our patients absolutely love it. It's bending the cost curve, improving access and helping improve capacity so we don't have to build more super expensive towers and hospitals. Some of the outcomes with hospital-at-home have been shown to be better than traditional hospitalization when it comes to delirium, falls, length of stay and complications. People actually heal better on their own in a comfortable home environment. Those are a few examples of areas that we're going to see growth in our ecosystem. See original article: https://www.beckershospitalreview.com/telehealth/telehealth-2-0-how-providence-is-taking-its-platform-to-the-next-level.html?origin=CIOE&utm_source=CIOE&utm_medium=email&utm_content=newsletter&oly_enc_id=1372I2146745E8F < Previous News Next News >

Member & Sponsor Levels NMTHA offers multiple benefit levels: ​ Membership Pricing structure based on organization size ​ All Member benefits included Sponsorship Available to members and non-members All Sponsor benefits included Does not include member benefits Membership is not required for sponsorship Member benefits NMTHA Member benefits include: Tax-deductible annual dues as donation to 501(c)(3) organization NMTHA Committee membership and leadership opportunities Inform and influence local/state/national telehealth policy Gain industry insight, knowledge, professional development Networking, community forum, special events e-Newsletter, email updates, workshop notifications On-demand webinars, training videos, interviews View job postings, resume builder, skill-building content Members Select the plan that fits your organization type Health Systems, Health Plans $ 1,000 1,000$ Every year Provides access for up to 6 people Select Hospitals, Associations, Group Practices $ 500 500$ Every year Provides access for up to 4 people Select Individuals $ 150 150$ Every year Provides access for up to 1 person Select Students, Equity Members $ 20 20$ Every year Provides access for up to 1 person Select Membership dues renew annually until cancelled. For plans that include multiple users, click HERE to learn how to add users to your membership plan. For login instructions, click HERE . NMTHA Sponsor benefits include: Tax-deductible sponsorship is donation to 501(c)(3) organization Organization featured on NMTHA's dedicated Sponsor webpage Webinar presentation to NMTHA Board of Directors Poster presentation at NMTHA's Annual Town Hall Sponsor benefits Sponsors For Members and Non-Members NMTHA Sponsors (Membership not required) $2,500 $ 2,500 ​ (Member benefits not included. Membership is available separately.) Valid for one year Select

Extended Reality for Telehealth The technologies enabling a more fully immersive telehealth experience of the future Jordan Owens September 20, 2022 There has been a digital transformation in telehealth in the form of remote meetings and video consultations. Just a few years ago, it was considered innovative to meet with a patient over video: now it’s seen as routine. Necessity can be a catalyst for innovation and telehealth is now here to stay. But that doesn’t mean the industry has finished growing, changing — or expanding. Extended reality (XR) is a catch-all term used to describe the many and various ways that technology can enhance what we perceive with our senses: how the real and virtual worlds can combine to extend perception, observation, and — in the case of telehealth — patient care and diagnosis. Using extended reality tools like augmented reality headsets and wearable devices, healthcare workers can diagnose with better accuracy, treat patients faster, and provide an optimal level of care — even when the patient is on the other side of the country (or the world). Some of the innovative ways that people are combining telehealth and extended reality include: Wearable technology to enhance remote patient monitoring You enter a remote telehealth session with a patient. You ask them what seems to be the issue. They respond, “Well, my ring says that my sleep patterns have been disturbed for the past few nights due to elevated heart rate, and then today my temperature has gone up. Here, look at the data for yourself.” Wearable technologies — from smart watches and wristbands to patches, rings, and even headsets — help collect valuable health data. These devices are already shaping the future of telehealth by making remote patient monitoring faster, easier, and more accurate than ever before. There are currently thousands of wearable devices on the market, tracking a variety of conditions. But as sensor technology improves, the accuracy of these devices improves as well. In fact, Gartner predicts that “by 2024, miniaturizing capabilities will advance to the point that 10% of all wearable technologies will become unobtrusive to the user,” leading to rapid market growth over the next three to five years. Virtual reality environments to set remote patients at ease The immersive nature of VR makes it a great way to distract patients from the stress they’re feeling. In fact, virtual reality has already proven effective in helping anxious in-office patients relax in stressful situations — like a child receiving a vaccine. This soothing, calming effect can be replicated in telehealth as well. Virtual environments can help alleviate some of the awkwardness of remote telehealth sessions, and help the patient feel closer — both physically and mentally — to the caregiver, which can improve patient care. According to a recent paper on the use of extended reality in telehealth: “Some patients report reluctance to self-advocate during typical telehealth sessions because of poor eye contact and audio interference if more than one person speaks at a time (….) Technologies that evoke presence—the perception, feeling, and interaction with simulations as if they were real — can meaningfully impact the practice and outcomes of telehealth.” While VR technology might not yet be advanced enough to create a fully immersive telehealth experience, it could be very soon. Imagine the possibilities. Augmented reality to improve patient care and diagnosis Wearables aren’t just for patients. There are many devices on the market that can augment and enhance the skills of medical caregivers as well. Visual overlays can help practitioners improve the accuracy of incisions, find difficult veins, take patient temperatures remotely, and much more. Many of these AR headsets, like those designed by RealWear, are also voice-controlled, leaving the practitioner’s hands free to do the work that needs to be done. They can also use the headsets to contact, and even video chat with, clinical specialists to get advice and guidance — making it easier for first responders in the field to accurately diagnose and treat illnesses and injuries before the patient even arrives at the hospital. Getting started with extended reality in telehealth As with any new technology, it’s important to work with partners who provide not only general support, but also vertical-centric support. Pexip is achieving this through partnering and working closely with headset manufacturers like RealWear and Hippo. We are also working with vertical-centric partners like SimplyVideo, allowing Pexip customers to add a variety of XR functionalities to their existing video telehealth platform. Pexip’s vision for the future is centered around leveraging technology to enhance and improve what people can achieve. We’re excited for the journey ahead and hope you will join us. About the Author Jordan Owens is the VP of Architecture for Pexip. He joined Pexip in 2012 from TANDBERG and Cisco where he led the Americas Technical Support organization, the Americas Product Engineering team, and a Pre-Sales Engineering organization for the previous 10+ years of his career. At Pexip, Jordan is responsible for leading the Americas engineering organization and serving as an extension of the global R&D organization. He can be reached at jordan@pexip.com See original article: https://www.americantelemed.org/blog/extended-reality-for-telehealth/ < Previous News Next News >

Rural Providers Weigh Telehealth Investment Against Regulatory Uncertainty Holly Vossel June 8, 2022 Hospices are leveraging expanded telehealth options to maximize access for hard-to-reach rural patients despite lingering regulatory uncertainties. Case in point, the Providence Institute for Human Caring last year launched a tele-palliative care program aimed at addressing rural patients’ unmet needs. Thus far, the initiative has yielded positive results, but the process hasn’t always been easy, according to Dr. Gregg VandeKieft, executive medical director of the institute’s Palliative Practice Group. Snags along the way included dairy cows blocking staff from reaching patients. “For the first time we’re able to offer equitable access to specialty palliative care services for patients who need and want them in this rural setting,” VandeKieft told local news. “But we often have to balance providing health care with the time schedules and welfare of livestock, crops and other realities of rural living.” Washington-based Providence Health System provides a range of facility- and home-based care, including senior services and hospice. The company has more than 119,000 employees serving communities in six states. The TelePC program has increased care collaboration between Providence and the patients’ other providers, including family caregivers. It has also reduced travel time for the palliative care team and curbed unnecessary patient transfers and recurring hospitalizations. Hospice and palliative care providers have wrangled for decades with obstacles that complicate access to rural patients and make their care more expensive. For starters, rural regions are less likely to have a Medicare-certified hospice than urban counties. The service areas of the nearest hospices may not extend far enough to reach some of the people in those zones. When rural patients do have a provider in range, those hospices do their best to deliver care while contending with lower patient volumes, a smaller labor pool, long-travel times between home visits and the resulting travel costs. Some of the challenges are very unique to rural areas, like livestock schedules, lack of nearby caregiver support and limited internet bandwidth capacity. Telehealth has been an important part of improving providers’ ability to reach rural patient populations, according to Dr. Michael Fratkin, chief medical officer for ResolutionCare, a Vynca company. Fratkin founded palliative care provider ResolutionCare in 2015. Advanced care planning technology company Vynca acquired the company last year in its first move into the clinical care space. The pressures on rural providers go beyond the logistical. A successful tele-palliative care program requires not only greater access to high-speed internet in those areas, but also the confidence of the people they serve. Many rural residents place a lower value on telehealth services compared to the in-person care they are used to, said Fratkin. “The advantages of telehealth are the gain of seeing people at home and instantaneously sharing space with them,” Fratkin told Hospice News. “We are not physically entering their private space, not requiring them or staff to drive. What’s most important is creating that safe space to share. There are biases that virtual care is second rate. We have to blast through these biases. They are a bigger barrier to palliative and hospice care than dairy cows.” Then came the pandemic, and with it broad expansion of how providers can use telehealth — at least for the time being. Rapid deployment of telemedicine during the COVID-19 public health emergency (PHE) has created “a new pathway” for bringing palliative and hospice care specialists to rural areas, according to authors of a recent report published in the JAMA Health Forum. Additional studies further support the claim that changes to telehealth policy improved access. But without further regulatory or legislative action, those pathways will close when the federally declared emergency ends. The U.S. Department of Health & Human Services (HHS) most recently extended the PHE period to expire in July. The agency has not indicated whether or not they will renew it. As hospices navigate how they will use telehealth in the long-term, these uncertainties put them in a bind. Many are trying to weigh the benefits of telehealth investments against the possibility that they may soon have to shut down or cut back those programs. One factor policymakers might need to consider is that people may now expect that these services will remain available to them. The events of the past two years have opened the eyes of many patients to telehealth’s potential , according to Fratkin. “The pandemic telehealth experiment is unmeasured, but what we’ve discovered by being thrust into this experiment is that I don’t think patients want to give it up,” Fratkin told Hospice News. “They discovered the value of communications technology allowing them to stay in their lives and not interrupt care. Some of these providers are running back to the status quo as if it was working, but we’re going forward, not backward in this.” < Previous News Next News >

Libraries Add Telehealth to the Rural Communities They Serve Mari Herreras October 20, 2022 In the early days of the Covid pandemic, Dianne Connery realized something needed to be done for people in her rural Texas community to help connect folks to their medical appointments. Connery, director of the Pottsboro Area Library in Pottsboro, Texas, said it started when one woman with pulmonary disease came to the library for help, desperate to meet with her doctor but too high risk to come to his office—a two-hour drive south to Dallas. “Libraries are such perfect places for this because often we have the fastest internet in town, and we are used to helping people with technology,” Connery said. Connery and her fellow librarians sprang into action—creating a private space in Connery’s office with her laptop that had a camera. That gesture allowed the woman to meet with her doctor and go over recent MRI results. “I had never lived in a rural town until 2010 and didn’t realize how hard it is to access digital technology. You need a solid infrastructure for robust internet. Rural communities like ours don’t have that,” she said. From that first telehealth appointment in Connery’s office grew the library’s telehealth program that’s received national recognition. However, it never would have happened without Connery, with support from the town council, having fiber installed to support a teen eSports program long before the start of the pandemic. More community members used Connery’s office those early telehealth appointments, but through a National Library of Medicine grant and a community appeal, she was able to create a private appointment space from an old junk room and purchase the needed hardware and equipment. The next step was a unique partnership she developed with the University of North Texas Health Sciences Center to pair patients with the medical providers they needed. People can be seen two days a week for those using Medicare and Medicaid. Another day of the week is reserved for behavioral health appointments and another day is reserved for folks seeing their regular health providers. Connery’s work on the telehealth program doesn’t end there. The American Heart Association recently provided her library with blood pressure kits members of the community can check out. They also received a grant to hire a community health care worker to do outreach and education at the library and community spaces like the American Legion and the VFW. Now she’s focused on developing a digital literacy curriculum with the help of a three-year grant that helped her hire a digital navigator. Connery said she’s excited to see other rural libraries in Texas start telehealth programs but hopes more funding loops back to libraries desperate for increases in their own budgets. Connery is part of a national consortium of libraries who meet monthly to discuss telehealth programming—a growing interest in other rural communities beyond her Texas borders. Last month, a new telehealth program recently launched at two rural Pima County Library branches in Ajo and Arivaca—the first of its kind in Arizona—allowing folks with transportation or internet issues access to their doctors without having to drive several hours across the desert to nearby Tucson. “A huge sense of relief,” is how one Ajo resident recently described her experience that helped her connect with her primary care doctor in Tucson about worrisome symptoms she experienced after recovering from Covid. At the Salazar-Ajo Library she was able to collect the vitals her doctor needed using equipment provided by the library. And in the privacy of the library’s meeting room, she met with her doctor via a laptop and the internet provided by the library to go over her symptoms and vitals. “Being able to take my vitals and provide those to my doctor seems really important,” the Ajo resident said. “… while I was on my call with her, she had me do my vitals. We started with the blood pressure cuff, and how to apply it. Then my oxygen with the pulse rate oximeter.” The end of the appointment her doctor determined that the symptoms were not uncommon for someone who has had Covid, allowing the Ajo resident some relief and a better understanding of her recovery. Daniela Buchberger, Pima County Library’s Ajo branch managing librarian, said the new program, Health Connect, provides a private room for telehealth medical appointments. Inside is a laptop with a camera and equipment needed for a patient to take their own vitals: a digital scale, a thermometer, a blood pressure cuff, and a pulse rate oximeter. A patient will need to have the link provided by their doctor, usually via email. Library staff, due to privacy restrictions, aren’t going to be able to help someone log-on or use the equipment although the patient can bring someone with them to their appointment in the study room. Each library has written instructions on laminated cards as well as easy-to-follow visuals to help guide their experience. According to the Pima County Library, Health Connect is made possible by the Arizona State Library, Archives, and Public Records, a division of the Secretary of State, with federal funds from the Institute of Museum and Library Services. It is a joint effort between the Library, Pima County Health Department, University of Arizona’s College of Nursing, the Arizona Telemedicine Program, and United Community Health Care. "Access to telehealth is essential for people to get the care they need when traveling to an in-person visit isn't possible,” said Ken Zambos, program manager for Workforce and Economic Development in Pima County. “By providing this service, the library is providing access to equipment that transforms healthcare delivery and positively affects healthcare outcomes." Buchberger said a library card isn’t needed to use the room. However, reservations are needed and available in hour and half increments. Each person using a room is expected to clean all equipment after use with alcohol wipes provided. A fan in the room will be used to provide white noise to help with privacy as much as possible. “We may not have as much traffic as other libraries, but we are an important part of the community. The library is free, so is the internet,” Buchberger said. “Not everyone here has a car or a computer, but they have us.” About the Author Mari Herreras is the newest member of the Arizona Telemedicine Program and Southwest Telehealth Resource Center teams, serving as Communications Manager. She has worked in marketing and communications in publishing and nonprofits, as well as an award-winning journalism career for community and alternative newsweeklies in Tucson, Los Angeles, Seattle, and Wenatchee, Washington. See original article: https://southwesttrc.org/blog/2022/libraries-add-telehealth-rural-communities-they-serve < Previous News Next News >

Digital Health Tools Transforming Pediatric Telemedicine, Teletherapy & Telehealth Dr. Maheu February 24, 2022 The COVID-19 pandemic has led to an unprecedented rise in pediatric telemedicine to alleviate the strain of behavioral health issues. Unprecedented stressors abound. Children are now more often confined to their homes and are less able to socialize. They may be forced to adjust to their parents’ working from home. They may witness economic and emotional fluctuations that leave them more anxious than at any time in recent history. With the increased demand for care with a shortage of available pediatric behavioral professionals, many organizations have shifted to pediatric telemedicine and telehealth or teletherapy tools.. COVID 19 and Challenges for Pediatric Telemedicine for Behavioral Health A meta-analysis published in JAMA Network, pediatrics found that one in every four children suffered depression during the COVID-19 lockdown and the anxiety prevalence rate was 20.5%. According to the Centers for Disease Control and Prevention (CDC), compared to 2019, the number of mental health-related emergency visits in 2020 went up by 24% for children in the 5-11 age group and 31% in the 12-17 age group. The American Association of Pediatrics and the American Association of Child and Adolescent Psychiatry have officially declared an emergency as pediatric behavioral health went through a crisis countrywide. Parents had pretty tough times getting support for pediatric behavioral health following the closure of clinics and shortage of pediatric-trained therapists. Digital health tools primarily developed for adult health care have been adapted to connect parents to trained child therapists to overcome geographical and pandemic-related barriers. Full article here: https://telehealth.org/pediatric-telemedicine-2/?smclient=f760e669-8538-11ec-83c8-18cf24ce389f&smconv=5bc4c379-a4c1-484f-a411-33ec93777504&smlid=12&utm_source=salesmanago&utm_medium=email&utm_campaign=default < Previous News Next News >

Amazon Healthcare Building a National Telehealth Business Dr. Maheu, Telehealt.org January 2021 Amazon Care recently announced that it will expand nationally to all Amazon workers and other interested companies across the country in the summer of 2021. Amazon, the $1.6 trillion shipping giant, is launching a new service to provide essential medical services through Amazon Healthcare as a national telehealth business. Amazon Care uses an app that allows consumers to connect with doctors, nurse practitioners, and nurses virtually, 24 hours a day, via in-app chat or video. Initially launched and tested with Washington-based employees, Amazon Care recently announced that it will expand nationally to all Amazon workers and other interested companies across the country in the summer of 2021. “Making this available to other employers is a big step,” Amazon Care Director Kristen Helton said. “It’s an opportunity for other forward-thinking employers to offer a service that helps bring high-quality care, convenience and peace of mind.” Notice the last three descriptors: “high-quality care, convenience and peace of mind.” From the perspective of many healthcare providers, healthcare in the US has been lacking in each of these three areas. For employers registering for the service, which has partnered with Care Medical, employees near their headquarters will get online and in-person doctor visits. Employees elsewhere will get just the virtual components. Through Care Medical, Amazon Care currently offers an app to connect employees to a medical professional for a video consultation. It also offers follow-up care in the home for patients. The goal is to lower healthcare costs internally for Amazon and externally for some of the world’s most influential companies, using telehealth to meet people on their terms, with good care, wherever they are. Amazon’s Multi-Layered Business Strategy Anyone watching Amazon over the last year will be well acquainted with its accelerating moves to provide the early inklings of healthcare. Early Amazon Healthcare efforts were announced by Telehealth.org’s Telehealth News on 6/4/2020. In that article, it was reported that Amazon Health announced a pilot program offering virtual medical services to employees and their families. Amazon then expanded the presence of Alexa voice assistant, announcing that it was making it possible for voice assistant developers to offer HIPAA-compliant services for the Alexa platform. Amazon Pharmacy, a drug-delivering business in 48 states with steep discounts for Prime members was also released in November of 2020. Most recently Amazon has launched another offering called Amazon HealthLake, a HIPAA-compliant service that allows healthcare providers, health insurance companies, and pharmaceutical companies to store, transform, and analyze health data at a petabyte scale. As described on the Amazon HealthLake website: Amazon HealthLake removes the heavy lifting of organizing, indexing, and structuring patient information to provide a complete view of the health of individual patients and entire patient populations in a secure, compliant, and auditable manner. Using the HealthLake APIs, healthcare organizations can easily copy health data in the Fast Healthcare Interoperability Resources (FHIR) industry standard format from on-premises systems to a secure data lake in the cloud. HealthLake transforms unstructured data using specialized machine learning models, like natural language processing, to automatically extract meaningful medical information from the data and provides powerful query and search capabilities. Organizations can use advanced analytics and ML models, such as Amazon QuickSight and Amazon SageMaker to analyze and understand relationships, identify trends, and make predictions from the newly normalized and structured data. From early detection of disease to population health trends, organizations can use Amazon HealthLake to conduct clinical data analysis powered by machine learning to improve care and reduce costs. < Previous News Next News >

Report: Telehealth Programs Increase Workload for Nurses and Support Staff Katie Adams December 20, 2022 Many providers think their telehealth program increases the workload for nurses and support staff, according to a recent report. In 2023, hospitals and physician practices will have to focus on making their telehealth workflows more efficient, which may involve partnering with third-party administrators. Telehealth isn’t as widely utilized as it was at the dawn of the pandemic, but the care modality is definitely here to stay. However, many providers believe their telehealth program increases the workload for nurses and support staff, according to a recent report from research firm Sage Growth Partners. Providers also said they don’t think physicians enjoy using telehealth visits to treat patients. In 2023, hospitals and physician practices will have to focus on making their telehealth workflows more efficient, which may involve partnering with third-party administrators, the report said. In September, Sage Growth Partners surveyed 95 health system executives and 75 leaders of physician practices. Practices with fewer than five physicians were excluded from the survey. Most respondents said that their organizations will focus on optimizing and sustaining their current telehealth programs in 2023 rather than expanding them. In fact, only about 10% of participants — 11% of hospitals and 8% of practices — said they are looking to grow their telehealth offerings next year. Health system executives were more likely than practice leaders to say that telehealth visits should make up a higher percentage of their ideal in-person-to-telehealth visit mix. Health system leaders said the mix should be 30% telehealth and 70% office. Among practice leaders, the ideal mix looks more like 20% and 80%. Their difference of opinion also extended to another question on how they think telehealth utilization will grow by visit type over the next two years. Health system leaders said that utilization will fall slightly for most visit types — even behavioral health. They said that 36% of behavioral health visits were delivered via telehealth in September, but they expect this to fall to 33% in September 2024. Urgent care and telepathology were the two visit types for which health systems leaders predicted telehealth growth — they expect telehealth utilization to increase from 3% to 7% for urgent care and from 2% to 4% for telepathology. Practice leaders expected telehealth utilization to increase slightly or remain the same for most visit types. Specialty care was the only exception — for this visit type, practice leaders predicted utilization to fall from 23% to 20% over the next two years. Both groups agreed that telehealth actually increases burden on staff though practice leaders seem to feel it more acutely. More than half of practice leaders said telehealth has increased support staff’s workload, and 28% said it generates more work for nurses. Among health system executives, 35% said telehealth increased support staff’s workload, and 30% said it creates more work for nurses. Additionally, less than half of total respondents (46% of hospitals and 47% of practices) agreed that telehealth increases physician satisfaction and physicians like using telehealth visits to treat patients. A key reason for this is that many providers are operating their telehealth programs using inefficient workflows, according to the report. Nearly 60% of survey respondents said they have not yet created new workflows for telehealth visits. Instead, hospitals and physician practices are still relying on workflows that mirror in-person visits. In 2023, providers will need to improve these workflows, and many will consider bringing on the help of third-party telehealth administrators, such as Amwell or Caregility, the report said. Hospitals are more than twice as likely to use third-party partners to administer telehealth services — with 20% of hospitals doing this compared to 9% of practices. Hospitals were also more likely to say they would change their telehealth administering party over the next two years — with 44% of hospitals saying this compared to 25% of practices. Photo: Anastasia Usenko, Getty Images See original article: https://medcitynews.com/2022/12/report-telehealth-programs-increase-workload-for-nurses-and-support-staff/ < Previous News Next News >

Telemedicine & Telehealth: For Allied Health Professionals, Too Faith Lane April 20, 2022 With more and more people using telehealth applications since the pandemic, one education expert asked how to expand training to include Physical Therapists and Occupational Therapists According to a recent study, one in five adults polled about health care during the coronavirus pandemic said that they or someone in their household delayed receiving medical care or were unable to get care, due to office closures or shutdowns. Although the pollsters focused questions about doctor or dental appointments, providers across the board experienced disruption in their specialty areas, including Peggy Stein, OTD, OTR/L, CHT, an Occupational Therapist in Oregon. Occupational therapy, or OT, focuses on how people perform activities that are most important to their daily lives, so for people who need it, missing out affects quality of life, according to Stein. “OT is important to assess the ability of people to participate in usual activities. Work is important and many people equate occupation with work. However, life involves more than work. Participating in life includes taking care of ourselves, our family and friends, pets, home, yard, or attending to community. These are all ‘occupations’,” Stein said. “The state did halt therapy for a few weeks, and many providers had upheaval for several months,” she said. And while Stein eventually returned to her practice, the buzz surrounding providing telehealth continued in the medical and therapeutic communities. “Back in March 2020, we hosted a webinar. We had numerous occupational therapists, physical therapists (PTs) and speech language pathologists (SLPs) in attendance; more than we have previously seen attending our telemedicine training programs,” said Melanie Esher-Blair, MAdm, Distance Education & Event Coordinator for the Southwest Telehealth Resource Center (SWTRC) and the Arizona Telemedicine Program (ATP). “They wanted more information on how to put the ‘tele’ into their scope of practice to maintain continuity of care for their clients,” said Esher-Blair. She said she knew the SWTRC and the ATP had the experts for developing a program. Both OT and PT national associations have information regarding how telehealth fits into the scope of practice, so attendees of the March webinar agreed creating a training around telehealth was important. An interdisciplinary team worked together to come up with the Occupational and Physical Therapy Webinar Series. For full post and access to video: https://southwesttrc.org/blog/2022/telemedicine-telehealth-allied-health-professionals-too < Previous News Next News >

Legislators Throughout the Southwest are Moving Towards Institutionalizing Telehealth Services Kirin Goff, Southwest Telehealth Resource Center July 2021 Legislatures across the southwest have sprung into action to enact bills that permanently expand telehealth services As the COVID-19 pandemic becomes increasingly under control and more states are ending their public health emergency declarations, legislatures across the southwest have sprung into action to enact bills that permanently expand telehealth services. At the forefront of this new legislation is Arizona’s HB 2454 that Governor Doug Ducey signed into law on March 5, 2021 to provide comprehensive amendments to the state's laws governing telehealth. In Arizona and other southwest states’ new telehealth laws, entities are generally prohibited from denying coverage for telehealth services and are required to cover remotely provided services at the same rate as equivalent in-person services. Exceptions to these requirements may be developed by an advisory committee of government officials, practitioners, and other stakeholders, who will determine, among other things, circumstances in which telehealth services are inappropriate. Even in the absence of a rule prohibiting telehealth services, healthcare providers must use good faith in determining whether telehealth services are appropriate, and if so, which communication modalities are appropriate. Communication Modalities Prior to the public health emergency response to the pandemic, audio-only services were generally permissible only if the healthcare provider had an existing relationship with the patient and audio-visual communication was not reasonably available. Voicemail was specifically excluded. Going forward, telehealth services in Arizona may be provided, when appropriate, through interactive audio/video, asynchronous store-and-forward technology (i.e., digitally stored medical imaging, multimedia files, other information that can be reviewed remotely), and remote patient monitoring technology. Legislation in other states throughout the southwest also includes measures that govern the types of communications by which telehealth services can be provided. In many cases, telehealth can be provided by means other than real-time, audio-visual communication. Nevada SB 5, for example, amends an existing definition of telehealth to include audio-only interactions. Utah's SB 161, which was enacted, allows providers to use HIPAA-compliant asynchronous audiovisual technology for certain treatments. Amendments to New Mexico's Cannabis Regulation Act (HB 2, also enacted) provide a patient to be diagnosed as a qualified patient via telemedicine, which includes store-and-forward and remote patient monitoring technologies as options. Collection and Reporting of Telehealth Data to Form Policy Decisions Legislators in Nevada, like those in Arizona, seek to collect and use data on telehealth services to aid in forming policy. Nevada SB 5 requires the state's Department of Health and Human Services to establish (if funding permits) a data dashboard allowing analysis of access to telehealth by different groups and populations. The bill goes further to include behavioral health boards, the Patient Protection Commission, and the Legislative Committee on Health Care to use the dashboard in formulating policy. Another Nevada bill (ACR 5) establishes a legislative committee to address the shortage of behavioral health professionals in the state. This committee will study the provision of behavioral health services through telehealth and consider ways to expand the use of telehealth to provide such services. Expansion of Services Various bills explicitly expand telehealth services in particular fields such as dentistry (Colorado SB 21-139, New Mexico SB 200), audiology and speech pathology (Colorado SB 21-021, New Mexico HB 210), occupational therapy (Colorado HB 21-1279), and dietetics and nutrition (New Mexico HB 147). Other measures are aimed at expanding broadband access:(Nevada AB 388; Colorado HB 21-1109), including efforts specifically directed at underserved communities (Arizona HB 2885, Nevada AB 388), seniors (Colorado SB 21-210, New Mexico SM 6), and children (New Mexico SM 15). In-Person Medical Examination Requirements In-person requirements have long been a contentious topic in the provision of initial telehealth services in certain contexts. For example, Arizona’s HB 2454 prohibits providers from prescribing Schedule II drugs after an audio-only communication with the patient, but generally allows other drugs to be prescribed after audio-only telehealth communications. In another context, Nevada’s SB 266 provides for in-person medical examinations for workers' compensation claims, but only if initial examinations were performed through telehealth services and only if a party requests an in-person examination. Interestingly, some bills seek to relax restrictions. For example, New Mexico’s HB 12 seeks to eliminate a previous requirement that a practitioner could only certify a patient for medical cannabis use if the practitioner had previously examined the patient in-person. Overall, the surge of bills moves us towards institutionalizing telehealth. Importantly, the latest round of legislation also exposes how much more there is to learn about optimizing telehealth and identifying best practices as uptake continues to increase across the southwest. New Mexico HB 147: https://track.govhawk.com/public/bills/1414538 New Mexico SM 6: https://track.govhawk.com/public/bills/1425880 New Mexico SM 15: https://track.govhawk.com/public/bills/1443803 New Mexico’s HB 12: https://track.govhawk.com/public/bills/1428580 Source: https://southwesttrc.org/blog/2021/legislators-throughout-southwest-are-moving-towards-institutionalizing-telehealth < Previous News Next News >

New Wave of Federal Bipartisan Bills to Expand Telehealth Center for Connected Health Policy June 2021 A good majority of the recently introduced bills focus on increasing telehealth reimbursement, however a few look to increase funding for telehealth services and infrastructure. At present, CCHP is tracking over 100 pieces of telehealth legislation in the current federal legislative session. This month we have seen a number of bipartisan bills introduced, continuing the federal push to expand telehealth availability and codify flexibilities allowed during the COVID-19 public health emergency (PHE). A good majority of the recently introduced bills focus on increasing telehealth reimbursement, however a few look to increase funding for telehealth services and infrastructure. It is notable the significant amount of support from both sides of the aisle for telehealth. For instance, representatives Dan Newhouse (R-WA) and Tom O’Halleran (D-AZ) introduced the Rural Remote Monitoring Patient Act (HR 4008) that would establish a pilot grant program to support the use of remote patient monitoring in rural areas. Senator John Kennedy (R-LA) introduced as part of a package of telehealth bills a reintroduction of a bill similar to legislation from 2020 titled the Telehealth Health Savings Account (HSA) Act (S 2097). The Telehealth HSA Act would allow employers to offer high-deductible health plans that include telehealth services without limiting employees’ ability to use health savings accounts. According to Kennedy’s press release, “a current IRS regulation stops employees from making or receiving contributions to HSAs if they hold a high-deductible health plan that waives the deductible for telehealth services, meaning employees holding high-deductible health plans often need to pay out of pocket for telehealth services. The Coronavirus Aid, Relief and Economic Security (CARES) Act (HR 748) temporarily waived this regulation, but S 2110 would make the waiver permanent.” We have also seen a few of the recent bills look at audio-only and codifying pandemic telehealth flexibilities. The Protecting Rural Telehealth Access Act (S 1988) by Senator Joni Ernst (R-Iowa) and also sponsored by Senators Jerry Moran (R-Kan.), Joe Manchin (D-W.Va.), and Jeanne Shaheen (D-N.H.), would: *Allow payment parity for audio-only telehealth services *Make permanent the ability for patients to be treated at home *Let rural health clinics (RHCs) and federally qualified health centers (FQHCs) serve as distant sites for telehealth services The Advancing Telehealth Beyond COVID-19 Act of 2021 by Representative Liz Cheney (R-Wyo.), introduced with Representative Debbie Dingell (D-MI), makes the following permanent changes: *Removes originating site and geographical limitations *Maintains telehealth flexibilities for RHCs/FQHCs *Expands coverage for audio-only services *Removes restrictions that limit clinicians’ ability to remotely monitor and track patient health and provide them access to innovative digital devices Additionally, we have seen bipartisan support around broadband legislation, such as from Senators Michael Bennet (D-Colo.), Angus King (I-Maine), and Rob Portman (R-Ohio), who recently introduced legislation which seeks to address the digital divide. Their Broadband Reform and Investment to Drive Growth in the Economy (BRIDGE) Act of 2021 would allow states to deploy “future-proof” networks able to meet communities’ broadband needs, including supporting local initiatives on affordability, adoption, and inclusion. According to Bennet’s press release, The BRIDGE Act would: *Provide $40 billion to States, Tribal Governments, and U.S. Territories for affordable, high- speed broadband *Prioritize unserved, underserved, and high-cost areas with investments in “future proof” networks *Encourage gigabit-level internet wherever possible while raising the minimum speeds for new broadband networks to at least 100/100 Mbps, with flexibility for areas where this is technologically or financially impracticable *Emphasize affordability and inclusion by requiring at least one affordable option *Increase choice and competition by empowering local and state decision-making, lifting bans against municipal broadband networks, and allowing more entities to compete for funding Lastly, additional information was just released regarding Cures 2.0 – another bipartisan bill, which creates the Advanced Research Projects Agency for Health (ARPA-H), a President Biden budget request proposal. According to a discussion draft and section-by-section summary, Cures 2.0 will address a variety of areas, including telehealth access, while incorporating and building upon several additional bipartisan bills, such as the Telehealth Improvement for Kids’ Essential Services (TIKES) Act (H.R. 1397 / S. 1798) and Telehealth Modernization Act (H.R. 1332 / S. 368). The telehealth provisions proposed in Cures 2.0 include: *Review the impact of telehealth on patient health and encourage better collaboration *Provide guidance and strategies to states on effectively integrating telehealth into their Medicaid program and Children’s Health Insurance Program (CHIP) *Make many of the COVID-19 PHE flexibilities post-pandemic permanent, such as: -Removing the geographic and originating site restrictions -Expanding the range of health care providers that can be reimbursed by Medicare for furnishing telehealth services to any health care professional eligible to bill Medicare -Enhancing telehealth services for use by FQHCs, RHCs, hospices, and for home dialysis The authors anticipate that the Cures 2.0 bill will be introduced in the coming weeks and hope to see it signed in the fall. While the fate of these telehealth bills is yet to be seen, it does seem to highlight strong federal support for expanding access to telehealth post PHE with such a large amount of bipartisanship support behind them. Given Medicare’s historically conservative approach in regard to telehealth pre-PHE, any additional shift would be significant. CCHP will continue to update its tracking tools and monitor the ever evolving telehealth landscape as we continue to move through the current federal legislative session. < Previous News Next News >

CCHP Leadership Provides A Look Back at Telehealth Policy in 2022: Yes...The Year is Almost Over! Mei Kwong December 20, 2022 As another full year of living under the public health emergency (PHE) for COVID-19 comes to an end, we are taking a look back to see what has happened this year with telehealth policy on both the federal and state level. Since the PHE is still in place and likely to continue into 2023, permanent changes on the federal level have been fewer in comparison to what many states have been doing. In fact, some states began making permanent telehealth policy changes as early as late 2020. Other states have taken similar actions to their federal counterparts and put a definitive future expiration date on temporary telehealth policies. FEDERAL The most significant federal legislative telehealth policy action seen this year took place in the Budget Act of 2022 which included language extending some of the temporary waivers to telehealth in Medicare for an additional 151 days after the PHE. This statutory change led to additional clarifications that the Centers for Medicare and Medicaid Services (CMS) made in their Physician Fee Schedule for 2023 (PFS). CCHP also recently released a fact sheet on the relevant telehealth policies. The final result as the policy stands now is: For 151 Days After the PHE: Certain providers including federally qualified health centers (FQHCs), Rural Health Clinics (RHCs), occupational therapists, and physical therapists may continue to provide eligible services via telehealth under the Medicare program. The list of temporary services eligible to be delivered via telehealth and covered by the Medicare program will continue to be available during this 151-day period. The geographic limitations under permanent telehealth Medicare policy will be suspended during this 151-day period and the home will continue to be an eligible originating site for all eligible services during the extension. Audio-only can continue to be used as a modality for eligible services during the 151-day extension. Permanent policy requirements such as a previous in-person visit for mental health services taking place in a non-geographically eligible location, in the home or via audio-only is suspended during this 151-day period. Certain other federal waivers that exist under the PHE are currently not included in this 151-day grace period. This includes the Office of Civil Rights (OCR) exercising discretion in enforcing HIPAA which OCR has noted will expire when the PHE is declared over or expires, whichever comes first. As can be seen by the foregoing, very little has changed this year regarding permanent policy, just what will happen in the immediate aftermath of the end of the PHE. There have been some indications that Congress may pass legislation to extend the federal waivers, or at least some of them, beyond the 151-day period. HR 4040 authored by Representative Liz Cheney (R, WY) passed the House earlier this year, but no further action was taken. That bill would have extended some of the temporary waivers for an additional two years. However, what might be considered by Congress now is rumored to be only a one-year extension. It remains to be seen if some additional action will be taken legislatively. Feeding into the federal policymakers’ decision-making process have been several reports from various federal agencies in the past year. The Office of the Inspector General (OIG) released several reports around telehealth in 2022 including: Telehealth Was Critical for Providing Services to Medicare Beneficiaries During the First Year of the COVID-19 Pandemic Certain Medicare Beneficiaries, Such as Urban and Hispanic Beneficiaries, Were More Likely Than Others to Use Telehealth During the First Year of the COVID-19 Pandemic Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks The last study listed above is important to take note of given the concerns raised by policymakers for the potential of abuse and fraud. However, the OIG report noted that in the first year of COVID-19, less than 1% of telehealth claims made to Medicare raised flags for potential fraud, which should provide some reassurance to policymakers. Broadband has been an issue both on federal and state policymakers’ minds. While connectivity is a greater issue beyond how it impacts telehealth, it cannot be denied that telehealth will simply not work if the patient and provider cannot connect, although policy expansions related to audio-only have sought to mitigate this gap to a certain extent. In 2022, the Federal Communications Commission transitioned the Emergency Broadband Benefit Program into the Affordable Connectivity Program which provides assistance in paying for connectivity. The National Telecommunications and Information Administration (NTIA) compiled federal funding opportunities that support broadband planning, digital inclusion and deployment projects on one site. States have also been gearing up activity around broadband, some of it funded by the federal government such as NTIA awards to Nebraska to develop strategic plans to expand high-speed broadband and other investments made by the state itself. No doubt, broadband will continue to be a significant issue in 2023. STATES As CCHP’s recent Legislative Roundup newsletter noted, 2022 was another active year for state telehealth policy legislation, though not as robust as it was in 2021. Overall, in 2022, of the bills enacted and subjects CCHP tracked, licensure proved to be the most popular policy issue addressed with 61 bills across the states passing. This was followed by 27 enacted bills related to professional regulations and telehealth, many having to do with prescribing and 18 bills for pilot/studies/demonstrations. Enacted Medicaid and private payer reimbursement bills were 17 and 12, respectively. The licensure focus is of particular interest to note. While many of the pieces of legislation passed related to joining licensure compacts, states also made exceptions to licensure for specific situations. States are starting to address the various situations usually involving an already established relationship between patients and providers that prior to the pandemic had remained grey areas. A common concern raised during the pandemic related to licensure involved a patient temporarily re-locating to another state, perhaps as a college student, going on vacation or caring for a family member, but still wanting to receive services from their own provider in their home state. Kentucky passed HB 188 that forbids a regulatory board from promulgating regulations related to telehealth that prohibit “the delivery of telehealth services to a person who is not a permanent resident of Kentucky who is temporarily located in Kentucky by a provider who is credentialed by a professional licensure board in the person’s state of permanent residence.” While clarity is always welcomed, the exceptions individual states are passing will create more complexity in the telehealth policy landscape particularly for practitioners who provide services in multiple jurisdictions. Reimbursement is an area that generates significant interest. For Medicaid related legislation, the type of modality used and services that would be covered under the program were popular issues addressed through legislation. For example, Virginia SB 426 requires the Medicaid state plan be amended to allow for remote patient monitoring (RPM) services for patients with certain types of medical conditions such as high-risk pregnancy and transplant patients when there is evidence that use of RPM is likely to prevent readmission to a hospital. Private payer telehealth legislation can also be quite specific. Louisiana HB 304 now requires telehealth coverage and payment parity equivalent to in-person services for physical therapy in particular. However, what we also saw were legislators moving towards ensuring there were patient protections/choice codified in state laws related to private payer plans and telehealth. Mississippi SB 2738, among other things, states that insurers cannot limit coverage of services to select third-party organizations. Commercial plans only offering telehealth delivered services to enrollees through a third party and not allowing their in-network providers to use telehealth has been a concern that was growing even prior to the pandemic. This stems from concerns raised by policymakers regarding patient choice or patients being “forced” to use telehealth and continuity of care concerns that continue to exist today. Overall, the number of states expanding telehealth policies increased. As noted in CCHP’s latest update to its 50 State Telehealth Policy Summary Report, Fall 2022, compared to its Fall 2021 update, three more state Medicaid programs are covering store-and-forward telehealth, five more states are covering RPM under Medicaid, and state Medicaid programs covering audio-only went up from 22 states to 34 states and DC. Additionally, three states have added payment parity requirements to their private payer laws. WHAT’S NEXT FOR 2023? As noted above, rumors have swirled around that there may be movement on the federal level to extend some of the telehealth waivers beyond the 151-day grace period, similar to what was proposed in the Cheney bill. However, it is likely that any such change will be included in a larger bill, such as the budget bill, rather than a standalone telehealth bill. There are also several outstanding issues that continue to not be addressed such as the registry for telehealth that the Drug Enforcement Administration (DEA) was to finalize regulations for in 2019. Some may recall that among the list of exceptions to allowing telehealth to be used to prescribe a controlled substance without the telehealth provider having examined the patient in-person included when a PHE was declared and the creation of a registry. For the registry, presumably once a provider is qualified to be on the registry, they need not have to meet any of the other narrow exceptions to prescribe via telehealth. That registry has never been created, though Congress had directed the DEA to finalize regulations by the end of 2019. On the state level, we likely can expect to see continued action around coverage, licensure, and professional regulations, as well as continued discussion around patient choice. During this past year, there has been increased discussions regarding “telehealth-first” health plans and the impact on patient choice. Whether policymakers take a more active role in regulating these plans remains to be seen, but the discussion around patient choice protections will continue. One thing is clear: the telehealth policy landscape is by no means “settled” as 2022 draws to a close. Outstanding questions around temporary policies still remain and even settled policies implemented a year or so ago have been tweaked in some states. To hear more about what's occurred in 2022, plus what we can anticipate for 2023, watch CCHP's newest short video. As we head into 2023 we can be certain that the telehealth policy landscape will continue to evolve and change, and we look forward to having you continue on this journey alongside CCHP. Have a Happy New Year and see everyone in 2023! Mei Kwong, CCHP Executive Director See original article: https://mailchi.mp/cchpca/cchp-leadership-provides-a-look-back-at-telehealth-policy-in-2022-yesthe-year-is-almost-over < Previous News Next News >

Telehealth Waivers Wind Down, Restricting Some Providers From Delivering Care Across State Lines Hailey Mensik August 2021 States allowed medical professionals licensed elsewhere to hold virtual visits with their residents during the pandemic. Some are making the rollbacks permanent, but others are reversing again. State lawmakers temporarily scrapped hundreds of regulations early in the COVID-19 pandemic to help businesses and consumers deal with widespread shutdowns, giving patients greater access to telehealth and helping spur an explosion in use of virtual care. A number of states allowed medical professionals licensed elsewhere to hold telehealth visits with residents of their state during the pandemic, and some already have or are looking to make the rollbacks permanent. Exact numbers are difficult to track because some policies overlap and are organized differently in different states, but as of July 28, 17 states and the District of Columbia still had some type of telehealth waivers in place, according to the Federation of State Medical Boards. Other states like New York, Minnesota, Florida and Alaska are among those that have pulled back emergency waivers. Alaska is going back to its old ways after its governor's emergency order ended. Patients there can only visit telehealth providers licensed in the state now after about a year without that rule. The same goes for Florida after its emergency declaration expired on June 26. Meanwhile, Arizona lawmakers passed sweeping legislation in May making the state's pandemic-related telehealth waivers permanent, including requiring insurers to cover audio-only visits and allowing out-of-state medical professionals to conduct telehealth visits with patients in the state. Advocates for allowing providers to permanently deliver virtual care across state lines say it would help ease staffing shortages, help patients and doctors maintain existing relationships and benefit patients in isolated communities by making faraway specialists more accessible. But as long as medical licensing is regulated at the state level, the broad access to services and providers that existed during the pandemic won’t continue for everyone. Patients in rural areas are often far away from a doctor's office, and in states like Alaska where flexibilities expired, can be even further from providers practicing certain specialties, such as a pediatric intensivist or certain oncologists, said Mei Kwong, executive director for the Center for Connected Health Policy. "Maybe there aren't enough of those cases in those particular states to make it worth a provider's while to go and move there, but there's still a need because they may still have people who need those services," Kwong said. The patchwork of red tape could also pose a challenge for providers who have pivoted to delivering more virtual care over the past year. Mia Finkelston, a family medicine physician in Maryland, made the switch to telehealth nearly a decade ago and has been practicing with Amwell ever since. She's currently licensed in 29 states, and said the process to get her licenses varied widely. "It's not standard as far as fees, it's not standard as far as what documents you need to give them. It really is based on those state medical boards and what they decide is important to them," Finkelston said. As more states' waivers expire and others' rules change, one option for providers who want to continue delivering care across state lines is through the Interstate Medical Licensure Compact, which currently includes 30 states, the District of Columbia and Guam. Similar to the nurse licensure compact, it allows eligible physicians to practice in other compact states. It’s worth noting, however, that the Interstate Medical Licensure Compact does not issue a compact license or a nationally recognized medical license for physicians, but rather streamlines the process for them to receive multiple licenses from individual state medical boards. Physicians pay an initial $700 compact fee, then an additional cost for each license in any compact state they want to practice in. States must pass legislation to join the compacts. "No two states are totally alike in their legal and regulatory framework for the practice of medicine, which of course, affects telehealth, which is just one aspect of the overall US healthcare system," Kyle Zebley, director of public policy at the American Telehealth Association, a coalition with a board that includes representatives from hospitals like HCA and payers like CVS, said. "Therefore a way to be consistent with our federal system, consistent with the way that the practice of medicine has been done in this country for so long, we've come up with this great model of compact, which is a way to be consistent with all that while still allowing for care across state lines," Zebley said. As lawmakers try to facilitate continued access to telemedicine for those who need it most, licensure reforms will be key, the authors of a February article in the New England Journal of Medicine argue. "The growth of large national and regional health systems and the increased use of telemedicine have expanded the scope of health care markets beyond state borders," the authors said. They agree that a federal medical licensing system is the loftiest reform option and strengthening existing compacts is the way to go, suggesting Congress pass legislation to encourage holdout states to join the Interstate Medical Compact. Other options include encouraging states to practice reciprocity, where they automatically recognize an out-of-state license, as the Department of Veterans Affairs does with physicians in its system. Source: https://www.healthcaredive.com/news/telehealth-waivers-wind-down-restricting-some-providers-from-delivering-ca/603169/#:~:text=Healthcare%20Dive-,Telehealth%20waivers%20wind%20down%2C%20restricting%20some%20providers%20from%20delivering%20care,but%20others%20are%20reversing%20again. < Previous News Next News >

Grants & Funding The Federal government has numerous funding sources for telehelath support: USDA Community Connect Grants USDA Distance Learning and Telemedicine Grants Other Telemedicine Grants FCC Rural Health Care - Healthcare Connect Fund USDA COMMUNITY CONNECT GRANTS ​ This federal program funds broadband deployment into rural communities where it is not yet economically viable for private sector provi ders to deliver service. For more information, please visit USDA Community Connect Grants . ​ ​ USDA DISTANCE LEARNING AND TELEMEDICINE GRA NTS ​ Th is federal program helps rural communities use telecommunications' unique connectivity capabilities to overcome effects of remoteness and low population density. Grant funds may be used for a cquisition of eligible capital assets, such as: Technical assistance and instruction for using eligible equipment ​ Inside wiring and similar infrastructu re that further DLT services Acquisition of instructional programming as a capital asset Computer hardware, network components, and software Audio, video, and interactive vid eo equipment Terminal and data terminal equipment For more information , please visit USDA Distance Learning and Telemedicine Grants . ​ ​ OTHER TELEMEDICINE GRANT OPPORTUNITES ​ The Health and Human Services Division for telehealth and broadband related programs posts funding opp ortunities HE RE . ​ ​ HEALTHCARE CONNECT FUND ​ The New Mexico Telehealth Alliance (N MTHA) manages the Southwest Telehealth Access Grid (SWTAG), a Federal Communications Commission (FCC) approved consortium for funding through the Healthcare Connect Fund (HCF). If you manage one or more healthcare provider sites serving clients in New Mexico, contact NMTHA to discuss joining SWTAG. Advantages to applying to SWTAG via NMTHA include: Lower application and administrative costs. Access to expert funding advice for a mix of rural and urban sites. Professional assistance with proven track record of funding success. Additional information on eligibility and application procedures can be found HERE . ​ Community Connect Distance Learning Other Healthcare Connect