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ATA: What's ahead for telehealth policy after the pandemic Andrea Fox September 23, 2022 Federal and state advocacy team members discussed the status of telehealth policy as the public health emergency deadline looms and the industry questions, 'Is the pandemic over?' The American Telehealth Association is working with Congress and several federal agencies to shape the fate of policies and payments for telehealth services that experienced a rapid uptake during the COVID-19 pandemic. WHY IT MATTERS Now that President Joe Biden has declared the COVID-19 pandemic over, the ATA's Telehealth Awareness Week policy update webinar explored how federal and state telehealth policies may be affected as Congress decides whether or not to end the public health emergency (PHE). Federal priorities for telehealth have evolved with the pandemic with restrictions lifted by a Congress deciding if the limiting of certain restrictions should be lifted permanently. The PHE must be reviewed every 90 days, so Congress will have to revisit the renewal by mid-October, according to policy experts presenting during Wednesday's online event. "As we know, [President] Biden has said in recent days that the pandemic is over, so it's possible that the technical public health emergency might expire sometime in the very near future," said Megan Herber, director at Faegre Drinker who advises ATA and ATA Action on all things Federal policy. Telehealth payments and provider practices are highly regulated on the Federal level, said Quinn Shean, strategic advisor at Tusk Ventures and the state policy advisor for ATA and ATA Action. But even if providers do not serve Medicare populations, "Medicare policy trickles down," added Herber. For example, before the pandemic, patients had to be in a rural area in a hospital or clinical setting to receive reimbursement for telehealth. "That is the current status quo right now – as long as the COVID-19 public health emergency is in place," Herber explained. But in about five months, "all of those waivers go away automatically unless Congress does something." Approaches to policy can be different in different contexts, noted moderator Alexis Gilroy, co-leader of the healthcare and life sciences practice at Jones Day. "Where do you come at it based on the particular lane it sits in?" In terms of state-level telehealth policy, there are multiple state priorities because states differ in their approaches to telehealth coverage requirements for public and private health plans, reimbursement for services provided via telehealth, and eligibility to deliver reimbursable services. States also differ in how they regulate synchronous and asynchronous telehealth and remote patient monitoring. They vary on which types of providers can deliver telehealth, what establishes a valid patient/provider relationship and if out-of-state practitioners can treat patients in the state remotely without a license, explained Shean. "We have a patchwork of 50 different state requirements here," she said. The ATA has been focused on developing a consistent regulatory framework so telehealth can be deployed across states and fully leveraged. "The ATA is committed to modality-neutral policies," instead of dictating which tools clinicians choose to use to deliver telehealth, she said. ATA is pushing for fair payment for telehealth and home health as well as licensure flexibility across state lines. "It's really aligning our state frameworks with the 21st Century care model," and the states are moving quickly, she said. There have been hundreds of pieces of legislation to update state telehealth policies. The organization is also working with the U.S. Drug Enforcement Agency and Congress to address the future of online prescribing of controlled substances. Many of the barriers to telehealth policy have been based on perceptions that telehealth is somehow substandard and that romanticizes in-patient care, but telehealth has often delivered care where there was no prior access to healthcare, said Shean. "We need to recognize the access gaps that telehealth can fill" and recognize the guardrails that are in place with telehealth as they are with other care settings, said Shean. As more retail providers like CVS, Amazon and others enter the space through mergers and acquisitions, they will also have an impact on the direction of telehealth policy, including how to protect the patient data these companies will have more access to. But with more stakeholders pushing for telehealth on the state level, "having a broader tent now helps show the different patient populations that can be served here and brings more focus," Shean pointed out. THE LARGER TREND Under the CARES Act, Congress granted the Centers for Medicare & Medicaid Services authority to waive certain restrictions for Medicare coverage of telehealth. The agency was able to remove geographic restrictions, expand care at home, increase the amount of Medicare-covered services via telehealth and more. Additional legislative proposals, including the Telehealth Benefit Expnasion for Workers Act, Telehealth Extension Act and others, suggest broadening access to telehealth. "Throughout the pandemic, telehealth has proven to be a vital tool for Americans to receive timely and quality care from their own home," said Tim Walberg, R-Mich, during the bill's introduction at the Capitol in March. "For rural communities in particular, telemedicine has helped remove barriers to care, expand access to specialists and improve health outcomes." ON THE RECORD "There is urgency [for Congress] to act – don't wait until four months and 20 days after the pandemic ends; we need some stability," said Herber. "We'd love to make it permanent, and a lot of these policies we have been asking for since before the pandemic, so it's not really new," she concluded. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS publication. See original article: https://www.healthcareitnews.com/news/ata-whats-ahead-telehealth-policy-after-pandemic < Previous News Next News >

How Does a Telemedicine Pain Program Work in Rural American with Multi-Vulnerable Patient Populations? Dax Trujillo, MD July 20, 2022 In April 2017 Summit Healthcare started a multi-disciplinary program to treat patients with chronic and acute pain in the White Mountains of Arizona. Our patient service area is HRSA-designated as having a shortage of providers and medically underserved. The area is the size of Rhode Island and includes Native American reservations and other vulnerable populations. Many of our patients live in a high poverty area which makes access to care challenging. In order to provide multi-disciplinary services that include interventional procedures, monitored medication management and cognitive behavior therapy, we needed to create a hybrid program. Our program incorporates in-person, video/audio and telephone visits. By using three different modes of care delivery we were able to reach and follow more patients with better outcomes. Since April 1, 2017 we have had over 900 patients participate in our telemedicine pain program. The visits include virtual appointments for medical management, behavioral therapy, and general wellness checks after an in-person visit; virtual check-ins for procedure or testing follow-ups and eVisits via email communication to answer questions and/or review prescription issues or re-ordering. Due to the rurality of the service area we estimate that patients were saved from having to travel 66,144 miles to a physician’s office. This was a significant relief to patients with limited means to transportation, knowing that their weekly, monthly in-patient visits were reduced to quarterly in-patient visits. Patient satisfaction has been high due to the reduction of travel time and costs. Simultaneously, the patient perceived they were being more closely monitored and their pain issues addressed in a timely manner. Another benefit is that more than one professional can join a telemedicine visit with the patient which allows a more holistic and comprehensive visit for better value based care of the patient. By providing virtual visits as part of the entire treatment program, we have saved thousands of dollars in chronic pain treatment costs. Through evidence-based research we know that patients are achieving better healthcare outcomes in this hybrid program by incorporating telemedicine technology. Our program has had overall success with addressing pain but there are some risks involved that must be addressed within your institution to provide a platform that is HIPPA compliant and protects critical sensitive health information. Providing a secure platform must be a top priority when delivering pain treatment virtually due to the sensitive nature of the disease/treatments with this patient population. While most patients do well with the hybrid program we do have patients for whom it is not appropriate. Due to our location, a subset of patients do not have access to broadband internet service so we cannot perform visits via video or sometimes audio. Other patients have expressed a preference for in-person visits while another group prefers all visits to be virtual. Patients needing neuraxial interventions or surgeries will need to be seen in-person. Each patient has their own unique circumstances so having a hybrid pain treatment program with various care delivery options allows us to reach more patients previously not being treated for their chronic pain issues. In the future we will purchase a remote patient monitoring platform/equipment that can be used with our chronic pain patients to better track their vitals, physical and mental health. This will also allow us to manage medications and behavioral issues related to pain and opioid addiction, both of which are prevalent in our service area. Our hospital system is also developing a hospital at home program which will incorporate the telemedicine pain program for patients with co-morbidities. The future of healthcare access is using hybrid delivery of care systems that include telemedicine, to improve accessibility and outcomes for chronic pain patients. For original article: https://southwesttrc.org/blog/2022/how-does-telemedicine-pain-program-work-rural-american-multi-vulnerable-patient < Previous News Next News >

New Nationwide Poll Shows an Increased Popularity for Telehealth Services Center for Connected Health Policy June 2021 Expansion of telehealth is welcomed by most Americans. The American Psychiatric Association (APA) completed a new national public opinion poll finding that expansion of telehealth is welcomed by most Americans. Nearly 4 in 10 reported having used telehealth services, nearly 6 in 10 said they would use telehealth for mental health services, and more than 1 in 3 said they prefer telehealth. In addition, more individuals seem to have used telehealth via video (69%) than via phone (38%). Perception of the quality of telehealth appears to have improved as well, at 45% up from 40% last year. The results came from a recent online survey of 1,000 adults – additional information on the poll and its findings can be accessed on the APA website - https://www.psychiatry.org/newsroom/news-releases/New-Nationwide-Poll-Shows-an-Increased-Popularity-for-Telehealth-Services. < Previous News Next News >

Telehealth integrated into EHR is the way to go for CarDon & Associates Bill Siwicki October 19, 2021 The skilled nursing organization has a 90% treat-in-place rate for all telehealth encounters, and data from its platform has helped identify areas for improvement. Just before the COVID-19 pandemic struck, CarDon & Associates, which operates 20 senior housing/skilled nursing communities in the Midwest, was exploring different ideas to give its staff time back, improve resident outcomes and reduce rehospitalizations. THE PROBLEM The organization wanted an effective telehealth platform with new technologies to streamline the process for contacting physicians and improving documentation in its system of record. It also wanted to give its nurses a sense of confidence with technology that could guide them through assessments to keep residents in-house. "Once the pandemic started, we had to act fast and implement new portable devices and temporary solutions to provide virtual physician and consult visits as well as provide our residents a way to connect with their families and friends," said Brandy Armstrong, RN, director of clinical information at CarDon & Associates. "The swift implementation worked, but we still wanted a better, more secure solution that would assist our staff and provide quality care for our residents. The pandemic made searching for a telehealth platform a higher priority." PROPOSAL CarDon & Associates turned to Third Eye Health for a telehealth solution. The telehealth technology offered fast connectivity with access to board-certified, state-licensed physicians who are trained to provide care in a post-acute setting. Coverage includes nights, weekends and holidays. "The solution includes a care coordination team that facilitates communication between our care team and their physicians," Armstrong explained. "Our care team could communicate with telehealth physicians and the care coordination team through the platform. The system sends alerts to the user's email for new messages, watch lists and new encounters. "The purpose of the platform was to provide an easy-to-use application on a portable device that would give our nurses quick access to physicians to treat our residents in-house, improve documentation and provide reporting and analytics." Brandy Armstrong, RN, CarDon & Associates "They also offer a cloud-based, HIPAA-compliant platform that integrates with our EHR," she continued. "All telehealth-generated documentation includes a wet signature that imports from their platform into our system of record." Lastly, the vendor offers reporting and analytics that measure clinical performance, usage, resident encounters treated in place and chief complaints. "The purpose of the platform was to provide an easy-to-use application on a portable device that would give our nurses quick access to physicians to treat our residents in-house, improve documentation and provide reporting and analytics," she said. MARKETPLACE There are many vendors of telemedicine technologies and services on the health IT market today. Healthcare IT News has published a special report detailing many of the vendors and their offerings. Click here to read the special report. MEETING THE CHALLENGE Before implementing the telehealth solution, CarDon & Associates distributed iPads to all nurses and CNAs, so it was already starting to transition to a more mobile workflow. After it deployed portable devices, the organization started implementing the new telehealth solution with training provided by vendor staff. "Our nurses use the telehealth platform heavily as part of their everyday workflow during the evening and weekend coverage time," Armstrong noted. "The nurses have a portable device to use specifically for telehealth encounters. They sign in at the beginning of their shift and contact the telehealth provider when needed. "The nurses use the platform for new admissions, readmissions, bridging scripts and changes in condition," she added. "They can have video encounters with the touch of a button and interact with a physician within two minutes." The telehealth solution is integrated with the organization's system of record from vendor MatrixCare. The organization collaborates with telehealth vendor staff along with MatrixCare staff to ensure successful integration with each facility at which it implements the technology, she said. RESULTS To date, CarDon & Associates has a 90% treat-in-place rate for all telehealth encounters. Out of 2,090 consults, 1,826 residents were treated in place. Using the data in the telehealth platform, the organization was able to identify areas for improvement. And improved documentation has been integrated with the system of record. ADVICE FOR OTHERS Armstrong has a variety of tips for healthcare organizations considering similar telehealth systems integrated with EHR technology: Identify what problems you are trying to solve, what goals you are trying to meet and how you will evaluate outcomes. Determine who in your organization will develop a policy and procedure, and who will be involved with planning, implementation and evaluation. Involve frontline staff in discussions to get their input, insight and buy-in. Buy-in will be necessary for the implementation phase. Consider appointing a champion to help with ongoing education to ensure the technology is being used the way it was intended. Share your outcomes with staff members within your organization. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication https://www.healthcareitnews.com/news/telehealth-integrated-ehr-way-go-cardon-associates < Previous News Next News >

San Juan Regional Medical Center gets CARES Act funding to expand telehealth services By Hannah Grover, Farmington Daily Times February 15, 2021 AZTEC — Before COVID-19, San Juan Regional Medical Center used telehealth in a limited fashion to support providers and to do provider consultations, according to Chief Information Officer Matt Miliffe. AZTEC — Before COVID-19, San Juan Regional Medical Center used telehealth in a limited fashion to support providers and to do provider consultations, according to Chief Information Officer Matt Miliffe. The pandemic changed things. San Juan Regional Medical Center and San Juan Health Partners worked quickly to expand telehealth offerings. Now the hospital is receiving CARES Act funding to help improve its technology and better provide that service. "Demand (for telehealth) was immediate and has continued to grow," Miliffe said. San Juan Regional Medical Center will receive $1.25 million in CARES Act funding to supply emergency generators as well as to make upgrades in the IT network, according to a press release from the office of Sen. Martin Heinrich, D-NM. IT upgrades, new generators on the way These technology upgrades will support telehealth and field hospital operation projects that have been implemented in an effort to bolster the hospital's response to COVID-19. The grant funding will be matched with $617,000 in local funds. All locations except for San Juan Health Partners Urgent Care began offering a mixture of telephone and video visits in an effort to comply with public health orders, sustain the services offered and prevent the spread of the coronavirus, according to Barbara Charles, administrative director for San Juan Health Partners. The medical center's network infrastructure wasn't designed to service the high demands of video consultations and Miliffe said the IT team has had to push the current capabilities. "However, significant upgrades to the wired and wireless infrastructure is needed to sustain and improve the existing experience, and allow for the continued growth in telehealth demands driven by the pandemic," he said. "This funding will make a fundamental difference in our ability to serve our community’s needs." Your stories live here. Fuel your hometown passion and plug into the stories that define it. Create Account COVID: State health department closes Home Depot over COVID-19 cases One of the barriers that the center has seen is the remote nature of the community. Many patients can only connect through phone due to limited internet connectivity or cell service that can't support video. "The inability to consistently connect by audio and video is an ongoing barrier," Charles said. This funding is part of more than $2.24 million of CARES Act money that will be coming to northwest New Mexico to address healthcare and economic needs. In addition to San Juan Regional Medical Center, the Northwest New Mexico Council of Governments, which is based in Gallup, has been awarded $990,000 to address economic development needs of small businesses and entrepreneurs that have been harmed by the COVID-19 pandemic. The Northwest New Mexico Council of Governments serves Cibola, McKinley and San Juan counties. According to the press release, the council of governments hopes to create 100 jobs and retain 100 jobs through a revolving loan fund that this funding will assist in creating. Legislative session:New Mexico lawmakers work to address economic impact of COVID-19 U.S. Sen. Martin Heinrich Heinrich said in a press release that he has been "moved by the resiliency and grit" of rural New Mexico communities as they have faced a variety of public health and economic challenges related to the pandemic. "That is why I fought so hard to include funding in the CARES Act to help New Mexico’s rural health care systems, small businesses, and entrepreneurs to weather this storm," he said. "This funding is long-overdue and I will continue working for federal resources that New Mexico’s rural communities need to take on the COVID-19 pandemic and rebuild our economy in a way that supports everyone." Heinrich as well as Sen. Ben Ray Luján, D-NM, and Rep. Teresa Leger Fernandez, D-NM, announced $2.24 million of CARES Act funding for northwest New Mexico on Feb. 12. San Juan Regional Medical Center President and CEO Jeff Bourgeois Hospital: Telehealth is here to stay San Juan Regional Medical Center President and CEO Jeff Bourgeois thanked the lawmakers for the funding in the press release and emphasized that the hospital provides essential healthcare services for the Four Corners area. "This funding will ensure that we can meet the diverse needs of our patients and community and improve care for those we are privileged to serve," he said. While the pandemic jump started the demand for telehealth in the community, Miliffe said the San Juan Regional Medical Center does not anticipate it fading away. "Looking ahead to post-pandemic times, we see a long term and stable need for these services in our community as patients look to receive their healthcare in more of a consumer fashion, with services and offerings tailored around them as the individual," Charles, of San Juan Health Partners, said. "It is expected that the need or demand for telemedicine will continue long term. Many patients with health needs that may not require an in-person or face-to-face visit may find this option more flexible and convenient. Additionally, given the unknowns of the pandemic – this remains a safe alternative to in-person visits for patient to seek as needed or routine healthcare needs." Charles said telehealth also plays a key role in the COVID to Home program, which allows COVID-19 patients to receive close monitoring while in self-isolation at their own houses. "Because of this program’s close monitoring through telehealth visits, many patients have been able to stay out of the hospital and manage their care at home through the telephone or video calls. In other cases, caregivers have been able to intervene to coordinate a higher level of care for patients who needed it," she said. "To date, the COVID to Home program has helped more than 1,200 patients manage their care at home, something that would not have been possible without telehealth." Hannah Grover covers government for The Daily Times. She can be reached at 505-564-4652 or via email at hgrover@daily-times.com . This story has been modified to correct the attribution on some quotes. < Previous News Next News >

Legislation Legislation New Mexico Legislation S.B. 93 - Broadband Access and Expansion Act H.B. 141 - ED Infrastructure Technology Definition S.B. 24 - Parity of Regulation of Telecommunication Federal Telehealth Legislatio n H.R. 7992 - Telehealth Act (2019-2020) H.R.3228 - VA Mission Telehealth Clarification Act (2019-2020) H.R.4900 - Telehealth Across State Lines Act (2019) H.R.5473 - EASE Behavioral Health Services Act (2019-2020) H.R.7233 - Knowing the Efficiency and Efficacy of Permanent Telehealth Options Act (2020) H.R.7338 - Advancing Telehealth Beyond COVID–19 Act (2020) S.2408 - Telehealth Across State Lines Act (2019) S.3988 - Enhancing Preparedness through Telehealth Act (2019-2020) S.4039 - TELEHEALTH HSA Act (2020) S.4216 - KEEP Telehealth Options Act (2020) Federal Broadband Legislation H .R.205 - To accelerate rural broadband deployment. H.R.4229 - Broadband Deployment Accuracy and Technological Availability Act S.4021 - Accelerating Broadband Connectivity Act of 2020

Contact SBRL Community Contacts Get answers to your Federal and State broadband questions: New Mexico broadband contacts Federal broadband contacts Contacts for New Mexico broadband questions: Rand Tilton, NM Department of Informatio n Technology (NM DoIT)/Broadband Rand.Tilton@state.nm.us Gar Clarke, NM DoIT Geospatial Program Manager Presented October 2021 webinar: "NM Broadband and What’s Next." Recording: HERE Sli des: HERE NM Broadband Program (NMBBP ): Online Interactive Broadband Map Statewide Broadband Strategic Plan (June 2020) NM Speed Tester New Mexico Contacts for Federal broadband questions: U.S. Senator Ben Ray Lujan: Sen. Lujan wants to know about telehealth or broadband barriers and successes you have experienced. Telehealth barriers and successes: M e lanie_Goodman@lujan.senate.gov Health polic y matters: Calli_Shapiro@lujan.senate.gov Broadband and telecommunications matters: Jeffrey_Lopez@lujan.senate.gov. Senator Ben Ray Lujan's recording about New Mexico telehealth: HERE Federal

The future of telemedicine: purpose-built, integrated platforms Zoll Data Systems March 1, 2022 Integrated telemedicine solutions can address current pain points. By: Businessperson with tablet pointing to AI and data graphics Maximizing provider returns with big data Stethoscope and calculator on graphs How Emergency Medicine Physicians Can Increase Revenue in 2021 with Medicare PFS Cuts Looming person holding an insurance card. Billing Medicare and Private Payers for Telehealth Visits: What to Expect Post-Public Health Emergency Doctor talking to mother and daughter at reception desk Insurance Verification Technology Prevents Errors that Cause Costly Denials SPONSORED Global Edition Telehealth The future of telemedicine: purpose-built, integrated platforms Integrated telemedicine solutions can address current pain points. By: March 01, 2022 10:27 AM Photo Credit: adamkaz/Getty Images Propelled into mainstream use by the COVID-19 pandemic, telemedicine is becoming standard practice for many healthcare providers. According to David Ernst, MD, president of telemedicine innovator EPOWERdoc, these solutions will transform access to care and continue to drive more cost-effective delivery models, particularly at the EMS and emergency medicine level. Telemedicine’s technological pain points While telemedicine has undoubtedly come a long way, it still has significant limitations. One of the biggest limitations is provider usability. Often, telemedicine “platforms” are actually several disparate solutions cobbled together. These may include a video conferencing app, patient registration portal for demographic and insurance information, EMR, e-prescription app and discharge system. Consequently, providers must toggle between separate software programs to review and enter patient data for a single encounter. This inefficient approach can introduce errors, create frustration for patients and providers, and jeopardize the continuity of care. There is hope, however: Telemedicine technology is making rapid advancements through purpose-built platforms. Read full article here: https://www.healthcareitnews.com/news/future-telemedicine-purpose-built-integrated-platforms < Previous News Next News >

New ULC Uniform Telehealth Act Highlights Important Policy Considerations & Licensure Trends Center for Connected Health Policy August 2022 The new Uniform Telehealth Act states that services can be provided via telehealth consistent with existing practitioner standards of care and it also establishes a registration process allowing out-of-state providers to deliver services through telehealth to patients in states that choose to adopt the Act. For full post see: https://www.cchpca.org/resources/new-ulc-uniform-telehealth-act-highlights-important-policy-considerations-licensure-trends/ < Previous News Next News >

New FAIR Health White Papers Shows Large Telehealth Utilization Increases Before COVID-19 Center for Connected Health Policy April 2021 Results showed that telehealth utilization increased by 73% from 2018 to 2019 with telehealth claims comprising over one-third of all health care claims in 2019. In its fourth edition of the Healthcare Indicators and Medical Price Index White Paper, FAIR Health found that the fastest area of healthcare utilization growth from 2018 to 2019 occurred for telehealth services. FAIR Health conducted the annual analysis using its data repository of 32 billion claims for patients in commercial insurance plans. Results showed that telehealth utilization increased by 73% from 2018 to 2019 with telehealth claims comprising over one-third of all health care claims in 2019. FAIR Health also noted that the most common claim type for telehealth was for mental health services, bolstering other recent evidence that telehealth utilization continues to grow for behavioral and mental health services. The findings are an important contribution to ongoing policy discussions about where telehealth is going after the pandemic. While most telehealth experts have been paying close attention to telehealth utilization during the pandemic, these findings suggest that the story of telehealth’s rapid growth likely begins in 2019, one year prior to the public health emergency. FAIR Health is a national nonprofit organization that maintains a large database of privately insured healthcare claims data. The organization performs healthcare utilization and cost analyses on market trends for use by researchers, consumers, and industry stakeholders. For more information about FAIR Health's data, view their website. FAIR Health Consumer: https://www.fairhealthconsumer.org/#about FH Healthcare Indicators and FH Medical Price Index 2021: https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/FH%20Healthcare%20Indicators%20and%20FH%20Medical%20Price%20Index%202021--A%20FAIR%20Health%20White%20Paper--FINAL.pdf < Previous News Next News >

Access to Care, Health Equity Lagging in the US; Is Telehealth Safer Than In-Person Care? Jacqueline LaPointe August 2021 The US ranked last when it came to access to care, health equity, and other measurements of healthcare, while telehealth may prove to be a safer option for patients. Right now, the US may boast the most medals from the Olympic Games Tokyo 2020. However, new research shows that the country is lagging in most healthcare metrics, including access to care and health equity. In other news, data suggests that telehealth could be a safer option for patients and small businesses look to self-funding options. US SPENDS THE MOST, BUT COMES OUT LAST The United States ranked last on measurements of health equity, access to care, administrative efficiency, and healthcare outcomes compared to ten other wealthy nations, the Commonwealth Fund recently reported. Yet, the US still spent the most of its gross domestic products on healthcare. Additionally, the US lagged behind comparable countries in terms of healthcare affordability. “U.S. disparities are especially large when looking at financial barriers to accessing medical and dental care, medical bill burdens, difficulty obtaining after-hours care, and use of web portals to facilitate patient engagement,” the report stated. The only measure the US performed favorably on was in the care process domain, which researchers attributed to the success of preventive care and patient engagement. IS TELEHEALTH SAFER THAN THE DOCTOR’S OFFICE? According to a new study, the answer is yes, at least when it comes to flu season. Researchers from the University of Minnesota, Harvard, and athenahealth found that people who went to the doctor’s office after someone infected with the flu had visited were much more likely to get the virus themselves. However, that increase was not seen in people seeking treatment for medical issues like UTIs. The data indicates that telehealth and other means of virtual care can reduce the chance of infection among patients. “Our findings highlight the importance of infection control practices and continued access to telemedicine services, as health care begins to return to pre-pandemic patterns,” Hannah Neprash, an assistant professor at UM’s School of Public Health and one of the study’s authors, said in a news release issued by the university. "In-person outpatient care for influenza may promote nontrivial transmission of these viruses. This may be true for other endemic respiratory illnesses too, including COVID-19, but more research is needed." SMALL BUSINESSES EYE LEVEL, SELF-FUNDING FOR EMPLOYEE COVERAGE A new trend is emerging among small businesses. A recent study from the Robert Wood Johnson Foundation shows that small businesses are shifting toward level- and self-funding for healthcare insurance coverage over the individual health insurance marketplace. This shift occurred during the COVID-19 pandemic, possibly because employers were less inclined to deny needed coverage to workers. Additionally, health benefits are one of the few ways small businesses can compete with their larger peers in this worker-driven environment. But the trend could change with implementation of the American Rescue Plan’s new individual health insurance marketplace subsidies. CHILDREN’S HOSPITAL USES DATA ANALYTICS TO IDENTIFY CARE GAPS Ann & Robert Lurie Children’s Hospital in Chicago leveraged data analytics capabilities to flag pediatric care gaps and do something about them during the COVID-19 pandemic. “If you don't have the analytics to show where you're at, you may not understand what's happening out there in the market. We were able to use the analytics to show there's been a big decrease, and then we quickly put together a response plan, including communication, radio ads, other types of communication channels, to respond to that,” Scott Wilkerson, chief integration and business development officer at the children’s hospital, told HealthITAnalytics during an interview. The insights gleaned from the data were key to maintaining appropriate access to care during the pandemic and could be a strategy for balancing in-person and virtual care as communities decide how to stay open and protect residents from rising COVID-19 numbers. FDA EXPANDS EUA FOR INVESTIGATIONAL COVID-19 ANTIBODY COCKTAIL The FDA recently updated the emergency use authorization for Regeneron’s investigational COVID-19 antibody cocktail, REGEN-COV, to include its use in individuals with post-exposure prophylaxis. Providers can now administer the drug monthly to qualifying patients if they are at high risk of severe disease and have not been fully vaccinated or who may not mount an adequate response to vaccination. Now, the drug is the only COVID-19 antibody therapy currently available across the US for both treatment and post-exposure prophylaxis. The expansion of the emergency use authorization was based on results from a Phase 3 clinical trial, which showed that REGEN-COV reduced the risk of symptomatic infection by 81 percent in individuals who were not infected with COVID-19 when they entered the trial. Previous clinical trial data also found that the drug reduced risk of death by 20 percent in patients hospitalized with COVID-19 who had not mounted their own immune response. ANTITRUST AGENCIES MAY TARGET VERTICAL INTEGRATION DEALS The Biden-Harris administration has made consolidation in healthcare a top priority for antitrust agencies and HHS, per a recent executive order. But this doesn’t just mean the colossal deals making headlines (e.g., the recent Beaumont-Spectrum Health merger). Industry experts believe the executive order could mean greater focus on vertical integration deals, such as those between hospitals and physician practices and those between payers and physician groups. “We’re going to see more scrutiny in these areas, particularly with the new vertical merger guidelines the FTC and DOJ issued in 2020. That is certainly top of mind to the FTC and the FTC has substantial experience with hospital-physician consolidation and continues to actively study its effects on competition and quality,” Ken Vorrasi, antitrust litigation partner at Faegre Drinker, told RevCycleIntelligence. Source: https://healthcareexecintelligence.healthitanalytics.com/news/access-to-care-health-equity-lagging-in-the-us-is-telehealth-safer-than-in-person-care < Previous News Next News >

Can virtual nursing help ease clinician burnout? Bill Siwicki November 14, 2022 The turnover rate for nurses stands at 27%. Can telemedicine save the day? No hospital or health system is immune from the challenges of the nationwide nursing shortage. As organizations look for ways to reduce the administrative burden on nurses and improve engagement and satisfaction, virtual nursing is one consideration. Many tasks performed by nurses in the inpatient setting are repetitive – a virtual nursing unit allows nurses to manage these tasks remotely. Bedside nurses and staff then are freed up to focus on patient-facing care, while those in the virtual unit can monitor patients, enter data in the medical record and more. To better understand the ins and outs of virtual nursing, we interviewed Dr. Shayan Vyas, senior vice president and medical director for hospitals and health systems at Teladoc Health. Q. What is the national nursing shortage like today? How does it play out in hospitals and health systems? A. Every health system I've spoken with, that we work with, says workforce challenges are among the top three issues keeping them up at night. This is particularly true for nursing staff. In 2021, nurses were leaving the profession at an alarming rate. According to NSI Nursing Solutions, the turnover rate for nurses increased by 8.4% in 2021 and currently stands at 27%. An increase in patient volume and occupancy rates, among other factors, have led to severe emotional and physical exhaustion and, ultimately, job dissatisfaction and burnout. A 2021 McKinsey survey found that 32% of nurses were likely to leave their current position due to insufficient staffing levels, a lack of support and the emotional toll of the job. President Obama once said that "nurses are the heartbeat of the United States healthcare system," and I really believe that to be true. They put their lives on the line to serve and care for others every single day, and we need to give them the tools to more effectively, efficiently and safely care for others and save lives. Virtual care offers new strategies to address these challenges; virtual nursing is an important component that health systems can include in their transformation and care delivery redesign initiatives. Q. What is virtual nursing, and how does it work? A. Virtual nursing, simply put, is the delivery of nursing care and services from a remote location. Virtual nurses are responsible for monitoring multiple patients while collaborating with the nurses, physicians, therapists and other staff who provide care at the patient's bedside. The virtual nursing unit can be centralized (for example, nurses work from a command center in a healthcare facility), distributed (nurses work from home or other remote locations) or hybrid. Adopting virtual nursing provides a way to mitigate potential staffing losses due to short-term injury or other conditions that require nurses to be off their feet. It is also a way to extend nurses' careers, for example, by offering nurses with developing or chronic physical limitations the option of working seated in a command center, instead of providing physically challenging care on a nursing unit. Virtual nursing programs also can help attract nurses by providing different options for shifts and work styles. This model supports organizations by enabling them to have virtual nurses work from anywhere – allowing them to provide much-needed care and services without requiring nurses to relocate so that they live close enough to a hospital to be able to go on-site for their shift. It also helps new nurses with clinical support, medication verifications and overall non-physical patient bedside care assistance. Health systems that have created virtual nursing programs to augment their bedside nurses have found virtual nursing can extend nurses' careers and improve job satisfaction for floor nurses by taking away responsibility for many tasks that do not require physical touch. This allows the bedside nurse to focus on hands-on patient care and contributes to higher patient satisfaction because of the responsiveness and additional attentiveness it enables. Virtual nursing can also allow advanced nurse practitioners like PAs and ARNPs the ability to connect virtually with a virtual intensivist, and the virtual nurse can help with many of the nonphysical contact needs of patient care. Q. How can virtual nursing reduce the administrative burden on nurses and improve engagement and satisfaction? A. While hands-on care will always be needed, many duties can be fulfilled virtually, including coordinating procedures, getting sign-offs from multiple care team members, reconciling medications, providing patient education, answering questions, initiating the discharge process and more. In many successful virtual nursing programs, administrative tasks like discharge paperwork, medication reconciliation, etc., have been shifted from bedside to virtual nurses. Virtual nursing systems enable virtual nurses to monitor patients and communicate with them, their families, and other visitors and care team members in real time, including responding to patient nurse calls. The goal is to provide a new level of support to patients, nurses and the bedside team. Several health systems with virtual nursing programs have reported high job satisfaction for their virtual nurses. Nurses say the virtual role enables them to spend more time with patients overall. The extra time, and the complementary nature of virtual and bedside nursing roles, contributes to improved job satisfaction for both bedside and virtual nurses, and positive experiences for patients. Q. Please talk a bit about one of your hospital clients using virtual nursing and the results they've achieved. A. Overall, the benefits of virtual nursing include staffing flexibility, potential retention and recruitment advantages, the ability to leverage staff resources, and favorable nurse and patient satisfaction. Another major benefit of virtual nursing is a reduced length of stay, resulting in improved throughput, as well as time saved in the discharge process. Some lesser-known benefits of virtual nursing are a differentiated and improved patient experience, with potential associated improvements to patient satisfaction and HCAHPS and NPS scores. Patients also are seeing a significant improvement in satisfaction as they no longer have to pull a bedside staff member to help answer questions or assist with administrative documentation. Our client, Saint Luke's Health System in Kansas City, Missouri, has helped address the nursing shortage by having virtual nurses support bedside nurses. The virtual nurses can assist with non-hands-on care, education, documentation, admission, discharge, answering questions, and reviewing the care plan or physician rounding with the patient and their loved ones, among other tasks. The unit has enhanced Saint Luke's bedside care response rates, increased patient and nurse satisfaction, reduced the burden on bedside nurses, and positively impacted quality and safety for a better work environment. Patients are discharged within two hours of the discharge order, some 20% faster than in other units, and they're also out of the hospital before noon at a 44% faster rate. This has, in turn, reduced the wait time for patients in the ED and reduces the time to treatment. What's more, these benefits have boosted nurse morale, improving workforce engagement, reducing fatigue, even improving Saint Luke's recruitment capabilities. We need to provide nurses, our frontline workers, with technology that improves their work, quality of life, and the level and effectiveness of bedside care. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/can-virtual-nursing-help-ease-clinician-burnout < 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 >

2022 In Review: State Telehealth Policy Legislative Roundup CCHP December 06, 2022 LEGISLATIVE ROUNDUP As the year winds down, the Center for Connected Health Policy (CCHP) is providing its annual State Legislation Roundup. Enacted state telehealth bills in the 2022 legislative session followed trends forged in the previous 2021 legislative cycle, although at a slightly lesser volume. While 2020 was largely focused on scrambling to meet the needs of the population during the COVID pandemic through temporary telehealth waivers and flexibilities, both 2021 and 2022 challenged states to decide how to translate their temporary COVID policies into permanent telehealth policies, and in many cases making adjustments to their previously passed laws concerning telehealth. There was also a proliferation of legislation that addressed cross-state licensing issues in earnest through registration processes, targeted licensing exceptions and compacts. Among 41 states and DC, 180 legislative bills tracked by CCHP passed in the 2022 legislative session. While this is down from the 201 legislative bills enacted in 47 states in 2021, it’s still significantly higher than the bills passed in 2020 (104 bills). The number of bills in each individual topic area CCHP tracks varied from previous years. For example, while bills addressing private payer reimbursement, Medicaid reimbursement and regulatory requirements were lower this cycle than 2021 levels, bills addressing cross-state licensing were significantly up, while bills addressing online prescribing, and demonstrations, studies and reports were also somewhat higher than in 2021. Note that CCHP began tracking Puerto Rico and Virgin Islands legislation in September 2022 for the first time. However, no enacted bills were found related to telehealth in either of the territories during the 2022 session. See full article: https://mailchi.mp/cchpca/2022-in-review-state-telehealth-policy-legislative-roundup < Previous News Next News >

Epic research shows telehealth efficacy, makes case for more reimbursement Andrea Fox December 15, 2022 The study of 35 million telehealth visits found that most patients did not require in-person visits within 90 days of online appointments, indicating virtual visits as an effective "alternative, rather than duplicative" care modality. A dual team study of in-person, same-specialty follow-up rates after telehealth appointments published by Epic Research examined the cadence of care and found virtual medicine to be an effective tool. WHY IT MATTERS Analyzing the effectiveness of different methods for delivering care is important to guide decisions about how to allocate resources, according to the study's key findings report. To determine which specialties were able to fulfill patient needs using telehealth and which required in-person follow-up visits more often, two teams of researchers examined more than 35 million telehealth visits conducted between March 1, 2020, and May 31, 2022. What they found, according to the report, is that high in-person follow-up rates within three months were present only in specialties that require regular hands-on care, such as obstetrics and surgery. Follow-up visits within 90 days of telehealth appointments were not, by and large, instances of duplicative care, but a method of care delivery that can increase healthcare access, the researchers say. "Healthcare providers should continue to educate policymakers and administrators on the function telehealth plays as an alternative, rather than duplicative, encounter," they said in the report, adding that payers should extend telehealth visit coverage. The researchers also found that genetics and nutrition are the specialties that made the most efficient use of telemedicine. And while 15% of mental healthcare and psychiatry telehealth appointments required in-person follow-up in the next three months, that specialty had the largest volume of all studied for telehealth utilization. Of the more than 4.3 million telehealth visits during the study period, nearly 3.7 million mental health and psychiatry telehealth visits did not require in-person follow-up. THE LARGER TREND While telehealth use increased during the COVID-19 pandemic, one study of 40.7 million adults found telehealth comparable for chronic conditions. However, some experts quickly found telemedicine well-suited for use in behavioral health after the onset of the pandemic. Also, the COVID-19 public health emergency eliminated the requirement to have an in-person visit with a patient before prescribing medication-assisted treatment (MAT) for opioid use disorder (OUD). While an end to the PHE would signal a return to the in-person visit requirement for OUD prescriptions, several healthcare organizations have urged the U.S. Justice Department and the Drug Enforcement Agency to revise telehealth controlled substance rules. In rural areas, telehealth has increased access to care, including the ability to treat OUD with MAT. "Telehealth flexibilities and ePrescribing waivers have been crucial in enabling providers to care for patients during the pandemic and have greatly expanded access to care in situations where patients were unable or unwilling to travel to a physical location," Dr. Maroof Ahmed, co-founder of Quit Genius, told Healthcare IT News by email in October. ON THE RECORD "These findings suggest that, for many specialties, telehealth visits are typically an efficient use of resources and are unlikely to require in-person follow-up care," according to the researchers' key findings report. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS publication. See original article: https://www.healthcareitnews.com/news/epic-research-shows-telehealth-efficacy-makes-case-more-reimbursement < Previous News Next News >

Senator Warner Encourages DEA Action on Telehealth & Prescribing Center for Connected Health Policy May 2021 A lack of a more permanent fix to the prescribing issue could create hurdles for patients to access treatment to SUD services. Earlier this month Senator Mark Warner (D-VA) sent a letter to Attorney General Merrick Garland regarding the long-delayed regulations from the Drug Enforcement Agency (DEA) for a telehealth registry to prescribe controlled substances. In the letter, Senator Warner expressed great concern for the delay and that “the DEA’s failure to address this issue means that a vast majority of health care providers that use telehealth to prescribe controlled substances to and otherwise treat their patients have been deterred in getting them the quality care they need.” The Ryan Haight Act of 2008 allowed for certain exemptions to the use of telehealth to provide controlled substances without the telehealth provider having seen the patient in-person first, however these exemptions are narrowly tailored. Two such exemptions are: when a public health emergency (PHE) is declared, and if a provider is registered on a telehealth registry that the DEA will create. Due to the current COVID-19 PHE, providers now are able to prescribe a controlled substance without an in-person visit, but the exemption will disappear once the PHE is declared over. In 2018 under the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, Congress directed the DEA to promulgate final regulations for the registry by the end of 2019. Although a December 2019 regulatory posting indicated the DEA’s intent to publish the rule, the deadline came and went without even draft regulations being released for public comments. In March 2020, a PHE for COVID-19 was declared allowing one of the exceptions for prescribing to be activated. However, the PHE is not slated to last indefinitely and many, including Senator Warner, are looking for a more lasting change. Senator Warner also sent inquiries to the previous administration regarding the status of the registry regulations that went unanswered. During COVID-19, concern for the ability of patients with substance use disorders (SUD) to access services rose as demands on health services focused on responding to the pandemic and people sheltered in place. While much of the country is beginning to open up again, a lack of a more permanent fix to the prescribing issue could create hurdles for patients to access treatment to SUD services. < Previous News Next News >

Review of Veterans Health Administration’s Use of Telehealth During Pandemic Center for Connected Health Policy April 2021 Veteran’s Affairs Office of the Inspector General (OIG) assessed the Veterans Health Administration’s virtual primary care response to the COVID-19 pandemic. From February 7 to June 16, 2020, the Veteran’s Affairs Office of the Inspector General (OIG) assessed the Veterans Health Administration’s virtual primary care response to the COVID-19 pandemic, based upon reviewing primary care encounter data, interviews with VHA leaders, and use of primary care provider questionnaires. In its report, the OIG found that face-to-face primary care visits decreased by 75% and contact by telephone represented 81% of all primary care encounters. In regards to VA Video Connect (VVC), providers stated that not only were there technical complications related to specifically scheduling VVC visits, but many patients didn’t have internet access or the appropriate equipment needed for video calls. The OIG identified the need for additional training and support for veterans and test visits with patients and staff to walk through the process before the visit. In addition, the OIG recommended the Under Secretary for Health evaluate veteran access to reliable internet connectivity necessary for use of VVC and take appropriate action. Department of Veterans Affairs, Office of Inspector General: https://www.va.gov/oig/ Veterans Health Administration: https://www.va.gov/health/ < Previous News Next News >

Teladoc Reports $133M Net Loss in Second Quarter, but Visit Numbers Are Up Kat Jercich, Healthcare IT News July 2021 Meanwhile, Amwell announces its acquisition of SilverCloud Health and Conversa Health. The virtual care giant Teladoc released its earnings report this week, showing a net loss of $133.8 million for the second quarter of 2021. Total net loss for the first half of 2021 was $333.5 million, compared to $55.3 million for the same time period last year. At the same time, the vendor said its $503 million second-quarter revenue earnings had more than doubled compared with 2020. This change led Teladoc to forecast its total yearly revenue to be in the range of $2 billion to $2.025 billion, with a predicted net loss between $3.35 and $3.60 per share. Its visit numbers were also up, at 3.5 million: 28% higher than the second quarter of 2020, during the first wave of the pandemic. The company expected 13.5 million and 14 million total visits this year. After the earnings report, Teladoc's shares fell more than 7% in the extended session Tuesday, as reported by MarketWatch. Still, execs voiced optimism, driven in part by the launch of myStrengthComplete and what the company described as a "significant new agreement" with the Health Care Service Corporation. "Teladoc Health delivered a strong second quarter, marked by exciting new client wins, product launches, and tremendous progress on our quest to be the category-defining provider of whole person virtual care," said CEO Jason Gorevic in a statement. "We have solid momentum heading into the second half as the market embraces the unified care experience that only Teladoc Health has the breadth and scale to achieve," he added. New Amwell acquisitions Teladoc competitor Amwell was also in the news this week for its $320 million acquisition of SilverCloud Health and Conversa Health. SilverCloud Health delivers a range of digital cognitive behavioral health programs, which the company says are evidence-based and clinically validated. According to SilverCloud, the programs are used by more than 300 organizations, including Kaiser-Permanente, Optum and Providence Health. Amwell will use the platform to enrich its own behavioral health offerings and develop new programs. Conversa Health, meanwhile, uses automated patient interactions to ensure patients stay on track before and after live or virtual visits. It is used, the company says, by organizations including Northwell Health, UCSF Health, UNC Health, University Hospitals and Prisma Health. Amwell says it will use Conversa's technology to advance initiatives aimed at longitudinal care, clinical quality and population health. The acquisitions will also enable Amwell to create new digital workflows and programs and expand its client base to include those of Conversa and SilverCloud – especially in the U.K. "We believe that future care delivery will inevitably blend in-person, virtual and digital care experiences; and as such, we are uniquely building a global platform to support such advanced, coordinated care," said Ido Schoenberg, chairman and co-CEO at Amwell. "By integrating SilverCloud Health and Conversa Health into our platform, we are demonstrating Amwell’s fundamental and repeatable design to continually scale digital healthcare services across the different sites of care," he added. "These acquisitions will amplify the presence and reach of care teams and reaffirm that as the needs of the healthcare marketplace evolve so too will the Amwell platform." < Previous News Next News >

COVID-19 Policy Playbook Recommends Removal of Telehealth Restrictions for OUD Treatment Center for Connected Health Policy May 2021 Legal recommendations for a safer more equitable future Researchers from the Network for Public Health Law have published a COVID-19 Policy Playbook, that outlines legal recommendations for a safer more equitable future. Chapter 18 of the playbook features access issues to treat individuals with opioid use disorder (OUD). The chapter outlines several of the federal concessions made for telehealth during the PHE, including the ability to utilize non-public facing audio-visual communication technology regardless of their level of HIPAA compliance, and the ability to prescribe controlled substances, particularly buprenorphine via telemedicine. They also note that states have made similar flexibilities available at the state level in many cases. The chapter concludes with a list of recommendations, including the following: *The Secretary of Health and Human Services (HHS) should permit treatment to be initiated via telehealth *Restrictions should be removed on who can receive treatment via telehealth. *States should authorize provision of buprenorphine via telehealth where applicable. COVID-19 Policy Playbook: https://static1.squarespace.com/static/5956e16e6b8f5b8c45f1c216/t/6064ad386b6e756cabb56f96/1617210684660/COVIDPolicyPlaybook-March2021.pdf < 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 >