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Connected Care Update

November 16, 2020

Please find below updates on how the health care system is leveraging telehealth and remote patient monitoring - including research, data, and polling on its current use in response to COVID-19.

Alliance News

PLEASE SIGN-ON to Consensus Principles on Telehealth Across State Lines

The Alliance for Connected Care seeks your support on an open letter to U.S. State and Federal Policymakers calling for care across state lines to support patients and empower healthcare professionals.

This high-level statement is intended to call attention to the need for telehealth care across state lines, through solutions that allow for mutual recognition of health professional licensure. Please sign here. Please also feel free to share this opportunity with others.

    Federal Updates

    Department of Veterans Affairs: (11/9) – VA released its COVID-19 Response report, which details its efforts to address the pandemic from early January through June 30. Overall, the VA implemented a wide range of actions to ensure the safety of its patients and employees, including testing, hiring additional staff, and moving appointments to telehealth meetings to keep Veterans and employees safe and has seen a 1,525% increase in home or offsite telehealth visits. View the press release and report.

      Congressional Activity

      Senator Loeffler Releases the Modernizing Americans’ Health Care Plan: (11/13) – Sen. Loeffler (R-GA) released the Modernizing Americans’ Health Care Plan, a framework to protect patients with pre-existing conditions, lower costs, increase choice and expand health care options. The new plan includes the TELEHEALTH HSA Act and the VA Mission Telehealth Clarification Act.

      The Senate Appropriations Draft Released: (11/11) – The Senate Committee on Appropriations today released all twelve of its Fiscal Year 2021 (FY21) funding measures and the FY21 subcommittee allocations. Most notable was a follow-up provision on the special registration for controlled substances. As you remember, we submitted a stakeholder letter to the DEA on this issue last month with more than 80 signers.

      Remote Prescribing of Controlled Substances. —The Committee continues to place a priority on reducing the crisis of prescription drug abuse and recognizes that some controlled substances, such as medication-assisted treatment, can be a critical part of treatment and must be available as clinically appropriate. The Committee directs DEA to complete the requirements under section 3232 of the SUPPORT for Patients and Communities Act (Public Law 115–271) to promulgate regulations clarifying the limited circumstances in which Special Registration for Telemedicine may occur under the Ryan Haight Act (Public Law 110–425). The Committee further directs DEA to provide a briefing on the status of these regulations within 30 days of the enactment of this act

      Other telehealth funding provisions included funding for Pediatric Mental Health Care Access, funding for the Office for the Advancement of Telehealth (OAT), funding for Telehealth Centers of Excellence, and programs leveraging telehealth for opioid abuse prevention. None of these provisions are final, as a compromise between the House and Senate will be needed by early December.

        State Telehealth News

        Big Country News: (11/13) – Washington State Insurance Commissioner Mike Kreidler extended the emergency order regarding telehealth services in the state through December 11. The order directs all state-regulated health insurers to make additional coverage changes to aid consumers throughout the pandemic, including by relaxing rules around telehealth modalities that can be utilized for care.

        The Hour: (11/12) – Colorado Governor Jared Polis announced his request for a $35 billion budget for FY2022 to ease suffering and position the state for long-term recovery after the pandemic. Included in the budget is $160 million in rural broadband investment to support education and telehealth services.

        The Highland County Press: (11/12) – The Ohio Senate introduced a bill to expand telehealth during the pandemic, following the passing of a companion bill (HB 679) in the Ohio House in June. The bill seeks to expand telemedicine provisions to additional specialty areas and to keep health plans from charging more for appointments that are comparable to an in-person visit. The bill would also allow providers to negotiate with health plans on reimbursement rates related to telehealth services.

        Healthcare Finance: (11/10) – The MetroHealth Medical Center in Cleveland, Ohio found that expanding the use of telehealth during the pandemic has reduced cancellation rates to nearly zero and led to improvements in no-show rates and completed visits within its rheumatology ambulatory clinics.

        Papers, Surveys, and Studies

        Check out the Alliance for Connected Care studies and polling website for more resources.  

        Patient Engagement HIT: (11/12) – According to a survey conducted by OnePoll on behalf of DocASAP, patients are increasingly calling on their medical providers to offer a mix of in-person and telehealth care access. Once COVID-19 subsides, 44 percent of patients said they would prefer their providers to offer both in-person care and care via telehealth.

        Healthcare IT News: (11/10) – Comparing May 2019, when almost all visits were completed in the clinic, to May 2020, when the majority of visits were conducted via telemedicine, the no-show percentage went from 7.57% to 3.09%, representing a 59% at Upstate Medical University.

        The Taskforce on Telehealth Policy, convened by the Alliance, the National Committee for Quality Assurance, and the American Telemedicine Association found similar contributing effects of telehealth on reduced no-show rates. View the full report here.

        American College of Rheumatology: (11/9) – Using retrospective data on rheumatology outpatient appointments, MetroHealth System found that Telemedicine appointment cancellations were nearly zero (1 out of 825 telemedicine appointments offered) in the 10-week During COVID-19 period as compared to the pre-COVID-19 period. The authors conclude that barriers to accessing in-person healthcare because of transportation or other issues has been a challenge that might be conquered by telemedicine.

        Telemedicine and e-Health: (11/4) – A study conducted by Penn Medicine and Independence Blue Cross found that a telemedicine platform reduced the time between a primary care visit and a dermatology consult from six weeks to less than six hours. Read additional coverage from mHealthIntelligence.

        American Academy of Physical Medicine and Rehabilitation – A study published in October analyzed results from four categories of discharged patients: those who participated in the telehealth program, those who did home physical therapy, those who did independent breathing, strength, and endurance exercises, and those who did not exercise at all. The study found that strength and endurance in patients who participated in physical therapy virtually improved as much as those who did home-based physical therapy programs. Read additional coverage from The Harvard Crimson.

        Telehealth News and Market Developments

        Amwell: (11/12) – Amwell announced new connectivity, device and cart offerings. Spurred by the impact of the COVID-19 pandemic, Amwell is introducing Amwell Now, new Touchpoint Tablet software, and the C500 telemedicine cart to help health systems and other healthcare organizations easily leverage telehealth.

        mHealthIntelligence: (11/11) – McLeod Health has partnered with schools in South Carolina to expand its School-Based Telehealth Program (SBTP) that provides non-emergency medical care to students through McLeod Telehealth visits. “At any point during the school day, our students can visit their school nurse and connect remotely to quality healthcare with a local provider,” Florence District One Superintendent Dr. Richard O’Malley explained.

        University of Arkansas for Medical Sciences: (11/10) – Researchers at the University of Arkansas for Medical Sciences (UAMS) will use a $228,000 federal grant to test telehealth as a way to improve Arkansas’ death rate among pregnant women. The team will recruit 50 pregnant women to test whether patient care can be improved using the combined systems of telemedicine, remote health monitoring and the UAMS Institute for Digital Health & Innovation Call Center.

        MedPAC “Expansion of telehealth in Medicare”: (11/9) – This week, the Medicare Payment Advisory Commission discussed whether and how to permanently expand telehealth in fee-for-service Medicare. Commissioners talked about how to achieve the benefits of telehealth while limiting the risks around quality and costs. They also indicated that future MedPAC meetings will discuss how to better structure telehealth flexibilities for clinicians in advanced APMs.

        MedCity News: (11/9) – Eko, a health tech startup that makes a digital stethoscope and electrocardiogram raised $65 million in series C funding. It plans to use the funds to build out a telehealth platform and at-home monitoring program for cardiopulmonary patients.

        Home Health Care News: (11/8) – BayCare, a Florida-based nonprofit health system, announced it will provide access to acute-level care in the home to help care for patients battling COVID-19, heart failure and COPD, and other conditions. Through the hospital-at-home program, BayCare will also administer IV therapy, IV medications, IV hydration and other services.

        American Optometric Association: In October, the American Optometric Association Board of Trustees approved a new position statement on telemedicine’s role in optometry. The new position statement replaces the board’s 2017 policy statement. View the press release and full 2020 position statement on telemedicine.

        Notable Telehealth Commentary

        On Monday, November 9, the Medicare Payment Advisory Commission (MedPAC) discussed whether and how to permanently expand telehealth in fee-for-service Medicare. 

        "Decisions made now might be inappropriate for telehealth of several years from now" because technology is changing so fast, said Bruce Pyenson, a MedPAC commissioner and consulting actuary at Milliman in New York City. MedPAC executive Jim Mathews welcomed the idea of commissioners suggesting that some limits might be set. “It might be helpful for groups like us to say, 'These expansions seem to make sense; these maybe not so much and should be pulled back,' against strong pressure to make everything permanent," he said. Opinions were divided on whether Medicare should continue reimbursing doctors for telehealth visits performed via telephone. 

        Commissioner Lawrence Casalino, MD, PhD, was opposed to getting rid of payments for telephone visits, "both for equity and efficiency reasons," he said. Brian DeBusk, PhD, also spoke in favor of audio-only visits. "I see audio as a secure, safe medium for some less sophisticated, lower socioeconomic status beneficiaries," said DeBusk, who is CEO of DeRoyal Industries, a medical equipment manufacturer in Powell, Tennessee.

        Commissioner Pat Wang, president and CEO of Healthfirst, a health plan in New York City, said the potential for fraud with audio-only visits is immense. Commissioner Wayne Riley, MD, president of the State University of New York (SUNY) Downstate Health Sciences University, disagreed. While safeguards against fraud may be needed, "I would not want to totally discontinue telephonic access, particularly for vulnerable communities.” 

        Also, this week, the Bipartisan Policy Center held an event on “What's Next for Telehealth: Sustaining and Expanding Access After COVID-19.” Sen. Angus King (I-ME), Maine health care providers, and BPC experts discussed the benefits of telehealth during the pandemic and what things look like for the future of telehealth throughout the country. “One of the few silver linings of this pandemic has been the incredible acceleration of the adoption and expansion of the ability of telehealth, particularly in rural areas," King said. "I don’t think it can be stressed enough what an important development this is.”

        Finally, Sen. Tina Smith (D-MN) said at an Axios event that the expansion in telehealth services to address the coronavirus pandemic needs to continue. Patients and providers have described telehealth as a lifeline, Smith said, especially in the need for mental health care, which has exploded during the pandemic.

        Upcoming Events

        November 17 at 5:00 – 6:00 PM Eastern – CMS COVID-19 Office Hours

        Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

        • Increase Hospital Capacity – CMS Hospitals Without Walls;
        • Rapidly Expand the Healthcare Workforce;
        • Put Patients Over Paperwork; and
        • Further Promote Telehealth in Medicare

        Toll Free Attendee Dial In: 833-614-0820

        Access Passcode: 2491556

        Audio Webcast link:

        November 18 – National Consortium of Telehealth Resource Centers, “NCTRC Telehealth Hack – Privacy and Liability.

        November 18 – The Hill, “Innovation Forward: Technology and Diabetes Care.”

        November 19 – National Consortium of Telehealth Resource Centers, “Leveraging Telehealth to Address Social Determinants.”

        November 19 – Southwest Telehealth Resource Center, Arizona Telemedicine Program, “2020 Mid-Year Rural Health Policy Roundup.”

        November 20 – AHIP, “Innovations to Virtualize Healthy Living Across Care Settings.”

        Past Events

        HIMSS TV, “How telehealth is enhancing patient-primary care provider interactions.” In the fifth episode of the Telehealth Connection TV miniseries, Dr. Karen Abrashkin from Northwell Health discussed how virtual care tools have allowed providers to connect with senior patients in their own homes during the pandemic.

        Please subscribe to this newsletter and send any news or events to for inclusion.

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