Drug Enforcement Administration Public Listening Session Registration Opens TODAY, August 7, 2023
The Drug Enforcement Administration (DEA) announced public listening sessions on its telemedicine prescribing regulation on Tuesday, September 12, 2023 and Wednesday, September 13, 2023.
Through the listening sessions, DEA aims to receive additional input concerning the practice of telemedicine with regards to controlled substances and potential safeguards that could effectively prevent and detect diversion of controlled substances prescribed via telemedicine.
Specifically, DEA is inviting all interested persons to express their views at the listening sessions concerning:
The advisability of permitting telemedicine prescribing of certain controlled substances without any in-person medical evaluation at all,
The availability and types of data that would be useful in detecting diversion of controlled substances via telemedicine that are either already reported or could be reported, and
Specific additional safeguards that could be placed around the prescribing of schedule II controlled substances via telemedicine.
To attend the listening sessions, you must submit the attendance form no later than August 21, 2023. The form will open on Monday, August 7. In-person attendance will be granted via random lottery among those who have submitted attendance forms.
Inside Health Policy: Senate Approps Seek FTC Study On Interstate Licensing Merits (7/25) - Senate Appropriators have tucked report language into a spending bill that calls for the Federal Trade Commission (FTC) to continue studying how interstate licensing affects health care competition, drawing praise from telehealth stakeholders who are upset some states are rolling back interstate provider licensing flexibilities allowed during the COVID-19 pandemic. The call for the FTC study is in report language attached to Senate appropriators’ fiscal 2024 Judiciary, Financial Services and General Government spending bill, which they advanced July 13. The Alliance for Connected Care thanks the committee for including the language.
“As states began to roll back licensure flexibilities over the past year or so, it has caused delays/disruption in care for patients who relied on telehealth to see their providers in another state. This study would help examine some of the trends/flexibilities in place during the pandemic from the competition standpoint to see where there may be roadblocks that can be addressed,” the group says.
Senate Appropriations Committee: Labor, Health and Human Services, Education, and Related Agencies Fiscal Year 2024 Appropriations Bill (7/27) - The Senate Appropriations Committee advanced the Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill by a vote of 26-2. The bill now heads to the full Senate for consideration.
The Committee included several telehealth-specific language in the report. Most notably:
Out-of-State Telehealth for Students - The Committee encourages the Secretary to investigate barriers to continuity of behavioral health care due to State licensing agreements, particularly for students in higher education. The Committee is concerned that students who move or reside out-of-State from their primary behavioral health provider may not be able to maintain access to their provider via telehealth.
Opioid Use in Rural Communities - The Committee encourages SAMHSA to support initiatives, including the use of technologies to ensure the use of telehealth, focusing on addressing the needs of individuals with substance use disorders in rural and medically-underserved areas.
Center for Primary Care Research - The Committee includes no less than $2,00,000 for the Center for Primary Care Research to support efforts to coordinate research in telehealth in primary care, among others. The areas of focus should include, but not be limited to, expanding research on persons with multiple co-morbid conditions and improving primary care in rural and underserved areas.
Sen. Rosen (D-NV): Introduction of the Strengthening Telehealth and Education for Rural Communities Act (7/20) - Sens. Rosen (D-NV) and Lummis (R-WY) introduced the bipartisan Strengthening Telehealth and Education for Rural Communities Act (S. 2447), which would reauthorize the distance learning and telemedicine grant program. The bill would also help close the rural and urban divide by ensuring that high-quality health care and education are accessible by internet to rural and tribal communities.
The National Institute on Drug Abuse is soliciting data on the impact of telehealth initiation of controlled substances which were permitted under the COVID-19 Public Health Emergency (PHE) and subsequently extended on May 11, 2023, when the PHE ended.
Data requested include:
Benefits associated with telehealth prescribing of controlled substances, including prescription opioids, stimulants, benzodiazepines, and dissociatives
Harms associated with telehealth prescribing of controlled substances, including prescription opioids, stimulants, benzodiazepines, and dissociatives
Comparative diversion risk of prescriptions initiated via telehealth vs. in person
Fierce Healthcare: Moving Beyond Telehealth (7/31) - Fierce Healthcare released a white paper, sponsored by Spectrum Enterprise, on how unified communications can transform health care collaboration for patients and providers. Scalable bandwidth and better communications capabilities can help relieve disconnected communication systems. Leveraging technology that’s intuitive and easy to use can ease the burden on clinicians and help improve their productivity and ability to provide better patient care.
Blue Shield of California: Advancing Climate Action with Virtual Health Care (7/20) - As climate change increasingly threatens the nation's health care infrastructure and members' health outcomes, the adoption of more virtual care models is needed to build climate resilience and reduce carbon emissions in health care. The white paper found that the use of a hybrid virtual care model at both study sites led to a 25 percent decrease on average for carbon emissions and a 35 reduction in water consumption. For additional coverage, see Becker's Payer Issues.
JAMA Network Open: Provision of Digital Health Technologies for Opioid Use Disorder Treatment by US Health Care Organizations (7/17) - More than a third of health systems with accountable care organization (ACO) contracts are using at least one type of technology, including remote patient monitoring and on-demand support tools. The study finds that the providers using those tools already have a substance abuse strategy in place and are using the technology to complement existing care. For digital health to have the biggest impact, it has to be embraced by more providers, especially in underserved areas, and used to reach patients who can't or aren't getting treatment. For additional coverage, see Health Leaders.
JCO Oncology Practice: Patient- and Provider-Level Factors Associated With Telehealth Utilization (6/19) - According to data published in JCO Oncology Practice, incorporation of telehealth visits during the pandemic did not result in redundant care as determined by per-physician patient volume. Results showed the telehealth utilization rate increased from less than 0.01 percent in 2019, prior to the start of the COVID-19 pandemic, to 11 percent in 2020. The findings suggest that telehealth can be integrated into cancer practices without evidence of duplicative care. Future work should examine sustainable reimbursement structures and policies to ensure accessibility of telehealth as a means to facilitate equitable, patient-centered cancer care. For additional coverage, see Healio.
Telehealth News and Market Developments
MedCity News: Driving for Results: 3 Key Benefits of Telehealth (8/3) - Telehealth enables the delivery of health care services and medical information through digital communication technologies. It encompasses multiple remote options, which can include, virtual outpatient visits for both acute and chronic conditions, consultations, and remote patient monitoring. Some advantages of telehealth includes its ability to empower patients and providers by optimizing clinical and administrative efficiencies saving both time and money.
Skilled Nursing News: How Telemedicine Drastically Reduces SNF Transfers to Hospitals (8/1) - Silvercrest Center partnered with Sound Physicians in a 14-month pilot program from July 2021 to August 2022, with a goal of reducing its hospital transfers by providing direct access to virtual physicians during off hours via telemedicine. The video planform during a virtual encounter allowed for a thorough clinical exchange between patient, physician and nursing. The program found that both long-stay and short-stay hospitalizations and emergency department (ED) transfers all declined significantly. Silvercrest Center continues to be hopeful on the role of telemedicine in the health care sector.
Medical Economics: How Can Telehealth Benefit Small Private Practices? (7/27) - Many large medical practices and hospitals have embraced telehealth due to its convenience, accessibility, and ability to reduce the spread of infectious diseases. But telehealth is not just for large practices and hospitals — small practices can benefit from it, too. With a clear understanding of these technologies and all that they offer, small practices can use them to become more productive and efficient than ever before. Telehealth can help small practices overcome staff shortages, support the delivery of personalized care, streamline operations, among others.
Becker's Hospital Review: Where Telehealth Stands After COVID-19 (7/26) - Despite the end of the COVID-19 public health emergency, telehealth is still a widely used option than before the pandemic. The convenience of receiving care from one's home is still driving many patients to seek out telehealth options. However, for telehealth to stick around permanently, lawmakers need to hammer out regulations and rules for virtual care. Some hospital leaders are looking to Washington, D.C., to provide guidance on how telehealth care can be delivered as the country moves out of the COVID-19 pandemic.
STAT News: The American Medical Association's (AMA) New President on the Future of Telehealth (7/25) - Dr. Jesse Ehrenfeld, inaugurated in June, is the current president of the AMA. Dr. Ehrenfeld is the first board-certified clinical informaticist to be in AMA's leadership, bringing a set of skills that could be particularly useful as medicine reacts to the rapid evaluation of technology. STAT spoke to Ehrenfeld about three major areas of health technology, telehealth, electronic health records, and artificial intelligence, and the potential and progress yet to be made in each of them.
Health Leaders: I/DD Care Provider Uses Telehealth to Save $100K in Emergency Room (ER) Costs Over Two Years (7/25) - Mainstay Life Services, which offers support for people with intellectual and/or developmental disabilities in Pennsylvania, reduced ER and urgent care clinic visits and improved clinical outcomes through virtual care. The provider reportedly saved almost $100,000 in emergency care costs over the past two years through telehealth. Through the program, 92 percent of those telehealth visits were resolved without need for further medical care, including 27 percent that would have resulted in a trip to the ER or an urgent care clinic.
American Parkinson Disease Association: The Expanding Role of Technology Within Health Care for Parkinson's Disease (7/25) - There are many opportunities to advance clinical care, participate in clinical trials, and seek out Parkinson’s disease (PD) wellness opportunities. Many people with PD live in areas with few or no movement disorders specialists, or even neurologists, as a result they either see no specialist or must drive hours to receive specialized care. Telemedicine allows these individuals to get access to expert PD doctors from afar. Additionally, as PD progresses, people may have more severe issues with cognition and movement or have a care partner who is older and has difficulty with mobility or driving. Telemedicine allows access to health care without any of the hurdles of transportation to the facility.
PR Newswire: Telemedicine Provider HealthTap Launches Campaign to Increase Access to Health Care for Hospitality Workers (7/24) - HealthTap, a virtual primary care provider, announced a program to increase access to health care for restaurant and bar workers across the country. The "Here's To Your Health" program offers restaurant and bar workers access to one free virtual doctor visit and a year of unlimited texting with a doctor they choose, as well as discounted prescriptions, among others. According to the Bureau of Labor and Statistics, 70% of hospitality workers, including cooks, food and cocktail servers, bartenders, bussers, hosts, and dishwashers, do not receive employer-provided health benefits. The program aims to raise awareness of the need for affordable, accessible health care in the hospitality industry.
Health Leaders: Digital Health Helps Carilion Children's Monitor NICU Feeding Processes (7/21) - Carilion Children's Hospital announced a partnership with Astarte Medical, which would enable NICU staff to access the latter's analytics platform. The platform, NICUtrition, would analyze patient feeding practices and outcomes to identify feeding protocol effectiveness, patient risk factors, and best practices that can positively impact patient outcomes. Digital health tools that can be accessed through the EHR can help with that data gathering and analysis, offering crucial clinical decision support when and where needed.