The Drug Enforcement Administration (DEA) will have public listening sessions on its telemedicine prescribing regulation on September 12 and 13, 2023.
To attend the listening sessions, you must submit the attendance form no later than TODAY, August 21, 2023. In-person attendance will be granted via random lottery among those who have submitted attendance forms.
Inside Telehealth: Telehealth Legislation Unlikely to Move by End of 2023 (8/10) - Key telehealth lobbyists say it's extremely unlikely any other telehealth bills will be discussed this year. The eventual work on telehealth will likely be bipartisan, but most likely won't happen until after the 2024 election. Organizations are continuing to push forward telehealth-related initiatives. The Alliance for Connected Care is engaged in:
Ensuring providers working from home do not have to include their home address on Medicare enrollment forms, which was not addressed in the draft 2024 PFS;
Direct supervision via telehealth; and
Remote physiologic monitoring and remote therapeutic monitoring codes.
Inside Telehealth: DEA Rethinks Telehealth Prescription Rules (8/4) - DEA has decided to revisit ways to expand telemedicine prescribing of controlled substances now that the COVID-19 public health emergency is over.. The Alliance for Connected Care, and others, held multiple meetings with the White House Office of Management and Budget and DEA in early May to discuss issues they had with DEA’s proposed rules and called for the agency to promulgate what they touted as safer and more patient-focused approaches, including the special registration idea. Telehealth stakeholders are concerned about the limited in-person space in the meeting room will put some stakeholders at a disadvantage.
“I’m struggling to understand how a lottery system ensures that everyone is heard because we all know that people in the room in a meeting have more influence than people who are virtual or submit written comments,” Krista Drobac, executive director of the Alliance for Connected Care
REQUEST FOR DATA
Broadband and Telehealth
The Alliance received a Congressional request for health care expertise on the necessary broadband upload speeds for telehealth use. Please send publications, data, or even anecdotal recommendations ad speeds to the Alliance team.
National Institute on Drug Abuse: Study Finds Telehealth Associated with Increased Likelihood of Receiving Evidence-Based Standard of Care (8/7) - Researchers at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and the National Center for Injury Prevention and Control, a part of the Centers for Disease Control and Prevention (CDC) found that telehealth was associated with increased likelihood of receiving evidence-based standard of care. The study found:
In 2021, an estimated 2.5 million people aged 18 and older had opioid use disorder in the past year, yet only 36 percent of them received any substance use treatment, and only 22 percent received medications for opioid use disorder.
Those receiving substance use treatment via telehealth were approximately 38 times more likely to receive medications for opioid use disorder compared to those who did not receive treatment via telehealth, (including those who received any substance use treatment without telehealth as well as those who did not receive any substance use treatment).
Adults with severe opioid use disorder were 5 times more likely to receive medications for opioid use disorder compared to those with mild opioid use disorder.
Select coverage on the DEA Public Listening Session:
The Hill: Advocates Applaud DEA for Being Open to Relaxing Virtual Prescribing Rules (8/7) - Telemedicine advocates are applauding DEA for being open to relaxing its rules on allowing controlled substances to be prescribed via telemedicine.
Health Leaders: DEA Schedules Listening Sessions to Discuss Telemedicine Prescriptions (8/4) - The notice marks a change in tone for the agency, which has long resisted creating that registration process even though it was mandated by Congress in 2008 through the Ryan Haight Online Pharmacy Consumer Protection Act. Telehealth advocates have long argued that providers should be able to prescribe certain medications without first needing an in-person exam as a way of expanding access to and treatment for mental health and substance abuse issues.
McKnights Senior Living: Society for Post-Acute and Long-Term Care Medicine Weighs In (8/10) - The Society for Post-Acute and Long-Term Care Medicine is pleased that the federal government is taking more seriously the need to relax restrictions on prescribing medication via telehealth. Regulation around telemedicine, particularly as it relates to eldercare and end-of-life, should be guided by the principle of medical necessity.
Centers for Medicare and Medicaid Services (CMS): Biden-Harris Administration Medicare Dementia Care Model (7/31) - The Department of Health and Human Services (HHS), through CMS, announced its Guiding an Improved Dementia Experience (GUIDE) Model, which aims to improve the quality of life for people living with dementia, reduce strain on unpaid caregivers, and help people remain in their homes and communities through a package of care coordination and management, caregiver education and support, and respite services. CMS expects nearly all services available through its at-home dementia care program could be provided via telehealth and the new monthly Medicare payments for the program will likely pay for telehealth and technology.
Brunswick Times-Gazette: Statement of Sen. Warner (D-VA) on DEA's Rule Allowing Certain Controlled Substances to be Prescribed via Telehealth (8/7) - Sen. Warner (D-VA) released a statement on DEA's notice on considering the creation of a special registration process that would allow quality health care providers to prescribe controlled substances over telehealth safely.
“The pandemic showed us that telehealth is an indispensable tool for folks that need convenient access to care. So for the past couple years, I’ve been pushing for continued flexibility around telehealth rules. Glad to see this step in the right direction.”
Sen. Warner (D-VA) has been a vocal advocate for telehealth and has previously called on the DEA to establish this process.
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
PR Newswire: Remote Patient Monitoring Adoption Increased over 300 Percent in Two Years (8/16) - Vivalink, a digital health care solutions provider, announced results of a survey on the state of RPM adoption and the rapid rise of acute RPM and hospital-at-home programs. The survey found that eighty one percent of clinicians are currently using RPM on patients, a 305 percent increase from 2021. Furthermore, 84 percent of the total respondents currently using RPM also plan to increase their usage in 2024. This data indicates strong momentum for RPM in a post-pandemic environment.
Key insights from the survey include:
45 percent of providers utilize RPM for acute monitoring, such as hospital-at-home programs.
The most compelling reason driving adoption of RPM was rehospitalization, with improving patient outcomes and real-time vitals monitoring as other key benefits.
77 percent of providers predict that within the next five years RPM-based care will outpace traditional in-patient hospital care.
Medical Economics: The State of Telemedicine Today (8/8) - Telemedicine remains an important vehicle for providing many kinds of care. To gauge the current state of telemedicine, Doximity surveyed 1,200 physicians and 2,400 adult patients about their reasons for using telemedicine and its impact on care quality and access. Notably, the survey found a 37 percent increase in patient adherence to treatment plans. Approximately 88 percent of providers agreed that telemedicine increased patients access to health care.
Telehealth News and Market Developments
AHIP: Updated Core Set Highlights the Role of Telehealth (8/17) - The Core Quality Measures Collaborative (CQMC) announced updates to eight of its core measure sets. The CQMC also updated the implementation guidance that accompanies the core sets to highlight the role of telehealth, changes in endorsement status, and considerations for measure use to facilitate the widescale adoption of the sets. The CQMC routinely assesses its measure sets to ensure novel concepts are incorporated while only high-value measures are maintained. The updates include the addition of new measures which assess the outcomes of care and emphasize the need for improved care coordination and care transitions.
mHealth Intelligence: Scaling an RPM Program to Enhance Chronic Disease Management (8/14) - Prisma Health is expanding its remote patient monitoring program after a slew of positive clinical results, but expansion involves significant change management. Prisma Health launched its RPM and CCM program following a partnership with virtual care company HealthSnap last June. The health system is currently in the process of expanding the RPM and CCM program to 81 primary care physicians. This process requires collaboration with multiple stakeholders within the health system.
Cincinnati Children's: Cincinnati Children’s and Parkview Health Expand Specialty Care Telehealth Partnership (8/10) - Cincinnati Children's announced a partnership with Parkview Health on telehealth clinics to enhance care in pediatric neurosurgery, rheumatology and drug-resistant epilepsy for kids. The consultations with Cincinnati Children’s experts will be available to outpatients at Parkview Regional Medical Center, which will work closely with community and hospital-based providers to coordinate care and support services for children and their families who will benefit from these specialty medical services. Under the new agreement, Cincinnati Children’s and Parkview Health will continue to share best practices and treatment protocols, and advance innovations that are based on Cincinnati Children’s world-class research. For additional coverage, see mHealth Intelligence.
Healthcare IT News: How RTM is a Potential Game-Changer for Improving Outcomes (8/9) - With remote therapeutic monitoring, care teams are alerted and can intervene quickly when a patient is concerned or isn’t progressing as expected. Early action potentially can prevent complications and avoid unnecessary ED visits. RTM can empower patients toward better health and reduce extra in-person visits, making it easier and less costly for people, such as those in rural areas, to receive care. It also can reduce unnecessary trips to the emergency room and hospital readmissions that cause health care costs to skyrocket. Healthcare IT News interviewed Bronwyn Spira, CEO and cofounder of Force Therapuetics to offer a deep dive into RTM and how it can improve health outcomes.
Healio: American Heart Association Launches Its First Individual Telehealth Certification (8/9) - The American Heart Association (AHA) launched a certification that demonstrates commitment to telehealth care. The online program includes research, hands-on experiences and best practices. The certification aims to standardize training for health care providers in telehealth care delivery, increase skills and competencies in telehealth care delivery and help improve patient outcomes though telehealth integration.
Sanford Health: Sanford Expands Remote Patient Monitoring (8/9) - Sanford Health announced its Sanford CareSignal, a remote patient monitoring program that allows patients to self-report symptoms via call or text. The program will monitoring chronic obstructive pulmonary disease (COPD), depression, type 2 diabetes, heart failure, and recovery after discharge from the hospital or emergency department (ED). For additional coverage, see Becker's Health IT.
Refresh Miami: MedSys Provides Remote Patient Monitoring for Chronic Care (8/8) - MedSys, a remote patient monitoring health tech startup, is focused on improving health outcomes for patients with chronic conditions. About 81 million adults in the US have at least one chronic condition, and the majority of that group have more than one condition. Chronic diseases and conditions, like hypertension, heart disease, COPD, diabetes, heart failure, obesity and respiratory health, account for more than 75 percent of the $4.1 trillion annually spent on health care in the US. MedSys has also partnered with AT&T and its FirstNet program to ensure connectivity for patients to utilize the MedSys platform.
Healthcare IT News: What the Telehealth Expansion Act Means for Tackling Social Determinants and Boosting Health Equity (8/7) - Kamala Green, social drivers of health program manager at National Government Services, explains how the Telehealth Expansion Act (H.R. 1843/S. 1001) and other efforts like it will address challenges around SDOH to make quality care accessible to all. The bill makes permanent telehealth flexibilities that were first introduced in the CARES Act of 2020 in response to the COVID-19 pandemic, flexibilities that were set to expire at the end of December 2024 along with other telehealth extension provisions. It allows for health plans and employers to cover telehealth visits for individuals with high-deductible health plans and health savings accounts, providing families with the critical flexibility that allows them to maintain access to a range of affordable virtual care services before the deductible is met.