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Connected Care Update

November 9, 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.

Federal Updates

Federal Communications Commission: (11/6) – On November 6, FCC opened the Connected Care Pilot Program application window. Applications are due by Monday, December 7, 2020, at 11:59 PM ET. The Connected Care Pilot Program will provide up to $100 million from the Universal Service Fund (USF) over a three-year period to selected applicants to support the provision of connected care services. The Pilot Program will provide funding for selected pilot projects to cover 85% of the eligible costs of broadband connectivity, network equipment, and information services necessary to provide connected care services to the intended patient population. The Pilot Program will not fund end-user devices or medical equipment. View the press release, FAQs and additional information.

Department of Veterans Affairs: (11/4) – VA announced the release of the Office of Information and Technology’s (OIT) 2020 Year in Review, “Driving Digital Transformation at VA,” a report highlighting VA’s innovative IT initiatives that improve Veterans’ access to benefits and services. Among the highlights, expanded VA Video Connect systems helped Veterans conduct more than 1.5 million telehealth appointments from their homes or other non-VA sites — a 1,066% surge compared to 2019. View the press release and a full report with a fact sheet.

HHS Office of Inspector General: Last week, HHS OIG updated their work plan to include a report next year based on Medicare Parts B and C data and will identify program integrity risks associated with Medicare telehealth services during the pandemic. OIG will analyze providers' billing patterns for telehealth services and describe key characteristics of providers that may pose a program integrity risk to the Medicare program.

    Legislative Activity

    Telehealth Modernization Act House Companion: (11/5) – Reps. Carter (R-GA), Blunt Rochester (D-DE) and McMorris Rodgers (R-WA) introduced the Telehealth Modernization Act (H.R. 8727), the House companion to the legislation introduced in the Senate (S. 4375) by Senate Finance Committee Chair Alexander (R-TN) and which now has five bipartisan cosponsors including Sens. Schatz (D-HI), Wicker (R-MS), Hyde-Smith (R-MS) Blackburn (R-TN) and Collins (R-ME). While the Telehealth Modernization Act language is not posted yet, it should be identical companion language to Senator Alexander’s bill. This bill:

    • Removes originating site restrictions (the broad way in which this is worded also addresses geographic restrictions)
    • Authorizes the Secretary of HHS to retain additional services added during COVID
    • Authorizes the Secretary of HHS to expand the types of practitioners who may practice telehealth services
    • Addresses telehealth concerns for FQHCs, Rural Health Clinics, Hospice Care, and Home Dialysis

    State Telehealth News

    mHealth Intelligence: (11/6) – Brigham and Women’s Hospital in Boston, MA is using a telehealth platform in a trial program aimed at identifying and treating stress and burnout in health care professionals. Emergency care providers in the program will receive access to a connected health platform to answer daily questionnaires and post free-response entries in an online journal.

    mHealth Intelligence: (11/4) – Northwestern Medicine in Chicago is expanding its telemedicine platform to give patients and care providers at two regional hospitals in Illinois on-demand access to emergency pediatric services. This connected health service aims to reduce the need for costly and stressful transports to pediatric specialists from the Ann & Robert H. Lurie Children’s Hospital.

    Tennessean: (11/2) – Expanding telehealth flexibilities enacted during COVID-19 that allowed providers to practice telehealth across state lines could help Tennesseans in rural areas experiencing a health care provider shortage. This op-ed advocated for making such relaxations of state-based telehealth restrictions permanent, citing state licensing requirements as a major barrier for physicians to provide needed care to patients.

    Becker’s Hospital Review: (11/2) – The NYC Test & Trace Corps, a COVID-19 testing initiative led by the NYC Department of Health and NYC Health + Hospitals, announced a partnership with Essen Health Care, a clinical telehealth provider that offers primary care, urgent care, and specialty services via telehealth. The partnership will deploy mobile testing units to underserved neighborhoods of NYC to deliver free testing services to residents.

    Papers, Surveys, and Studies

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

    JAMA: (11/5) – A new study published in JAMA examined changes in use of preventive services, nonelective care, elective procedures, prescription drugs, in-person office visits, and telemedicine visits were examined during the first 2 months of the COVID-19 pandemic in 2020 relative to existing trends in 2019 and 2018. Disparities in the association of the pandemic with health care use based on patient’s zip code–level race and income were also examined. Notably, the study found smaller cuts in in-person care and lower rates of telemedicine use were observed among patients who reside in lower-income or predominately non-white zip codes.

    Omada Health: (11/3) - Outcomes of the Preventing Diabetes with Digital Health and Coaching for Translation and Scalability (PREDICTS), presented at ObesityWeek Interactive this week demonstrate Omada Health’s Digital Diabetes Prevention Program (d-DPP) achieved a statistically significant and clinically meaningful improvement in Hemoglobin A1c reduction and weight loss over a 12-month period.

    Diabetes Care Journal: (11/2) – A national CDC questionnaire of more than 900,000 participants from 2016-2017 identified racial and geographic disparities in internet use among patients with hypertension or diabetes. The authors note that, while telehealth could be a great tool for patients in underserved populations, it may further exaggerate disparities in access to care especially during the current COVID-19 pandemic. The study found that the prevalence of internet use for people with either high blood pressure or diabetes was 56% for Hispanic people, 62% for Black people and 77% for white people.

    Telehealth News and Market Developments

    Amwell: (11/4) – Amwell announced that it has earned full URAC Accreditation in Telemedicine. URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement, and innovation.

    Healthcare IT News: (11/4) – TriHealth, a health system based in Cincinnati, Ohio, experienced a 3,650% increase in telehealth use after switching to Zoom.

    Healthcare IT News: (11/3) – HealthTree founder Jenny Ahlstrom, who was diagnosed with multiple myeloma a decade ago, said policy changes that have facilitated access to virtual care should remain permanent. Near the beginning of the pandemic, HealthTree asked 1,100 patients about their use of virtual care. By April or so, 60% said they'd used telehealth, compared with 10% before COVID-19. One big reason for that is the ability to access specialists around the country, Ahlstrom said.

    Washington Post: (11/2) – MedStar Health system has reached 500,000 telehealth visits during the pandemic. Telehealth visits became a central part of trying to manage the spread of the novel coronavirus, with many hospitals and medical offices expanding their online capacity so patients who were under shutdown orders or concerned about exposure could still receive care. “There was a time at which 100,000 video visits was considered a pretty important milestone,” said Ethan Booker, an emergency room physician and medical director of Medstar’s telehealth innovation center and video visit programs, and an Alliance Board Member. “And so to be at five times that number is to my mind — someone who’s been doing telehealth now for five years — just an astronomical number,” he said.

    Becker’s Hospital Review: (11/2) – A panel of telehealth experts weighed in on challenges and opportunities that have been spotlighted by the pandemic during a session at the Becker's Telehealth Virtual Forum this week. Dr. Adam Landman, CIO of Brigham and Women's Hospital noted that one of the challenges is determining what the appropriate amount of telehealth is. Dr. Keith Griffin, CMIO of Novant Health Medical Group, remarked that he hopes telehealth continues to be part of a care plan. And, Dr. Todd Czartoski, chief executive of telehealth, chief medical technology officer at Providence noted that CMS regulations and limitations prevented telehealth expansion in the past.

    The Daily Record: (11/2) – Two Ohio healthcare companies have partnered with Amazon to offer telemedicine services with free prescription medications to the retail giant's customers

    Accreditation Commission for Health Care: (10/2) – ACHC announced the launch of its Distinction in Telehealth for healthcare providers. ACHC collaborated with Health Recovery Solutions (HRS), a national provider of telehealth and remote patient monitoring solutions, to develop the accreditation distinction.

    Morneau Shepell: (11/2) – Morneau Shepell, a provider of wellbeing, mental health and digital mental health services, announced the launch of its first unified telemedicine solution in the United States.

    Upcoming Events

    November 9 – Medicare Payment Advisory Commission Meeting (MedPAC), November Public Meeting, “Expansion of telehealth in Medicare.”

    November 9 – 11 – Fierce Health IT Virtual Series, “Telehealth’s Takeover.”

    November 10 – National Consortium of Telehealth Resource Centers, “NCTRC Telehealth Hack – Licensure and Patient-Provider Relationships.

    November 11 – AHIP, “Virtual Primary Care and Its Role in Keeping Care In-Network.”

    November 12 – American Association for the Advancement of Science, “Responsible AI: Medical Triage During COVID-19 and Beyond.

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

    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

    Xtelligent Healthcare Media’s Healthcare Strategies podcast series, Pursuing Value-Based Whole Person Care in Telehealth, Population Health.” With the healthcare industry experiencing a period of rapid change, whole-person health has never been more important. Caraline Coats, vice president of Bold Goal and population health strategy, explains how payers and other healthcare professionals can engage in value-based, whole-person care in a couple of different settings including telehealth and population health.

    Becker’s Healthcare Telehealth Virtual Forum. This week Becker’s held a virtual forum with healthcare leaders discussing topics such as the role of telemedicine and what’s on the horizon, how providers can best use data from increased wearables and virtual visits, how to drive patient engagement and satisfaction, and many others related to telehealth and remote patient monitoring. All of the sessions are recovered and can be viewed on demand here. In addition, Becker’s compiled a list of eight key takeaways.

    HIMSS Telehealth Connection TV, Using Telehealth to Continue the Patient-Primary Care Provider Relationship.” Telehealth Connection TV: Dr. Karen Abrashkin, medical director of Northwell Health's House Calls program, says virtual care tools have allowed providers at Northwell Health to connect with senior patients in their own homes.

    HIMSSCast,How COVID-19 and telehealth are changing the physician workforce.” HIMSS Media editors sit down with Wheel CEO Michelle Davey to talk about virtual care, COVID-19, burnout, and more.

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