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.
The Alliance for Connected Care continues to maintain and update a COVID-19 website tracking guidance from federal agencies on telehealth and remote patient monitoring including a state emergency waiver tracking chart.
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Alliance Statement for the Record
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Senate Commerce Committee, Communications, Media and Broadband Subcommittee Hearing on: “State of Telehealth: Removing Barriers to Access and Improving Patient Outcomes.”
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Alliance Statement for the Record: Senate Hearing on “State of Telehealth: Removing Barriers to Access and Improving Patient Outcomes.” The Alliance submitted a letter
to the Senate Commerce, Science, and Transportation Committee, Communications, Media, and Broadband Subcommittee on a hearing examining the importance of access to telehealth services, and the role that broadband plays in the public health response.
Our statement summarizes the following recommendations:
- Congress should invest in efforts that support broadband affordability for patients and providers.
- Congress must continue to coordinate with other federal agencies to ensure improvements are being made to our taxpayer-funded programs, and that all patients deserving of these benefits are being afforded access.
- Congress must make permanent the Emergency Broadband Benefit program.
- Congress must continue to address anticompetitive behaviors in all industries, and explore solutions that support patients.
- Congress should invest in efforts that support the deployment of broadband for all Americans, including those living in rural areas, on Tribal lands and to our nation’s health care providers and centers.
- Congress must maintain access to audio-only services for patients who, in the interim, continue to lack broadband access and/or affordability.
- Congress should pass the Data Mapping to Save Moms’ Live Act (S. 198/H.R. 1218) in the 2022 Consolidated Appropriations package.
- Congress should consider addressing antiquated licensure requirements that impeded access to care to address gaps in the delivery system and provide high-value care directly to consumers in rural or underserved areas.
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Telehealth Sign-On Opportunity |
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The Alliance for Connected Care invites your organization to participate in the following new sign-on opportunities
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Deadline to sign is October 19 |
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Letter to Governors on Maintaining Licensure Flexibilities During the Ongoing Pandemic
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The Alliance, National Organization for Rare Disorders (NORD), and ALS Association collaborated on a letter urging state governors and legislatures to consider maintaining and expanding medical licensure flexibilities for the duration of the federal public health emergency. This is critical to ensure patients, particularly patients with compromised immune systems that are still vulnerable to contracting the virus, can access health care regardless of where they reside through the facilitation of care across state lines as the pandemic continues. We will plan to send this letter to all 50 governors across the US, and we are also requesting input in the form on contacts that organizations might have within state governors’ offices.
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Congress
Rural Telehealth Access Task Force Act: (10/8) – Reps. Pence (R-IN) and Craig (D-MN) introduced the Rural Telehealth Access Task Force Act (H.R.5506), which would establish a Rural Telehealth Access Task Force to determine how to address barriers to the adoption of telehealth technology and access to broadband internet access service in rural areas. View the press release.
Primary Care and Virtual Care Affordability Act: (10/8) – Reps. Schneider (D-IL) and Wenstrup (R-OH) introduced the Primary Care and Virtual Care Affordability Act (H.R. 5541), which would extend the exemption for telehealth services from certain high deductible health plan rules. View the bill text.
Senate Commerce Committee, Communications, Media and Broadband Subcommittee hearing on: “State of Telehealth: Removing Barriers to Access and Improving Patient Outcomes.”
(10/7) – The Senate Commerce hearing examined the importance of access to telehealth services, the utilization and changes during the COVID-19 pandemic, the critical role of access to broadband in the public health response, and how to structure future deployment and policy to address the needs of underserved communities. Several major themes emerged for ensuring equity both in broadband deployment and telehealth access. For example, Senate Commerce, Science & Transportation Committee Chair Cantwell (D-WA) asked specifically about how to improve the cumbersome licensing process, and Sen. Blunt (R-MO)
highlighted his Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, which would deal with regulatory challenges with licensure by providing temporary licensing reciprocity for all practitioners or professionals. Additionally, there was overwhelmingly large support for continuing audio-only post-public health emergency, and funding for many of FCC’s successful telehealth programs including the COVID-19 Telehealth Program. Notably, FCC Commissioner Carr
suggested that Congress could examine a permanent funding stream for the COVID-19 Telehealth Program. View additional coverage from Bloomberg Law.
Witness:
- Sterling N. Ransone, Jr., MD, FAAFP, President, American Academy of Family Physicians
- The Honorable Brendan Carr, Commissioner, Federal Communications Commission
- Sanjeev Arora, MD, MACP, FACG, Founder, Project ECHO; Distinguished Professor of Medicine, University of New Mexico
- Deanna Larson, President, Avel eCARE
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Administration
HHS Agency for Healthcare Research and Quality (AHRQ): Supplemental Evidence and Data Request on Telehealth for Women (10/12) – The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from the public to inform a review on Telehealth for Women, which is currently being conducted by the AHRQ's Evidence-based Practice Centers (EPC) Program. Comments are due by November 12. Key questions include:
- What is the evidence of effectiveness of telehealth as a strategy for delivery of health care services for reproductive health?
- What are patient preferences and patient choice in the context of telehealth utilization?
- What is the effectiveness of patient engagement strategies for telehealth?
- What is the impact of COVID-19 on the effectiveness of telehealth and patient engagement?
- What are the barriers to and facilitators of telehealth for women's reproductive health in low-resources settings and populations?
- What are the harms of telehealth for women's reproductive health?
- What is the evidence of effectiveness of telehealth as a strategy for screening and interventions for interpersonal violence?
- What are patient preferences and patient choice in the context of telehealth utilization?
- What is the effectiveness of patient engagement strategies for telehealth?
- What is the impact of COVID-19 on the effectiveness of telehealth and patient engagement?
- What are the barriers to and facilitators of telehealth for screening and interventions for interpersonal violence in low-resources settings and populations?
- What are the harms of telehealth for screening and interventions for interpersonal violence?
Contextual Question: What guidelines, recommendations or best practices have been developed for the design and use of telehealth and virtual health technologies for women for any clinical conditions, including on patient preferences, patient choice, patient engagement, and implementation in low-resource settings?
Centers for Disease Control and Prevention: National and State Trends in Anxiety and Depression Severity Scores Among Adults During the COVID-19 Pandemic (10/8) – New research from the Centers for Disease Control and Prevention (CDC) on anxiety and depression in the United States during the COVID-19 pandemic found a peak between December 2020 and January 2021, as COVID-19 case counts peaked.
CDC noted that this data highlights how essential telehealth services are during the COVID-19 pandemic. "Fluctuations in symptoms of anxiety and depression during the pandemic highlight the importance of real-time monitoring of mental health symptoms," the CDC wrote in the report.
HHS: HHS Launches Spanish Language App to Help Latinos Navigate Health Care Questions, Issues New Report Highlighting Latino Coverage Issues (10/8) – HHS launched a Spanish version of its QuestionBuilder app, which can help Latino patients prepare for their in-person or telehealth appointments. The HHS Agency for Healthcare Research and Quality (AHRQ) built QuestionBuilder en Español, which is being released during Hispanic Heritage Month and Health Literacy Month, to improve health care access and equity for Latinos. Latinos have among the highest uninsured rate of any racial or ethnic group within the United States.
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State Telehealth News and Activity
mHealth Intelligence: Iowa Includes PAs, Speech-Language Pathologists, Audiologists in Telehealth Rules (10/7) – The Iowa Board of Physician Assistants and Board of Speech Pathology and Audiology released new regulations
last month, which were aimed at making certain pandemic-era measurements permanent. The regulations allow physician assistants (PAs), speech-language pathologists and audiologists to use telehealth. The new rules allow PAs to use a synchronous telehealth platform to interview a patient and obtain relevant medical history prior to treatment, and to fulfill the requirements for the doctor-patient relationship. A new chapter was added to the state’s Administrative Code to allow speech-language pathologists and audiologists to use HIPAA-compliant telehealth platforms, as long as the patient agrees to using telehealth beforehand and encounters are properly documented.
Bloomberg Law: Telehealth Across State Lines Called Fix for Workforce Shortage
(10/7) – In a recent Senate Commerce, Science, and Transportation committee hearing, several witnesses and Senators noted that restrictions in licensure state-by-state are seen as a barrier to getting patients needed care. Allowing doctors and other providers to easily practice telehealth across state lines would also help address health care staffing shortages nationwide, which have been exacerbated by the pandemic.
mHealth Intelligence: Rhode Island Program Gives Seniors the Support They Need to Use Telehealth (10/6) – Integra, an accountable care organization (ACO) based in Rhode Island, launched a new program to give seniors the resources they need to use telehealth. The ACO partnered with Pawtucket Housing Authority and Rhode Island Parent Information Network (RIPIN) on the program, which provides mHealth-enabled tablets and bilingual community health workers to help seniors learn how to use telehealth, then connect with a care provider for a scheduled visit.
State of Connecticut: Governor Lamont Marks National Digital Inclusion Week, Promotes Connectivity Resources Available to Residents (10/5) – Connecticut Governor Ned Lamont marked National Digital Inclusion Week, and emphasized his administration’s efforts to help Connecticut families get online and leverage digital tools for learning, telehealth, work, and other applications. Governor Lamont also signed Public Act 21-159 to support equitable access to broadband across the state.
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Telehealth Research, Reports and Surveys
AJMC: Patient and Supporter Factors Affecting Engagement with Diabetes Telehealth (10/8) – Telehealth programs are an increasingly popular approach to facilitate diabetes care by enhancing remote monitoring, communication, and collaboration among patients, caregivers, and health care providers. A study of 123 adults with type 2 diabetes and high blood pressure, enrolled with a family supporter, received automated interactive voice response (IVR) and coach-provided visit preparation calls over 12 months. Automated IVR calls were completed more often when urgent issues were identified to patients’ providers, but less often if patients had high blood press or depression. In conclusion, visit preparation call content should be tailored to patient education level, and family help with medications may identify patients needing additional support to engage with telehealth.
Better Medicare Alliance: Medicare Advantage Sees Fewer Covid-19 Hospitalizations In Beneficiaries And Offers Greater Access To In-Person And Telehealth Non-Covid Care During Pandemic (10/7) –A new data brief commissioned by Better Medicare Alliance, the leading research and advocacy organization supporting Medicare Advantage, finds that Medicare Advantage had a 19% lower rate of COVID-19 related hospitalizations during the first nine months of the pandemic than fee-for-service (FFS) Medicare. Key findings on telehealth are summarized below:
- Access to telehealth before and during the pandemic: Before the pandemic, 21% of Medicare Advantage beneficiaries reported access to telehealth services compared to 16% of FFS Medicare beneficiaries. During the pandemic, 50% of Medicare Advantage beneficiaries reported access to telehealth services, compared to 48% of FFS Medicare beneficiaries.
(*actual access to services may be higher, as these numbers reflect beneficiary knowledge of telehealth availability)
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Telehealth News and Market Developments
The Seattle Times: Teletherapy often leaves out older people. Here’s how a Washington researcher is trying to help them connect (10/10) – The pandemic made telehealth — remote health care, usually over a video application — ubiquitous in Washington. But when Veterans Affairs psychiatrist Dr. Debby Tsuang began offering telehealth appointments to her patients, mostly older adults at high risk for complications from COVID-19, many were reluctant to log on to a computer or tablet to set up a video meeting. Most preferred a traditional phone call to discuss their mental health needs. However, telemedicine is “here to stay,” Tsuang said. “And we just want to be able to bridge whatever technological divides might exist in either Black or white [communities], or rural or urban — or any vulnerable individual.”
mHealth Intelligence: New Partnership Gives Wisconsin SNFs Access to After-Hours Telehealth (10/8) – North Shore Healthcare has announced a partnership with Sound Physicians for the connected health platform, which will enable staff at 52 of the company’s SNFs to access healthcare providers on demand after normal business hours for virtual care. "The pandemic has opened the industry's eyes to the importance of telemedicine-based services in SNFs, and the regulatory environment now supports the growth of Curve and its partnership with forward-looking organizations like Southview,” Avi Katz, who owns Southview Acres Health Care Center in Minnesota, said of the partnership.
Health Affairs: The Surge ff Telehealth During The Pandemic Is Exacerbating Urban-Rural Disparities In Access To Mental Health Care (10/7) – The use of telehealth during the pandemic has been much lower in rural communities, even after controlling for local health care resources, COVID-19 burden, broadband infrastructure, and indicators of socioeconomic status. For example, one study reported that use of telehealth was roughly 25 percent lower in rural areas compared to urban areas. Another study had similar findings, with approximately 30 percent less telehealth use in rural areas versus urban areas. The authors recommend several actions that may alleviate this disparity, including expanding community broadband availability, incentivizing telehealth use in rural communities either through increased reimbursement or more investment in telehealth training and IT infrastructure.
mHealth Intelligence: Telehealth Access to Mental Health Specialists Can Be a ‘Game-Changer’ in the ED (10/7) – At Florida's Cleveland Clinic Indian River Hospital, access to mental health specialists via telehealth has not only helped the busy emergency department speed up care, but improve the quality of care those patients receive. Nowadays, hospitals like Cleveland Clinic Indian River have a virtual link to behavioral health specialists to help anyone coming through the ED. This has helped the hospital reduce turn-around times for psych consults from 24 hours to less than 40 minutes, while also ensuring that patients get the appropriate level of care.
mHealth Intelligence: Rhode Island Program Gives Seniors the Support They Need to Use Telehealth (10/6) – Integra is partnering with the Pawtucket Housing Authority and the Rhode Island Parent Information Network (RIPIN) on the program, which provides mHealth-enabled tablets and a bilingual community health worker to help seniors learn how to use telehealth, then connect with a care provider for a scheduled visit. The program was piloted earlier this year at two senior housing complexes in Pawtucket, and is now being rolled out to seniors throughout the city, thanks to a grant from the Rhode Island Foundation. It’s available to any senior in the city, regardless of insurance coverage, whose care provider offers connected health services.
Teladoc Health: Teladoc Health Reimagines Primary Care with Primary360 (10/6) – Teladoc Health announced the Primary360 service — which it has piloted for the past few years — will now be broadly available to commercial health plans, employers, and other benefits sponsors. Teladoc says several large companies use the service now, and it will be available through Aetna next year.
Firefly Health: Firefly Health Launches Health Plan for Employers: (10/4) – Firefly Health announced a virtual-first health plan aimed at small- and medium-sized employers. In addition to providing access to a virtual first primary care team, Firefly provides navigation services to guide people to in-person partner clinics, physician groups, and specialty care when necessary.
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Upcoming Events
October 12, AHIP, “Digital Adoption in Health Care: Reaction or Revolution?”
October 13, AHIP, “Creating a High-Impact Telehealth & Remote Patient Monitoring Program.”
October 19-20, Xtelligence Healthcare Media, “2nd
Annual Connected Health Virtual Summit: Using Hybrid Platforms to Create New Standards of Care.”
October 20, eHI, “Challenges to Delivering (and Receiving) Telehealth Across State Lines.”
October 20, Telehealth Equity Coalition, “Advancing Telehealth Adoption Through Diverse Voices & Story Telling: A Briefing from the Telehealth Equity Coalition.”
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Previous Events
The Hill: “The New Role of Telehealth.” Lawmakers on both sides of the aisle say telemedicine has bolstered access to health care for many Americans since the beginning of the coronavirus pandemic. Speaking at The Hill’s “The New Role of Telehealth” event on Tuesday, Rep. Brad Schneider (D-Ill.), said telehealth gives patients added flexibility and improves “capability and capacity” for providers. “People who use telehealth, both providers and patients, have very much appreciated the opportunity,” Schneider, a member of the Ways and Means Subcommittee on Health, told The Hill’s Steve Clemons.
Healthcare IT News, “Telehealth privacy compliance becomes urgent as emergency waivers sunset.” In this edition of “Workplace Re-Entry in the Healthcare Industry,” healthcare attorney Aaron Maguregui discusses HIPAA and patient privacy in regard to telehealth and his projections for the post-COVID world.
HIMSS TV, “Virtual care regulation can spur, not stifle, innovation.” In this episode of the Virtual Care Paradigm, Nathaniel Lacktman, partner at Foley and Lardner LLP, discusses how regulation can facilitate innovation in the digital health space – and how providers can keep up with changes to come.
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