December 21, 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

Alliance Joins Letter to Hill in Support of Temporary Extension of DEA Waiver in COVID Relief Package: (12/14) – The Alliance sent a letter to Senate and House leaders calling for Congress to extend the Drug Enforcement Administration (DEA) waiver of the prior in-person requirement before telemedicine is allowed for prescribing of controlled substances under the Ryan Haight Act through the end of 2021. The provision is included in the $908 billion Bipartisan Emergency COVID Relief Act of 2020. The letter was also highlighted in mHealth Intelligence, “Our experience during COVID-19 has demonstrated the value of increased access to telemedicine to enable all qualified providers, including Community Mental Health Centers and addiction treatment facilities, to prescribe Medication-Assisted Treatment (MAT) to patients with Opioid Use Disorder (OUD),” mHealth Intelligence quoted from the letter penned by the Alliance for Connected Care.

• Read the Letter to Hill to Support Provisions to Allow Telemedicine Prescribing of Controlled Substances

Wide range of groups call for telehealth in end of year package: The Alliance’s letter last week to Congressional leaders calling for the extension of telehealth flexibilities through the end of 2021 gained media attention this week. The letter was featured in Healthcare IT News and mHealth Intelligence.

• Digital Health Groups Call on Congress to Extend Telehealth Access: (12/11) – The Alliance for Connected Care, American Telemedicine Association, College of Healthcare Information Management Executives, Connected Health Initiative, eHealth Initiative, Health Innovation Alliance, HIMSS and the PCHAlliance called on Congressional leaders to act to preserve access to telehealth as part of an end of year package.

• Read the Letter to Congressional Leaders on Extending Telehealth Flexibilities

Congressional Activity

Permanency for Audio-Only Telehealth Act: (12/18) – Reps. Smith (R-MO) and Cardenas (D-CA) introduced the Permanency for Audio-Only Telehealth Act (H.R. 9035), which would expand accessibility to certain telehealth services under the Medicare program. Full text of this legislation is available on the Alliance website. View the press release.

Op-ed: Sen. Scott (R-SC): Permanently expand telehealth coverage: (12/15) – Sen. Scott (R-SC) this week issued an op-ed highlighting his support for the CONNECT for Health Act and urging Congress pass legislation that would permanently expand access to telehealth. “[E]nacting the CONNECT for Health Act would help us put lessons learned from the pandemic into immediate action and improve our health care system for Americans from all walks of life, particularly with regards to our seniors and those living in rural or underserved communities.”

Federal Updates

HHS Telehealth Innovation Summit: (12/22) – This Summit is designed for leaders to hear from HHS leaders on what they have learned and also for HHS hear from leaders in the telehealth community about challenges and opportunities they face in reimbursement, best practices, public-private partnerships, healthcare resilience, biosecurity and the future of telehealth. The session will provide time for panelists to have a general discussion about their experiences with telehealth during the COVID-19 outbreak. Then there will be breakout sessions where panelists will discuss a certain topic related to telehealth including -- Measuring Successful Outcomes during the COVID-19 Pandemic, Physician Best Practices, Telehealth Policy, Reimbursement Groups, Impact on Value and Access, Innovation, Data, and National Resilience, and Tele-Mental Health.

VA Office of Inspector General (OIG): (12/17) –VA OIG issued a report on the Veterans Health Administration’s emergency department and urgent care center operations during the COVID-19 pandemic. The report also highlights issues and other lessons learned. Specific lessons learned that redesigned the day-to-day operations for how emergency or urgent care can be delivered in a pandemic included increase in space with the use of mobile units that were technologically equipped with video and intercoms for remote monitoring and the pursuit of telehealth options with distribution of monitoring devices to patients for home monitoring including pulse oximetry to measure oxygenation levels and thermometers to measure temperature. View the summary and report.

Center for Medicare & Medicaid Innovation (CMMI): (12/17) – CMS’ Innovation Center released the final evaluation report for the Frontier Community Health Integration Project (FCHIP) demonstration. FCHIP offered critical access hospitals (CAHs) located in eight counties in Montana, Nevada and North Dakota with the opportunity to elect using one or more Medicare payment waivers. Overall, the FCHIP CAHs experienced a large increase in telehealth billing during FCHIP. CAHs reported that telehealth enhanced the community’s access to care by providing a solution to travel distance and transportation barriers to care, and that telehealth services were very well-received by patients. Physical and technical infrastructure barriers to using telehealth were relatively easy to address throughout the demonstration. At the conclusion of the demonstration, six telehealth CAHs gave final evaluation interviews, and all indicated they would continue to provide telehealth after the demonstration. View the one-pager and report.

HHS Agency for Healthcare Research and Quality (AHRQ): (12/15) – AHRQ issued a blog describing expanding telemedicine in the age of COVID-19. The blog notes challenges and opportunities and the importance of developing the evidence base for telemedicine best practices. “This large-scale change in clinical practice is a natural and evolving experiment that can inform best clinical and technology practices. The time is right to take advantage of the vast and varied experiences with telemedicine and expand AHRQ’s agenda to support careful study of the factors which underlie clinical effectiveness, provider proficiency, and patient satisfaction,” the blog states.

Department of Veterans Affairs (VA): (12/14) – VA announced that veterans using the VA’s Video Connect app on their mobile phones through AT&T’s cellular network will no longer incur data charges when using the video telehealth technology to connect and meet with their VA health care providers and teams. In fiscal year 2020 veterans attended more than 3.8 million video telehealth appointments from their homes, representing an increase of more than 1200% when compared to fiscal year 2019.

State Telehealth News

Portland Business Journal: (12/17) – The Oregon Department of Consumer and Business Services announced an agreement with several major insurance plans in the state to extend telehealth coverage and parity through at least June 30, 2021. The Oregon Health Plan will also continue to offer pay parity for telehealth services in addition to commercial payers.

Gallatin News: (12/16) – Tennessee State Representative Lowell Russell announced that a major focus for the upcoming legislative session would be to make telehealth permanent. He believes telehealth has helped to increase access and affordability for Tennessee patients, therefore helping to remove barriers to care and lead to greater health outcomes.

State of Reform: (12/16) – Lawmakers across the State of California have already introduced over 200 bills for the 2021 legislative session and telehealth is likely to be a major focus. Among the bills introduced is AB 32, which would require the California Department of Health Care Services to continue telehealth flexibilities implemented during COVID-19 indefinitely.

Worcester Business Journal: (12/16) – During COVID-19, Massachusetts has led the nation in telehealth appointments, as more patients in the state have chosen to have virtual appointments with their doctors compared to any other state. As of November, 47.6 percent of all medical appointments in Massachusetts took place via telehealth, which is the highest utilization rate in the country.

Papers, Surveys, and Studies

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

PricewaterhouseCooper (PwC) Health Research Institute (HRI): (12/16) – PwC’s annual report found that digital tools and telehealth were among the top health industry issues of 2021. Ninety-two percent of healthcare provider leaders told HRI their organizations are using telehealth for primary care services. The largest share, 68%, said telehealth has been most useful for follow-up appointments. Only 17% of health provider leaders said telehealth was useful for ongoing care management, which may indicate a missed opportunity to help the 11% of consumers who told HRI they are struggling to manage their chronic conditions.

Telehealth News and Market Developments

Intermountain introduces program to monitor COVID-19 patients from home: (12/17) – Alliance Member Intermountain Healthcare has added a Remote Patient Monitoring (RPM) program in all 23 of its hospitals in Utah and Idaho to monitor patients with COVID-19 who don’t meet criteria for hospital admission, but warrant closer outpatient monitoring.

Healthcare IT News: (12/17) – The Boston Medical Center deployed communication technologies to bring care teams, patients and families together to plan healthcare. The tools have helped enable a 40% reduction in avoidable inpatient visits and a 29% reduction in length of stay.

The Hill: (12/16) – Brian Hasselfeld, medical director for Digital Health and Telemedicine at Johns Hopkins Medicine and Dr. Baligh Yehia, senior vice president of Ascension and president of the Ascension Medical Group in St. Louis, MO call for Congress to include the TREAT Act its end-of-year legislation. The TREAT Act (S. 4421/H.R. 8283) would provide temporary license reciprocity for health care professionals in all states for all types of services during nationwide public health emergencies.

Health Affairs: (12/16) – Sean Cavanaugh, chief policy officer and chief commercial officer at Aledade issued a blog discussing what the future for telehealth will look like post-pandemic, and what is needed to support its expansion. “The key is to embed telehealth in a payment system already designed to prevent overutilization,” he states. “That means a payment system that takes into account the total cost of care for a patient; one that rewards providers for keeping patients healthy and reducing wasteful spending.”

mHealth Intelligence: (12/16) – Yale New Haven Health System deployed more than 1,800 connected health devices across the seven-hospital system and studied the effects between March and August. “With what we’ve learned and been able to use telehealth for with COVID, we’ve learned and seen firsthand how effective and useful a tool it is,” says Allen Hsiao, MD, the health system’s vice president and chief medical information officer. “Telemedicine is now simply just medicine, and neither physicians nor patients will want it to go away. It shouldn’t replace all face to face visits, but it is a powerful complementary option when weighing convenience, other benefits, and risks.”

Business Wire: (12/15) – Current Health announced that its remote patient monitoring (RPM) platform will be implemented in the Mount Sinai Health System to help manage care for cancer patients for the first time. The Current Health platform monitors patients continuously and remotely, allowing physicians and nurses to provide enhanced virtual care for high-risk patients from their home.

EP Lab Digest: (12/15) – More COVID cases mean more cardiac episodes that could benefit from remote monitoring. “With cardiovascular injury a long-term effect for COVID-19 survivors, healthcare needs a proven means of telemetry-style remote cardiac monitoring that can facilitate faster interventions and improve health outcomes,” said Infobionic CEO Stuart Long.

CATO Institute: (12/14) – Shirley Svorny is a Professor of Economics Emeritus at California State University and an adjunct scholar at the Cato Institute highlights that the barrier to interstate telemedicine is that physicians must be licensed in every state in which they practice. She calls for Congress to define the location of the practice of medicine as that of the physician. She also notes the Alliance’s recommendation that states participate in interstate licensing compacts that incorporate mutual recognition of state medical licenses. The Alliance is also working to expand interstate licensure through our Medical Excellence Zone efforts.

mHealth Intelligence: (12/14) – Students at the University of Tennessee’s (UT) Knoxville’s College of Nursing will get firsthand telehealth provider communication experience next semester testing out a new virtual care app. The V-Visit Sim app gives students the opportunity to improve their clinical reasoning skills through 35 clinical scenarios in an asynchronous online environment. The app will be used by nurse practitioner students, medical students, physician assistant students, and others working toward becoming advanced practice providers.

Upcoming Events

December 22, 2020, HHS, "Telehealth Innovation Summit." 

January 13, 2021, California Hospital Association, “Licensing and Telehealth Waivers Webinar.”

January 14, 2021, California Medical Association, “Telehealth Series for Small and Medium Sized Practices: Telehealth 2021 Overview.”

January 15, 2021, Center for Connected Health Policy, “Telehealth & Medicaid: Waivers and State Plan Amendments to Address COVID-19.”

January 21, 2021, AHIP, “Innovations to Virtualize Healthy Living Across Care Settings.”

January 22, 2021, Center for Connected Health Policy, “Telehealth & Medicaid: Provider Engagement and Education.”

January 29, 2021, Center for Connected Health Policy, “Telehealth & Medicaid: Patient Engagement and Education.”

February 2, 2021, AHIP, “2021 Perspectives: The Essential Role of Whole Person Virtual Care.”

February 5, 2021, Center for Connected Health Policy, “What’s Next? A Roadmap for Telehealth Policy Beyond the Pandemic.”

Past Events

HIMSSCast, “Common pitfalls of healthcare connectivity and what to do about them.” HIMSSCast host Jonah Comstock talked with Kajeet’s Director of Strategy, Dominic Marcellino, about some of the different roadblocks to secure, reliable connectivity and how to approach tackling them.

Healthcare Strategies Podcast, “Envisioning the Future of Senior Care in Telehealth, In-Person Settings.” As seniors continue to adapt to telehealth modalities, how can health systems best leverage these technologies to empower senior-focused care? Renee Buckingham, president of Partners in Primary Care, discussed her practice’s technology solutions and how technology use in senior care might evolve in the future.

Please subscribe to this newsletter and send any news or events to crystal.wallace@connectwithcare.org for inclusion.