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Ramona Midkiff

Markey urges bipartisanship in push to update broadband plan

By News

Sen. Ed Markey (D-Mass.) said Monday he is hopeful there is bipartisan support in Congress to take action on updating national broadband plans.

His statement underscored the urgency of modernizing the plan to expand internet access as the coronavirus pandemic continues to highlight the digital divide.

“I’ve always believed that, essentially, telecommunications policy is bipartisan — should be bipartisan. You have to work hard to make it ideological,” Markey said during the INCOMPAS Policy Summit.

“My hope is that we’ll be able to really move forward in a way that reflects the ultimate need for bipartisanship,” he added.

On Sunday, Markey and Rep. Anna Eshoo (D-Calif.) reintroduced the National Broadband Plan for the Future Act, coinciding with the 25th anniversary of the 1996 Telecommunications Act which transformed broadband deployment.

Markey and Eshoo’s legislation calls for the Federal Communications Commission (FCC) to update the national broadband plan in a way that addresses concerns highlighted by the coronavirus pandemic.

It would require the FCC to assess the U.S.’s progress in deploying broadband infrastructure since the 25-year-old plan was created, and develop a new roadmap for closing the digital divide.

“I’m proud of the roadmap that my previous provision created and the amazing progress we’ve made over the last decade. However, we still have a ways to go before we finish the job. During the coronavirus pandemic, we are seeing more than ever how necessary robust and affordable broadband is to the future of American life, education, jobs, and medical care,” Markey said in a statement.

Eshoo similarly called attention to issues of the digital divide emphasized by the pandemic, as professional and personal life has largely shifted online.

“From telehealth to remote learning to teleworking, high-speed internet is essential in our day-to-day lives. We must make broadband affordable and accessible for all Americans. That’s why I’m proud to reintroduce the National Broadband Plan for the Future Act to ensure all Americans have broadband,” Eshoo said in a statement.

Sen. Roger Wicker (Miss.), the top GOP member of the Senate Commerce Committee, signaled Republicans are willing to reach across the aisle to update the 1996 law.

“.@SenatorWicker looks forward to working with his colleagues to modernize aspects of the law to accelerate broadband deployment to unserved areas and promote continued investment and innovation in the communications sector,” the committee Republicans tweeted.

Housed within the 1996 law is the controversial Section 230 of the Communications Decency Act, which provides a legal liability shield for tech companies over content posted on their platforms by third parties.

Section 230 has increasingly come under fire from both sides of the aisle. Democrats argue tech companies aren’t doing enough to combat misinformation and hate speech, and Republicans have issued unsubstantiated claims that tech giants are censoring content in a way that demonstrates an anti- conservative bias.

Stay Heart Healthy with Broadband Technologies and Apps

By News

Broadband and heart health go together like peas and carrots. And just like how vegetables are important for a healthy diet, broadband can play a valuable role in heart health. Did you know that heart disease is the leading cause of death for men and women in the United States? Fortunately, though, heart disease is often preventable. Knowing which digital tools are available can help you take steps toward preventing heart disease today.

 

PearYour phone can help you eat a healthy diet: The food you eat goes a long way in preventing heart disease. According to the American Heart Association, a heart-healthy diet should be high in fruits and vegetables, fiber-rich whole grains, fish, nuts, and legumes and low in saturated fat and sugar. There are many recipe apps for your mobile device that can help you plan and cook heart-healthy meals. If you don’t have time for a home-cooked meal, there are also apps that let you quickly look up nutritional information about prepared foods by scanning barcodes with your phone.

scaleCalorie counting apps can help you avoid packing on the pounds: Being overweight can increase your risk of heart disease. The best way to maintain a healthy weight is to balance the amount of energy you take in (calories) with the amount of energy you release (exercise). Keeping track of calories can be tricky, but there are apps to make this easier. Calorie-counter apps help you log the food you’ve eaten and then automatically total and compare to your recommended daily calorie count.

swimWearable fitness trackers motivate you to exercise regularly: As we all know, physical activity has many heart-related benefits. These include lowering blood pressure, reducing bad cholesterol, and helping to maintain a healthy weight. Wearable, watch-like devices that monitor activity and heart rate are becoming increasingly popular for fitness. Many users report that these trackers motivate them to be active, displaying activity data on their mobile phones. Some people even share the information through social media and compare with their friends as another accountability tool for reaching their personal fitness goals.

heartmonitorWireless devices can monitor your blood pressure at home: High blood pressure is a significant risk factor for heart disease, and it can often go unnoticed. Small, wireless blood pressure monitors let you easily and quickly check your blood pressure at home. These devices measure blood pressure from the arm or wrist and send the information to a mobile phone or computer. From there, you can keep track of the results over time and even share with your doctor. This makes it easier to detect a new blood pressure problem or monitor whether a blood pressure medication is working.

Want to Know More? The Connect2HealthFCC Task Force is working to raise consumer awareness about the value of broadband in the health and care sectors. Learn about the FCC’s Connect2Health Task Force and its work on consumer health issues at www.fcc.gov/health. For information about other communications issues, visit the FCC’s Consumer website at www.fcc.gov/consumers.

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50-State Survey of Telehealth Commercial Insurance Laws

By News

09 February 2021

Health Care Law Today Blog

Authors: Nathaniel M. Lacktman Jacqueline N. Acosta Sarah J. Iacomini Sunny J. Levine

For years, Foley has monitored legal policy in the telemedicine and digital health industry, following how advances in technology have coupled with improved state regulations to supercharge the growth of telehealth and virtual care services in the United States. We now share the results of our 2021 50-State Survey of Telehealth Commercial Payer Statutes, which confirm significant legal advancements supporting the industry. The report provides a detailed landscape of the state telehealth commercial insurance coverage and payment laws, and is useful to healthcare providers (both traditional and emerging), lawmakers, entrepreneurs, telemedicine companies, and other industry stakeholders as a guide of telehealth insurance laws and regulations across all 50-states and the District of Columbia (D.C.).

Our first national telemedicine and digital health report was published seven years ago, with this report being our firm’s fourth publicly-available survey on telemedicine.  Our prior reports found one of the most significant barriers to adoption was limited or unclear reimbursement for telehealth and digital health services.  Enter the COVID-19 pandemic, which compelled state and federal policymakers to remove restrictions and expand reimbursement for telehealth and virtual care at a rate previously unseen. The new changes followed the previously established pathway of coverage, but the pace at which they were made was stunning. Medicare introduced nearly 100 telehealth service codes covered on a temporary basis until the Public Health Emergency expires, including payment for telephone-only consults.  States and commercial health plans followed suit.  Although some of the reimbursement expansions are temporary and slated to end when the Public Health Emergency expires, many have already become permanently codified into state law.

Foley’s 50-state survey of telehealth commercial insurance laws examines each individual state and D.C.. We provide the actual language of all the statutes and regulations and have created a multistate table and various heat maps to better illustrate the landscape and give policymakers and industry advocates a macro perspective. Our summaries and analyses reveal trends and patterns, and  highlight subtle but important differences between state law language.

Coverage Provisions

Coverage Provisions Map & Legend

While it is true that clarity of coverage and limitations on reimbursement remain  frustrations for telehealth growth, the legal landscape has materially improved. Currently, 43 states and D.C. maintain some sort of state telehealth commercial payer law; a sea change compared to a decade ago.

Reimbursement Provisions

Reimbursement Provision Map & Legend

In 2021, we anticipate more efforts among states to update their prior telehealth coverage laws to keep pace with the industry’s growth or make permanent those expansions temporarily adopted during COVID-19.

We extend our sincere gratitude to the telehealth advocacy groups, professional associations, academic medical centers, lawmakers, visionary start-ups, bold entrepreneurs, and all the individuals who have helped—and continue to help—make telemedicine and digital health what it is today.

To read the full survey, download the 2021 report.

Want to Learn More?

Visit foley.com/telemedicine for a complete list of events where members of the Foley Telemedicine and Digital Health Industry Team will be speaking.

For more information on telemedicine, telehealth, virtual care, remote patient monitoring, digital health, and other health innovations, including the team, publications, and representative experience, visit Foley’s Telemedicine & Digital Health Industry Team.

This blog is made available by Foley & Lardner LLP (“Foley” or “the Firm”) for informational purposes only. It is not meant to convey the Firm’s legal position on behalf of any client, nor is it intended to convey specific legal advice. Any opinions expressed in this article do not necessarily reflect the views of Foley & Lardner LLP, its partners, or its clients. Accordingly, do not act upon this information without seeking counsel from a licensed attorney. This blog is not intended to create, and receipt of it does not constitute, an attorney-client relationship. Communicating with Foley through this website by email, blog post, or otherwise, does not create an attorney-client relationship for any legal matter. Therefore, any communication or material you transmit to Foley through this blog, whether by email, blog post or any other manner, will not be treated as confidential or proprietary. The information on this blog is published “AS IS” and is not guaranteed to be complete, accurate, and or up-to-date. Foley makes no representations or warranties of any kind, express or implied, as to the operation or content of the site. Foley expressly disclaims all other guarantees, warranties, conditions and representations of any kind, either express or implied, whether arising under any statute, law, commercial use or otherwise, including implied warranties of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Foley or any of its partners, officers, employees, agents or affiliates be liable, directly or indirectly, under any theory of law (contract, tort, negligence or otherwise), to you or anyone else, for any claims, losses or damages, direct, indirect special, incidental, punitive or consequential, resulting from or occasioned by the creation, use of or reliance on this site (including information and other content) or any third party websites or the information, resources or material accessed through any such websites. In some jurisdictions, the contents of this blog may be considered Attorney Advertising. If applicable, please note that prior results do not guarantee a similar outcome. Photographs are for dramatization purposes only and may include models. Likenesses do not necessarily imply current client, partnership or employee status.

Authors

Nathaniel M. Lacktman

Partner

Jacqueline N. Acosta

Special Counsel

Sarah J. Iacomini

Associate

Sunny J. Levine

Associate

These were the specialties that used telehealth the most in 2020: study

By News

by Robert King

A study released this week in the journal Health Affairs gives a look at who flocked to telemedicine from January to June 2020 and what types of patients employed the technology. (Getty/airdone)

Endocrinologists and gastroenterologists were the specialty clinicians that used telemedicine the most last year during the onset of the pandemic, a new study found.

The study, released Tuesday in the journal Health Affairs, gives a look at who flocked to telemedicine from January to June 2020 and what types of patients employed the technology. The COVID-19 pandemic and new flexibility from the federal government led to massive increases in telemedicine use across the healthcare industry.

“Telemedicine use during COVID-19 varied across different clinical settings and patient populations, with lower use found among insurance enrollees in disadvantaged areas,” the study said.

Before COVID-19 hit the U.S., fewer than 2% of clinicians in each of the specialties examined used telemedicine. There was an exception among mental health clinicians like psychologists (4.4%) and psychiatrists (5.5%).

Researchers analyzed outpatient visit volume for telehealth from Jan. 1 to March 17 and from March 18 to June 16—when COVID-19 had spread—last year.

In the COVID-19 period, telemedicine was used at least once by 67.7% of endocrinologists who were surveyed, making them the clinicians that used the technology the most. Gastroenterologists (57%), neurologists (56%) and pain management physicians (50%) also were specialists that used telehealth frequently.

The specialty that used telemedicine the least was optometry, with 3.3% of clinicians using it at least once, and physical therapy was low as well at 6.6%.

Researchers also looked at the characteristics of patients who got care via telemedicine during the period. There were more than 16 million people in the sample. Nearly 80% of the patients were commercially insured, and nearly 90% of them lived in an urban area.

The study also found that telemedicine use was lowest in communities that had a higher poverty rate, with 27.9% of patients in those communities not using it. However, 31.9% of patients that did use telemedicine were from a community with a low rate of poverty.

“There are concerns that increased use of telemedicine during the pandemic may exacerbate health disparities because of the ‘digital divide’ defined as the absence of necessary broadband or smartphone technology among disadvantaged populations,” the study said.

The study comes as the healthcare industry moves to make permanent the explosion of telehealth use caused by the pandemic. Healthcare groups are pressing Congress to make some of the flexibility given by the federal government permanent.

FCC Acting Chairwoman Jessica Rosenworcel Prioritizes Visits to Hospitals in Telehealth Push

By News

Photo of Jessica Rosenworcel in February 2015 from New America used with permission

By:  

February 7, 2021 – Federal Communications Commission Acting Chairwoman Jessica Rosenworcel on Tuesday made a visit to Children’s National Hospital, and a virtual visit to the University of Virginia, to emphasize the agency’s goals of investing in telehealth strategies, with a specific emphasis on serving marginalized communities, veterans, and low-income patients.

Rosenworcel acknowledged that more needs to be done to connect Americans in both urban and rural areas, and that telehealth strategies are often a lifeline for areas that lack significant healthcare infrastructure, “Telehealth can help bridge the gap,” she said, “Problems can be addressed quickly, before they prove life threatening.”

This is true under normal circumstances, but the COVID-19 Pandemic “catapulted” telehealth forward. She stated that to better address the growing demand for telehealth resources, the FCC would remain committed to its goal of expanding affordable broadband access, particularly to low-income and veteran patients.

Roseworcel also emphasized that the need to provide telehealth for marginalized communities and otherwise unspecified communities that have been historically underserved was a top priority for the FCC.

The FCC has implemented several plans designed to address these concerns, and support telehealth initiatives around the country. One such initiative is the Rural Health Care Program. In 2020, the FCC announced that it would provide an additional $197.98 million to the program, providing a total of $802.7 million for the year.

Another critical initiative the FCC is using to achieve these goals is the Connected Care Pilot Program, which, among other things, emphasizes providing relief to veterans and low-income Americans. This program is now operational in 11 states with over 150 treatment sites.

The Connect2HealthFCC Task Force is continuing to engage in data collection and analysis, through initiatives such as Mapping Broadband in America, to determine which regions and communities are most at risk during the COVID-19 pandemic, and how their access to reliable internet could impact them.

Another one of the task force’s endeavors is the Broadband and Cancer Collaboration for Appalachia, a partnership between the National Cancer Institute, the FCC, and other stakeholders I the region, designed to identify how broadband connectivity can impact rural cancer patients living in underserved areas.

In addition to the initiatives they are working on, the FCC has also proposed an $18.7 million fine for those who violate the FCC’s competitive bidding rules outlined in the Rural Health Care Program. The fine would also apply to those who use or attempt to use fraudulent or misleading documentation to seek funding from the Universal Service Fund.

These programs are a part of those emphasized by Rosenworcel in her efforts to close the digital divide between Americans, not just during the COVID-19 Pandemic, but even after the crisis has subsided.

PROGRESS SEPTEMBER 2020 Orangeburg County schools helping expand health care; district teaming up with providers to offer telehealth

By News

After signing a memorandum of understanding, Palmetto Care Connections Chief Executive Officer Kathy Schwarting, left, Orangeburg County School District Superintendent Dr. Shawn Foster, center, and then-Regional Medical Center President and CEO Charles Williams come together for a celebratory fist bump.

DIONNE GLEATON T&D Staff Writer Jan 31, 2021

The Orangeburg County School District developed a mobile application that can link its students and their families with telehealth services.

OCSD partnered with Palmetto Care Connections, a Bamberg-based nonprofit telehealth network; the Regional Medical Center; Family Health Centers Inc. and Bamberg Family Practice for the creation of a S.M.A.R.T. (Students’ Medical Access to Resources in Telehealth) Virtual Health Collaborative.

School officials, along with those from partnering agencies, converged upon the district office in Orangeburg in September to announce the effort.

Under the initiative, a S.M.A.R.T. Virtual Health Collaborative app appears on all district-issued devices and leads to a webpage of telehealth providers. Students and families can also begin accessing telehealth services through the district’s website by clicking on the app and selecting a provider of their choice.

S.M.A.R.T. can also be accessed directly through the following link: www.ocsdsc.org/telehealth. Individuals can also simply go to www.ocsdsc.org, click on Quick Links at the bottom right of the page, scroll down to Parent/Student Resources and click on OCSD – SMART Virtual Telehealth.

OCSD Superintendent Dr. Shawn Foster said it is critical to provide access to health care services to individuals who are not only without transportation, but the necessary technology to access the services remotely.

Foster recalled speaking with then-RMC Chief Executive Officer Charles Williams about the challenge.

“I recall Mr. Williams and his epidemiologist were talking about some of the struggles that they were having here in the community in regard to access, that he had people in this community calling in, wanting to see a doctor,” Foster said.

If the caller said they didn’t have transportation, “the hospital then followed up and would ask, ‘Well, do you have a device to use?’ They said, ‘Well, I don’t have a device. I don’t even have a smart phone.’ So they found themselves in a challenging situation, where they were trying to provide services over the phone, which is not an ideal circumstance,” he said.

Foster said it wasn’t long before the FHC came on board with the telehealth initiative.

An opportunity existed that allowed OCSD to fill a gap in providing services, he said.

“I’ve said since day one that I hope to have Orangeburg in a space where our education is no longer product-driven, that we’re solution-driven.

“When I say product-driven, I mean it’s more than about getting 24 credits and getting a high school diploma. It’s about being an educational institution that is willing to seek solutions to gaps that we have in our community,” he said.

The superintendent thanked the other community partners such as Palmetto Care Connections and its staff, including Director of Technology Matt Hiatt.

PCC is seeking to expand the list of providers in the S.M.A.R.T. Virtual Health Collaborative. There is no expense to medical entities for participation in the collaborative, but there is a request that they provide professional and patient care to those they serve.

PCC Chief Executive Officer Kathy Schwarting said, “Our whole purpose and mission in life is to make sure that rural and underserved communities have access to care. I’ve spent 25 years in rural health care, and I’ve always said that your zip code should not define the quality of service you have, the type of service, or the quality of the life that you live.”

“If you want to live in Orangeburg, Bamberg, Allendale, you should still have access to the same high-quality services. That’s what PCC is built on. … We have helped lots of rural communities in the state implement school-based telehealth, but not with the vision that Dr. Foster has had. So I’m very grateful for that,” Schwarting said.

Pickens Co. passes ordinance to better broadband in underserved areas

By News

by:

Posted: Updated:

PICKENS COUNTY, SC (WSPA)– Approximately $1.6 million will be used to fix some major broadband issues in Pickens County. Many families said the lack of connectivity is a big problem in several areas.

On Monday, the Pickens County Council passed an ordinance to better broadband through an initiative.

“Actually, it’s been very hard,” Jane Wright said. “I can’t even explain how hard it’s been, but it’s been very very hard,” she said.

In an age where a bedroom is the new classroom, and most living rooms are now offices, some like Wright have had problems getting connected.

“I live at the edge of town and I’m ineligible to receive services from Spectrum or from regular AT&T service because the bandwidth where I live at is not strong enough or high enough for me to even have a plan,” Wright said.

Pickens County Administrator Ken Roper said, they noticed the issues last Spring when people were in lockdown during the pandemic.

“When everything was locking down and people were having to talk about doing school from home, or work from home, or telemedicine, and all of those sorts of things, and we started recognizing that you know, we don’t have the internet connectivity in this county that lets us do that sort of thing,” Roper said.

Now, an agreement with Blue Ridge Electric Cooperative Inc., will help with the problem.

“We were able to incentivize the co-op, pay the co-op to connect our buildings and to take those broadband lines through those underserved communities. We’re very excited about this,” Roper said.

Eight different areas in Pickens County have been identified as underserved.

“Those eight areas have relatively high concentration of people, and relatively low access to internet. So they’ve got 20-year-old technology like dial-up internet,” Roper said. “The worst place for that is kind of Highway 93, passed Liberty, towards Norris and the Cateechee community. That area has a lot of people in it, but not a lot of access to broadband,” Roper said.

Some county facilities will help boast the entire community.

“In August, we came up with an idea. That idea was to see if we could find a community partner, someone in the broadband industry, to connect our facilities, the county facilities like the fire departments, the libraries, the recycling centers, the airport. And by connecting those facilities, could we get broadband in those communities that don’t have it,” Roper said.

Roper said the county already has a budget for the broadband initiative.

“The good news there is that Pickens County has a capital reserve, a fund balance is a better way to put it. We have money in the bank. We’ve saved for a rainy day because we’ve been very frugal through the years. So what we’re basically telling Blue Ridge Co-op is, that if you will run the lines in the areas that we know are needing the service the most, that we will reimburse you for each of these eight blocks. Each of these eight areas that are underserved, we will reimburse you $200,000 per area, to run the lines to our facilities,” Roper said.

Now the funding will be a band-aid for many.

“It will be very beneficial, because like I said, a lot of people in the area that I live in, which is on the edge of town, people have no service,” Wright said.

Roper said by the end of the year, Blue Ridge Co-Op plans to have broadband lines up for areas like Liberty and Norris. Once completed, the Sunset community, Dacusville, and Pumpkintown areas will be next in the following months.

Acting Health & Human Services Secretary Signals Extension of PHE through 2021

By News

The Acting Secretary for the U.S. Department of Health & Human Services (HHS) indicated in a recent letter to state Governors that the Department intends to extend the declaration of a Public Health Emergency (PHE) through at least the end of 2021. The Public Health Service Act grants HHS broad authority to issue a PHE declaration that remains active for a 90-day period. In 2020, HHS took a wait-and-see approach to reauthorizing the PHE declarations it issued in response to the COVID-19 pandemic. This meant reevaluating the PHE declaration based on the evolving situation and reauthorizing the PHE declaration near the end of each 90-day period. In addition, the Acting Secretary indicated in the letter that the Department will provide states a 60-day notice prior to the termination of the PHE declaration.

In the Acting Secretary’s own words, this shift is intended to bring “predictability and stability” to states and their public health programs, many of which have tied expiration of their telehealth expansions to the federal PHE declaration. The letter specifically highlights the flexibilities that the PHE declaration affords for the provision of telemedicine services to Medicaid and Medicare beneficiaries. For state Medicaid programs, this will also create some budget certainty with an extension of the Federal Medical Assistance Percentage (FMAP) rate increase set to expire at the end of the PHE.

Current Medicare telehealth flexibilities, such as the removal of the rural requirement and expansion of certain procedure codes and telephone visits, are all scheduled to sunset once the PHE declaration is rescinded. Medicare expanded additional Category 3 procedure codes in the 2021 Physician Fee Schedule that will sunset at the end of the calendar year in which the PHE declaration is terminated (see CCHP’s Physician Fee Schedule Fact Sheet for more information). Based on the Acting Secretary’s letter, this could mean that these flexibilities and expanded services will all sunset by the end of 2021 unless Congress passes legislation to codify them.

The announcement is also likely to have an impact on some private payer’s temporary telehealth policies. A recent Center for Connected Health Policy report titled, An Analysis of Private Payer Telehealth Coverage During the COVID-19 Pandemic, found that several of the largest national insurers that temporarily expanded their telehealth coverage or waived cost sharing for telehealth services tied their expiration to the federal PHE declaration. Under the Families First Coronavirus Response Act (FFCRA), private payers are also required to cover telehealth services that are associated with a COVID-related diagnosis through the end of the PHE.

For more information, view the full letter from the Acting Health & Human Services Secretary.

Tailoring Telehealth to Manage Back to Work and School Programs

By News

Eric Wicklund

Editor
[email protected]

Telehealth is helping businesses and schools bring people back to the workplace and campus, setting the stage for a more sustainable, long-term connected health strategy.

As the coronavirus pandemic continues to wreak havoc on the economy, businesses and schools are taking a look at telehealth to help manage “return to” strategies.

While connected health has long played a part in business health plans and school health programs, the COVID-19 crisis has turned the spotlight back onto direct-to-consumer and asynchronous platforms that allow people to connect with providers on demand. Businesses, schools, even government offices want to use those platforms to screen employees and students before they leave home and to quickly identify and treat those who show up sick.

“Ensuring a healthy and safe workforce actually starts ahead of showing up at the office,” says Kristen Valdes, founder and CEO of b.well Connected Health, one of dozens of connected health companies who have pivoted during the pandemic to launch platforms. “It’s helping employees to attest to the fact that they have not been exposed, that they are not symptomatic. Or if they were previously infected, that they are cleared to return to work.”

“Providing solutions to workers from a digital perspective also enables them to have clear instructions on how to present into the office,” she adds. “So is there a specific door that they should enter? Do they need to have their temperature screened upon entry? Are there certain markings on the floor or walls that they should follow in getting to their desk or their office environment? Are there policies around how many people can be in any one place, whether it’s getting coffee in a kitchen area or in a conference room? Is gathering appropriate?”

This also gives providers and payers an opportunity to reinforce the value of telehealth and mHealth services beyond the pandemic and back-to work and school programs, shifting the focus from identifying a potential illness to offering on-demand health and wellness services.

For Providers, A Community Service

As health systems, hospitals and medical practices look to recover from the stresses of the coronavirus pandemic, some see back-to-work and school programs as a means of re-engaging with the community. Many, if not all, were forced to shut down or severely curtail in-person care during the height of the crisis, and these programs offer a chance to reconnect with the public.

“Health systems should be poised to provide expert resources and clinical knowledge, including sophisticated infection control processes and procedures to guide employers and schools through the overwhelming amount of information and often conflicting guidelines available in a hyper dynamic landscape,” says Lori Japp, PA-C, vice president of urgent care and employer solutions for Colorado’s UCHealth.

Japp says healthcare providers can create virtual clinics in businesses and schools, allowing management to screen employees or students coming into the facility and triage anyone who might exhibit signs of infection. They can also help set up remote patient monitoring programs to treat those workers and students who are sent home.

In addition, those telehealth platforms can be used to treat other concerns as well. This is especially important as providers look to restart primary care, chronic care management and elective services that have been delayed or ignored.

“Our virtual clinics allow employers and academic administrators access to timely on-site intervention for common situations such as workplace injuries, illness, and other urgent care needs without having to send the employee or student to another facility for care,” Japp says. “In addition to being on-site, these services can be accessed remotely and virtually, synchronously and asynchronously.”

Japp says the changing nature of the pandemic makes it important for businesses and schools to partner with health systems, so as to gain access to the latest information on diagnosis and treatment.

“The landscape is continuously changing with new research, guidance, policies and procedures, making it prohibitive for a small- or medium-size business or school to keep up in the context of a possibly unknown financial future for both employers and universities,” she says. “Allocation of resources is changing in the workplace with more employees and students working remotely, which changes workplace dynamics.”

In the future, she expects health systems to expand their testing capabilities and RPM programs to not only avert another pandemic, but to help businesses and schools maintain a healthy workforce and stay ahead of seasonal problems like the flu.

Synchronous versus asynchronous telehealth

Asynchronous, or store-and-forward, telehealth enables two parties – patient and provider or provider and provider – to exchange information and images on an online platform at their convenience. It differs from synchronous telehealth in that the latter occurs in real-time, often on an audio-visual platform.

Integrating Back to Work Telehealth Into Health Plans

Payers are also gearing up to help members ease their way back into work and school.

“We see a real advantage in having the right care available at the right time,” says Diane Wolfenden, a regional vice president for Michigan-based Priority Health. “Telehealth gives us an opportunity to be more innovative, and to create access points that people prefer.”

Learning lessons from COVID-19, health plans large and small are pivoting toward healthy workplace initiatives that emphasize on-demand virtual care – not only for primary care services, but also behavioral health. Some studies have noted that access to mental health services will be even more necessary as people deal with the stress and anxiety of returning to the office, factory floor, store or school.

With telehealth and mHealth, Wolfenden says, health plans also have the opportunity to communicate more often with their members.

“You can’t just send out an e-mail or an article and say ‘That’s good,’” she says. “Accessibility is going to be important, whether we’re in a pandemic or not.”

By focusing on back-to-work and school programs, payers can increase their touch points with members, first focusing on testing and on-demand access to care. Those conversations can then evolve into health and wellness advice, appointment and medication reminders, even discussion about societal and social factors – the so-called social determinants of health – that can affect long-term health.

“During COVID we were (focusing on) messages on the need to not put off or cancel healthcare, and on offering support, especially in behavioral health,” Wolfenden says. “Now we can use those (channels) to keep the conversation going, improve those touches and boost engagement.”

Creating a New Market for Connected Care

Telehealth vendors are also pivoting to address the need for back-to-work programs. Some have fine-tuned asynchronous, orstore-and-forward, telemedicine platforms that allow employees to fill out a questionnaire at home, after which they’re directed to the appropriate care – a telehealth visit, scheduling for an in-person appointment, or resources that might include directions to the nearest COVID-19 testing center or information on vaccines, health plan benefits, even mental health services

For companies new to the idea of offering telehealth, this opens the door to a wide range of preventive health and wellness services.

“The important thing is providing choice,” says Valdes, of b.well Connected Health. “More and more employers are able to offer those choices. So if I am someone who has indicated that stress is my biggest overall health concern, I may be interested in trying out a mindfulness and meditation app to control anxieties. Or, I might want a telehealth visit with a behavioral health specialist where I can actually talk one-on-one with someone without taking time off work or sitting in a physician office. And therefore, we can use consumer likelihoods and preferences to provide that combination of in-person virtual and digital care. Everything from digital therapeutics like Headspace or Calm or Ginger for telehealth. That’s how we enable people to engage in their overall health from work or from home.”

This also addresses a trend seen in telehealth before COVID-19 surfaced: the need to tailor platforms to individual needs.

“I think a common mistake is providing a one-size-fits-all solutions,” she says. “We are individuals, each one of us, with our own preferences and our own needs. So if you said to a population, ‘We want you to use this telemedicine or this test or this location,’ there are going to be people who don’t agree with that.”

“So a lot of mistakes and incorrect assumptions are assuming that an entire population will follow one program,” Valdes adds. “And that’s why choice is so important. Employers really need to think about providing optionality. Don’t think about one solution provider and one program, think about putting together a program that offers choice that gives that one centralized launching point through a central platform so they know that it’s supported by the organization as a whole.”

Making Telehealth Work for Returning Employees

To be sure, business and schools – and everyone else, for that matter – are dealing with situations they haven’t encountered before. Few, if any, have had to implement programs that test and substantiate one’s health before they leave home.

Telehealth and mHealth tools give them that opportunity, as well as the freedom to design a plan that meets their needs now and well into the future.

“Every employer is different,” Valdes points out. “Some employers have essential personnel that must return. Others have entire populations of people who can work from home remotely for an indefinite period of time. Let’s go back to the example that I gave around when you show up to work, are you required to have a mask? Will one be provided? Are you required to sanitize and get your temperature taken or not? It’s very difficult for providers and payers to configure and customize these programs specific to an employer.”

“And each employer also has specific local and state mandates that they have to follow in addition to federal mandates,” she concludes. “So it’s important to know that whether you partner with a healthcare provider or a payer, or you build your program on your own, that you have the needs of your program defined that are specific to your own organization and that whoever develops your program has the ability to customize and very quickly also change. Because requirements are changing, as you know, sometimes day by day when it comes to COVID.”