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Source:  WLTX

Funds part of USDA’s $167 investment nationwide to connect areas to high-speed internet

Stephen Miller, CEBS By Stephen Miller, CEBS August 11, 2021
Source: SHRM
Access to telehealth kept people out of hospital emergency rooms, new research shows. That’s likely to result in lower claims costs for employers.

About 1 in 7 people (14 percent) who used telehealth said they would have sought care in an emergency department or urgent care facility if telehealth had not been available, and more than half of those people had their primary health issue resolved using telehealth, based on responses from 1,776 adults interviewed June 28 to July 18, 2021.

The survey, conducted by the Bipartisan Policy Center (BPC) and Social Sciences Research Solutions (SSRS), showed that:

One-third of respondents reported having a telehealth visit for themselves or a dependent last year.

8 in 10 adults said their primary health issue was resolved during their telehealth visit.

The most common purpose for a telehealth visit was a preventive service, prescription refill or routine visit for a chronic illness.

Rural residents said they were more likely to use telehealth for surgical consults than people living in non-rural areas.

The survey also found that more than 9 in 10 adults were satisfied with the quality of their visit and were equally satisfied with both audio and video telehealth visits. Older adults were more likely to use audio-only, telephone services, however.

“New telehealth flexibilities have allowed millions of Americans to access health care from home, and as our survey shows, telehealth has the potential to take non-emergency cases out of the emergency department,” said Marilyn Serafini, BPC health project director.

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By Eric Wicklund

Source: mHealth Intelligence

A Montana Congressman has introduced a bill that would establish Medicare coverage for asynchronous (store-and-forward) telehealth services in all 50 states, expanding the possibilities for a platform that would improve rural access to care.

August 09, 2021 – A Montana Congressman wants to improve rural healthcare access by ensuring Medicare coverage for asynchronous (store-and-forward) telehealth programs throughout the country.

The Rural Telehealth Expansion Act, introduced last week by US Rep. Matt Rosendale (R-MT), would lend credence to a platform that is growing in popularity, particularly in direct-to-consumer telehealth services. Asynchronous platforms allow the patient and provider to connect on their own time (rather than in real time), sharing images, data and messages in a secure portal.

The modality is especially valuable in rural and remote regions of the country where the broadband connectivity needed to conduct real-time audio-visual telehealth visits is unreliable or non-existent. Some states have moved to cover the modality in recent months, but the Centers for Medicare & Medicaid Services still limit Medicare coverage to Alaska and Hawaii.

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By Eric Wicklund

Source: mHealth Intelligence

The Choose Home Care Act of 2021 would expand Medicare coverage for seniors who choose to go home after a hospital stay rather than to a skilled nursing facility. It would also open the door to remote patient monitoring, telehealth and other services.

July 30, 2021 – Home healthcare providers are divided over a bill introduced this week in the Senate that would expand Medicare coverage for seniors choosing home-based services, including telehealth and remote patient monitoring programs, after a hospitalization.

The Choose Home Care Act of 2021, introduced by Senators Debbie Stabenow (D-MI) and Todd Young (R-IN), aims to give more seniors the option to receive care at home for 30 days after a hospitalization, rather than going to a skilled nursing facility or other transitional setting. The legislation would open the door to a variety of home-based services, including skilled nursing, therapy, primary care, personal care, RPM, telehealth, meals, home adaptations and non-emergent transportation.

“The Choose Home Care Act represents a tremendous step forward for Medicare beneficiaries who would prefer to recover at home, but have been previously prevented from doing so under current policy restrictions,” William A. Dombi, president of the National Association for Home Care & Hospice (NAHC), said in a press release. “Given the many benefits of accessing healthcare and support services at home, as well as the importance of protecting vulnerable patients from COVID-19 and other infectious diseases, this must-pass legislation would go a long way to improve seniors’ health in a safe, cost-effective way.”

But not everyone agrees. Amid a flurry of press releases issued after news of the bill’s introduction came out, the American Health Care Association/National Center for Assisted Living offered a strong rebuke.

“We adamantly oppose this bill in its current form,” the group said in a statement. “The complex Choose Home Care Act would supplant existing benefits, create duplicative payments, confuse beneficiaries and increase out-of-pocket costs. At the same time, this legislation lacks clear quality and safety provisions, leaving patients vulnerable to inadequate care.”

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Telemedicine opened up new possibilities for patients with disabilities and chronic conditions.

Three years ago, at age 14, my sister was diagnosed with a rare chronic connective tissue disorder. Her illness makes it extremely difficult—and sometimes dangerous—for her to sit up, walk, ride in a car, and do many other everyday activities. It also means that in order to receive treatment, she has to see specialists who live in other states two or more hours away from our small Vermont town. Even going to see her primary care doctors, ironically, means potentially jeopardizing her health in the process. “It feels like a risk/reward calculation every time we go,” she says.

The pandemic, despite all of its difficulties, did bring some blessings for her: All of her medical appointments shifted online and she was suddenly able to get the care she needed without the risk that going to the doctor would make her condition even worse.

While this shift to telehealth made health care easier and more accessible to everyone, it has had even bigger benefits for many people who suffer from chronic illnesses or have disabilities.

Kiki Christensen, who has suffered from a multi-system illness called Ehlers-Danlos syndrome for 45 years since the age of 10, was able to virtually access 13 new care providers—including two specialists who practice far away from her home in California—who helped her with the many multi-system side effects of her illness. She was also able to save energy during the pandemic by continuing to meet with her regular doctors virtually. 

“Telehealth enabled me to assemble the care team that I’ve always needed,” she says over email. “Instead of the energy deficit required to cross town in a car, I was able to see doctors at home. This enabled me to save enough energy and strength to continue daily at home physical therapy, and to access an online Qigong class that helps me very much. I was also able to knock out my migraines due to the experts at USC Keck. I never would have seen them if it was only in-person because I could not drive to Keck in the past.” 

This change has made a world of difference for Christensen. “I went to Disneyland with my cousin last month,” she says. “I totally shocked myself with how much strength I had gained.”

The broad access to telehealth across state lines was made possible by states waiving medical licensure requirements as a part of emergency orders during the pandemic. These made it possible for health care providers to have appointments with patients in other states.

Now that emergency orders are being lifted, the future of telehealth is unclear.

“One of the big benefits of what happened during the pandemic was an expansion, but it was also a sense of clarity,” said Ateev Mehrotra, a healthcare policy researcher at Harvard, in a late June symposium on telehealth. “We’re about to enter a time where it’s very, very confusing because everyone’s going to potentially have a different set of rules. And for a telehealth provider, that makes things 10 times worse because you have 10 sets of rules for every state you’re in.” 

Now, providers may have to give up their newer virtual patients or jump through a lot of hoops to keep them. And patients who were able to see doctors from the comfort and safety of their homes may have to again make those risk/reward calculations about whether it’s worth traveling to receive care.

The good news is that a number of organizations and states are taking measures to preserve the freedom of care that telehealth has enabled. 

The Interstate Medical Licensure Compact is an agreement among 30 U.S. states that streamlines the complex licensure requirements for medical providers who want to offer telehealth care across state lines. Eligible physicians can use one application to qualify for licenses from all participating states. A similar compact, Psypact, exists for mental health providers. 

Legislators in Connecticut, Arizona, and Delaware have recently passed bills that will allow out-of-state providers to continue to provide telehealth services to those in their states.

There are also two federal bills in progress in the House and Senate that aim to reduce barriers to telehealth. The Senate bill would remove all federal geographic requirements for digital health appointments. 

“Remote access to healthcare was suddenly available for all of us during the pandemic,” says Christensen. “It should have always been available, as soon as the technology permitted. Certainly, we can’t take it away now for the most vulnerable among us.” 

These Allendale County seniors participated in the pilot digital literacy training recently.  On the back row are, from left, Enoch Robinson, Georgia Williams, Henry Singleton, Glinda Smith and Bernice Gill. In front are Jannette Bennett, Mamie Peeples, Geraldine Cohen, Helen Bowers, Mary Edwards and Lavonia Brodus. Photo via PCC.

By Al Dozier, special to Statehouse Report  |  For many seniors in rural areas, getting online is virtually  learning a new language.  But it could vastly improve their health.

Elderly residents in rural areas of Barnwell and Allendale counties recently completed a “literacy learning” program conducted by Palmetto Care Connections (PCC), a statewide, non-profit telehealth organization.

The program was part of a pilot project funded by the Rural Local Initiatives Support Corporation (LISC) and the S.C. Department on Aging to help 100 seniors who live in rural communities with digital literacy training. The program provides each with a free digital tablet plus a free cellular service for 12 months.

Participants took classes at a local senior citizens center where they were provided with the free digital tablet, something many have rarely used.  It’s that table-top device the grandkids are always playing with.

There was some doubt in the beginning about seniors taking on something like digital learning.  But PCC officials said the opposite was true.

“They loved it,” said Kathy Schwarting, CEO of PCC, which is located in Orangeburg.

Some of the participants gave positive comments about the class in a recent news release posted by PCC.

“I enjoyed the class, liked the people and could follow the instructions they gave,” said Leslie Dowling of Blackville. I learned about sending and receiving emails, which is something I didn’t know. It makes me feel real good.”

“I’m planning on using telehealth,” said Harry Singleton of Allendale. “It’s good to have the opportunity to talk to my doctor without having to go to his office.”

Helping seniors connect with health care providers was considered the most important issue, but Schwarting said the program also offered the opportunity to learn how to email friends and family, which was very important to many of the participants.  Some even learned how to play games on the computer.

Senior service organizations throughout the state are familiar with the program.

Shawn Hege, director of Senior Services at Generations Unlimited in Barnwell and Blackville, said: “This program was amazing—a great service to our seniors, especially those who need more interaction. Seeing their faces light up when they connected with family and friends was incredible.”

Soon after the first sessions were offered, Schwarting said many participants asked for longer sessions. Some wanted more classes. She said PCC agreed to those requests.

A statewide model?

The  accomplishments of the program promise change for the state, Schwarting said.

“It is our hope that this pilot program will be a model of one approach to closing the digital divide in South Carolina,” she said.

Seniors from Clarendon, lower Richland and Williamsburg counties are slated to complete the training in the coming weeks as part of the initial pilot program. PCC plans to expand the training for senior and underserved populations throughout the state.

PCC co-chairs the South Carolina Telehealth Alliance, along with the Medical University of South Carolina, serving as an advocate for rural providers and partnering with organizations to improve health care access and delivery for all South Carolinians.

Rural areas are always short-handed for medical needs, according to state officials. They typically have fewer health care resources than other areas — fewer physicians and other providers, fewer facilities and fewer hospitals, if there is one at all. When there is a hospital, it may have fewer, or less intensive, services.

That’s why PCC officials say “literacy learning” has become a critical need.

Ehrhardt, S.C.–Ehrhardt Pharmacy owner and pharmacist Donna Avant, R.Ph., was recently named 2021 Pharmacist of the Year by the South Carolina Pharmacy Association in appreciation for exemplary leadership.

“Donna Avant is truly an extraordinary pharmacist,” said Kathy Schwarting, CEO of Palmetto Care Connections (PCC), a non-profit telehealth network headquartered in Bamberg, S.C. “Donna consistently goes above and beyond to serve the health care needs of Ehrhardt and the surrounding communities not only with prescriptions, but health screenings, chronic disease education and outreach.”

“In 2020, Ehrhardt Pharmacy partnered with PCC to offer telehealth services for their customers,” said Schwarting. “Bamberg Family Practice is currently providing telehealth visits to their patients at Ehrhardt Pharmacy, and Low Country Health Care System as well as S.C. Department of Mental Health plan to begin telehealth services at Ehrhardt Pharmacy soon. The telehealth program is just one example of Donna’s outside of the box thinking and dedication to helping her customers get the health care services they need. On behalf of the PCC Board of Directors and the PCC team, we congratulate Donna on the tremendous honor of being named South Carolina Pharmacist of the Year.”

A graduate of the University of South Carolina College of Pharmacy with a Bachelor of Science degree in Pharmacy, Avant has worked as a pharmacist for more than thirty-three years. Her work history includes pharmacist for Eckerd Drug in Walterboro, S.C.; Wal-Mart Pharmacy, filling where needed at various S.C. locations; Winn Dixie Pharmacy in Hampton, S.C., serving as district manager for more than 35 stores in three states; and pharmacist in charge at Wal-Mart Pharmacy in Barnwell, S.C.

In November of 2013 Avant became the sole owner and operator of Ehrhardt Pharmacy, LLC, a rural independent pharmacy in Ehrhardt, S.C. The pharmacy offers soda fountain with hand-dipped ice cream and home-made milkshakes, gift shoppe, home medical supplies, full-service pharmacy, and drive-thru. In addition, Donna and her staff provide a myriad of community services including: Summer children’s reading/crafting/lunch programs; HIV screenings; immunizations; blood pressure checks; hypertension counseling; free community vitamin program; and lifestyle change classes for individuals with diabetes and pre-diabetes.

For more information about telehealth at Ehrhardt Pharmacy contact the pharmacy staff at 803-267-2121.

Established in 2010, PCC is a non-profit organization that provides technology, broadband, and telehealth support services to health care providers in rural and underserved areas in S.C. PCC received the National Cooperative of Health Network Association’s 2021 Outstanding Health Network of the Year award.

PCC co-chairs the South Carolina Telehealth Alliance, along with the Medical University of South Carolina, serving as an advocate for rural providers and partnering with organizations to improve health care access and delivery for all South Carolinians.