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– Community health centers will need a good grasp of telehealth to survive both the coronavirus pandemic and what lies beyond.
That’s the take-away from a new article in Health Affairs, which notes the lack of telehealth adoption prior to COVID-19 and outlines three steps that should be taken to bring CHCs, which serve more than 28 million underserved Americans, up to speed with connected health.
(For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.)
That strategy may be crucial. While federal and state governments have taken steps to boost telehealth adoption during the ongoing pandemic, CHCs, federally qualified health centers and rural health centers have in many cases struggled to use the technology because they hadn’t laid the groundwork prior to the pandemic. Meanwhile, with the nation in the midst of an economic slump and hundreds of thousands without jobs, these health centers will likely see a surge in traffic as more and more people lose their health insurance.
The Health Affairs article, written by June Ho-Kim of Brigham and Women’s Hospital (and a primary care physician at Upham’s Corner Health Center, a FQHC) and Eesha Desai and Megan Cole of the Boston University School of Public Health, points out that only 38 percent of the nation’s 1,330 CHCs were using telehealth in 2016, and two years later that number had only jumped to 44 percent.
READ MORE: New Bill Aims to Give FQHCs, RHCs Relief From Telehealth Paperwork
Of the 56 percent not using telehealth in 2018, only one in every five was giving it any thought. And of the 44 percent using telehealth at that time, roughly 70 percent were providing telemental health services and 47 percent were using it for specialist consults – and only 30 percent were using telehealth for primary care and 21 percent were offering chronic care management services.
Furthermore, CHCs faced significant barriers to adoption telehealth. The top three were lack of reimbursement – prior to COVID-19, Medicare didn’t reimburse for telehealth services at these centers and didn’t recognize them as a distant site for telehealth delivery – lack of resources and lack of training. In rural areas, meanwhile, almost 20 percent didn’t have the broadband connectivity to support telemedicine technology.
The COVID-19 emergency changed that dynamic. With the pandemic reducing in-person care and putting the onus on remote care, CHCs saw their in-person visits plunge and were forced to lay off staff, reduce hours or even close. Federal and state governments responded with a barrage of emergency measures aimed at reducing the barriers to telehealth and boosting reimbursement.
“While an important first step, policy makers cannot simply infuse more funding to CHCs and expect them to withstand the challenges of the COVID-19 era,” the article points out.
It offers three “targeted strategies” for improved telehealth adoption:
- Mandate payment parity for all telehealth services, not only during COVID-19 but beyond.
READ MORE: Coronavirus Grant Gives Massachusetts FQHCs a Chance to Embrace Telehealth
“Without commensurate reimbursement for telehealth, CHCs cannot maintain patient volume or make the long-term investments necessary to remain financially viable,” the article states. “A ‘ of paying CHCs a fixed payment per patient per month would give practices flexibility in how and where to treat the patient, although this may be politically and practically challenging. Meanwhile, payment parity has already been implemented and could simply be permanently codified into existing reimbursement schemes, giving providers the option to select the best mode of treatment without making financial trade-offs.”
- Provide funding and guidance for telehealth adoption.
This includes hardware and software, broadband access and training, and ancillary systems to handle traffic on different channels, such as phone and video.
“Adding robust protocols and systems will allow for the successful implementation and scaling of telehealth,” the article states.
- Provide support so that CHCs can reach vulnerable, underserved populations.
This would include funding for translation services and support for patients not familiar with the technology. Payers, meanwhile, should provide support for patient care navigators and waive any requirements that place geographic or original site restrictions on telehealth and that mandate audio-visual platforms.
Finally, local governments should offer mHealth devices to underserved populations and create internet hotspots and charging stations to improve access. Insurers could support these efforts with reimbursements through the Federal Communications Commission’s Lifeline program.
READ MORE: CMS Clarifies New Telehealth Services and Coverage for FQHCs, RHCs
“COVID-19 may pose long-lasting damaging effects on CHCs and the patient populations that they serve,” Kim, Desai and Cole write. “Nonspecific federal and state funding will allow CHCs to survive; however, deliberate action is needed to enhance telehealth capacities and ensure long-term resilience.”
“By reorienting the goals for implementing telehealth, policy makers, payers, and providers can empower health centers to thrive into the future and meet the nation’s underserved patients where they are, even during the pandemic,” they conclude. “In the long run, telehealth can increase access and equity – but only if the right investments are made now to fill the gaps laid bare by COVID-19.”
An analysis of insurance claims shows just how heavily the country has relied on telehealth during the COVID-19 crisis.
Private health care claims data shows that telehealth usage has surged amid the coronavirus pandemic.Getty Images
Since the COVID-19 pandemic began, it’s been expected to drive notable growth in telehealth. The remote delivery of clinical services via telecommunications technology, telehealth allows patients to “visit” health care providers while avoiding the in-person contact that may put them at risk of coronavirus transmission. Telehealth also helps meet the need for expanded health care resources during the pandemic. Federal and state governments and private health insurers have taken action to increase access to telehealth during the crisis.
Before this pandemic, my experience with remote health care was limited to a few phone calls to doctors’ offices to discuss prescription refills or to confirm no new symptoms after starting a new medicine.
Now, I have two telemedicine appointments under my belt and here’s my personal verdict — it’s strange, but definitely something I could get used to.
The benefits of being able to consult with a medical professional from the safety of my own home, in a time when we are all actively trying to avoid a highly contagious and deadly virus percolating through society are undeniable.
Typically, when I schedule any kind of appointment, I do my best to pick a time slot that is very early in the morning or late in the afternoon because I know that although I will only get about 20 minutes of face time with an actual medical professional, the whole experience is bound to throw a monkey wrench in my day.
It will take me up to 30 minutes with traffic to drive to the doctor’s office. Then, even though I arrived 15 minutes early as instructed, I will spend about 10 minutes filling out the same four forms I’m asked to complete upon every visit, and another 15 to 20 more minutes just sitting in the waiting room, watching and listening as other people are called back to exam rooms. The wait might feel even longer if I’m seated near someone who is quite clearly there for a consultation regarding some kind of horrific and potentially communicable cough-inducing sickness, and not just a routine check up like me.
When my name is eventually announced, I will be guided to a room where I will wait some more. Sometimes I will only spend about 10 more minutes sitting on an exam table, crinkling that thin paper covering with every fidget. Sometimes it’ll be more. Then following a brief, very familiar chat with my doctor and a friendly nurse, I will hop back in my car and spend another half hour racing to get back to my office, or to get home before hunger turns into road rage.
For my recent telemedicine video call, all I had to do was walk to my couch, log onto my computer and click a link. My doctor appeared on my screen right at the scheduled appointment time, and we ran through the expected questions and chatted casually about my overall well being and how I’ve been coping during this particularly wild time. And that was it. The whole experience took less than a half hour, then I was able to get right back to work.
Granted, there were parts of the visit that were a bit odd and unfamiliar. Like the fact that I had to send my doctor a selfie so that she could more closely examine my eyes and face. But by and large, I didn’t feel that I missed out on anything by not completing the visit in person. In fact, I was more at ease about the encounter because I was more comfortable in my home environment, free from worry that anyone I was sharing a waiting room with might have Covid-19 or any other infectious disease. And I’ve never been crazy about the idea of paying the copay for a visit that sometimes feels like it could have been done via email anyway.
I understand that there are some medical encounters that will continue to be necessary to conduct in person. I’m no doctor, but I imagine it would be a little tricky to complete a thorough eye examination or a mammogram remotely.
Still, as the public adjusts to a slew of new practices taking hold in the health care arena amid Covid-19, I take comfort in the knowledge that I can access the same quality care from just a click away instead of a 30-minute drive. Maybe it’s the technology-and-ease-of-access-loving millennial in me, but I expect and hope this ongoing mass migration to telemedicine will leave a lasting mark on our collective interactions with this industry.
American drugmaker Pfizer has claimed that a COVID-19 vaccine could be ready by October-end this year. The pharmaceutical company is conducting clinical trials with German firm BioNTech on several probable vaccines in Europe and the United States.
“If things go well, and the stars are aligned, we will have enough evidence of safety and efficacy so that we can…have a vaccine around the end of October,” Pfizer CEO Albert Bourla
The report also cited UK drug firm AstraZeneca’s head Pascal Soriot who said that one or more coronavirus vaccines could start rolling out by the end of this year (2020). AstraZeneca is working in partnership with the University of Oxford to develop and distribute a vaccine being piloted in Britain.
Also Read: Coronavirus vaccine: Indian researchers make breakthrough; 6 candidates in the works, says govt
“The hope of many people is that we will have a vaccine, hopefully several, by the end of this year,” Sorio was quoted in the news report as saying. He, however, added, “we are running against time”.
The report also underlined the warnings from experts around the challenges that could be “daunting” as it evaluated that approximately 15 million vaccine doses would be needed to stop the COVID-19 pandemic.
The news report also quoted Soriot as saying that one of the concerns in developing a vaccine was the falling transmission rates as it would be hard to properly carry out clinical trials of the COVID-19 vaccine in a natural setting.
The report further added that globally over 100 labs are working to develop a vaccine against coronavirus, out of which 10 have reached the clinical trial phase. COVID-19 has claimed more than 3.5 lakh lives and infected over 5 million people globally so far.
For Immediate Release
FCC APPROVES NINTH SET OF
COVID-19 TELEHEALTH PROGRAM APPLICATIONS
Commission Continues Approving Telehealth Funding During Coronavirus Pandemic
—
WASHINGTON, June 3, 2020—The Federal Communications Commission’s Wireline Competition Bureau today approved an additional 53 funding applications for the COVID-19 Telehealth Program. Health care providers in both urban and rural areas of the country will use this $16.46 million in funding to provide telehealth services during the coronavirus pandemic. To date, the FCC’s COVID-19 Telehealth Program, which was authorized by the CARES Act, has approved funding for 238 health care providers in 41 states plus Washington, D.C. for a total of $84.96 million in funding.
Below is a list of health care providers that were approved for funding:
- Access Health Louisiana, in Kenner, Louisiana, was awarded $930,098 for laptop computers, tablets, network upgrades, telehealth equipment, and a telehealth platform and software licenses and will use the funding to reduce COVID-19 transmission and increase care for COVID-19 patients as well as to expand at-risk and vulnerable patient access to telehealth services.
- Airline Children’s Clinic, in Houston, Texas, was awarded $58,312 to support the purchase of a telemedicine cart, laptop computers for health providers and tablet computers for patients, and remote patient monitoring equipment to immediately establish and deliver telehealth services to triage COVID-19 suspected cases, treat, support, and monitor COVID-19 confirmed cases, and develop a long-term telehealth service for patients that may have mobility issues due to age or chronic medical conditions.
- Avenel Community Health Center, in Lemoore, California, was awarded $194,700 for telecommunications network improvements to help deploy a telehealth platform and expand telehealth offerings during the COVID-19 pandemic and for remote blood pressure machines to monitor patients with chronic health conditions.
- Betances Health Center, in New York, New York, was awarded $122,710 for laptops, tablets, phones, mobile hotspots, video conferencing software and equipment, and remote monitoring and diagnostic equipment to maintain access for the patient population to primary care and behavioral health services, to keep patients engaged throughout the COVID-19 pandemic, including by using telehealth, to address patient mental health disorders that have been exacerbated by the pandemic, and to free up hospital resources for those with COVID-19.
- Boulder Community Hospital, in Boulder, Colorado, was awarded $638,842 for video visit workstations for the hospital, telehealth platform software licenses, and remote monitoring equipment to provide home monitoring for COVID-19 patients and other high-risk patients, video visits for ambulatory, primary care, and urgent care clinics to screen for COVID-19, and tele-hospital visits that allow patients in the emergency department and inpatient units to use their own device to have a video visit with a physician.
- Callen-Lorde 18th Street Clinic, in New York, New York, was awarded $917,255 for mobile hotspots, tablets and laptop computers for providers and patients, telehealth and conferencing equipment, and other software licenses to enable patients and health care providers to access the technology and connectivity necessary for remote delivery of primary care, behavioral health and dental care to patients sheltering-in-place as well as patients facing access barriers, including technological barriers.
- Catholic Health System of Long Island, in Rockville Centre, New York, was awarded $141,397 for telemedicine carts, tablets, video monitors, and telehealth platform licenses to implement a tele-intensive care unit for the treatment of COVID-19 patients, conduct video and audio telehealth visits to screen patients, and employ an outpatient COVID-19 post-hospitalization unit, which will function as a virtual extension of the care offered when the patient was hospitalized.
- CCI Health and Wellness Services, in Silver Spring, Maryland, was awarded $618,628 for telemedicine carts, computers, tablets, sign language and language interpretation services, call center subscription services, telehealth and videoconferencing software licenses, and remote monitoring equipment to enable health care providers to continue to provide high quality medical services, such as primary care, pediatric, and behavioral health services, to over 33,000 patients quarantined at home because of the COVID-19 pandemic.
- Chehalis Clinic, in Chehalis, Washington, was awarded $451,400 for network upgrades, remote patient monitoring devices, laptop computers, and tablets to upgrade telecommunications infrastructure and expand telehealth opportunities in response to the COVID-19 pandemic at three clinics offering primary, behavioral health, and dental care.
- Clarke County Hospital, in Osceola, Iowa, was awarded $170,072 for tablet computers, network upgrades, and remote monitoring equipment to offer telehealth from home for potential COVID-19 patients and to provide telehealth video units in patient and exam rooms to minimize provider-patient contact and preserve personal protective equipment.
- CNS Healthcare, in Novi, Michigan, was awarded $152,075 for laptop and desktop computers, smartphones, and other telecommunications equipment to use telehealth and connected devices to treat children, adolescents, and adults with mental health and serious emotional disorders who are unable to receive services at a clinic due to COVID-19.
- Community Counseling Services, in Malvern, Arkansas, was awarded $40,850 for tablets, phones, remote monitoring equipment, and telehealth subscriptions to provide video consultations for behavioral health and substance abuse counseling sessions provided via telehealth.
- Community Mental Health Centers of Warren County, in Lebanon, Ohio, was awarded $67,979 for tablets, headphones, laptop computers, webcams, and telehealth stations to be able to connect via telehealth with patients during the COVID-19 pandemic.
- Compass Behavioral Health, in Garden City, Kansas, was awarded $23,025 for laptop computers and tablets to use telehealth and allow patients access to medical providers and other medical staff to address mental health needs, including increased anxiety and depression due to isolation from stay at home orders.
- DeSoto Regional Health System, in Mansfield, Louisiana, was awarded $240,390 for a telemetry video system, tablets, desktop computers, and connected telemedicine devices to provide COVID-19 screening, treatment, and follow-up for patients and to be able to evaluate, speak, and continuously capture vital signs, without having to enter the patient’s room.
- Duncan Regional Hospital, in Duncan, Oklahoma, was awarded $56,266 for teleconferencing equipment and software licenses, and remote monitoring equipment to expand telehealth offerings for primary care and mental health patients by sending equipment home with chronic patients to allow home care monitoring and communication with medical staff during the COVID-19 pandemic and, after the pandemic, to provide better care in rural locations.
- Eastern Shore Rural Health System, in Onancock, Virginia, was awarded $174,634 for laptops, tablets, and telehealth equipment to be used by medical providers for audio and video telemedicine visits due to COVID-19 to offer chronic disease management, address disease control, help with medication tolerance, provide pediatric services virtually, and conduct remote assessment of patients with suspected COVID-19.
- Excelsior Youth Center, in Spokane, Washington, was awarded $96,500 for tablets, telehealth equipment and software, and telecommunications equipment upgrades to employ remote consultations and screening for COVID-19, and telehealth monitoring and treatment to help patients with chronic disease management, mental health services, and other routine and urgent medical needs.
- The Family Center, in Brooklyn, New York, was awarded $49,855 for desktop computers, network upgrades, and software licenses to use telehealth resources to provide behavioral health services to vulnerable families living in some of the most impoverished communities in New York.
- Family Health Services, in Twin Falls, Idaho, was awarded $284,739 for tablet computers, headphones, telehealth software licenses, and floor stands to implement enhanced telehealth procedures for primary care and behavioral health appointments to reduce exposure to the COVID-19 virus.
- Family Pride of Northeast Ohio, in Chardon, Ohio, was awarded $8,013 for laptops and tablets to provide outpatient behavioral health treatment via telehealth for families and seniors without access to telehealth hardware.
- The Floating Hospital, in Long Island City, New York, was awarded $47,658 for video conferencing equipment and software, computers, and network equipment to offer remote consultations, treatment, and monitoring for patients requiring intensive primary care, many of whom have no access to Medicaid or other insurance, such as low-income families, homeless families, and families living in domestic violence safe houses throughout New York City.
- Health Care Partners of SC, in Conway, South Carolina, was awarded $156,293 for laptops, tablets, telehealth video and audio equipment, and network upgrades to increase the ability to offer telehealth consultations and remote monitoring for primary care, behavioral health, and dental and other patient needs.
- Heart of the City Health Center, in Grand Rapids, Michigan, was awarded $493,586 for a telehealth platform, network upgrades, telecommunications equipment, laptops, and tablets to offer healthcare to vulnerable populations during the COVID-19 public health crisis and for years to come via a greatly expanded telehealth platform that will reach many more patients.
- Hilltop Regional Health Center, in Tacoma, Washington, was awarded $534,139 for laptops, telehealth equipment and software, and network upgrades to provide care to patients with COVID-19 in a manner that maximizes patient and staff safety, to patients with limited transportation, and to patients in need of ongoing care due to chronic conditions or behavioral health needs.
- HopeHealth, in Florence, South Carolina, was awarded $423,645 for remote monitoring equipment and telemedicine carts that will be stationed at 10 clinic sites throughout four counties so providers exposed to COVID-19 that are required to self-isolate can continue seeing patients, and patients that are most vulnerable to the virus can be seen at home via telehealth remote monitoring devices for care coordination and medical tracking.
- Hough Clinic, in Cleveland, Ohio, was awarded $560,356 for computers, connected devices, a remote patient interface platform, and network upgrades to enhance the ability to provide remote consultations and remote patient monitoring and treatment to patients who have chronic diseases and are at high risk for contracting COVID-19.
- Howard University Hospital, in Washington, D.C., was awarded $881,958 for telemedicine carts and associated software licenses, tablets, and network upgrades to deploy in-patient telemedicine services in the Emergency Department, Intensive Care Units, and medical/surgical departments treating patients with and without COVID-19 symptoms, including remote video and voice consultation and treatment of all patients to reduce the possibility of transmission.
- Labette Center for Mental Health Services, in Parsons, Kansas, was awarded $41,619 for tablets, laptop computers, monitors, telehealth equipment, and conferencing software licenses to offer telehealth services such as video and voice consultations, mental health therapy and treatment, and remote treatment and monitoring.
- Lakeland Regional Health System, in St. Joseph, Michigan, was awarded $351,175 for telemedicine carts, tablets, telehealth and remote monitoring equipment, telehealth software licenses, and network upgrades to facilitate remote monitoring of ICU beds at all hospitals in the system and to expand telehealth infrastructure to allow all 350 health care providers to see patients virtually.
- Lifeline Connections, in Vancouver, Washington, was awarded $49,580 for laptop computers and software upgrades to enhance the ability to use telehealth capabilities to address the significant increase in demand for behavioral health services caused by the COVID-19 disease.
- LifeSkills, in Bowling Green, Kentucky, was awarded $491,818 for laptops, network upgrades, and telemedicine software to expand telehealth capabilities throughout an 18-county region in rural Western Kentucky by providing assessments, therapy, medication management, and other behavioral health treatment for the intellectually or developmentally delayed population.
- Lisbon Community Health Center, in Lisbon, Ohio, was awarded $376,191 for laptop and desktop computers, tablets, telecommunications system upgrades, telehealth equipment, and remote monitoring equipment to offer telehealth medical, dental, behavioral health, women’s health, and medication-assisted treatment services in five locations to contain the spread of COVID-19.
- Lorain County Alcohol and Drug Abuse Services, in Lorain, Ohio, was awarded $26,922 for laptops, tablets, internet service, telehealth equipment, and software to provide addiction and mental health outpatient treatment, counseling and prevention services.
- Martin Luther King, Jr. Family Clinic, in Dallas, Texas, was awarded $294,368 for remote monitoring and diagnostic equipment, telehealth software licenses, laptops and tablets, mobile hotspots, and network upgrades to allow health care providers and other clinical staff to consult and monitor patients remotely.
- Meharry Medical College, in Nashville, Tennessee, was awarded $718,752 for desktop computers, tablets, mobile hotspots, a telehealth platform, and internet access to use for screening low-income and elderly patients with symptoms suggestive of the COVID-19 infection or at a high-risk for complications from infection with the COVID-19 disease.
- Memorial Hospital, in Logansport, Indiana, was awarded $103,457 for laptop computers, tablets, web cameras, and telehealth software licenses to enable patients to interact with health care providers remotely and decrease the necessity for physical visits to the hospital and health care providers to consult with and remotely monitor a COVID-19 patient without physically coming in contact.
- Mental Health Association of Essex and Morris, in Montclair, New Jersey, was awarded $39,959 for phones, wireless data service plans, and telehealth software to offer mental health services to patients using telehealth technologies to reduce the chances of spreading COVID-19.
- Minnesota Community Care, in St. Paul, Minnesota, was awarded $498,818 for laptops, phones, remote monitoring equipment, and software licenses to increase telehealth capacity at several clinics, including for COVID-19 testing, treatment and referral, and to expand patient access to telehealth with internet connected devices.
- Positive Directions, in Westport, Connecticut, was awarded $9,420 for laptops and telehealth software licenses to provide seamless telehealth services at the outpatient clinic providing therapy and medication management services to adolescents and adults with psychiatric and substance abuse disorders.
- Providence St. Joseph Health Consortium, in Renton, Washington, was awarded $1,000,000 for telemedicine carts, telehealth monitors, and internet access to offer two-way audio/video provider-to-patient consultations and clinical assessments for use in emergency departments and intensive care units across the entire health system and to permit quarantined medical personnel to evaluate patients from a remote location.
- Rochester General Hospital, in Rochester, New York, was awarded $794,909 for videoconferencing software, remote monitoring equipment, tablets, and network upgrades to increase capacity across the entire health system for remote monitoring of patients, including patients who are isolating at home, and to prevent the spread of COVID-19 by transitioning its non-clinical workforce to remote settings.
- RotaCare Bay Area, in Milpitas, California, was awarded $159,022 for laptops, tablets, and remote monitoring equipment to enable physician volunteers to offer services remotely throughout the Bay Area to high-risk patients at their home without the risk inherent in leaving their homes to visit clinics and to average-risk patients who opt to connect through the telehealth network.
- Luke Hospital, in Marion, Kansas, was awarded $15,941 for laptop computers and tablets to continue serving patients during the COVID-19 pandemic by using telehealth for consultations and other routine treatment for an aging population that may have limited access to technology at home.
- Singing River Services, in Gautier, Mississippi, was awarded $414,717 for laptop computers, mobile hotspots, phones, network and telecommunications equipment upgrades, and software licenses to treat remotely and safely children and adults who have been diagnosed with a mental illness, including patients with the COVID-19 virus, and who have other behavioral health challenges.
- Sixteenth Street Community Health Center, in Milwaukee, Wisconsin, was awarded $257,284 for telemedicine carts, network upgrades, telehealth software, remote monitoring equipment, and telehealth equipment to provide pediatric, primary care, obstetrics, and psychiatric medical services to non-COVID-19 patients without requiring them to leave their home and to offer testing and follow-up monitoring and care via telemedicine visits for COVID-19 positive patients.
- Southeast Community Health Systems, in Zachary, Louisiana, was awarded $561,131 for tablets, phones, mobile hotspots, and remote monitoring equipment to treat symptomatic COVID-19 patients via telemedicine to reduce exposure, to expand the telehealth program to diagnose and treat high-risk and chronic patients, and to use connected devices to improve patient health outcomes.
- Southwest Mississippi Mental Health Complex, in McComb, Mississippi, was awarded $659,092 for telehealth carts, computers, tablets, telehealth software licenses, network upgrades, and remote monitoring equipment to increase the availability of telehealth services for treatment of substance abuse and mental health services across an eight-county region, with an emphasis on COVID-19 patients and families, as well as front line workers caring for COVID-19 patients.
- University of Louisiana-Lafayette, in Lafayette, Louisiana, was awarded $271,850 for a telemedicine cart and tablet computers that will provide a technology platform to expand access to telehealth, reduce the demand on emergency rooms and urgent care clinics, establish a telemedicine service for employees, faculty, and students, and improve health outcomes of employees, faculty, and students who test positive for COVID-19 through daily remote monitoring.
- Vantage Health System, in Englewood, New Jersey, was awarded $34,856 for desktop and laptop computers as well as network upgrades to expand telehealth options to continue substance abuse and behavioral health treatments.
- Vermont Psychological Services, in Charlotte, Vermont, was awarded $7,171 for computers, tablets, and telehealth software to continue providing behavioral health services for patients with COVID-19 using telehealth.
- Westchester Medical Center, in Valhalla, New York, was awarded $593,957 for telemedicine carts, telehealth enabled intensive care equipment, mobile audiovisual setups with tablets, and video-conferencing software to support existing ICU capacities now converted to the care of COVID-19 patients, to expand the tele-ICU support services to new locations with strained resources, and to utilize funding to coordinate care across the hospital network to effectively manage bed capacity and patient distribution.
- Whitehall Family Health Center, in Columbus, Ohio, was awarded $150,475 for tablets and remote monitoring and diagnostic equipment to prevent the spread of the COVID-19 virus and increase the ability to remotely triage COVID-19 patients and, using telehealth, decrease the number of high risk patients who have to leave their homes to receive medical care.
To learn more about the FCC’s COVID-19 Telehealth Program and view a complete list of funding recipients to date, visit https://www.fcc.gov/covid19telehealth. To learn more about the FCC’s Keep Americans Connected Initiative, visit https://www.fcc.gov/keepamericansconnected.
Telehealth claim lines increased 4,347% nationally from March 2019 to March 2020, growing from 0.17% of medical claim lines to 7.52% over that time, according to new data from FAIR Health’s Monthly Telehealth Regional Tracker.
The data represents the privately insured population, excluding Medicare and Medicaid. In an indication that the growth was related to the COVID-19 pandemic, the increase was even greater in the Northeast, where the pandemic hit hardest in March. Telehealth claim lines grew 15,503% in the Northeast, from 0.07% of medical claim lines in March 2019 to 11.07% a year later.
Telehealth had already been growing in recent years, but even faster growth has been predicted as a result of COVID-19. The technology permits healthcare services to be delivered without in-person contact, reducing the risk of disease transmission, and frees up in-person resources for COVID-19 patients. And with fewer elective procedures occurring around the country due to widespread restrictions, the telehealth share of total medical claim lines was expected to increase.
The platform’s growth from February 2019 to February 2020, before the rapid escalation of the pandemic in the U.S., was substantially lower. Nationally, the increase as a percentage of medical claim lines in that period was 121%; in the Northeast it was 174%.
The Northeast was far and away the region that saw the highest increase in telehealth usage, but significant increases also occurred in the West, where the increase as a percentage of medical claim lines was 1,986%. In the Midwest it was 2,842%, and in the South, 3,427%.
WHAT’S THE IMPACT?
Other notable findings from the Tracker concerns diagnoses. From March 2019 to March 2020, acute respiratory diseases and infections decreased as a percentage of telehealth claim lines nationally and in all regions except the West.
In March, there is typically a drop from February in acute respiratory diagnoses as a result of the seasonality of influenza, but this drop from March to March may indicate that many people with acute respiratory symptoms, fearing they had COVID-19, preferred this year to see a physician in person.
Nationally, hypertension was one of the top five telehealth diagnoses in March 2020, whereas it was not in March 2019, or even in February 2020. Increased issues with blood pressure for people with hypertension may be related to increased stress during the pandemic. Another factor may be increased telehealth-monitoring of patients with hypertension so they do not need to go into the physician’s office to be monitored.
THE LARGER TREND
In March, the Centers for Medicare and Medicaid Services allowed for more than 80 additional services to be furnished via telehealth and for providers to bill for telehealth visits at the same rate as in-person visits.
The waivers will expire at the end of the pandemic, but CMS Administrator Seema Verma said recently that some would remain. Also, bipartisan support in Washington for telehealth suggests that some of the changes may become permanent, contingent on new legislation that would have to be crafted and passed by Congress.
📲Episode 3 of #TakingThePulsePod
🎙️ Nexsen Pruet Health Care Attorney Darra Coleman makes her co-host debut! She and Heather, along with Palmetto Care Connections CEO Kathy Schwarting, MHA, chat all things #telehealth
⚕#Telehealth has the potential to change the face of health care as we know it – but what about access to remote health care in rural communities? What challenges lie ahead in this sweeping move to #telehealth?
🔊Listen now | Stream at www.thepulsehealthcast.com
Telehealth is allowing SNFs to provide timely and effective care during the COVID-19 pandemic, but its impact is likely to extend well into the future.
– Skilled nursing facilities across the country are using telehealth to reduce costly and unsettling hospitalizations — an essential goal during the coronavirus pandemic. SNFs are also laying the groundwork for improved care management and coordination well after the emergency is over.
Falls Village Skilled Nursing & Rehabilitation in Cuyahoga Falls, Ohio, went live with Tacoma, WA-based Sound Telemedicine in October 2019. Their goal was to reduce a rehospitalization rate of 23.7 percent that was “higher than you’d (our organization) like it to be,” according to Administrator Nick Gulich. Currently– Falls Village has a 21.9% readmission rate for that same patient cohort which is now better than the national rate of 22.3% for Short-term Medicare patients.
“The whole idea with telehealth originally was to reduce readmissions to the hospital,” he says. “The ability to connect with a dedicated physician on off-hours that could assess decompensating patients has proven to be overwhelmingly valuable and has definitely kept many patients from ending up back in the hospitals unnecessarily.”
“With the emergence of the COVID-19 epidemic, it has taken on a whole new level of importance,” Gulich adds. “The ability to reduce exposure from the community while still having the ability to assess the patients virtually has been crucial. I believe this has become a mutually beneficial tool for both the staff at the facility as well as the providers as it makes them more accessible than they ever would have been previously.”
Before using telehealth, the 103-bed, 130-staff facility used the same protocols for patient care that most other SNFs used. When a patient began showing signs of decline, nurses would call for a doctor — literally, during off-hours and weekends.
“We were relying solely on the nurse caring for the patient to call the physician and give as detailed of an update as they could on what was going on,” Gulich explains. “But it’s hard for those attending physicians, especially in the middle of the night, to get the full picture on patients. And many times, they would have been called in too late. Without the doctor being able to lay eyes on the patient or get the full story, plenty of folks would end up going back to the hospital.”
With telehealth, nurses can access a tele-hospitalist, either immediately or by scheduling an online consult for within the hour. A telemedicine cart, equipped with real-time audio-visual capabilities and an mHealth-enabled stethoscope, is wheeled into the patient’s room.
“It has been quite beneficial, even just the access to a dedicated physician so that they (attendings/medical directors) are not being woken up in the middle of the night and caught off guard by this,” Gulich says. “It has certainly prevented numerous residents from going back out to the hospital.”
The telehealth service also ensures that patients who do return to the hospital are there for a good reason. They’ve been seen — virtually — by a tele-hospitalist who has approved transport and is in touch with the Emergency Department to coordinate care. The platform eliminates unnecessary transfers (which are often flagged by CMS for penalties) because the tele-hospitalist can diagnose and treat more patients right at the facility.
According to Gulich, the telehealth service also instills confidence in nurses.
“Nurses very much appreciate the fact that they have dedicated access to a physician on those off-hours,” he says. And “it boosts their assessment skills. They know what to look for a bit better. It has boosted their confidence.”
And that confidence translates into better care management and better clinical outcomes. With the experience of collaborating with a tele-hospitalist, nurses learn how to be better care providers, knowing what to look for and anticipating when a patient might be having problems.
While the primary goal of the telehealth platform is to reduce off-hours hospitalizations, nurses are beginning to use the service for daily care management as well.
“When we first rolled it out, I strictly saw it as an emergency management type of thing, so I have been a little bit surprised to see that more and more,” Gulich says. “Ultimately, most of the encounters are routine management kind of things. If you’re getting more of those addressed promptly, that adds up. With telehealth, they’re able to reach out for more routine types of things that aren’t necessarily emergent. It’s a resource.”
SNF staff can use the technology to get timely answers to questions and better manage day-to-day care. That daily care will be important as Falls Village gets used to telehealth. In the six months since the facility launched a telehealth service, hospitalization rates have decreased and the skilled patient census has inched upwards. More stability translates to better care and better outcomes.
What’s more, hospitals are likelier to do business with facilities such as Falls Village because of that success with telehealth; as a result, SNF administrators can use that as a marketing tool for filling staff openings and becoming a provider of choice for their local hospitals.
“I think the fact that we utilize telemedicine makes us more marketable and appealing to hospitals,” says Gulich.
Among the positive statistics is the SNF’s rehospitalization rate. In the six months that they’ve been using telehealth, the facility has been able to push that rate down to 21.9 percent.
As staff become more accustomed to telehealth, particularly in daily care management, the facility intends to find more ways to use the platform, including access to specialty care services (e.g., mental health, social services, chronic care management). “Utilizing the platform to the fullest extent increases its longevity,” Gulich stresses.
This extended lifespan will be particularly important when the current coronavirus pandemic ends and SNFs run the risk of losing out on Medicare coverage currently included in emergency orders. By proving the value of telehealth, they might be able to persuade lawmakers to extend those benefits or even make them permanent.
“Personally, this is going to be the wave of the future for nursing homes,” Gulich concludes. “It’s going to become the norm that every facility would ultimately have telehealth.”
A bill introduced this week on Capitol Hill would require the Health and Human Services Department to study how telehealth has been used during the COVID-19 pandemic, with a report due back one year after the emergency ends.
By – A new bill before Congress calls for a study of whether telehealth has improved access and care outcomes during the coronavirus pandemic.
Introduced this past Monday by Rep. Robin Kelly (D-IL), the Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020 (HR 7078) would reportedly order the Health and Human Services Department to study telehealth use during the emergency and report back to Congress one year after the emergency has ended.
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The bill – the text for which had been received as of June 3 – joins a growing list of efforts to keep connected health programs and concepts front and center beyond COVID-19. Some states and payers have moved to make telehealth coverage permanent, while several members of Congress are lobbying Congressional leaders to extend regulatory freedoms for telehealth in areas such as children’s health and mental health.
Kelly’s bill, first noted by Politico at the beginning of the week, would direct HHS Secretary Alex Azar to oversee the study, which would include overall telehealth traffic, the different types of telehealth services offered to patients, the modalities used and the types of healthcare locations – hospitals, doctor’s offices, health clinics, the patient’s home, etc. – where care was delivered.
The bill, and many of the other actions taken so far, aim to establish new coverage policies for telehealth either before or soon after current emergency telehealth rules end. One particular target is the Centers for Medicare & Medicaid Services, which has issued a series of wide-ranging decrees aimed at expanding Medicare and Medicaid coverage during the pandemic.
“Data and information and research informs policy and resources, and that’s what we’re trying to do — gather as much information and really study the issue quickly before CMS regulations do run out,” Kelly told Politico this week.
About Palmetto Care Connections
Palmetto Care Connections (PCC) is the telehealth network for South Carolina that offers telehealth support services to rural and underserved health care providers.
