How Telemedicine Can Help Prevent the Spread of Coronavirus
Telehealth Regulation in the U.S. Is a Mess
The existing state laws regarding telemedicine are a jungle. According to the Center for Connected Health Policy (CCHP), many laws on the books are ambiguous or even conflicting, and no two states in the entire U.S. treat telehealth exactly the same way. Naturally, this presents challenges to providers, health systems, and patients in the adoption of telehealth. CCHP has created an interactive map of current telehealth-related laws and reimbursement policies by state. All 50 states plus D.C. provide some type of fee-for-service Medicaid reimbursement for live video telehealth consultations. Some states provide Medicaid reimbursements for other services such as remote patient monitoring and store-and-forward. Most states also regulate the ways private payers can reimburse for telehealth.
Despite Promising Future, Telehealth Adoption Has Remained Low Until Now
Telemedicine seems very promising in terms of delivering affordable, quality care to many patients in an efficient way. One hospital has cut treatment costs for chronic care patients by about 50% within just two years by implementing a telehealth program. One health system’s 2017 study of its sports medicine patients found that patients and families who used telemedicine for their appointments saved an average of $50 in travel costs and over 50 minutes in waiting and visit time. However, only around 10% of Americans have ever used telehealth services, and levels of both access and awareness are lower than expected. Perhaps the COVID-19 outbreak will finally convince many Americans to begin adopting telemedicine for non-emergency cases.
Telehealth Offers Many Advantages for Managing Disease Outbreaks
Just last week, both the CDC and the WHO urged hospitals and clinics to expand their use of telemedicine to help triage sick patients who might be at risk for coronavirus infection. Telehealth assessments can help doctors evaluate and treat mild cases while escalating only the most severe cases of infection towards in-person care, thus alleviating the increased strain on health systems and freeing up hospital beds to be used only for the sickest patients. The “worried well” can be put at ease without having to spend the time and resources required for an in-person evaluation. Also, patients can avoid exposure and limit person-to-person spread of viruses in crowded waiting rooms.
Telemedicine Is Already Playing a Part in the Response to the Coronavirus
As of this writing, confirmed cases of COVID-19 infection have surpassed 400,000 worldwide and 60,000 in the U.S. alone. President Trump has declared a national state of emergency. Experts predict a dramatic short-term spike in the demand for telehealth as a result of coronavirus fears. One privately-held U.S. telehealth company saw an 11% increase in patient traffic in the first week since the first coronavirus-related death was reported in the U.S. More recently, some telemedicine companies have claimed their traffic has doubled.
The HHS, FDA, and diagnostics companies Quest and LabCorp are coordinating to make coronavirus diagnostic lab tests commercially available ASAP. New data-sharing rules are now under review at the Office of Management and Budget which would allow patients to consent to share their medical information with entities not covered by HIPAA, enabling easier sharing with telehealth providers and faster triage and treatment.
On Tuesday, March 17, the Trump administration announced that it is expanding Medicare coverage for telehealth. Previously, Medicare patients who wanted to use their coverage to pay for telehealth visits had to live in a rural area and travel to a clinic to receive a telehealth visit from a doctor in a major city. Congress passed—and President Trump signed—an emergency $8.3 billion spending bill in response to COVID-19, and the bill includes a $500 million provision to help Medicare waive these geographical restrictions on telehealth. Now, beneficiaries of Medicare, Medicaid, and CHIP can use their coverage to visit a doctor from home!
Starting March 6, the Department of Health and Human Services has said that it will exercise discretion in waiving penalties for providers who may use non-HIPAA-compliant platforms such as Facebook or Skype in good faith to provide care for patients remotely. HIPAA regulations might otherwise prevent some patients, such as those in rural areas, from receiving health care at all during this difficult time.
SAMI-Aid Is Part of the Telehealth Revolution
While primary care doctors may be booked solid for weeks in advance and ER visits can cost upwards of $1,000, virtual healthcare is still available far more quickly and affordably. A rising star in the telehealth industry is Silicon Valley-based SAMI-Aid. SAMI-Aid offers free membership and allows anyone to speak with a physician for less than $60 per consultation, generally within 60 minutes or less.