Advancing Telemedicine’s Future

The Internet Innovation Alliance https://internetinnovation.org, a non-profit association sponsored a briefing October 31, 2018 at the National Press Club to discuss s number of factors related to stepping up telemedicine especially in rural communities.

Starting the conversation, Former Congressman Rick Boucher said, “More and more hospitals are closing in rural communities but telemedicine could be fully used to fill the gap. However, the use of the telemedicine faces barriers since patients are often unaware how using technology can help them, patients are worried about the security of their health records, unsure of the reliability of the technology, and lastly, how reimbursement issues will be addressed.”

Moderating a panel to discuss ideas and thoughts on the use of telemedicine, Dr, Karen Rheuban, Pediatric Cardiologist and Director of the University of Virginia (UVA) at the Karen S Rheuban Center for Telehealth https://uvahealth.com/services/telemedicine, pointed out that 50 rural clinics in rural Virginia are now successfully connected to the UVA Medical Center.

Andy Southerland MD, Associate Professor of Neurology, at the University of Virginia Health System https://uvahealth.com discussed how the telestroke program at UVA is providing emergency help in real-time and in the last 5 to 10 years, the telestroke program has exploded in use.

He told the audience how UVA initiated the ITREAT study with funding from HRSA and the Virginia Alliance for Emergency Medicine Research, to test the feasibility of doing mobile neurological assessments during ambulance transports. ITREAT enables ambulances and emergency rooms to conduct a live video link between the ambulance and the emergency room.

The Veterans Administration https://www.va.gov is leading the way to help veterans receive care via connected care. Neil Evans MD, Chief Officer for Connected Care at the Veterans Administration, reports how effectively connected care works at the VA. The VA handles millions episodes of care and now a good portion of veterans receive their care through via a telehealth modality.

Morgan Reed, President of the App Association said, “There is a tremendous shortage of doctors in Wyoming since issues related to regulatory and funding barriers are reducing care in the state.” One of Wyoming’s major problems is caring for patients with type 2 diabetes. Lack of care for some patients has resulted in a high rate of patients losing limbs so the need to monitor patients on a consistent basis is vital. She displayed a bathmat that allows foot ulcers to be immediately diagnosed. As soon as the patient stands on the bathmat, the information is transmitted electronically to the healthcare provider.

Carrie Johnson, Strategy and Policy Tribal Affairs Specialist, explained how AT&T’s First Net https://www.corp.att.com/public-safety/att-firstnet public safety responder program is helping in rural and tribal areas. First responders currently rely on more than 10,000 separate radio networks which may not be interoperable with one another.

So AT&T is working with First Net with funding from NTIA to create the first ever nationwide broadband network for the public safety community. The First Net program is extending into new areas, upgrading sites, and is developing new mobile cell sites to enable a faster flow of information.

Looking at issues involving payment policies, Sylvia Trujillo, Senior Washington Counsel for the American Medical Association https://www.ama-assn.org pointed out that the AMA is concerned with how present day policies are working. So in 2017, a Payment Advisory Group was set up to discuss the number of payment issues currently in place and how some of the issues specifically relate to the use of telehealth.

Ryan Howe PhD, Senior Technical Advisor at the CMS Center for Medicare Hospital and Ambulatory Policy Group https://www.cms.gov said, “The first step is for CMS to make sure that regulations and restrictions don’t get in the way for the use of telehealth now and in the future.

He discussed how the final 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP) final rule released on November 1, 2018, modernizes Medicare payment policies to promote access to virtual care. PFS and QPP will help ease health information exchange through improved interoperability.

Go to https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-24170.pdf for more information on the “Calendar Year 2019 Physician Fee Schedule and Quality Payment Program” final rule.

Concluding the conversation, FCC Commissioner Brendon Carr https://www.fcc.gov said “It is very important for the U.S to transition to 5G. He explained how a small town in Nevada in the middle of the dessert with one healthcare clinic was almost ready to close but fortunately, the clinic was able to use health technology to connect with a doctor in another community and patients are now able to receive medical care at a distance.

Commissioner reports, “The FCC wants to see 5G rollout soon not only to some big cities but also to rural areas. The use of telehealth will be favorably impacted by 5G, however, regulatory efforts and policies must be adjusted so every community will get a fair shot at taking part in the 5G revolution.”

Go to https://internetinnovation.org for the video posted on the Internet Innovation Alliance site.

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