Welcome to Telehealth Roundup, highlighting news and features about emerging trends in telemedicine and telehealth.
Lifeline Program Threat
Pending changes for the Federal Communications Commission (FCC)’s Lifeline program that provides phone and broadband internet service to low-income individuals — enabling them to stay in touch with physicians, access telehealth, and call emergency services — threaten the program, according to key stakeholders.
The FCC has said that the annual increases in data and other provisions built into the minimum standards adopted in 2016 are “flawed” and “could impact the ability of Lifeline carriers to continue providing affordable service.” It proposed slashing the scheduled increase without a boost to the subsidy to carriers.
Industry trade group National Lifeline Association and mobile service provider TracFone Wireless agreed that the scheduled changes were too much but also argued against the smaller increases proposed. “While the press release declares that it results in preserving affordable plans for Lifeline subscribers, Lifeline subscribers who will be notified on November 1, 2020 of a need to pay $15 or more because the FCC wanted them to have more data than is included in their free plan will likely disagree,” they wrote in a docket calling for freezing the rules in their current state.
A recent survey of 7,706 subscribers by the National Lifeline Association suggested that 8% of the current 6.9 million subscribers wouldn’t be able to make a co-pay and risk losing the service.
A group of state utility commission officials have argued that time is running short for the FCC to prevent a significant reduction in Lifeline access. The changes are slated to go into effect December 1, 2020.
Disparities Afflict Telemedicine, Too
Disadvantages for Black patients have carried over from in-office care to telehealth as well, according to a report in the Journal of Informatics in Health and Biomedicine.
Analysis of more than 140,000 patients seen at NYU Langone Health in New York City during the March-April pandemic surge showed a huge increase in telemedicine use, as has been reported elsewhere. For Black patients, that increase was driven primarily by younger people and women.
Still, white patients had 40% higher adjusted odds of accessing telemedicine than Black patients. Telemedicine users subsequently tested for coronavirus at the hospital system were 63% more likely to test positive if they were Black, suggesting they “may be sicker when seeking care through telemedicine compared to white patients,” the researchers noted.
Lower mean income and larger mean household size in the zip code were associated with lower likelihood of telemedicine use. “Roots of disparate use are complex and reflect individual, community, and structural factors, including their intersection; many of which are due to systemic racism,” the researchers wrote. “Evidence regarding disparities that manifest through telemedicine can be used to inform tool design and systemic efforts to promote digital health equity.”
Other solutions may include increasing minority representation among telehealth providers and targeted culturally appropriate outreach, they suggested.
Telehealth Policy Report
Preserving telehealth’s success beyond the COVID-19 pandemic was the focus of a report from the Taskforce on Telehealth Policy, which is a joint effort by the National Committee for Quality Assurance, the Alliance for Connected Care, and the American Telemedicine Association.
As Healthcare IT News reports, the report found a strong evidence base for safety of telehealth, especially in remote management of chronic conditions. But it supported allowing telehealth for various other types of conditions, too. The report recommended congressional funding for research on what works and that policymakers set minimum standards for telehealth patient safety and integrate them into existing standards.
The report also recommended lifting geographic restrictions and limitations on originating sites. As to expanding prescribing authority to telehealth, the task force suggested looking into the effect it would have. It endorsed fully reinstating enforcement of HIPAA protections suspended with the public health emergency.
Telehealth accreditation standards were updated Sept. 10 by URAC, a nonprofit healthcare quality validation organization.
Source: WEB DESK