Digital

AMA COVID-19 daily video update: COVID-19 care: Experts discuss efforts to expand telehealth

Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.


Featured topic and speakers

AMA Chief Experience Officer Todd Unger speaks with AMA President-elect Susan R. Bailey, MD, Vice President, Digital Health Innovations, Meg Barron and Assistant Director, Federal Affairs, Laura Hoffman on updates regarding COVID-19 including telehealth.

Learn more at the AMA COVID-19 resource center.

Transcript

Unger: Hello and welcome to American Medical Association's COVID-19 update. Happy Doctor's Day.

Today we're going to talk about efforts to expand telehealth and remove obstacles to this channel of medical care, even more critical now because of the COVID-19 pandemic. I'm joined today by Dr. Susan Bailey, president-elect of the AMA and an allergist/immunologist from Fort Worth, Texas, Meg Barron, AMA's vice president of digital health innovations in Chicago and Laura Hoffman, assistant director of federal affairs in Washington DC. I'm Todd Unger, AMA's chief experience officer in Chicago.

With COVID-19, there is new urgency behind telemedicine. Dr. Bailey, why is that?

Dr. Bailey: The AMA has been working on telemedicine for a long time but the COVID-19 pandemic has jump started a lot of us and it has proven to be an incredibly powerful tool to help physicians in practice stay in touch with their patients without having to see them face to face and is probably gonna enable a lot of physicians to keep their practices open and running during the duration of the pandemic.

Barron: Yeah, I would add to that and we're hearing from practices and systems all across the country that this isn't really a matter of days, weeks. It's gone from a nice-to-have solution to really a must have solution to be able to make sure that patients and physicians are keeping safe and that care that can be triaged appropriately, so that PPE can stay for those in person consultations that are necessary and for others to still have continuity of care with their own doctor but just via telehealth.

Unger: Dr. Bailey, you have your own private practice in Fort Worth and you have been ramping up your telemedicine practice. In fact, you were just on a telemedicine call before this segment. Was it like flipping a switch? Why don't you talk about how has it been getting it up and running? How are your patients responding?

Dr. Bailey: Our practice started using telemedicine a couple of weeks ago when local officials started issuing stay in place orders, and we were looking for ways to keep seeing our patients. And it has been surprisingly easy.

We found one that's just almost completely plug and play. We have found that the majority of our patients are more than happy to do this because they don't want to get out of their homes.

We have a stay at home order in Tarrant County and Fort Worth. And there are some that have been reluctant to use it, but with that, now, we're able to use the virtual check-in that formerly we were only able to use with Medicare patients that were in remote areas. And now we can use that on all of our Medicare patients. It's a phone call. It's not reimbursement, but it's better than nothing. So, the whole transition has been much easier than I thought it would be.

Unger: Meg, AMA just published a quick start guide to telemedicine. What do you see as key tips for getting practices up and running with telemedicine?

Barron: Yeah, no, thanks Todd. I mean we were, again, hearing from practices and systems all across the country, so we really wanted to extract some best practices and key nuggets of information that we could get out as fast as possible.

A lot of those things relate to just knowing what vendors exist and are out there and what key considerations to keep in mind when attempting to select a vendor or a new technology, what can be reimbursed and what new payment policy and regulation has been ruled out around that, including new CPT codes. And really from a workflow perspective, which often can be the most difficult, is just introducing a new technology into your care team environment, so that it can be as seamless as possible.

So, all of that we've aggregated into almost a Cliff Notes version of a broader playbook that we have in development that will launch actually later this week, so more to come on that.

The other thing I just wanted to quickly raise, is in addition to the quick guide, we have a virtual panel discussion live, as we speak, that's allowing individuals, physicians from our community to be able to have access to telemedicine experts, to directly ask questions that that might either A) be experiencing or wanting to hear directly from them best practices that they have seen in their own practice environment.

Unger: Laura, you know Meg mentioned that there are other issues besides the infrastructure of getting up and running. She specifically mentioned payment, but there are a variety of other topics that you and the advocacy team in Washington have been working on. Do you wanna talk a little bit about that?

Hoffman: Yeah, absolutely. The advocacy team has been working really nonstop, at warp speed, to help get physicians up and running and to ease some of the requirements that have existed to date on telehealth.

So, for example, like Dr. Bailey was mentioning, it's no longer limited to patients in rural areas. And, so, we've been working very closely with CMS, in particular, to waive a lot of the requirements that have limited availability of those services. We're gonna keep pressing on them to expand the use of telehealth, trying to get coverage of telephone visits, again to Dr. Bailey's point, because we know that not all patients are able to access these two-way, audio-video communications.

And one other thing I think that was very helpful, from the federal government, was letting physicians know that they could use various telehealth services, such as FaceTime or Skype without worrying about HIPAA penalties right now.

A lot of times it takes some time to get up and running and putting in place business associate agreements and conducting security risk analyses, all those things. And the Office for Civil Rights that we're not going to enforce the compliance and penalties and those areas for telehealth at the moment.

So, physicians should take some comfort in that, knowing that they can see COVID patients and patients for other types of illnesses or conditions that they may need to talk to their physicians about.

Unger: Thank you for that.

Dr. Bailey: A point I'd like to make. Todd, if it's okay, I'd like to make a point that it's very comforting to know that CMS is proposing to give us parity with telehealth visit, as compared to in person to person visits, but where are we in terms of private payers also paying for these visits?

Hoffman: Yeah, we're continuing to push on the private payer side as well. I think that as time goes on, there's gonna be some mounting pressure from CMS and others in the industry to ensure that same kind of parity. So it's great to have seen CMS taking the lead there, and we're absolutely continuing to push on private payers to advance those kinds of parity policies as well.

Barron: Some good news, too: We have a telehealth initiative right now with the Physicians Foundation and a number of different state societies, and we are hearing from some of the practices that are participating in that, that some of their payers are starting to actually begin reimbursement.

But I agree with Laura that once CMS additionally excels some of that, that we'll see additional traction, which is great.

Unger: Well, great. This has been an excellent discussion.

I want to thank my guests today, talking telemedicine, Dr. Susan Bailey, Meg Barron and Laura Hoffman. We'll be back with another update tomorrow. We're going to talk about the role of social media during the pandemic.

For updated resources on COVID-19, like the quick start guide to telemedicine that Meg mentioned, go to ama-assn.org/covid-19.

And to all the physicians out there, Happy Doctors Day and thank you for your work.