November 2020
Dear Colleagues,

Before we dig in, as we see increased incidence rates of COVID-19 throughout our region and the nation, the entire NETRC team wants to express again, our continued first and most important message is this:

THANK YOU, to each & every one of you who continue to be out on the front lines AND behind the scenes, as part of our essential workforce! Your innovation and passion is sincerely appreciated during this PHE response!

As we near the colder months of our calendar and continue on the expanded path of telehealth opportunities that 2020 has brought us, we hope this finds you and yours doing well. The fall season has been another gorgeous one throughout the Northeast, and we hope you found a second to enjoy some "leaf peeping", apple picking, or any other fall festivities our region has to offer!

The telehealth news and updates kept up the breakneck pace of 2020 throughout the fall months, and recent federal COVID-19 response updates indicate this landscape will continue into the new year of 2021. You can count on this edition of NETRC"s Northeast Connections to help you keep track of it all. Keep reading to find: regional and national updates, including a review of recent Federal guidance updates, along with a highlight on CCHP's Annual 50 State Telehealth Laws and Reimbursement Report, snapshot of upcoming regional and national telehealth events, the most recent publications and headlines, and more!

Best wishes to all, & please don't hesitate to reach out with your telehealth questions or success stories, or just to say hello. Thanks!

On Behalf of the NETRC Team Be well,
Reid Plimpton, MPH - Project Manager
Senator Angus King to Lead Discussion on Rural Benefits, Impacts of Telehealth 
Panel Discussion on the Future of Telehealth-
Friday, November 13, 2020-
12:00 p.m. – 1:15 p.m. EST

U.S. Senator Angus King (I-Maine) will lead a discussion with Maine healthcare providers, experts from the Bipartisan Policy Center, and health experts on the benefits and future of telehealth for Maine and across the nation’s rural areas. The pandemic has resulted in a dramatic expansion of telehealth services, especially in Maine. These services have allowed for safe access to care for millions of Americans, though the legislative, regulatory, and payment changes that made this possible are not permanent. This panel discussion will focus on how policymakers and healthcare providers can work together to consider the investments and changes needed to sustain access to 21st-century quality healthcare through telehealth to meet the needs of Americans.

The panel will feature: Jennifer Lundblad, President & CEO, Stratis Health; Dena McDonough, Associate Director, Health Project, Bipartisan Policy Center; Dr. Lisa Miller, Family Medicine Physician, Western Maine Health; and Scott Oxley, President, Northern Light Acadia Hospital.


Speakers Include:

Federal Policy and Guidance Updates
In Case You Missed It!
On Friday, October 23rd, DHHS Secretary Alex Azar signed a renewal of the Federal Public Health Emergency Declaration (PHE) due to the COVID-19 Pandemic. This extends the PHE considerations through January 2021.

In early November, the Center for Medicare and Medicaid Services (CMS), finalized the CY 2021 Home Health rules, among other changes, the new rules include multiple temporary telehealth changes in response to COVID-19 that will be permanent moving forward, such as RPM services and other telecommunication avenues within a patient's plan of care.
 
CCHP’s Updated 50 State Telehealth Laws and Medicaid Policies Report is Out!
 
An updated Fall 2020 version of CCHP’s “State Telehealth Laws and Reimbursement Policies” Report was released in September 2020. The Fall 2020 edition offers policymakers, health advocates and other interested health care professionals the usual detailed compendium of permanent state telehealth laws, regulations and Medicaid policies. For key Takeways, see the new At a Glance” Infographic or explore policy nuance in real time with their online interactive map tool!

In addition to their annual report, CCHP has started maintaining Regional Policy Trackers for each TRC Region, You can find the Northeast Reporting Tool Here.
FCC Connected Care Pilot
Applications NOW OPEN!
On Friday, November 6, 2020 the FCC opened the application window for the Connected Care Pilot Project, which has been on the horizon since late 2019.

The Commission adopted final rules for the Connected Care Pilot Program on April 2, 2020 (A summary of these rules can be found in a September Press Release; Here. The rules in their entirety can be found Here).

Eligible Applicants: Nonprofit and public eligible health care providers that fall within the statutorily detailed categories* of “health care provider” in section 254(h)(7)(B) of the Telecommunications Act of 1996, whether located in rural or non-rural areas.
*These Categories include:
  • Post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools;
  • Community health centers or health centers providing health care to migrants;
  • Local health departments or agencies;
  • Community mental health centers;
  • Not-for-profit hospitals;
  • Rural health clinics;
  • Skilled nursing facilities; or
  • Consortia of health care providers consisting of one or more entities falling into the first seven categories.

An eligibility determination is required for each health care provider site that will be included in an application for the Pilot Program. Health care provider sites that the Universal Service Administrative Company has already deemed eligible to participate in the FCC’s Rural Health Care Program or COVID-19 Telehealth Program may rely on that eligibility determination for the Pilot Program (See November 5, 2020 Press Release; Here.

Grant Objective:
Specifically, the Pilot Program will use USF funding to help defray costs of connected care services for eligible health care providers, providing universal service support for 85% of the cost of eligible services and network equipment, which include:

(1) patient broadband Internet access services;
(2) health care provider broadband data connections;
(3) other connected care information services; and
(4) certain network equipment. The Pilot Program will not provide funding for devices.
Learn more about what this program covers in the FAQ document; Here

Application Deadline: Monday, December 7, 2020 @ 11:59 EST

NCTRC Telehealth Landscape Survey
The National Consortium of Telehealth Resource Centers (NCTRC), consisting of 14 TRCs funded by a grant from the Office for the Advancement of Telehealth located within the Health Resources and Services Administration (HRSA), is asking for feedback that will help us to assess the current telehealth landscape in your region, as well as to identify how your TRC is meeting telehealth education and information needs.  

Please take a few minutes to fill out the survey so that the TRCs can learn how to better serve you!
Telehealth and COVID-19
Over the past few months, telehealth has continued to tranform in the blink of an eye, and on top of numerous changes in the policy and reimbursement worlds due to COVID-19, we've seen an impressive amount of adaptation and innovative implementation from providers.

On top of the insights on those found in this newsletter, the TRCs have continued to stay on top of compiling information as soon it becomes available; NETRC provides updates to the COVID-19 webpage on our website at least weekly to highlight these materials and more. Be sure to check there frequently for the newest information and materials!

In an attempt to continue to provide our stakeholders with the most recent information, we've added on to the federal guidance links available here in the past two newsletters with three recent Federal Agency Data Briefs pertaining to telehealth utilization.

Recent Federal Agency Data Reports and Issue Briefs
Centers for Medicare & Medicaid Services (CMS) Final Report to Congress entitled, “Reducing Barriers to Using Telehealth and Remote Patient Monitoring for Pediatric Populations under Medicaid” (Released 08/11/2020) Click Here

Agency for Healthcare Research and Quality (AHRQ): "Issue Brief: Telediagnosis for Acute Care: Implications for the Quality and Safety of Diagnosis" (Released 08/2020) Click Here

Office of the Assistant Secretary for Planning and Evaluation (ASPE): Issue Brief: Medicare Beneficiary Use of Telehealth Visits: Early Data From the Start of the COVID-19 Pandemic (Released 07/28/2020) Click Here

Federal COVID-19 Webites and Guidance Documents (updated as changes occur)
Office for Civil Rights (OCR) Guidance on HIPAA privacy and Novel Coronavirus. Original FAQ (Released 02/2020) Click Here; Recent Guidance available here

Drug Enforcement Administration (DEA) Telemedicine—COVID-19 information page- Click Here

Federation of State Medical Boards (FSMB) States waiving licensure requirements/renewals in response to COVID-19. As of August 5th, 2020 Click Here

Medicare List of Telehealth Services – Updated October 14, 2020: Click Here
Medicare Telemedicine Healthcare Provider Fact Sheet:. Click Here
Upcoming & Archived Webinars
Coming up Soon!
November 19th, 2PM- 3PM (Eastern)
NCTRC Webinar: Leveraging Telehealth to Address Social Determinants
Hosted by: Northeast Telehealth Resource Center (NETRC)
TRC Speaker: Christina R. Quinlan, Telehealth Revenue Cycle Optimization Strategist - Northeast Telehealth Resource Center

Webinar Description:
Advances in technology and telehealth not only have the potential to increase access, diversify revenue, and decrease social determinants of health but will also help integrate social care back into the health care landscape. As the healthcare industry is shifting from fee-for-service to value-based care, planning, implementing and enhancing telehealth as a service delivery model will be a crucial part of the puzzle in ensuring that we are on the leading edge and not the bleeding edge of reimbursement strategies.

November 18th, 2020 - 2p-3p EST
NCTRC Telehealth Hack - Privacy and Liability
The NCTRC is now hosting the Telehealth Hack Webinar Series!

Presenters:
Amanda Enyeart, JD, Partner - McDermott Will & Emery LLP.
Joseph P. McMenamin, MD, JD, Chief - McMenamin Law Offices, PLLC.
Description:
Expert presenters in the legal area of healthcare will provide a strong foundation for attendees throughout the November series.
This second webinar will address privacy and liability issues related to delivering healthcare through telehealth modalities. This comprehensive legal overview of telehealth will better equip attendees and familiarize them with the application of legal requirements within telehealth, allowing them to focus on providing quality care.

November 17th, 2020- 12pm-1pm EST
Public Health Institute (PHI)'s Dialogue4Health Webinar
Telerehabilitation in the times of COVID-19
Speakers: Hilde Sørli, Hege Øra, Ingebjørg Irgens, Birthe Dinesen, Mary Stilphen

The COVID-19 pandemic has significantly impacted rehabilitation protocols. Around the world, telerehabilitation has gained increasing popularity, allowing clinicians to assess and treat patients virtually.  In this Web Forum, experts from Scandinavia and the United States will present on the swift advancement of telerehabilitation during COVID-19, highlighting the feasibility, usability, effectiveness, and security of telerehabilitation for both patients and therapists across all specialties. Furthermore, our panelists will discuss sustainability and the future of telerehabilitation post-pandemic. 



And in case you missed it:
October 26th, 2:00pm- 3:00PM (Eastern)
National TRC Hack Series:
Building Accessible Telehealth for Patients with Disabilities from the Ground Up

Didactic: Federal Legal Considerations for Accessible Telehealth for Individuals With Disabilities
Speaker: Alyse Bass, JD, Clarette Yen, JD - U.S. Department of Justice, Civil Rights Division, Disability Rights Section

Case Study #1:
COVID-19’s Impact on Deaf and Hard of Hearing Patients- Identify the Barriers and Solutions to Address Them
Speaker Michael McKee, MD, MPH - The University of Michigan/Michigan Medicine, Department of Family Medicine

The Deaf Health Clinic, housed in the Department of Family Medicine, cares for over 150 Deaf signers and a much larger population of those who are hard of hearing. Mandatory virtual care for everyone created significant communication challenges for the 17% of US adults who are Deaf and hard of hearing (DHH). To address these challenges, Michigan Medicine/Department of Family Medicine in collaboration with the interpreter department, created a variety of protocols for both in person and telehealth appointments for DHH patients.

Case Study #2:
Increasing Reach and Accessibility of Telehealth Services for Children with Disabilities during COVID-19 and Beyond
Speaker: Jason Jent, PhD - The University of Miami Miller School of Medicine, Mailman Center for Child Development

The Mailman Center for Child Development provides services to over 15,000 children per year through a variety of assessment, prevention, and intervention services designed to address concerns of individuals with developmental disabilities and children with special health care needs. Within this case study, telehealth services will be highlighted as an effective mechanism for increasing reach of parenting interventions, neurodevelopmental evaluations, assistive services and technology use, and hearing programs for children with disabilities.


You can find All NCTRC HACK Webinar Recordings Here
#LaunchTelehealth2020- Recap Below;
Register now & view all recordings FOR FREE!
We had an absolute blast designing and hosting our collaborative #LaunchTelehealth2020 Virtual Conference Series with our colleagues at the Mid-Atlantic TRC (MATRC) throughout June and July; to the 900+ attendees who joined us from over 15 states, thanks for participating, and we hope you had a great time as well!

If you missed it (we know there's lots going on), no worries! All Event Sessions were recorded, and are available on the platform "on-demand" now, for FREE! To access all event materials and recordings, visit our Virtual Event Platform at: https://eventmobi.com/launchtelehealth2020/
  • The first time you visit the Virtual Event Platform, you will need to log in with your email address.  
  • If your email address is already in the system, but you have never accessed to content before, you will be prompted to create a password. If you have previously created a password, you will be prompted to enter your password. If you cannot remember your password, click on the “forgot password” link.
  • If your email address is not in the system, please go to https://telehealth2020.swoogo.com/launchtelehealth2020/ and click on “Register Now”. Registration is simple and FREE and once you are registered, a button will appear to redirect you to the Virtual Event Platform!

With recordings and slides available from over 40 Plenary or Breakout Presentations, 15+ Industry Partner Interviews to listen too, and 20+ Telehealth Academic Posters available for viewing, this is a resource you'll want to have in your pocket; we hope you enjoy!

If you have any questions, contact Reid Plimpton at: [email protected]
Recent Telehealth News
Patients shirked diagnostic testing, in-person preventive care amid telehealth boom this spring
Healthcare Dive, November 5, 2020 Link
Patients overwhelmingly turned to telehealth visits early in the COVID-19 pandemic but skipped out on diagnostic procedures and other preventive and elective care that can only be done in-person, according to a study published Thursday in JAMA Network Open.
 
FCC opens application window for Connected Care Pilot Program
mHealth Intelligence, November 5, 2020 Link
The three-year, $100 million program, aimed at boosting broadband connectivity in underserved parts of the country to support telehealth expansion, will accept applications for one month, beginning on November 6.
 
Year-long study validates telehealth use in diabetes prevention efforts
mHealth Intelligence, November 4, 2020 Link
Supporters of digital Diabetes Prevention Programs say the PREDICTS trial proves that telehealth and mHealth tools can improve clinical outcomes for people at risk of developing the chronic disease.
 
New telehealth accreditation program focuses on home health care
mHealth Intelligence, November 3, 2020 Link
The Accreditation Commission for Health Care has unveiled a Distinction in Telehealth designation for providers using telehealth in ambulatory care, behavioral health, home health, hospice, private duty and renal analysis.
 
Senators seek CMS support for telehealth services for expectant moms
mHealth Intelligence, November 2, 2020 Link
A bill introduced last week in the Senate would establish Medicare and Medicaid coverage for telehealth programs that use remote patient monitoring to track the health of expectant mothers.
 
Epic, Zoom and mobile app help at-risk clinic volunteers deliver care from home
Healthcare IT News, October 30, 2020 Link
Almost all of the physician and nurse volunteers at Clinic of the Cascades were over 65. Here’s how the three merged technologies allowed it to stay open during COVID-19.
 
NH hospital uses telehealth to support difficult deliveries
mHealth Intelligence, October 30, 2020 Link
Wentworth-Douglass Hospital in Dover is connecting via telehealth with NICU specialists at Massachusetts General Hospital for virtual support for the more than 1,300 deliveries they see each year A telemedicine network launched by Massachusetts General Hospital to provide on-demand neonatal support has expanded into New Hampshire.
 
New mHealth app identifies stroke signs through speech, facial movements
mHealth Intelligence, October 27, 2020 Link
Researchers at Penn State and Houston Methodist say the mHealth app, which uses AI technology, is as accurate in identifying stroke symptoms as an ER doctor using a CT scan.

Value-based care requires a balance of telehealth, in-person visits
mHealth Intelligence, October 29, 2020 Link
In a new Healthcare Strategies podcast, Chris Waugh, chief innovation officer of the 24-hospital network at Sutter Health, explains how the health system is creating a strategy that integrates virtual and in-person care to treat the whole patient.
 
Dozens of orgs call on DEA to enable remote prescriptions for controlled substances
Healthcare IT News, October 29, 2020 Link
More than 80 organizations led by the Alliance for Connected Care called this week for the U.S. Drug Enforcement Agency to implement a telemedicine special registration that would allow providers to remotely prescribe controlled substances. 
 
Fitbit launches COVID-19 mHealth study with US Army, Northwell Health
mHealth Intelligence, October 29, 2020 Link
Fitbit is using a $2.5 million grant from the US Army to study how its mHealth wearables can detect early signs of COVID-19, and will be launching the study through New York's Northwell Health system.
 
United Methodist Communities has early successes with telehealth and RPM
Healthcare IT News, October 28, 2020 Link
The New Jersey-based not-for-profit senior living and healthcare provider has successfully implemented the Virtusense Alert platform in more than 80 skilled nursing rooms across four campuses, strategically placed in the rooms of residents at the highest risk for falls. The VSTAlert system places advanced sensors in these rooms that continuously monitor for activity, falls and vital signs.
 
New mHealth app identifies stroke signs through speech, facial movements
mHealth Intelligence October 27, 2020 Link
Researchers at Penn State and Houston Methodist say the mHealth app, which uses AI technology, is as accurate in identifying stroke symptoms as an ER doctor using a CT scan.
 
Universal Community Health moves from text-enabled telehealth to robust ‘tele-assisted care’
Healthcare IT News, October 27, 2020 Link
The California-based health center has invested in virtual care workstations that allow physicians to remotely guide patients through near-complete examinations. Technology includes an iPad, an otoscope, a stethoscope and a high-definition camera that allow a patient with the guidance of a physician to do a physical exam.
 
Report notes CMS program’s success with telehealth for senior care
mHealth Intelligence, October 27, 2020 Link
PACE, a Medicare-Medicaid program serving thousands of seniors in 31 states, used telehealth to keep that care going during the pandemic. That success could spur more programs to use connected health in the future.

Lawmakers eye Medicare coverage for COVID-19 tests via telehealth
mHealth Intelligence, October 22, 2020 Link
A new bill before Congress would mandate Medicare coverage for at-home COVID-19 tests integrated with a telehealth platform.
Recommended Telehealth Research/Resources

Alliance for Connected Care, National Committee on Quality Assurance, and American Telemedicine Association, September 2020
 
American Academy of Family Physicians and Manatt Health Strategies, LLC, September 2020
 
American College of Physicians, 2020
 
Bains J, Greenwald PW, Mulcare MR, et al. Telemed. eHealth [epub ahead of print] August, 2020
 
Benziger CP, Huffman MD, Sweis RN, Stone NJ. Amer. J. Med. [epub ahead of print], July 2020
 
Borgen I, Romney MC, Redwood N, et al. Popul. Health Manag. [epub ahead of print], October 2020

Calderone J, Lopez A, Schwenk S, Yager J, Shore JH. mHealth 6:29, 2020

Carlberg DJ, Bhat R, Patterson WO, et al. J. Emerg. Med. 7:S0736-4679(20)30849-0, 2020
 
Center for Connected Health Policy, August 2020
 
Cheng A, Vasquez Guzman CE, Duffield TC, Hofkamp H. Telemed. eHealth [epub ahead of print], August 2020
 
Cleveland Clinic, April 13, 2020
 
 
Gerber MR, Elisseou S, Sager ZS, Keith JA. Fed. Pract. 37(7):302-308, 2020
 
Goodman RB, Lacktman NM. Healthcare Law Today, October 19, 2020
 
Jaffe DH, Lee L, Huynh S, Haskell TP. Popul. Health Manag. [epub ahead of print] August, 2020
 
Joshi AU, Lewiss RE, Aini M, Babula B, Henwood PC. JMIR mHealth uHealth [epub ahead of print], September 2020

Kemery DC, Goldschmidt K. J. Pediatr. Nurs. [epub ahead of print], August 2020
 
Kichloo A, Albosta M, Dettloff K, et al. Fam. Med. Community Health [epub ahead of print] August, 2020
 
Koziatek CA, Rubin A, Lakdawala V, et al. J. Emerg. Med. [epub ahead of print], 2020
 
Kruse C, Fohn J, Wilson N, et al. JMIR Med. Inform. 8(8):e20359, 2020
 
Lam K, Lu AD, Shi Y, Covinsky KE. JAMA Intern. Med. [epub ahead of print], August 2020
 
 
Lowe J, Shen S. Emerg. Med. [epub ahead of print], October 2020
 
Manta C, Jain SS, Coravos A, et al. Clin. Transl. Sci. [epub ahead of print], August 2020
 
Mehrotra A, Chernew M, Linetsky D, et al. The Commonwealth Fund, August 13, 2020
 
 
 
Reiss AB, De Leon J, Dapkins IP, et al. Medicina 56(9):E461, 2020

Sardesai I, Grover J, Garg M, et al. J. Family Med. Prim. Care [epub ahead of print], October 2020
 
Sherwin J, Lawrence K, Gragnano V, Testa PA. J. Telemed. Telecare [epub ahead of print], July 2020
 
 
Smith KM, Hunte HE, Graber ML. Agency for Healthcare Research and Quality, August 2020
 
Uscher-Pines L, Sousa J, Raja P, et al. J. Subst. Abuse Treat. [epub ahead of print], September 2020
 
Wahezi SE, Duarte RV, Yerra S, et al. Pain Physician 23(4S):S205-S238, 2020
 
Wasson JH. J. Ambul. Care Manage. 43(4):323-325, 2020
 
 
Wootton SL, King M, Alison JA, Mahadev S, Chan ASL. Respirol. Case Rep. 8(8):e00669, 2020
NEW NCTRC About Us Video!
If you aren’t sure who we are, and what we offer in terms of resources and technical assistance, this is the perfect opportunity to learn about us in just under 4 minutes; watch below or click the link at the end to access the full video!
About the NETRC
The Northeast Telehealth Resource Center (a proud member of the National Consortium of Telehealth Resource Centers) aims to increase access to quality health care services for rural and medically underserved populations through Telehealth. Our service area includes New England, Northern New Jersey, and New York. Learn more at www.netrc.org
This newsletter was made possible by grant number G22RH30352 from the Office for the Advancement of Telehealth, Health Resources and Services Administration, DHHS
NETRC | [email protected] | 800-379-2021 | www.netrc.org