First in Morning eHealth: Rep. Robin Kelly’s new telehealth bill

With help from Darius Tahir (@dariustahir)

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Quick Fix

— First in Morning eHealth: Rep. Robin Kelly’s new telehealth bill⁠: The Illinois Democrat wants a study on the impact of telehealth on Medicare and Medicaid during the pandemic.

— EHR study dampens expectations for cost savings: A study in JAMA Network Open suggests that using health records software to manage diseases won’t produce major health care cost savings, at least in the short-term.

⁠— Employers run with contact-tracing apps: State governments are still making their minds up about contact tracing, but employers are reportedly already taking off.

eHealth tweet of the day, in response to a WIRED piece on taking work offline in case of a blackout: Rogers Alley @BonesCrosby “It really depends on the nature of a person’s work. Downloading medical information might violate HIPAA standards, for example”

It’s MONDAY at Morning eHealth. Tell us what we’re missing at [email protected]. Tweet the team at @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Given the unprecedented public health challenge confronting regulatory affairs teams, the AgencyIQ leadership team has decided to pull research and analysis content concerning the virus and its regulatory implications in front of the paywall. It is available here: https://agencyiq.com/covid-19-resource-center/

Driving the Day

WHAT WITHDRAWAL FROM WHO MEANS FOR PANDEMIC RESPONSE— President Donald Trump’s plan to make good on his threat to withdraw from the World Health Organization has sparked worry from health experts, our colleagues Brianna Ehley and Alice Miranda Ollstein report. Trump has criticized the U.N. agency for failing to quickly sound the alarm when the virus emerged, and accused it of helping China cover up the threat. Friday’s news follows Trump’s temporary freeze last month on U.S. funding to WHO.

... The American Medical Association, the nation’s largest physician group, urged Trump in the “strongest terms possible” to reverse the decision. Sen. Lamar Alexander (R-Tenn.), the head of the chamber’s health committee, warned canceling U.S. membership could disrupt clinical trials for vaccines that will be in high demand around the world.

“Certainly there needs to be a good, hard look at mistakes the World Health Organization might have made in connection with coronavirus, but the time to do that is after the crisis has been dealt with, not in the middle of it,” Alexander said.

AN ATTEMPT TO SOLVE TELEHEALTH’S DATA PROBLEM⁠ — Telehealth skeptics in Congress have long argued that there’s not enough data on the technology’s impact on health and costs to support expanding its use. But the pandemic could change all that, says Rep. Robin Kelly, who’s introducing a new bill today mandating a study to gather exactly that information.

... Her bill, the Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act, directs HHS Secretary Alex Azar to oversee a telehealth study and to submit it to the House’s Energy and Commerce and Ways and Means Committees, and the Senate Finance Committee. That report would include the number of telehealth visits, the types of services patients received, and what kinds of clinics offered those services during the pandemic, among other details. The bill also directs Azar to award grants to states so they can do their own studies on Medicaid telehealth use.

Kelly’s call comes as providers and patients worry that recent federal and state policies making telehealth easier to access and bill for will be rolled back once the emergency period ends. “Data and information and research informs policy and resources, and that’s what we’re trying to do — gather as much information and really study the issue quickly before CMS regulations do run out,” she told Morning eHealth.

Virtual care is drawing bipartisan support during the pandemic. In a news release last week, Sen. Marsha Blackburn (R-Tenn.) urged lawmakers to “continue to support this expansion and codify the administration’s changes to support the health needs of the American people.”

Her comment came a few days after CMS finalized its rule allowing Medicare Advantage plans to expand telehealth coverage for rural patients.

NYC PROMOTES TELEHEALTH DURING REOPENING ⁠— As New York City moves toward reopening its economy, its health department has encouraged doctors’ offices to restore some services that were unavailable in the early months of the pandemic, but also to continue to use telehealth, audio-only and electronic communication as much as they can, our POLITICO colleague Amanda Eisenberg reports.

“The COVID-19 pandemic is having a profound effect on New Yorkers seeking care for serious health conditions not related to the virus,” Health Commissioner Oxiris Barbot said in a statement. “As the city enters into the next phase of the pandemic, we want health care providers citywide to prioritize patients with a higher risk of poor health outcomes when they reopen or expand clinical services.”

The city recommended certain groups and services that providers should consider when reopening, including people with worsening chronic conditions and patients with a history of intimate partner violence who may not be able to get care through telemedicine, according to Friday’s guidance.

... “Providers should continue to use telephone, telehealth, and electronic communications as much as is feasible and limit in-person visits to essential medical services that cannot be provided remotely,” Demetre Daskalakis, deputy commissioner for the health department’s disease control division, wrote. “Providers can help patients weigh the benefits of seeking in-person medical care against the potential risks of leaving home.”

Medical facilities that do take patients in-person are also expected to implement additional infection control measures and physical distancing precautions, according to the city.

NEW TELEHEALTH STATS⁠ — A post from McKinsey estimates that up to $250 billion of the country’s current health care spending could be done virtually, considering patients’ rapid adoption of telehealth.

About 76 percent of consumers were highly or moderately likely to use telehealth in the future, according to the consulting firm’s recent surveys. Seventy-four percent of people who had used telehealth reported high satisfaction.

Providers are getting on board too. About 57 percent of providers said they viewed virtual care more favorably than they did before the pandemic, and 64 percent said they’re more comfortable using it.

IN EHR STUDY, NO SIGNIFICANT CHANGE IN DIABETES COSTS — A major cohort study of type 2 diabetes patients in Denmark found that using EHR software with a disease management program led to a small increase in patients’ treatment costs and a reduction in emergency hospital visit costs, but there was “no statistically significant change in cost overall.”

“Large health care cost savings associated with improved use of EHR-based disease management systems should not be expected to be realized in the short term,” the researchers wrote.

CONTACT TRACING IN THE WORKPLACE — Thousands of employees around the world are already submitting to contact-tracing apps deployed by their workplace, Buzzfeed reports. But it’s not clear how well they work, ACLU’s Neema Singh Guliani told Buzzfeed. “When you have trained health professionals, they’re trained to build trust, where there are restrictions on how data can be used. Those existing structures don’t exist in the HR context,” she said.

SILICON VALLEY CHECK-IN — Twitter’s decision last week to fact-check President Donald Trump’s tweets has roped Silicon Valley’s biggest players into a political fight with Washington when they least wanted it, our POLITICO Tech colleagues Steven Overly and Nancy Scola write.

... “This is a debate that had been inside the Beltway that’s now gone national, and that means that advocates of online free speech need to prepare a national response,” said Carl Szabo, the vice president and general counsel at NetChoice, one of many tech industry trade groups responding to the Trump-Twitter showdown.

“What’s the opposite of ‘A rising tide lifts all boats?’ That’s this,” said one tech company policy official, who spoke anonymously because of the sensitivities of the situation.

ON TAP THIS WEEK — Some virtual events we’re tracking:

— ONC hosts a working session on patient identity and matching today. ONC head Don Rucker, deputy national coordinator Steve Posnack and chief clinical officer Andrew Gettinger are slated to speak, as is Rep. Bill Foster (D-Ill.), who has supported removing a ban on using HHS funds for national patient identifiers.

— On Thursday, the Bipartisan Policy Center convenes a discussion on rural telehealth during the pandemic.

What We're Reading

— On health data: Whole Foods has fired an employee who was keeping track of coronavirus cases, Lauren Kaori Gurley reports for Vice’s Motherboard.

— Ronda Kaysen draws a parallel between telemedicine and virtual home repairs in The New York Times.

— The Children’s Hospital of Philadelphia’s Meredith Matone writes in the Incidental Economist about taking a precision approach to contact tracing.