Telehealth and coronavirus

With help from Mohana Ravindranath (@ravindranize)

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Quick Fix

— Telehealth and coronavirus: The telehealth sector is getting several powerful boosts as officials rush to contain the coronavirus outbreak

— Tech companies get the call: Tech companies are getting the call to assist on artificial intelligence research and combat misinformation on coronavirus.

— HITAC on deck: And, in non-coronavirus news, the Health Information Technology Advisory Committee is meeting on those big interoperability rules from last week. (Remember that?)

And more. But first, the jump.

eHealth tweet of the day: Anne Wojcicki @annewoj23 “[on whether the coronavirus will encourage telemedicine takeup] I think this will change the adoption curves of digital care — from telemedicine to digital physical therapy to online exercise classes. I am discovering how effective I can be from home.”

WEDNESDAY: Hope everyone is managing under the coronavirus strain so far and able to stay connected with family and friends. Anything eHealth-related in the pandemic that we need to keep apprised of? Let us know by email at [email protected]. Discuss socially at @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Driving the Day

TELEHEALTH’S ROLE IN THE CORONAVIRUS RESPONSE — Telehealth seems to be one of the key legs supporting the coronavirus response, as the medical system aims to keep patients well-cared-for but also out of the hospital.

That means overhauling the regulatory and reimbursement system, which still hasn’t totally caught up to the needs of telehealth providers. Here’s the latest in the efforts:

— Federal response: The federal government unveiled two big changes to telehealth regulations.

First, HHS is using its authority during national emergencies to waive telehealth reimbursement restrictions and privacy protections so that patients are covered to video chat with their clinicians on consumer platforms like Google Hangouts and FaceTime, officials said Tuesday. President Donald Trump in a Tuesday briefing said his administration would “encourage everyone to maximize use of telehealth to limit exposure to the virus.” The companies did not offer any guidance for how the platforms should be used by patients and clinicians.

Second, licensed clinicians can now prescribe controlled substances to patients they haven’t met in person, as long as they communicate using audio and visual elements. That’s per DEA guidance published Tuesday; the Ryan Haight Act generally prohibits doctors from prescribing controlled substances to patients they haven’t examined in-person, except in certain situations — including a public health emergency.

This could help patients access medication-assisted treatment more widely — at least, during the coronavirus outbreak. But DEA still hasn’t issued the special registration process that would allow eligible clinicians to regularly prescribe controlled substances virtually. The 2018 opioid response legislation gave DEA until October 2019 to publish that process.

— California battles over reimbursement: Doctors and hospitals in the Golden State are pushing Gov. Gavin Newsom to accelerate previously-legislated reimbursement hikes in response to the coronavirus pandemic, our colleague Angela Hart reports.

The state had already agreed to reimburse virtual visits at the same rate as in-person ones, but it was scheduled to take effect later this year. Doctors’ groups would like the provision to be fast-tracked. Massachusetts has already boosted reimbursement rates.

Similarly, hospitals would like Newsom to extend telemedicine reimbursement for Medicaid. Newsom is interested in more telemedicine in that program; late Tuesday, he said he’d requested a waiver from the federal government to expand telemedicine for Medicaid.

— Texas: Texas Gov. Greg Abbott announced Tuesday the state government had evened reimbursement for telemedicine visits relative to in-person visits for state-regulated plans.

— ATA request to governors: The American Telemedicine Association is calling on governors to allow out-of-state physicians to practice medicine in their states via telehealth. Licensure has been a key regulatory barrier to telehealth, and it’s one that’s falling in the early stages of the coronavirus outbreak. States like Florida have already cut through some of their requirements in this space.

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TECH COMPANIES GET THE CALL — Tech companies are also getting the call to support the coronavirus response. Amazon, for example, is deploying its logistics networks to prioritize medical supplies and household staples.

That’s only the most recent in a battery of initiatives. The White House, in concert with top artificial intelligence researchers, announced it had assembled a corpus of 29,000 scholarly articles related to coronavirus for researchers to feed into AI applications, our colleague Steven Overly reports.

Misinformation has also been a recurrent concern. Misinformation about the effects of ibuprofen on coronavirus and other salacious worries have been burning up social media, our colleagues in Europe report.

HITAC ON DECK — In news that’s not coronavirus-related (it’s still possible), the Health IT Advisory Committee is holding a meeting this morning focused on the big interoperability rules that were unveiled an eternity ago. (Which is your correspondent’s metric for lengths of time greater than a day.)

The agenda features a wide cast from ONC and CMS making presentations on the rules; as ever, we’ll be tuning in to see if there’s anything newsworthy.

— In other ONC news … : The office has extended the comment period to April 3 on its draft health IT strategic plan.

Some enterprising individuals have already gotten their comments in. The University of California, San Francisco’s Center for Digital Health Innovation says the plan should include an interoperability measurement framework, to make sure we’re keeping track of how data-sharing is developing, and to allow bi-directional exchange and access as a goal. The Center argues allowing patients to write into EHRs will empower them to make corrections.

HHS BACK TO NORMAL AFTER CYBER ATTACK — HHS’ computer systems suffered a cyber attack Sunday night that some officials thought might be attributed to Iran, the Department and the National Security Council confirmed. The attack, first reported by Bloomberg News, was apparently an attempt to slow down the Department’s systems but didn’t do so “in any meaningful way.”

What We're Reading

ONC head Don Rucker makes the case for the interop rules in the New England Journal of Medicine.