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Telemedicine Wrap Up -- Industry Happenings in Sept 2018

Posted by James Baker, Chief Medical Officer | October 3, 2018 |
James Baker, Chief Medical Officer

As telehealth continues to move into the mainstream, the rapid pace of changes to the regulatory environment continues to benefit providers. New telemedicine applications are occurring, new clinical outcomes being weighed, and lawmakers are seeking new ways to expand access with telehealth.

This article will look at some of the latest news in the telehealth industry, including:

  • Last month HHS issued new guidelines designed to improve access to medication-assisted therapy for substance use disorders via telemedicine applications.
  • New legislation seeks to eliminate the prior-relationship rule for telehealth visits.
  • A new study shows clear benefits of telemedicine in skilled nursing facilities.
  • A bill introduced in the House seeks to make a person’s home an originating site for telehealth applications in the mental health field.
  • Telemedicine experts held a private roundtable with the White House to talk about telehealth expansion and the removal of barriers for providing the service.

Let’s dig a little deeper into telemedicine industry happenings from September 2018.

New HHS Guidelines for Use of Telemedicine to Treat Substance Abuse

Last month, the (U.S. Department of Health and Human Services (HHS) released new guidelines to help fight the opioid crisis in the United States. This initiative couldn’t come at a better time; the Centers for Disease Control and Prevention (CDC) released data showing drug overdoses are increasing. The National Institute on Drug Abuse (NIDA) suggests over 115 people in the U.S. die every day from an overdose of opioids. This includes prescription pain relievers, synthetic opioids like fentanyl, and heroin. This phenomenon has been called an epidemic and is widely viewed as a national crisis.

Into this troubling climate, come the HHS guidelines that seek to establish the use of telemedicine initiatives to improve access to evidence-based medication-assisted therapy (MAT), which provide behavioral counseling and medications to treat substance abuse disorders. Tools such as Methadone, Naltrexone, and Buprenorphine, help reduce withdrawal symptoms while weakening the drug’s grip on the patient.

The problem with MAT is the dilemma we face today with all rural healthcare: Access. Patients in rural communities must now travel long distances to receive treatment because there are too few clinical providers able to prescribe these medications. But the new HHS guidelines seek to remedy this problem by encouraging the use of telemedicine as a way to extend access into these communities. The HHS information page says, “Sadly, this information is not widely known among healthcare providers and other stakeholders; and many have been reluctant to utilize telemedicine for prescribing MAT.”

HHS asks other clinical providers to share these guidelines, “as we are hopeful that we can help eliminate this perceived barrier to treatment.”

New Legislation Lifts Patient-Relationship Restrictions

Telehealth made the news a second-time last month as it relates to expanding access for substance abuse. New legislation called “The Special Registration for Telemedicine Clarification Act,” seeks to eliminate the requirement that doctors have a pre-established relationship with patients before utilizing telemedicine technology. While the benefits for providing MAT are clear, legislators expressed concern, not that treatment for substance abuse would expand, but that broadband access needs to expand in order to also increase the use of telehealth technology in rural areas.

New Study Released Showing Telehealth’s Benefit for Nursing Homes

Digital Commerce 360 reported last month on a new study that sought to quantify the benefits of telehealth to cuts costs and increase care for nursing home patients. The research looked at telemedicine applications in a 365-bed skilled nursing facility in Brooklyn. The telemedicine application included:

  • Overnight on-call designed to supplement existing nursing staff.
  • A “dial-a-doctor” consult number for nurses concerned about changes to the condition of a patient when no doctor was available.
  • Bedside consultations that allowed a doctor to dial-in remotely while working with an on-site nurse.


The statistics were promising; in the first year, the service treated more than 550 patients. The study showed:

  • 91 patients avoided hospitalizations.
  • 54 received a more timely evaluation that led to their hospital admission.
  • The potential savings were estimated at $1.55 million in 12-months.

While it’s clear more research needs to be done, this latest application of telehealth technology holds real promise for cutting costs and improving nursing facility outcomes.

September Bill Seeks to Eliminate Originating Site Restrictions

mHealth Intelligence reported on a bill introduced last month in the House “designed to make telehealth and telemedicine a pivotal tool for Medicaid-based programs.”

While The Mental Health Telemedicine Act was designed to help fight the nation’s opioid epidemic, what it could potentially do for the field of telehealth is important to broader applications of the technology. The legislation will attempt to lift the onerous originating-site issues that require telehealth applications to extend from an approved facility. The bill would amend the Social Security Act to allow reimbursement for originating sites that include the patient’s own home. It also would eliminate the facility fees paid by originating healthcare sites.

One of the bill’s sponsors stated, “Everyone – regardless of where they live – should have access to telemedicine service from the comfort of their home so they can be treated. This bill is an important step in the right direction for those in need.”

White House Holds Private Roundtable on Telehealth Expansion

Last month, healthcare providers and telemedicine industry groups met in a closed-door roundtable with government officials from the White House, HHS, and the Federal Trade Commission to encourage their support of industry expansion and a reduction in the barriers to telehealth.

Politico reports that the discussion centered on “policy barriers to widespread access,” suggesting that telehealth leaders called for the elimination of originating site restrictions and other geographic or reimbursement hurdles. Telemedicine advocates suggest that not only are these barriers outdated, but they also restrict access to care at a time of increasing provider shortages, and severely limit competition in a healthcare industry hungry for innovation to improve outcomes.

The article implied the roundtable was viewed positively by the Trump administration, which said they are geared up for “continuing its work to ensure American patients have various options to access the healthcare they deserve.”

Contact OrthoLive for more information on our telemedicine application for orthopedic providers.

Topics: "telehealth", "telemedicine", legislation, 2018 trends, technology

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