AJMC Authors: Telemedicine 'Ideal' For Dealing With COVID-19


Can mitigate overcrowding in healthcare facilities and reduce exposure

COVID-19 threatens to overwhelm the U.S, healthcare system and supply chains, so healthcare providers should revisit disaster responses to include telemedicine, argue authors of an ahead-of-print article in the American Journal of Managed Care.

“Telemedicine systems are ideal for mitigating overcrowding of hospitals and clinics by triaging low-acuity patients while also preventing additional unnecessary human exposures and promoting delivery of high-quality care,” argue the authors, Kimberly Lovett Rockwell, MD,JD, and Alexis Gilroy,JD, of the Jones Day law firm.

Historically, they note, healthcare providers who wanted to deliver care through telemedicine “faced myriad legal and regulatory challenges."

Insurers, providers, and state and federal governments have taken steps in recent days to make telemedicine more available in response to COVID-19.  

• CMS announced on Wednesday that it was waiving several rules that havd restricted the use of telemedicine by Medicare beneficiaries in traditional Medicare. The waiving of the rules is not limited to visits related to COVID-19-related and, effectively, allows the use of Facetime and Skype for the visits.

• Many insurers are waiving out-of-pocket costs for telehealth visits. The Blue Cross Blue Shield Association announced yesterday that the 36 Blues will waive cost-sharing for telehealth services for the next 90 days.

• HHS Secretary Alex Azar has waived the requirement that physicians or other health care professionals hold licenses from the state where they provide services. Waiving this rule is intended to make it easier for telehealth companies to hire health care professionals because it effectively allows licensed professoials to provide telehealth services to people regardless of which state they live in. 

In addition to meeting the needs of low-acuity patients, telemedicine can be used for address the needs of patients with chronic illnesses to reduce in-person visits, write Rockwell and Gilroy.

“Such uses of telemedicine reduce human exposures (among healthcare workers and patients) to a range of infectious diseases and ensure that medical supplies are reserved for patients who need them,” wrote the co-authors.

Many European Union and Asian countries have expanded laws and regulations to permit greater adoption of telemedicine systems, according to Rockwell and Gilroy. In Italy, for example, all 20 Italian regions, as of 2018, have implemented telemedicine guidelines promulgated by the Italian Health Council in 2012 to facilitate greater use of telemedicine technologies throughout the country, they note. 

“Because state, federal, and international laws and regulations have expanded in recent years, months, and weeks to accommodate greater adoption of telemedicine systems (especially during this public health crisis), healthcare providers are now better situated to consider implementing such systems,” say Rockwell and Gilroy. “Although certain legal, regulatory, and reimbursement challenges remain, the COVID-19 outbreak may be the right impetus for lawmakers and regulatory agencies to promulgate further measures that facilitate more widespread adoption of telemedicine.”

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