Expanding Telehealth Services in Remote and Rural Regions

Alaska is Leading the Way in Telemedicine, But Increasing Access is Key

While we continue to learn about the health impacts of COVID-19 and evolve an appropriate response to the pandemic, U.S. Senator Lisa Murkowski (R-AK) participated in a Senate HELP Committee hearing focused on telehealth services and the lessons learned from the pandemic regarding this form of health care delivery. The hearing delved into significant changes made to telehealth policy by Congress, the administration, and states during the pandemic. The hearing included testimony from expert witnesses on the benefits and challenges of utilizing telehealth, what has been learned from using this service in the midst of the pandemic, and steps needed to improve access to telehealth both in the near term and into the future.

Experts who specialize in the delivery of telehealth services presented testimony during the hearing: Dr. Karen S. Rheuban, University of Virginia Center for Telehealth Director, Dr. Joseph C. Kvedar, American Telemedicine Association President, Dr. Sanjeev Arora Project ECHO/ECHO Founder and Director, and Dr. Andrea D. Willis, Senior Vice President and Chief Medical Officer for BlueCross BlueShield of Tennessee.

HELP Hearing Snip 1 06.17.20

CLICK HERE for video from the hearing.

During the hearing, Senator Murkowski spoke to the extraordinary benefits telehealth has provided to Alaskan communities, particularly in remote regions, and the challenges communities face regarding telehealth services, such as reimbursement of telehealth costs. Murkowski referenced a conversation with the administrator for the Petersburg Medical Center in Petersburg, Alaska and the positive impacts telemedicine services have brought to the small island community.

“We talked about the benefits that he has seen in his professional career as a result of telehealth. He’s not just an administrator, but also an audiologist. So he’s had interests on both sides, and what he has seen with the increased access to care, the improved delivery has been phenomenal, but we’ve had this lag. We haven’t seen to have gained the traction that we want in terms of full implementation, and it comes back to reimbursement. If you have the ability to do it but will not be reimbursed for that, it is an impediment,” said Senator Murkowski. “But he said, and I will quote from his letter here, ‘More progress has been made in telemedicine and the delivery of health care in the last 3 months than the last 20 years.’ That’s transformative. That’s what is happening right now.”

Senator Murkowski questioned witnesses on how we can take lessons learned from the pandemic regarding telehealth and use that information to expand and increase access to telehealth services in a way that provides the greatest amount of access for people living in remote areas and that also supports the health systems servicing those regions.

“But what we’re seeking to do here is, and the real benefit, the real win, is increased access. We all want to be able to do that and particularly for those in our remote areas. But in these remote areas you have health care systems that are often fragile, they are just on the margin of being able to cover their overhead, meet their expenses,” said Senator Murkowski. “So you don’t want to be in a situation here where you have built something that is not sustainable because the method of delivery, of access, has been made more efficient. How do we find this balance?”

Dr. Rheuban responded by describing Alaska as a leader in telehealth, and explained that balance will be found thorough the gathering of information from specialty groups, organized medicine groups, nurses, and others in the medical field.

“If I might give a quick anecdote from your own state which I visited a number of years ago. Stewart Ferguson, another ATA past president, shared that there was a fire in a health clinic in Northern Alaska, and the residents of the community raced in to save the telemedicine equipment. The rest of the clinic burned, but the telemedicine equipment was moved to the school. Patients truly appreciate access to care using technology,” said Dr. Rheuban. “I think we will find the balance of, and I think the specialty societies themselves, organized medicine, nursing – we will ascertain what is best practice, and the fact that we have new CPT codes that have been activated in the pandemic will also enable us to identify cost savings, outcomes, and guide us as we move forward. So I just want to give a shoutout to your state which has been a leader in telemedicine as well.”



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