COVID Series: Federal Funding for Telehealth with Sirius Healthcare
Episode 23930th April 2020 • This Week Health: Conference • This Week Health
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 Welcome to this week in Health IT News, where we take a look at the news which will impact health it. This is another field report where we talk with leaders from health systems and organizations on the front lines. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set up podcasts, videos, and collaboration events dedicated to developing the next generation of health leaders.

Are you ready for this? We're going to do something a little different for our Tuesday Newsday show. Next week we're gonna go live at noon Eastern 9:00 AM Pacific. We will be live on our YouTube channel with myself, Drexel Ford Sus Shade. And David Munch with Starbridge Advisors to discuss the new normal for health.

It, uh, with you supplying the questions with live chat. Also, you can send in your questions ahead of time at hello at this week in health it.com. Uh, I'm so excited to do this and I hope you'll join us. Mark your calendar. Noon Eastern 9:00 AM Pacific on April 28th. If you want to, uh, send the questions, feel free to do that.

Um, and uh, you can get to the show by going to this week, health.com/live. This episode and every episode since we started the Covid 19 series has been sponsored by Sirius Healthcare. Uh, they reached out to me to see how we might partner during this time, and that is how we've been able to support producing daily shows.

Special thanks to Sirius for supporting the show's efforts during the crisis now onto today's show. Today we're gonna talk about the CARES Act funding for Telehealth with Eli Tarlow with Serious Healthcare, and uh, he's another person who holds the former CIO title. Good afternoon, Eli, and welcome back to the show.

Good afternoon, bill. Thanks for having me again. You seem well adjusted. You're, you're making the transition to a former CIO. Um, actually, Drex to Ford has, has taken the, the term recovering CIO and sort of patented it. So if you're gonna use it, you have to give him, uh, royalties if you're gonna do that. By the way, I'm waiting for Drex to tell me what those 12 steps are.

there's, there is a group of us, um, you know, this conversation

by.

It was on, uh, Christiana. Christiana Care has received seven $14,000 grant from the FCC to support telehealth services during the Covid-19 pandemic. Uh, they're one of only 17 health systems that have received that funding to date. Um, but there are, there's hundreds of millions of dollars available, uh, in this program.

And we talked about this on our live show today. How important, uh, funding sources for it. Challenging time. So we're gonna go into the details. You're, you're gonna help us to really understand this program. So, um, with just that as the setup, you know, what is the program and, uh, how much is available. Sure.

Thanks Bill. So before we talk specifically about this program, the CARES and the Telehealth program, just to give some, some perspective perhaps. So this is actually the, the third stimulus bill. The first one, as many know, is what was called the Coronavirus Preparedness and Response. Supplemental Appropriation Act.

And that, um, that funding that bill, which, um, came out towards the end of, uh, February approved, um, was primarily focused on vaccination developments, research masks, and other PPE for the healthcare agents or need for treating patients. Um, some of it was for loan sepsis, for small business, et cetera. So that was kind of the first, um, push or the first bill that came out, um, that was about $8.3 billion.

The second bill that was, um, approved and announced was what they call the Families First Coronavirus Response Act. And that was, as many know, um, it was focused on unemployment insurance for laid off employees, free coronavirus testing for those that could not afford to pay food assistance for children, um, et cetera.

And so now the third one we're talking about. Is the specific to telehealth is part of the third, um, stimulus bill, which has been nicknamed Cares, which stands for the Coronavirus Aid Relief and Economic Security Act. So that bill was passed on March 27th for roughly $2 trillion, obviously the largest one to date.

Um, seven main groups, and I won't go into all of them. The one specific that we're gonna focus on is hospitals, public health, et cetera. And, um, more specifically is telehealth. The amount, um, the amount that was approved for telehealth in this, uh, in this part is, um, for up 200 million. Wow. 200 million. So, so who's eligible and, and how much can I apply for?

Is, is it based on the size of my health system? What, what, how much, how much can each award b? Sure. So the program is actually eligible, uh, it's open to eligible healthcare providers obviously treat patients. It doesn't matter if they're located in rural and non-rural areas, US territories, et cetera. Um, there's a limit of $1 million per organization.

That's the limit of a million dollars funded that can be awarded to any individual organization. Um, it's for post-secondary educational institutions. It's for community health, it's for local health departments, agencies.

Make someone make an organization approved for that funding. Um, I, I, so actually, let's go to, we could go into what are those eight areas, but we could also just go into, uh, you know, what, what does the money have to be used for in order, in order for me to be eligible to get this money? Excellent question.

So the this telehealth program, this COVID 19 telehealth program funding is to provide, um, eligible healthcare providers to support the purchases of telecommunication IT systems, connected devices that provide telehealth service to patients in response, obviously to coronavirus. So it's, it's, it could be anything from, you know, devices like, um, pulse oximetry, um, blood pressure monitoring thing.

I, uh, devices that themselves are connected. Um, it won't fund unconnected devices that patients could perhaps use at home and then manually report the results to their medical professional. So it's, um, you know, connected devices could be, include devices that are Bluetooth or wifi, kind of, uh, capable.

Interesting. So yeah, and, and people need to know that, I mean, this is through the FCC, um, which I guess makes sense, right? So we're talking about realtime monitoring types of devices. We used to do home health and we had, uh, devices that were connected up to a, uh, to an iPad, which was connected to, so.

Uh, monitoring stuff, the, the things that you would connect up, connect up to, to, uh, uh, wifi or connect up to a, a cell network, a mobile network, and communicate that stuff back, those things are eligible. Yeah. Let me give you some advice, some, uh, some examples because it's, it's really broad in, in the way I interpreted it.

Um, it could be telecom services, broad broadband community, uh, connect connectivity services. So. Actual voice services that organizations turned on, um, to do this. So it could actually be telehealth through voice. Um, it could be, um, tablets, smartphones, the procurement of those devices to support the, um, practice, if you will, of telehealth.

I mentioned some of those. Um, kind of pseudo med pulse oximetry, um, it could be platforms. Um, the ability to transfer images. Um, for patients. So it's, it, you know, the mind can, the mind can really wander in many places, but just as you mentioned it, it seems to focus specifically on connected devices and not devices that maybe you would dock and, and upload.

Oh, not, not to take us too far off because I, I really wanna, I wanna transition this and talk to you about the future of telehealth with just one, or with the closing minutes we have here, but it, I could almost read this and say, Hey, we need to upgrade our phone system. We're telehealth through our phone system.

I'm gonna take that million dollars and I'm gonna, I'm gonna purchase a Cisco platform to upgrade our call center. Yeah, I mean, if, if you're looking to purchase a new phone system for a hospital and Oh, and by the way, you know, we'll get telehealth out of it. Yeah. I don't think funding will, uh, the funding won't provide for a phone system, but if you can focus in on.

Telecom tele to promote telehealth, then that particular aspect I would imagine is eligible. So the, the spirit is to promote to, to really sustain the gains that we've experienced over the last couple of months in terms of, uh, really increasing access in, in improving the reach into the community, uh, keeping people in.

Covid, safe non covid environments, uh, for care. Uh, it's really expanding all the things that we've experienced over the last, uh, eight weeks or so, I would imagine. Yeah. And Bill, let me, maybe I'll give a couple of examples of, um. Of examples that we, where organizations have already been, uh, received approved funding.

There's one, uh, without naming names. There's an organization in Georgia that received about three quarters of a million dollars to implement telehealth video visits, virtual check-ins, um, to do remote patient monitoring. Um, so they, that was a very large, um, award, or I should say a large proposal, um, included.

Uh, and, and really it was about reducing. For, for that aspect is about reducing PPE during this, um, epidemic. So that was kind of the spirit is how do we look at telehealth, how do we look at technology options? And then I'll take you to a whole nother end of the spectrum where there's another organization in Pennsylvania that was awarded a couple hundred thousand dollars to provide telehealth services to children who receive organ transplants and are immunecompromised and at high risk for, um, can see.

That's really. Um, large, perhaps in variety, but always comes down to how does this really promote, uh, telehealth. Absolutely. All right, so let's, let's transition with the, uh, tail end of this. You know, uh, CIMA Verma over the weekend said, I think the genie's added the bottle on this one. Uh, and Cima Verma is the CMS administrator.

She said, I think it's fair to say that the advent of telehealth has just completely accelerated and that it's taken this crisis to push us to a new frontier, but there's absolutely no going back. So that's what CMA CMS is saying. Um, Eli, so I turn to and say, you point. Uh, for virtual care in our industry, absolutely.

Um, you just can't take, well, for starters, you can't take back what we've already done. I think the adoption has, uh, has gone so far that physicians, providers, organizations are not willing to give back what they've already, um, what they've already implemented, number one. Number two, um, there's actually a survey that was done recently, a survey of 800 physicians, um, and 60% of them.

Not seeing Covid patients today, were willing to move ahead just based on the advancements specific to Covid. And this was a survey done by, uh, general medicine practitioners, subspecialties surgeons, uh, that's people that haven't even begun using telehealth to promote, um, to help with Covid 19. And they're all on board.

And we just take a step back to maybe why we're now talking about telehealth so much more than we have you. Um, and maybe I, you know, I look at it and say, okay, what are the three areas that need to really happen, uh, to, to make telehealth work? Now, the first one is obviously the capability, right? You have to have the ability to do something distant that perhaps, you know, we historically did face-to-face.

And, you know, there's easy ones, you know, the, the, the less. Um, complicated ones like behavioral health, right? Where you don't have to actually necessarily touch the patient. It's facial expressions that maybe you need to see remotely or body language. But, you know, telehealth, telehealth is very relatively easy, um, in behavioral health situations, and that's how, you know, that was an early adopter of telehealth.

Then we went on to, you know, e-visit and emergency department. Are there ways that we can kind of have the emergency department visit? Distant I call rather than remote. So I look at it as three aspects and we go that along as we move along in this journey. There are really three aspects to consider. The first one is the obvious one, is it possible?

Can we provide the same or better level of care dis from a distance? And then there are things that will be a lot easier to do, and there are things that will be a little more complicated to do. I mean. To, to surgery to deliver a baby. These are things that are very, very difficult to do with telehealth.

Things that have less touch are, are more obvious. So the first one is, does, does the, is it possible? Does that capability exist? The second one is, is there an interest? Right? So we talk about the quadruple aim and physician burnout is a big one. Does this increase their burnout? Or perhaps does it decrease their burnout?

There's a big school of thought that says, well, if I can now do things from home and I don't have to go into the organization, well that makes my life easier. Well, look what happened. We went from real, you know, landline phones to cell phones. I don't know. There's an argument to be made either way. If our life got easier or more difficult now that we can, now that we're always available.

And then the third one, and this is really important, is does the reimbursement model exist? So you can have the technology, you can have the willingness, but one of the biggest things that happened recently with the stimulus bill with these, you know, the barriers that were really, um, broken down was that CMS has now agreed to fund telehealth.

And so I see that growing and growing and growing. And I just wanna mention one other thing related to that, um, is that now this Congress is considering a fourth, another bill called the Emergency Covid 19 Telehealth Response Act. Which expand Telehealth, Medicaid and Medicare reimbursement for physical therapists, occupational therapists, social workers, speech, uh, therapists, uh, audiologists.

So just try to imagine someone with ALS at home who now has access to therapy reimbursed by CMS through telehealth. So, I mean, I just, you know, I obviously, I'm excited about this. I think this is perfectly aligned with the quadruple aim, reduced cost. Patient experience, physician engagement. The world is flat.

And the last thought on that is that we're entering a generation of millennials that live by doing things distant. I mean, I think it just speaks to the future. Yeah, it, it is really exciting and I, I, I think some of the possibilities we haven't even thought of yet. I was, I interviewed somebody on the show and they said they, you come into their, uh, emergency department and, um, if, if you don't really wanna wait in the line, there's actually telehealth to the left.

It's like, go to the right and wait, wait in the emergency room, go to the left and actually do telehealth. And they, they weren't sure how it was gonna go and it went gangbusters because people were like, yeah, I'll try it. I mean, if it's gonna. By 45 minutes I'll try it. And kind of interesting when we.

The cost was lower. The, uh, they in some cases didn't need any emergency, uh, you know, visit whatsoever. They were able to see a primary care physician later, and it just, it relieved the, the burden on the, uh, on the emergency department and it, uh. It just created a new experience for this, uh, for, for the patient population there, there are so many untapped, untapped, uh, areas at this point.

How so? I wanted to, I did wanna close this up by saying, how hard is this to do? I mean, is there, um, do I have to write a grant proposal and get grant writers, those kind of things, or is it, there's, there's a, there's, you know, a website to.

Yeah, it's, well, first of all, it's not, it's not difficult. It's, unfortunately, it's not, it's not an online form. It's a pdf. It's, it's something to be completed. It's not a difficult, um, process. Um. My colleagues and I can help those that find it challenging. Um, two points to make about that. The first one is very important.

It's not necessarily only things that organizations are considering in the future. So anything that, any device, any eligible service that's been purchased, um, on or after March 13th, this past March 13th.

So if organizations just. Um, iPads, um, purchased different things for telehealth in response to Covid. Then they should come up with that list and, and seek reimbursement for that. The second, um, important note on that is that it's on a first come, first serve basis. So once this million is exhausted, then um, it'll be, the funding will be, won't be available.

No deadline has been set for, um, filling this out. To apply. The FCC has a site, it's a little lengthy, I'll just read it out. It's fcc.gov/ covid-19 telehealth program. Um, there's a lot. There's a great FAQ section. Um, and like I said, you know, myself, my colleagues can help other.

Fantastic. There's also a, uh, Sirius, uh, link. It's a pretty lengthy link, so what I'm gonna do is I'm gonna do a redirect. Uh, you can hit this week, health.com/sirius s IRIS slash telehealth, and it will redirect you over to the, uh, the Sirius, uh, site. They have a, a bunch of information for you on that, ways to get in touch with them, ways that, uh, Eli a.

Excellent. Thank you, bill. I appreciate the time. That's all for this week. Special thanks to our sponsors, VMware, Starbridge Advisors, Galen Healthcare Health lyrics, serious Healthcare and pro talent advisors for choosing to invest in developing the next generation of health leaders. If you wanna support the fastest growing podcast in the health IT space, the best way to do that is to share it with a peer.

Send 'em an email, dmm 'em. Whatever you do, however you do it. Uh, go ahead and do that and, uh, that would benefit us greatly. We appreciate your support. Please check back often as we will continue to drop shows until we get through this pandemic together. Thanks for listening. That's all for now.

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