Telehealth Gains Broad Support For Improving U.S. Health Care

WASHINGTON — The only remaining question after a Senate hearing on telehealth Thursday was not whether more of it is coming but when.

Telehealth refers to medical personnel providing health care through telecommunications, most commonly streaming video over the Internet.

“Over the past year, the COVID-19 pandemic has changed so much about our lives,” said Sen. Ben Ray Luján, D-N.M., chairman of the Senate Commerce subcommittee on communications, media and broadband.

He was referring most specifically to heavier dependence on telecommunications as doctors and their patients tried to avoid the close contact that could spread the disease.

“The landscape of American health care changed,” Luján said.

Before the pandemic, about half of U.S. health care facilities were not equipped to offer telehealth services, he said.

“Today, that figure is under 5%,” Luján said.

Several bills have been introduced in the House and Senate this year that seek to ensure a boom in telehealth during the pandemic does not go away.

In addition, Congress is putting final revisions on the Democrat-backed Build Back Better Act, which the Biden administration proposed originally as a $3.5 trillion expansion of the nation’s infrastructure.

Although Republicans are trimming the amount of money they are willing to dedicate to the projects, a proposal to dedicate $65 billion to increase broadband infrastructure is largely untouched in the partisan bickering. Broadband refers to high-speed digital communications, typically for the internet or cell phones.

“We all see the urgency here,” Luján said.

Sen. Roger Wicker, R-Miss., said, “Telehealth has become an indispensable part of our health care system.”

He added, “We will nor realize the full benefits of telehealth without broadband access.”

The U.S. Centers for Disease Control and Prevention reported a 154% increase in telehealth visits during the last week of March 2020 compared with one year earlier.

More than 14 million Americans lack access to broadband, according to a Senate report Wicker cited. About 11 million of them live in rural areas that do not have cell phone towers or satellite hookups to transmit the high-speed data.

Sanjeev Arora, a University of New Mexico professor of medicine, talked about a rural woman who needed speciality care for cancer but was unable to find a specialist who could help her for the emergency she faced.

“We had the medicine and the treatments to treat her,” Arora told the subcommittee. 

However, because she could not find a medical specialist she needed in time, she died.

Telehealth could resolve the need to promptly reach specialists who might not be available in rural areas, he said.

In his largely rural, southern state of New Mexico, skin cancer is a common problem. However, the number of dermatologists is so small that some patients must wait six months to get their specialty care, he said.

“In a state with one of highest skin cancer rates, patients cannot access dermatologist care,” Arora said.

State health officials are broadening the kinds of health care that they will allow through telehealth. Until the pandemic, it was used almost only for consultations between doctors and patients.

Now, state agencies are allowing more doctors to write prescriptions after telemeetings, home monitoring of patients and transmission of health data. Discussions among lawmakers continue about more robotic surgeries through the Internet.

Part of any bigger role for telehealth will depend on Federal Communications Commission authorizations.

FCC Commissioner Brendan Carr called telehealth “a top priority for me” as he updated the Senate on his agency’s progress toward installing the equipment and approving the licenses.

“We need to continue to streamline infrastructure rules,” Carr said.

The FCC is developing maps of the best places to install broadband equipment. Afterwards, FCC officials plan to distribute federal funding to local agencies and private contractors.

“We have funding in the pipeline that we need to get going,” Carr said.

A group of health care advocacy groups wrote a letter to congressional leaders in late August warning them not to wait too long to keep the telehealth services developed during the pandemic.

“Many of the telehealth flexibilities are temporary and limited to the duration of the COVID-19 public health emergency,” the letter from 430 trade associations, hospitals, insurers and other groups said. “Without action from Congress, Medicare beneficiaries will abruptly lose access to nearly all recently expanded coverage of telehealth when the COVID-19 (public health emergency) ends. This would have a chilling effect on access to care across the entire U.S. health care system, including on patients that have established relationships with providers virtually, with potentially dire consequences for their health.”