May 1, 2020: In this episode we explore the federal money that is available to healthcare organizations to fund the advancement of telehealth. We’re going to talk about the CARES Act funding for telehealth with Eli Tarlow, former CIO of Sirius Healthcare. Of course, given the nature of this global event, it is increasingly important to find alternative funding sources for health IT, such as telehealth systems. CARES stands for Coronavirus Aid Relief and Economic Security, and it is actually the third such stimulus buildup of its kind, which has approved an amount of $200 million of funding to eligible healthcare providers for IT and telehealth services. This includes real-time monitoring devices like pulse oximetry and blood pressure monitors, telecom and broadband connectivity services, and other devices that support the practice of telehealth. Eli Tarlow will walk us through what kinds of institutions and organizations are eligible, and what requirements they will need to fulfill in order to receive funding. Stay tuned for some useful resources!
Key Points From This Episode:
COVID Series: Federal Funding for Telehealth with Sirius Healthcare
Episode 239: Transcript – May 1, 2020
This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.
[0:00:04.5] BR: Welcome to This Week in hHalth IT news where we look at the news which will impact health IT. This is another field report where we talk with leaders from health systems on the front lines. My name is Bill Russell, healthcare CIO coach and creator of This Week in Health IT, a set of 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 going to go live at noon Eastern, 9 AM Pacific, we will be live on our YouTube channel with myself, Drex DeFord, Sue Schade, and David Muntz with StarBridge Advisors to discuss the new normal for health IT. With you supplying the questions with live chat, also, you can send in your questions ahead of time at [email protected] I’m so excited to do this and I hope you will join us.
Mark your calendar. Noon Eastern, 9 AM Pacific on April 28th. If you want to send the questions, feel free to do that and you can get to the show by going to thisweekhealth.com/live. This episode and every episode since we started the COVID-19 series have been sponsored by Sirius Healthcare. 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, on to today’s show.
[0:01:25.1] BR: Today we’re going to talk about the CARES Act funding for telehealth with Eli Tarlow with Sirius Healthcare. He is another person who holds the former CIO title, good afternoon Eli, and welcome back to the show.
[0:01:38.9] ET: Good afternoon Bill, thanks for having me again.
[0:01:41.0] BR: You seem well adjusted, you’re making the transition to former CIO. Actually, Drex Deford has taken the term of ‘recovering’ CIO and sort of patented it, so if you’re going to use it, you have to give him royalties if you’re going to do that by the way.
[0:01:56.4] ET: I’m waiting for Drex to tell me what those 12 steps are.
[0:02:01.4] BR: There is a group of us. You know, I’m excited about this conversation, you’re going to give us some details and, I’m going to start by referencing a story that I received in my email yesterday, and that was on ChristianaCare. ChristianaCare has received a $714,000 grant from the FCC to support telehealth services during the COVID 19 pandemic. They’re one of only 17 health systems that have received that funding to date but there are – there’s hundreds of millions of dollars available in this program. We talked about this on our live show today, how important it is to find alternative funding sources for IT because this is going to be a very challenging time.
We’re going to go into the details, you’re going to help us to really understand this program. With just that as a setup, what is the program and how much is available?
[0:02:56.2] ET: Sure, thanks Bill. Before we talk specifically about this program, the CARES and the telehealth program, just to give some perspective perhaps. This is actually the third stimulus buildup. The first one as many know, is what was called the Coronavirus Preparedness and Response Supplemental Appropriations Act.
That funding, that bill, which came out towards the end of February, was primarily focused on vaccination developments, research, masks, and other PPE for the healthcare agents needed for treating patients. Some of it was for loan sepsis for small businesses et cetera. That was kind of the first push or the first bill that came out. That was about $8.3 billion.
The second bill that was approved and announced was what they call the Families First Coronavirus Response Act, and that was, as many know, it was focused on unemployment, insurance for laid off employees, with free corona virus testing for those that could not afford to pay, food assistance for children, et cetera.
Now, the third one we’re talking about is specific to telehealth. This part of the third stimulus bill, which has been nicknamed CARES – which stands for the Coronavirus Aid Relief and Economic Security Act. That bill was passed on March 27th, for roughly two trillion dollars, obviously the largest one to date. Seven main groups, and I’m going to go to all of them, but the one specific that we’re going to focus on is hospitals, public health, et cetera and more specifically is telehealth.
The amount that was approved for telehealth in this part is $200 million.
[0:04:41.8] BR: Wow, $200 million. Whose eligible and how much can I apply for? Is it based on the size of my health system? How much can each award be?
[0:04:53.0] ET: The program is actually eligible – it’s open to eligible healthcare providers, obviously to treat patients, and it doesn’t matter if they’re located in rural or non-rural areas, US territories, et cetera. There is a limit of one million dollars per organization, that’s the limit – a million dollars funding that can be awarded to any individual organization.
It’s for post-secondary educational institutions, it’s for community health centers, it’s for local health departments or agencies, community mental health centers, not for profit hospitals. There’s eight different areas that make someone, make an organization approved for that funnel.
[0:05:32.3] BR: Actually, let’s go to – we could go in to one of those eight areas where we could also just go into – what does the money have to be used for in order for me to be eligible to get this money?
[0:05:47.1] ET: Excellent question. This telehealth program, this COVID 19 telehealth program funding, is to provide eligible healthcare providers, to support the purchase of telecommunication, IT systems, connected devices that provide telehealth service to patients in response to the coronavirus. It can be anything from devices like pulse oximetry, blood pressure monitoring, devices that themselves are connected. It won’t fund unconnected devices that patients could perhaps use at home and then manually report the results to their medical professional.
You know, connected devices could include devices that are Bluetooth or WiFi capable.
[0:06:36.5] BR: Interesting. People need to know that. I mean this is through the FCC, which I guess makes sense, right? We’re talking about real-time monitoring types of devices. We used to do home health, and we had devices that were connected up to an iPad, which was connected up to something else. Those kinds of devices may not be eligible for this, but the real-time monitoring stuff – the things that you would connect up, connect up to WiFi or connect up to a cell network, mobile network, and communicate that stuff back – those things are eligible?
[0:07:16.0] ET: Yeah, let me give you some advice, some examples, because it’s really broad and the way I interpreted it. It could be telecom services, broadband connectivity service. It could be actual voice services that organizations turned on to do this. It can actually be telehealth and voice. It could be tablets, smart phones, the procurement of those devices to support the practice, if you will, of telehealth.
I mentioned some of those kind of pseudo-biomed pulse oximetry. It could be platforms, the ability to transfer images for patients. The mind can really wander in many places, but just as you mentioned, it seems to focus specifically on connected devices and not devices that maybe you would dock and upload.
[0:08:12.0] BR: Not to take us too far off – because I really want to transition to this and talk to you about the future of telehealth with just one of the closing minutes we have here – but I can almost read this and say, hey, we need to upgrade our phone system. We’re going to do telehealth through our phone system. I’m going to take that million dollars and I’m going to purchase a Cisco platform to upgrade our call center.
[0:08:37.0] ET: Yeah. I mean, if you’re looking to purchase a new phone system for a hospital – and, oh by the way, you know, we’ll get telehealth out of it – I don’t think the funding will provide for a new phone system. But, if you can focus in on the value of the telecom to promote telehealth, then that particular aspect I would imagine is eligible.
[0:09:01.1] BR: The spirit is to promote and really sustain the gains that we’ve experienced over the last couple of months in terms of – really increasing access, improving the reach into community, keeping people in COVID safe, or non-COVID environments for care. It’s really expanding all the things that we’ve experienced over the last eight weeks or so, I would imagine.
[0:09:28.0] ET: Yeah. Bill, maybe I’ll give a couple of examples of organizations that have already received approved funding. There’s one – without naming names – is an organization in Georgia that are received about three quarters of a million dollars to implement telehealth video visits, virtual check-ins, to do remote patient monitoring. That was a very large proposal. It included, and it really was about reducing – for that aspect – it was about reducing PPE during this epidemic. So that was kind of the spirit, is how do we look at telehealth? How do we look at technology options?
Then, I will take you to a whole other end of the spectrum, where there is another organization in Pennsylvania that was awarded a couple hundred thousand dollars to provide telehealth services to children, who receive organ transplants, and are immune compromised, and at high risk for COVID-19. So you can see that it is really large, perhaps, in variety, but always comes down to ‘how does this really promote telehealth’?
[0:10:36.5] BR: Absolutely, all right so let’s transition with the tail end of this, Seema Verma over the weekend said, “I think the genie is out of the bottle in this one” – and Seema Verma is the CMS administrator – she said, “I think it is fair to say that the advent of telehealth has just completely accelerated, and that it’s taken this crisis to push us into a new frontier, but there is absolutely no going back.” That is what Seema Verma with CMS is saying. Eli, so I turn to you and say do you think this is going to be the tipping point for virtual care in our industry?
[0:11:07.3] ET: Absolutely. You can’t just take – well for starters, you can’t take back what we have already done. I think the adoption has gone so far that physicians, providers, organizations are not willing to give back what they have already [inaudible 0:11:21], number one. Number two, there is actually a survey that was done recently, a survey of 800 physicians. 60% of them, not seeing COVID patients today, were willing to move ahead just based on the advancements specific to COVID.
I think this is a survey done by general medicine practitioners, sub specialties, surgeons, that’s people that haven’t even begun using telehealth to promote, to help with COVID-19. And they’re all on board. If we just take a step back to maybe why we’re now talking about telehealth, so much more than we have maybe five years ago. I look at it and say, okay, what are the three areas that need to really happen to make telehealth work?
The first one is obviously the capability, right? You have to have the ability to do something distant, that perhaps we started with face-to-face. And, you know, there’s easy ones. The less complicated ones like behavioral health, where you don’t have to actually necessarily touch the patient. It’s facial expression, that maybe you need to see remotely, or body language, but you know, telehealth is relatively easy in behavioral health situations. And that is how – you know, that was an early adopter of telehealth.
Then we went on to e-visits and emergency departments. Are there ways that we can have the emergency department visit distant, that call, rather than remote? So I look at it as three aspects – and we go 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 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 do surgery, to deliver a baby, these are things that are very difficult to do with telehealth. Things that have less touch are more obvious. So the first one is: is it possible? Does that capability exists? The second one is: is there an interest? So we talk about the quadruple aim, and physician burnout is a big one.
Does this increase the burnout? Or, perhaps, does it decrease the burnout? There is a big school of thought that says, “Well if I can now do things from home, then I don’t have to go into the organization, well, that makes my life easier.” Well, look what happened when we went from landline phones to cellphones. I don’t know if there is an argument to be made either way, if our life got easier or more difficult now that we are 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 the barriers that were really broken down, was that CMS has now agreed to fund telehealth. So I see that growing and growing and growing, and I just want to mention one other thing related to that.
Is that now congress is considering a fourth, another bill, called the Emergency COVID-19 Telehealth Response Act, which will expand telehealth, Medicaid, and Medicare reimbursement for physical therapist, occupational therapist, social workers, speech therapists, 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 am excited about this.
I think this is perfectly aligned with the quadruple aim, reduced cost, patient care, patient experience, physician engagement. The world is flat, and the last thought on that is that we are entering a generation of millennials that live by doing things distantly. I mean I think it just speaks to the future.
[0:15:20.1] BR: Yeah, it is really exciting and, I think, so are the possibilities we have even thought of yet. I have interviewed somebody on the show and they said you come into their emergency department and if you don’t really want to wait in the line, there is actually telehealth to the left. It is like, go to the right and wait in the emergency room, go to the left and actually do telehealth. They weren’t sure how it was going to go, and it went gang busters because people are like, yeah I’ll try it! I mean if it is going to reduce my wait by 45 minutes, I’ll try it.
It was really interesting when we were talking about it, the number of people who went through it, experienced it, the cost was lower – in some cases, didn’t need any emergency visit whatsoever. They were able to see a primary care physician later, and it just relieved the burden on the emergency department, and it just created a new experience for the patient population.
There are so many untapped areas at this point. So I did want to close this up by saying, how hard is this to do? I mean do I have to write a grand proposal and get grant writers and those kind of things, or is it there is a website to hit a form and that kind of stuff? Because some of these grants have come out pretty quick.
[0:16:44.4] ET: Yeah, it is first of all it is not difficult. It is unfortunate it is not an online form, it’s a PDF. It is something to be completed. It is not a difficult process. My colleagues and I can help those that find challenging. Two points to make about that, the first one is very important. It is not necessarily only things that organizations are considering in the future. So anything – any device, any eligible service that has been purchased on or after March 13th, this past March 13th, 2020, is eligible.
So active organizations just leap into action, purchase the iPads, purchase different things for telehealth in response to COVID, then they should come up with that list and seek reimbursement for that. The second important note on that is that it is on a first come first serve basis. So once this $200 million is exhausted, then it will be ended – that funding won’t be available. No deadline has been set for filling this out.
To apply, the FCC has a site. It is a little lengthy, I’ll just read it out. It is fcc.gov/covid-19-telehealth-program. There is a great FAQ section and like I said, myself, my colleagues, can help others out if they find the need.
[0:18:13.7] BR: Fantastic, there is also a Sirius link, it is a pretty lengthy link so I am going to do a redirect. You could hit thisweekhealth.com/sirius/telehealth and it will redirect you over to the Sirius site. They have a bunch of information for you on that, ways to get in touch with them, ways that they can help you through the process. Eli, always a pleasure to sit down with you. Thanks for filling us in on this really exciting program.
[0:18:43.4] ET: Excellent. Thank you Bill, I appreciate the time.
[0:18:46.6] BR: That is all for this week. Special thanks to our sponsors, VMware, StarBridge Advisors, Galen Healthcare, HealthLyrics, Sirius Healthcare and Pro-Talent Advisors for choosing to invest in developing the next generation of health leaders. If you want to support the fastest growing podcast in the health IT space, the best way to do that is to share with a peer. Send them an email, DM whatever you do, however you do it. Go ahead and do that and that would benefit us greatly, we appreciate your support. Please check back often as we continue to drop shows until we get through this pandemic together.
Thanks for listening. That is all for now.