Literature Review

New telehealth rules: 5 takeaways on temporary flexibilities for 2025 Becker's ASC Review; in collaboration with Coronis Health; 1/21/25 With the passage of the American Relief Act, 2025, certain telehealth flexibilities initially introduced during the public health emergency (PHE) era have been extended. These provisions, however, are only authorized through March 31, 2025. A Jan. 9 blog post by Coronis Health breaks down what the extensions mean for telehealth providers and patients, what services and features were left out and why certain changes could become permanent in 2025. Five takeaways:

DEA proposes special registrations for telehealth prescribing TechTarget - xtelligent Virtual Healthcare; by Anuja Vaidya; 1/15/25  The DEA is set to publish a proposal for a special registrations framework that would allow certain healthcare practitioners to prescribe controlled substances via telehealth without performing an in-person exam first. The unpublished proposal made available on the Federal Register details the special registrations framework, which includes three types of registrations:

[Cure] Top palliative care stories from 2024 Cure; by Alex Biese; 12/28/24 This year, CURE® worked to provide education and insight that underscored the importance of palliative care in cancer treatment. Early integration of palliative care, whether through in-person visits, telehealth or ongoing emotional support, can make a significant difference in a patient's quality of life. Here are some of the top articles on the topic of palliative care from 2024.

Redefining acute virtual care for overburdened health systemsJAMA Network Open; Michael J. Maniaci, MD; Richard D. Rothman, MD; Jessica A. Hohman, MD; 11/24Over the past decade, the concept of delivering acute hospital-level care in the home has gained traction, particularly with advances in telemedicine and remote patient monitoring. This retrospective cohort study compared the outcomes of 876 patients who received acute virtual care at home with outcomes of 1590 patients who were treated using traditional in-hospital care for similar conditions. The study found that the Safer@Home patients spent a mean of 4 fewer days in the hospital (1.3 vs 5.3 days), without a significant increase in 30-day readmission or mortality rates. This all-virtual model effectively avoided the use of 3505 bed-days without compromising safety, both making this an impactful exploration of alternatives to traditional inpatient care as well as offering a promising alternative for underresourced health systems unable to support in-home care.

Hospital-at-home, telehealth, DME reimbursement top year-end home care priorities McKnights Home Care; by Adam Healy; 12/9/24 Home care advocates are advancing numerous home care advocacy priorities in the final days of 2024. They are focusing on telehealth, hospital-at-home and durable medical equipment (DME). Last week, the Long-Term Post-Acute Care Health Information Technology (LTPAC Health IT) Collaborative, which includes LeadingAge as a member, sent a letter to Congress asking for an extension of telehealth flexibilities enacted during the COVID-19 pandemic. These flexibilities, which allow providers to furnish virtual care services over state lines, among other capabilities, will expire Dec. 31 without congressional action.

Dallas’ Analog Informatics emerges from stealth to modernize patient engagement in over 150 languages Dallas Innovates, Dallas, TX; by Lance Murray; 12/4/24 AIC aims to "bridge the communication gap" between healthcare providers and patients worldwide by leveraging secure AI and modern communication tools. CEO Philip Lieberman created the platform based on his experiences in caring for his hospitalized mother-in-law during the COVID pandemic. ... Shocked that he knew “more about his Amazon packages” than the state of his loved one, Lieberman vowed to use the experience and resources he’d gained from the previous multinational companies he created “to bring compassionate yet automated continuous communication to every patient and their families.” ... AIC aims to "bridge the communication gap" between healthcare providers and patients worldwide by leveraging secure AI and modern communication tools.  ... AIC said its platform “bridges the communication gap” between healthcare providers and patients, offering continuous automated logistical support in more than 150 languages. 

A people-centric approach powers successful digital transformations in healthcare HFMA - Healthcare Financial Management Association; by Utlimate Kronos Group; 12/2/24 Digital transformation is a high priority for C-suite executives at healthcare organizations, and a dizzying array of new technologies in a growing market is beckoning. But to succeed, leaders must be able to meld the use of technology with a people-first mindset and embrace their people focus in a systematic, measurable manner. ... McKinsey research suggests that almost 90% of health system executives believe that digital and AI transformation is a high or top priority for their organization, though 75% indicated that budget constraints and issues with legacy systems were hampering achievement of technology goals. ... [The discussion includes the following.]

Nursing homes must break cycle of patient rehospitalization Special to the USA TODAY Network, republished by The Record, Bergen County; by Mary Holden Jones; 11/28/24 One of the most severe issues facing long-term care patients is rehospitalization. Over 20% of nursing home residents are readmitted to the hospital within 30 days of discharge, a cycle that often worsens health outcomes and creates significant emotional, financial and logistical burdens for families, caregivers and the health care system. ... While hospital stays are sometimes necessary, they create added risks of infections and the constant back and forth can add to confusion and cognitive decline — both of which further reduce quality of life and prolong recovery times. ... The emotional toll on families is equally significant. ... Fortunately, many rehospitalizations are preventable with more proactive, coordinated care. Technology-driven health care solutions offer a promising way to monitor patients’ health in real time, alerting caregivers and health care providers to early signs of trouble before a minor issue becomes a major problem.

Hologram technology wows rural care patients Becker's ASC Review; by Francesca Mathewes; 11/25/24 Cancer patients in rural Tennessee are testing virtual visits from hologram health consultants, Fox 26 News reported Nov. 23. The technology allows healthcare providers, in this case a physician, to consult with patients via a lifelike hologram. Clay Jackson, MD, a palliative care specialist in Germantown, Tenn., said that the technology has expanded access to care in the rural area, where patients might otherwise have to travel more than 100 miles for in-person care. "Two words: blown away. My patients can't believe how great the technology is," said Dr. Jackson in the report. "They may be a one-car family, it may be patients for whom additional travel would cause additional pain or discomfort or stress, especially those who are undergoing active treatment for their cancer," he added. The device and AI-powered spatial computing platform cost $29,000. The technology has been used in the entertainment industry and in professional sports, but this marks the first time the technology has been used in health consultations.

Pennsylvania signs home care, hospice efficiency bills into law McKnights Home Care; by Adam Healy; 11/5/24 Pennsylvania Gov. Josh Shapiro (D) signed into law two bills that will reduce operational challenges and improve recruitment efforts for home care and hospice agencies. House Bill 155 allows healthcare providers, including home care and hospice agencies, to use remote video technology for interviews with direct care workers. Meanwhile, Senate Bill 1080 allows licensed practical nurses (LPNs) to pronounce death in home-based hospice settings. These two new laws will make direct care worker recruiting processes more accessible and efficient, while improving end-of-life care for both patients and providers, according to the Pennsylvania Homecare Association. “The signing into law of HB 155 and SB 1080 helps create efficiencies in how we deliver home-based care,” Mia Haney, chief executive officer of PHA, said Friday in a statement. “With a growing demand for these services, efforts such as these allow providers to use their time effectively and focus on what’s most important — quality of care.”

Delivering palliative care by telehealth meets the needs of people with cancer National Institutes of Health (NIH) - National Cancer Institute; by Linda Wang; 10/28/24 The use of telehealth in cancer care surged during the COVID-19 pandemic, when, for a period of time, in-person medical care was limited and many visits to the doctor went virtual. Despite some recent pullbacks in telehealth flexibilities, many experts believe that telehealth will continue to have a role in cancer care. But how well does telehealth perform when it comes to delivering palliative care for people with cancer, which can rely on a deeper level of connection between patients and providers than may be possible with a virtual visit? A study of 1,250 people with advanced lung cancer has now provided some insights into that question. The study found that virtual and in-person palliative care were similarly effective in improving patients’ quality of life and other important measures of well-being, according to findings published September 11 in JAMA. It also found benefits for caregivers. The results show that “we can successfully deliver … high-quality [palliative] care in person and virtually,” said Joseph A. Greer, Ph.D., of Massachusetts General Hospital, who led the study. 

Southern Tier Health helps HomeCare & Hospice, Total Senior Care on USDA grant Olean Times Herald, Olean, NY; by Kellen M. Quigley; 10/22/24 A collaboration between three local agencies looking out for the health and well-being of their clients is getting a modern technological boost thanks to a federal grant. The Southern Tier Health Care System, Inc. (STHCS) was recently awarded nearly $140,000 through the U.S. Department of Agriculture’s Rural Development Rural Utilities Service Distance Learning and Telemedicine Grant Program. This funding is meant to empower rural communities by leveraging advanced technology to connect residents and healthcare providers, overcoming the challenges of distance and low population density. Of the total grant, $114,606.80 was allocated to HomeCare & Hospice and Total Senior Care for state-of-the-art digital communication and remote learning tools, including high-definition displays, advanced cameras and integrated audio systems.

Telehealth vs in-person early palliative care for patients with advanced lung cancer-A multisite randomized clinical trialJAMA; Joseph A. Greer, PhD; Jennifer S. Temel, MD; Areej El-Jawahri, MD; Simone Rinaldi, ANP-BC; Mihir Kamdar, MD; Elyse R. Park, PhD, MPH; Nora K. Horick, MS; Kedie Pintro, MS; Dustin J. Rabideau, PhD; Lee Schwamm, MD; Josephine Feliciano, MD; Isaac Chua, MD, MPH; Konstantinos Leventakos, MD, PhD; Stacy M. Fischer, MD; Toby C. Campbell, MD; Michael W. Rabow, MD; Finly Zachariah, MD; Laura C. Hanson, MD; Sara F. Martin, MD; Maria Silveira, MD; Laura Shoemaker, DO; Marie Bakitas, DNSc; Jessica Bauman, MD; Lori Spoozak, MD; Carl Grey, MD; Leslie Blackhall, MD; Kimberly Curseen, MD; Sean O’Mahony, MB, BCh, BAO; Melanie M. Smith, MD; Ramona Rhodes, MD; Amelia Cullinan, MD; Vicki Jackson, MD; for the REACH PC; 9/24 The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC [non-small cell lung cancer], underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery. [These] findings underscore the potential to increase access to evidence-based early palliative care through telehealth delivery.