Literature Review

DEA unveils long-overdue special registration for telemedicine in proposed ruleThe National Law Review; by Marika Miller, Nathan A. Beaver of Foley & Lardner LLP; 1/21/25 In the final days of the Biden administration, the Drug Enforcement Administration (DEA) released a proposed rule that would allow practitioners with a Special Registration to prescribe Schedule III-V, and in limited circumstances Schedule II, controlled substances via telemedicine. Practitioners with a Special Registration would still need to obtain a DEA registration in each state where they prescribe or dispense controlled substances. However, the proposed rule establishes a limited, less expensive State Telemedicine Registration as an alternative to the traditional DEA registration. The proposed rule imposes several obligations on practitioners with Special Registrations when they prescribe controlled substances via telemedicine.  [Click on the title's link to continue reading.]

Congress extends hospice telehealth flexibilities Hospice News; by Jim Parker; 12/21/24 Congress has extended the pandemic-era telehealth flexibilities through March 14, 2025. Early Saturday, legislators approved a continuing resolution to fund the government and avoid a shutdown. The bill contained language to extend the flexibilities, which includes the ability to perform face-to-face recertifications via telehealth. They were originally slated to expire on Dec. 31. The extension is a win for health care providers, including hospices, who have come to rely heavily on virtual services during the past five years.   

Perspectives on telemedicine visits reported by patients with cancerJAMA Network Open; Sahil D. Doshi, MD; Yasin Khadem Charvadeh, PhD; Kenneth Seier, MS; Erin M. Bange, MD, MSCE; Bobby Daly, MD, MBA; Allison Lipitz-Snyderman, PhD; Fernanda C. G. Polubriaginof, MD, PhD; Michael Buckley, MS, MBA; Gilad Kuperman, MD, PhD; Peter D. Stetson, MD, MA; Deb Schrag, MD, MPH; Michael J. Morris, MD; Katherine S. Panageas, DrPH; 11/24The growing time and cost burdens of cancer care on patients, health care professionals, and systems has led to a focus on optimizing accessibility and value. In this survey study of perspectives on telemedicine visits, a large majority of patients at a comprehensive cancer center expressed satisfaction with telemedicine visits in proportions that remained consistent beyond the end of the pandemic. These findings challenge health care systems to integrate telemedicine into routine cancer care and to overcome remaining technical challenges and barriers to ease of use.

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.

How Zoom is expanding its role in healthcare Modern Healthcare; by Hayley Desilva; 11/1/24 Zoom, a company that rose to prominence during the COVID-19 pandemic, is looking to expand its presence in healthcare through artificial intelligence.  The company recently announced plans to incorporate ambient AI documentation technology from digital health company Suki in its clinical platform. Zoom plans to use the ambient AI technology, which turns a recording of a doctor-patient conversation into usable clinical notes in the electronic health record, for virtual and in-person visits.  ... Here's a closer look at Zoom's history in healthcare and where it plans to go next.

Providence Alaska Medical Center tests virtual care model, announces hospice partner Alaska Business - Healthcare, News; 10/28/24 Providence Alaska Medical Center (PAMC) recently launched a new way of caring for patients that combines bedside nursing with a virtual or remote nurse and a dedicated patient care technician or certified nursing assistant. Known as co-caring or virtual nursing, the bedside nurse manages direct patient-care duties while the virtual nurse coordinates other support tasks. Also this month, the Washington-based not-for-profit healthcare system that operates PAMC announced it will partner with Compassus...Co-Caring Model Leverages Skilled Nurses: Virtual nursing is a response to a strained labor market. A study by the National Center for Health Workforce Analysis shows Alaska is projected to lead the nation in nursing vacancies, with as many as 23 percent of openings unfilled, by 2030. The co-caring model helps address the impending shortage while providing added patient care, Providence officials say.

Anxiety grows over telemedicine flexibility extension The Hill; by Joseph Choi; 10/24/24 Lawmakers and physicians are growing anxious for COVID-era telemedicine flexibility measures to be extended for a third time, as federal regulators signal a potential tightening of the rules ahead of a deadline at the end of the year. Since 2020, the Department of Health and Human Services and the Drug Enforcement Administration (DEA) have allowed physicians to prescribe schedule II to V controlled substances without in-person medical evaluations. ... Last year, the two agencies extended these flexibility measures through the end of 2024. With December fast approaching, a bipartisan group of lawmakers in both the House and Senate want another round of extensions secured. 

MD Home Health expands services with in-clinic, virtual care, remote patient monitoring, house calls and hospice Longview News-Journal, Phoenix, AZ; by MD Home Health; 10/15/24 Leading Home Health Agency in Arizona launches comprehensive onmnichannel healthcare approach. MD Home Health, a privately-held leading Arizona-based home health agency, today announced the expansion of its healthcare services to include in-clinic care, virtual care, remote patient monitoring, house calls, and hospice, making it one of the first privately-held home health agencies in Arizona to offer a full and comprehensive omnichannel healthcare approach. This expansion allows the firm to broaden its healthcare offering to significantly increase access to comprehensive, quality and convenient healthcare for residents across the Phoenix metro area. "Our new and comprehensive services are designed to ensure that patients have convenient and flexible options to access quality healthcare how, when and where they need it," said David P. Tusa, President and Chief Executive Officer of MD Home Health. 

Telehealth groups urge feds to extend virtual prescribing flexibilities  Healthcare IT News; by Mike Miliard; 9/11/24 With just four months to go until the scheduled expiration of Drug Enforcement Administration flexibilities on virtual prescribing of controlled substances, a long list of hundreds of healthcare stakeholders is calling on Congress and the White House to extend them before "countless patients [are] abandoned, left without lifesaving clinically appropriate care." Led by the American Telemedicine Association and its ATA Action arm, more than 330 disparate organizations have signed on to an effort urging federal officials to extend pandemic-era allowances for virtual prescribing that "have been a lifeline for countless individuals across the country, ensuring uninterrupted access to essential mental health care, substance use treatment, end-of-life care, and many other crucial treatments during a time when in-person visits were impossible or unsafe."

CareXM and Enhabit increase clinician capacity by 250% using virtual visits amid staffing shortages GlobeNewswire; by CareXM; 8/27/24 CareXM ... is proud to announce  some of the exciting results with Enhabit in their quick connect Virtual Visits platform. ... “We saw an increase in clinician capacity, allowing us to do more with less,” says Vice President of Care Management Shelley Baker of Enhabit, which provides care annually to 228,000 patients. “Completing visits virtually, when appropriate, has freed up our clinicians to better manage their schedules so they can be with patients who need hands-on care.” "While virtual visits do not replace the need for in-home visits, they do offer the ability to connect with patients more frequently, supplementing the visits that do need to be in-person,” said Si Luo, CEO at CareXM, “We see a growing need not just for visit utilization but for visit prioritization- let’s save our field nurses for those visits that truly do need to be in-person. ..."

Providers, patients would benefit from hospice telehealth extension, doc offers McKnights Senior Living; by Rachael Zimlich; 7/31/24 The COVID-19 pandemic triggered many changes in healthcare, and not all were bad. In the years since the coronavirus forced worldwide lockdowns and limited access to care, the healthcare industry increasingly has embraced measures such as remote care and telehealth. One surprising area that has benefitted from those changes is hospice care. Hospice care by telehealth provides an obvious convenience for patients, but [Sean Oser, MD, MPH] shared his surprise at how much the increased frequency and ease of visits — plus better insight into the patient’s home environment —could improve his own experience as the provider. ... The latest extension of rules to allow hospice provided via telehealth to be paid through Medicare will end in December. ... Representatives called out the need to extend the hospital-at-home waiver, which is set to expire at the end of 2024.

Telehealth can broaden reach of palliative care for lung cancer patients, per MGH study MedCity News; by Frank Vinluan; 6/16/24 Palliative care provided by video was equivalent to in-person visits with a clinician, according to study results presented during the recent annual meeting of the American Society of Clinical Oncology. Investigators say these results indicate telehealth can make palliative care accessible to more cancer patients. ... Guidelines of ASCO and other professional organizations recommend integrating palliative care from the time of a diagnosis of advanced cancer. Nevertheless, many patients don’t get this care, Greer said. On the clinician side, there are not enough specially trained palliative care clinicians, he explained. From the patient perspective, living in a rural area or lacking transportation can make it difficult to access such care.