Healthcare Technology: What to Know About Telehealth
“If you’re interested in good telehealth policies, don’t assume that others are going to do it for you. You have to do something yourself. You have to get involved. And this is a great time to do it.”
Kyle Zebley, Senior Vice President of Public Policy at the American Telemedicine Association (ATA)
Telehealth is here to stay. Accelerated by the Covid-19 pandemic, what once was a fringe form of clinical communication is now a major pillar of the healthcare system. Powered by modern technology, and acting as part of an overall hybrid approach, it helps address the most pressing challenges healthcare faces today, particularly around access.
But telehealth policy is not as plug-and-play as some of the technology it governs. State and federal regulations around reimbursement, tech, and privacy dictate how telehealth is accessed and delivered. Relaxed rules during the pandemic have helped accelerate adoption, but what happens to telehealth after the pandemic is over?
To learn more about the landscape of telehealth technology and policy and where it’s going, read on.
Meet the Expert: Kyle Zebley
Kyle Zebley is senior vice president of public policy at the American Telemedicine Association (ATA), working with and on behalf of ATA members and like-minded organizations to eliminate barriers to the expansion of telehealth and ensure patients, providers, and payers can realize the benefits of virtual care.
Previously, Zebley was the chief of staff in the Office of Global Affairs at the US Department of Health and Human Services (HHS). He collaborated with senior leadership from HHS, the White House, and other cabinet departments to develop, advise, and promote US global health policy, including in such policy areas as drug pricing, global health security, and non-communicable diseases.
Zebley is frequently quoted in major media coverage on the topic of telehealth, including by the Associated Press, Bloomberg, Harvard Business Review, and The Wall Street Journal. In early 2022, Kyle was named by POLITICO as one of the “four Washington players poised to shape digital health in 2022.”
The Evolution of Telehealth Policy
“Telehealth is the future of healthcare,” Zebley says. “It allows for increased access to clinically appropriate care in a convenient way, particularly in underserved communities, and despite the fact that we have such a huge provider shortage in this country. The potential is huge.”
At times, telehealth’s potential has been limited by the state and federal policies governing it. Telehealth brings together a wide variety of technologies and tactics, and with no singularly agreed-upon definition, regulation has been largely patchwork.
In the pre-pandemic era, providers and patients faced issues with limited access and stringent circumstances for reimbursable virtual care, while in-person requirements for the prescription of controlled substances further reduced the scope of what practitioners could do with telehealth.
But telehealth isn’t new, and neither are its advocates: the American Telemedicine Association (ATA) was founded in 1993 and counts over 400 organizations among its diverse membership.
“Prior to the pandemic, we were already seeing an uptick in utilization, with more and more individuals receiving care through telehealth,” Zebley says. “But the difference between the ability to access care virtually, prior to the pandemic and after, is night and day. Perhaps as many as ten years’ worth of industry advancements were made in the course of weeks in 2020.”
Necessity is the mother of invention; it’s also a close relative of progress. According to a McKinsey survey, the share of Americans who had used telehealth services jumped from 11 percent in 2019 to 46 percent by May 2020. While the total number of telehealth visits has pulled back slightly since, it’s still nowhere near pre-pandemic levels, and providers, patients, and policymakers are no longer looking at telehealth as if it were a stopgap measure.
“Not only is telehealth here to stay, I think it’s gonna become an increasing part of healthcare delivery,” Zebley says. “It will help address a lot of long-range challenges that not only the healthcare system in the United States but the healthcare systems around the world are facing.”
Balancing Privacy and Access in Telehealth Policy
At its core, telehealth is another way of delivering healthcare. As such, it faces many of the same challenges the healthcare system faces: data privacy, insurance reimbursement, and patient access. The pandemic temporarily altered how those priorities were ordered and calculated. Certain HIPAA restrictions around which technology could be used for the purposes of telehealth were waived to increase accessibility.
“The HIPAA waiver was done to maximize the opportunities for people to receive care virtually wherever they are, including in their home,” Zebley says. “It’s still in effect, but I think that there is a broad expectation that the HIPAA requirements will come back into force when the public health emergency comes to an end, and many telehealth organizations are prepared to transition away from that waiver.”
The American Association of Family Practitioners (AAFP) has recommended that policy continue to allow FaceTime, Zoom, and other ‘non-public facing’ video conferencing platforms for telehealth; they say it helps individuals with limited technological literacy gain access they otherwise wouldn’t. The Department of Health and Human Services (HHS) has a list of applications that are HIPAA-compliant and a list of non-public-facing applications which are usable under HIPAA flexibility. While the post-pandemic future of telehealth policy remains to be seen, providers must ensure they’re doing all they can to protect the patient’s data.
“Putting HIPAA aside, we will have to continue to, as a healthcare industry, grapple with privacy and data tracking and issues around who gets what data, and who gets to govern that data,” Zebley says.
The Future of Telehealth Policy
Telehealth brings together all the power of modern technology. It’s a critical resource in addressing healthcare workforce shortages and meeting the needs of an aging patient population with complex healthcare needs. Advances in remote patient monitoring, artificial intelligence, and asynchronous telehealth can help shape a more accessible future. But strong advocates are still needed to help enact policies that protect and support that future.
“If you’re interested in good telehealth policies, don’t assume that others are going to do it for you,” Zebley says. “You have to do something yourself. You have to get involved. And this is a great time to do it.”
Organizations like the ATA harness the collective wisdom of their members to drive telehealth policy that works. New and aspiring medical professionals can help. Even the simple act of contacting one’s senator, representative, or governor’s office can have an impact. Telehealth is, for now, an issue that enjoys enormous bipartisan support, and its successes are a monument to what can be done when Americans get on the same team. But the work isn’t done yet.
“We still have a ways to go in terms of getting the low-hanging fruit of public policy right,” Zebley says. “After we’ve done that, we’ll have to deal with a whole other range of sticky issues, where we know the questions, but we don’t necessarily know the answers: issues of interoperability, data regulation, the deployment of AI, and how to reduce algorithmic bias. We have our work cut out for us.”
Additional Resources on Telehealth Policy
To learn more about telehealth policy, check out some of the resources below.