The AARC PACT will head to Washington, DC, on April 4, and next week we’ll be asking AARC members across the country to email their members of Congress in support of one of the key issues PACT members will be talking to members of Congress about this year: making sure respiratory therapists are covered providers in any telehealth legislation that is proposed.
To get everyone ready to write those emails, we asked AARC Director of Regulatory Affairs Anne Marie Hummel to answer five key questions about telehealth we know RTs are asking.
Can you briefly define what the government and other payers mean when they say “telehealth” or “telemedicine”?
The term “telemedicine” is often used interchangeably with “telehealth.” The most common form of telehealth is an interactive audio and video telecommunications system that allows real-time, face-to-face communication between a physician or other qualified practitioner located at one site and a patient who is located at a different site.
Other types of telehealth include remote patient monitoring and store-and-forward technology. Remote patient monitoring uses one or more home-based or mobile monitoring devices, such as a peak flow meter, to wirelessly transmit vital sign data or other information as part of a patient’s plan of care for review and interpretation by a health care professional.
Store-and-forward technologies allow for electronic transmission of medical information such as digital images, documents, and videos through secure email transmissions to aid in diagnoses and medical consultations when video or face-to-face contact is not necessary.
How does the AARC envision the respiratory therapist being involved in the delivery of these services?
We believe respiratory therapists are uniquely qualified to provide telehealth services, given their understanding of respiratory disease states ranging from routine outpatient services to the most acute emergency care.
For example, respiratory therapists’ disease management skills are well-suited to telehealth services. Educating patients about their disease, teaching self-management skills, counseling patients on how to recognize the symptoms and triggers of their disease in order to minimize acute exacerbations, demonstrating proper inhaler techniques in order to improve medication adherence, and smoking cessation counseling are some of the telehealth services that could be provided.
Services could also cover broad areas, such as neonatal and pediatric care, critical care, and vent weaning, to name a few. In fact, a recent study involving the use of RTs to assess ventilated neonates and children in the ICU showed telehealth evaluations by RTs highly correlated with face-to-face evaluations for 10 of 14 aspects of standard bedside respiratory assessments.
Keep in mind, however, that it will be up to the Medicare program to determine which, or how many, respiratory services would be covered if telehealth legislation is passed that includes such services.
Why should the average RT who works in the hospital or other traditional setting care about telehealth and what it means for the future of health care?
Telehealth is becoming an integral part of the delivery of health care today and can offer new opportunities for respiratory therapists regardless of their workplace. This is especially important, as studies show that telehealth reduces hospital readmissions, improves quality of life, and reduces costs.
Advocating for RTs as telehealth providers enhances the profession and raises the stature of the RT in the eyes of all health care disciplines at a time when millions of new Medicare beneficiaries are being added to the rolls, when there is an ever-increasing emphasis on patients with multiple chronic conditions, including COPD and asthma, and when quality care and performance continue to be scrutinized by all payers.
What will have to happen in regards to legislation for the respiratory therapist to play a significant role in the delivery of telehealth services and why?
Because there is no specific Medicare benefit for respiratory therapy in the Medicare statute, recognizing the respiratory therapist as a “Medicare provider” has always been problematic when it comes to dealing with the Medicare program.
This is currently the case with telehealth, and that is why it is important for the AARC to continue to advocate for the RT to be recognized in the statute as a telehealth provider in order to expand the RT’s ability to deliver quality health care. Medicare provider coverage is currently limited to physicians, nurse practitioners, physician assistants, critical nurse specialists, certified registered nurse anesthetists, nurse-midwives, clinical psychologists, clinical social workers, and registered dietitians or nutrition professionals.
How will the AARC PACT be advocating for telehealth during the 2017 Capitol Hill Advocacy Day coming up on April 4?
Because this year marks the start of a new Administration and a Republican-controlled Congress, the legislative agenda for the 115th Congress is still being determined. Leading up to our Advocacy Day, it is not clear what will happen with telehealth legislation moving forward. Although we will still be tracking telehealth bills we expect to be reintroduced in this Congress — such as the Medicare Telehealth Parity Act, the CONNECT for Health Act, and the CHRONIC Care Act — we are asking members of Congress to include respiratory therapists as telehealth providers in any telehealth legislation that is introduced in this Congress rather than focusing on co-sponsorship of a single bill.
We are also asking Congress to include language in the FY 2018 Labor-HHS Appropriations Report that would task CMS to undertake an analysis of the most recent COPD claims in a variety of health care settings, which will help demonstrate the clinical value of RTs. We believe this approach is necessary to validate the RT’s skills and expertise, and it is less complicated to get language added to an appropriations report than pass a standalone bill. So this could be a big “win” for the profession.