FCC, FDA, HHS also working on telehealth

The Veterans Affairs Department operates the largest telehealth program in the world, but other federal agencies are involved with the technology and supporting policies.

The Federal Communications Commission recently released a National Broadband Plan that contains telehealth provisions. The Food and Drug Administration began considering regulations for mobile health devices. And the Health and Human Services Department is setting up telehealth pilot and innovation programs that were established by Obama administration's health care reform legislation.

FCC’s broadband strategy, published in March, emphasized telehealth/telemedicine and mobile health services, which it refers to as e-care. The strategy calls for expanded federal reimbursements and removing barriers to adoption by updating regulations for device approval, credentialing, privileging and licensing.

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“Congress and the Secretary of Health and Human Services should consider developing a strategy that documents the proven value of e-care technologies, proposes reimbursement reforms that [create incentives for] their meaningful use and charts a path for their widespread adoption,” FCC’s plan states.

FCC also urged FDA to clarify regulatory requirements and the approval process for converged devices that might be used for both communications and health care, such as iPhones that have applications for monitoring weight loss or blood pressure. FDA has already begun meeting with industry groups.

The commission also recommended a Health Care Broadband Infrastructure Fund to subsidize health care delivery to locations where existing networks aren't sufficient, and it recommended that the Indian Health Service get as much as $29 million a year to upgrade its broadband services.

Meanwhile, HHS is involved in several telehealth programs as part of its role in distributing economic stimulus law funding for electronic health records and other health information technology. Some dollars will flow to rural telehealth programs in the so-called Beacon Communities program.

In the later stages of funding appropriated from the economic stimulus law, starting in 2013, money might also go to fund new clinical processes, including telehealth, that can demonstrate improvements in quality, safety and efficiency, Dr. Farzad Mostashari, special adviser to the Office of the National Coordinator for Health IT, testified before a Senate panel April 22.

“It is abundantly clear that telehealth can make substantial contributions in all of these areas,” Mostashari said.

HHS supports several other telehealth pilot projects. For example, the Health Resources and Services Administration runs a $12 million grant program for telehealth services in rural areas.

According to the health reform legislation, HHS will establish a new Center for Medicare and Medicaid Innovation that will test payment and service models, and telehealth approaches will likely be part of that project, Mostashari said.

The center will evaluate using telemonitoring in intensive care units and for behavioral health, and it will subsidize other telehealth and remote patient-monitoring projects. The health legislation also allows for using remote monitoring for eligible medical practices in the Independence at Home Demonstration Program and Community-Based Collaborative Care Network Program, Mostashari said.