OPPORTUNITY: Minnesota COVID-19 Vaccine Connector – sign up to get on the list

The State of Minnesota has just unveiled the COVID-19 Vaccine Connector. It’s a portal to get people connected to get their COVID vaccines. Here’s the gist ( from the flier)…

The Minnesota COVID-19 Vaccine Connector is a tool that helps you find out when, where, and how to get your COVID-19 vaccine. Insurance and identification are not needed, and signing up is free. When you become eligible to get the vaccine, the Vaccine Connector will:

let you know you are eligible.

connect you to resources to schedule a vaccine appointment.

notify you if there are vaccine opportunities in your area.

How do I sign up?

Signing up for the Vaccine Connector is easy, safe, and secure. All Minnesotans should sign up, regardless of whether they are currently eligible to get vaccinated.

Online Sign up at: mn.gov/vaccineconnector

By Phone: Translation is available. If you are unable to sign up online, you can sign up over the phone. Translation is available by phone in all languages. Call: 651-318-0989 or 833-431-2053

I just signed up. It didn’t take five minutes and there was nothing I needed to look up.

This is another example of the importance of broadband, a device and the skills to use it! Someone could make a trip to friend’s house or public kiosk to get signed up – although not encouraged during a pandemic. But more than a barrier to signing up; lack of access will hinder the ability to get and receive notices.

One of the questions asks if you would be able to respond quickly if an opportunity arose – inherent in the question is do you have the technology to respond.

OPPORTUNITY: gBETA Medtech, as free 7-week accelerator program for medical startups

gBETA Medtech is a free, seven-week accelerator that works with medical device, healthcare related software, biotech and diagnostics startups. Applications are due February 21, 2021. The program runs from April 8 to May 28.

Here’s a quick look at what it could mean to a company…

Participating Companies Receive:

  • Individualized coaching and mentorship from the gBETA team during weekly, one-on-one meetings.
  • One-on-one meetings with 25+ mentors including serial entrepreneurs, subject matter experts and investors.
  • Weekly Lunch & Learn series featuring topics relevant to startups including understanding market size, choosing a revenue model, and how to pitch investors. Lunch & Learn events are free and open to the public.
  • Exclusive Pitch Night reception during which participating companies have the opportunity to pitch to an audience of entrepreneurs, mentors, investors and community members.
  • Opportunity to build relationships within each cohort of five companies, and the community of gener8tor and gBETA alumni.
  • $1M + in deals and perks from vendors like IBM Cloud, Rackspace, Amazon, PayPal, Zendesk and Microsoft.

BCBS extend telehealth coverage through 2021

Minneapolis/St Paul Business Journal reports

Blue Cross and Blue Shield of Minnesota announced Monday it would extend its modified virtual-care coverage through the end of 2021.

The covered services include behavioral health, physical and speech therapy, and medication management. The changes apply to people with fully insured commercial plans, individuals who purchase Blue Cross insurance and seniors with Medicare plans. Self-insured employers can choose to make the changes for their plans as well.

It’s a COVID silver lining if it helps more people get to the healthcare services they need. Although increased telehealth may accelerate closure of local hospitals…

The growth of telehealth is one of the major results of the Covid-19 pandemic. Health care executives have spoken for months about the growth of video visits and other tech tools that connect doctors and patients outside of hospitals or clinics. HealthPartners Inc., for example, closed seven clinics in part because they believed telehealth would make them redundant.

In May of 2020, Samitt told the Business Journal he thought a wider adoption of virtual health services could have helped to buffer some of the pain health care organizations felt during the early days of the Covid-19 pandemic.

Maybe the next step is finding a way to meet people where they are with telehealth, yet maintain a physical presence in the community to meet the need for in-person treatment. (It’s tough to have a baby via telehealth.) Maybe the answer is collocating healthcare facilities with places with increased need – be that a college, communal housing or even a sports facility.

Report shows MN one of few states with telehealth insurance payment parity

There’s a new report on telehealth insurance laws. Here’s the quick take from the report…

Foley & Lardner’s 2021 50-State Survey of Telehealth Commercial Insurance Laws provides a detailed landscape of the state telehealth commercial insurance coverage and payment laws. The report is useful to health care providers (both traditional and emerging), lawmakers, entrepreneurs, telemedicine companies, and other industry stakeholders as a guide of telehealth insurance laws and regulations across all 50 states and the District of Columbia.

In the time since our 2019 report, the legal landscape for telehealth reimbursement has significantly improved. Currently, 43 states and DC maintain some sort of telehealth commercial payer statute, with West Virginia joining the list in 2020. Yet, the quality and efficacy of these laws varies significantly from state to state. For example, three states have telehealth coverage laws on the books that do not actually mandate health plans to cover services delivered via telehealth (Florida, Illinois, and Michigan).

The new report tracks changes post-pandemic start…

Enter the COVID-19 pandemic, which compelled state and federal policymakers to remove restrictions and expand reimbursement for telehealth and virtual care at a rate previously unseen. The new changes followed the previously established pathway of coverage, but the pace at which they were made was stunning. Medicare introduced nearly 100 telehealth service codes covered on a temporary basis until the federal public health emergency declaration expires, including payment for telephone-only consults. States and commercial health plans followed suit. Although some of the reimbursement expansions are temporary and slated to end when the public health emergency expires, many have already become permanently codified into state law.

They look at what’s happening in each state include Minnesota:

  • Does the State Have a Statute? Yes
  • Coverage Provision? Yes
  • Reimbursement Provision? Yes
  • Unrestricted Originating Site? Yes
  • Member Cost-Shifting Protections? No
  • Provision for Narrow/ Exclusive/ In-Network Provider Limits? No
  • Remote Patient Monitoring? Store and Forward? Yes
  • Authorities Minn. Stat. § 62A.671-.672 (the report include the statute in full)

They also report that Minnesota is one of few states with reimbursement/payment parity. Here’s their quick take on payment parity…

What are Telehealth Commercial Coverage and Payment Parity Laws?
Currently, 43 states and DC have some sort of telehealth commercial insurance coverage law, with bills currently under development in several other states. These laws are sometimes referred to as “telehealth commercial payer statutes” or “telehealth parity laws.” They are designed to promote patient access to care via telehealth in a multitude of scenarios, whether the patient is in a rural area without specialist care, or a busy metropolitan city without time to devote three hours to travel to an in-person checkup in a crowded waiting room. There are significant variances across the states, but two related but distinct concepts have emerged: telehealth coverage and telehealth payment parity

Senators Klobuchar & Capito Introduce Legislation to Increase Seniors’ Virtual Connection to Health Care and Community Amidst Coronavirus Pandemic

Senator Amy Klobuchar announces

U.S. Senators Amy Klobuchar (D-MN) and Shelley Moore Capito (R-WV) reintroduced legislation to enhance telehealth support for seniors and increase access to technology for “virtual visits” during the coronavirus pandemic. The Advancing Connectivity during the Coronavirus to Ensure Support for Seniors (ACCESS) Act would help protect older Americans from risking exposure to the virus when accessing remote health care and connecting with loved ones. The legislation is cosponsored by Senators Bob Casey (D-PA), Joni Ernst (R-IA), Jacky Rosen (D-NV), Tina Smith (D-MN), Debbie Stabenow (D-MI), Jack Reed (D-RI), Chris Van Hollen (D-MD), and Catherine Cortez Masto (D-NV) and will be led in the House of Representatives by Rep. Jan Schakowsky (R-IL) and Rep. Gus Bilirakis (R-FL). The ACCESS Act is endorsed by AARP.

“During this pandemic, we must protect our seniors’ access to quality health care and ties to family and friends,” Klobuchar said. “This new legislation would help ensure that federal funding is available to expand telehealth and virtual services at nursing facilities so seniors remain connected to their health care providers and communities.”

“The coronavirus pandemic has highlighted the need for better connectivity across rural America. Additionally, coronavirus has put rigid restrictions on nursing homes because of the high-risk population they house,” Capito said. “The ACCESS Act makes investments in telehealth services and infrastructure for assisted nursing facilities to help them connect vulnerable seniors living in nursing homes with virtual access to their loved ones.”

Specifically, the ACCESS Act would:

  • Authorize an emergency supplemental appropriation of $50 million for the Department of Health and Human Services’ (HHS) Telehealth Resource Center to assist nursing facilities receiving funding through Medicare or Medicaid in expanding their use of telehealth services;
  • Establish a grant program authorizing HHS to award nursing facilities grants to nursing facilities to enable residents to participate in “virtual visits” with loved ones while the health risk of in-person visits remains high during the pandemic; and
  • Require the Secretary of HHS to issue guidance on additional ways to improve access to telehealth services in nursing facilities and temporarily designated nursing facilities during the pandemic.

Telehealth & 911 Telecom bills introduced in MN House (HF340, HF511, HF515)

The MN House Chief Clerk’s Office reports on three new bills that were announced and might be of interest to folks in the broadband world. The first two involve removing barriers that would make telehealth easier. The third recommends a Task Force of sorts to come up with 911 recommendations, which would include the network.

  1. HF340,A bill for an act relating to health care; requiring medical assistance to cover telemonitoring services; amending Minnesota Statutes 2020, section 256B.0625, by adding a subdivision.
    The bill was read for the first time and referred to the Committee on Health Finance and Policy.
  2. HF511,A bill for an act relating to human services; modifying requirements for substance use disorder and mental health treatment provided via telemedicine; amending Minnesota Statutes 2020, sections 245G.01, subdivisions 13, 26; 245G.05, subdivision 1; 245G.06, subdivision 1; 254A.19, subdivision 5; 254B.05, subdivision 5; 256B.0625, subdivisions 3b, 46; repealing Minnesota Statutes 2020, section 245G.22, subdivision 13.
    The bill was read for the first time and referred to the Committee on Human Services Finance and Policy.
  3. HF515,A bill for an act relating to public safety; establishing a 911 telecommunicator working group to establish statewide standards for training and certification; requiring a report.
    The bill was read for the first time and referred to the Committee on Public Safety and Criminal Justice Reform Finance and Policy.

Federal funds going to telehealth tools to help at-risk native elders

WCCO News reports that more than $500,000 from the federal Coronavirus Relief Fund will be used to provide equipment and technology to at-risk native elders…

The Minnesota Department of Human Services announced that home health care tools are being sent to Native American elders to help keep them safe during the COVID-19 pandemic.

On Tuesday, the DHS said blood pressure monitors, pulse oximeters and other technology that supports telehealth and behavioral health visits are currently on their way to native elders in communities around Minnesota.

Following a grant contract with the DHS, the Native American Community Clinic in south Minneapolis and the Northwest Indian Community Development Center in Bemidji are distributing the infection prevention tools.

Rep Deb Kiel (Crookston) will be looking to extend telehealth support beyond COVID

The Grand Forks Herald provides details on the areas’ legislators and their plans for the 2021 session…

Along with the budget, District 1 lawmakers say their priorities include reopening the economy while limiting the use of peacetime emergency powers by Gov. Tim Walz. They also mention health care needs, including expanding access to providers through telehealth. Minnesota’s legislative session began on Tuesday, Jan. 5.

Rep. Deb Kiel is looking to make permanent telehealth changes made in deference to COVID…

Longtime District 1B Rep. Deb Kiel, R-Crookston, also said her priorities include reopening the economy, which she called one of the most pressing issues for her district. The tax dollars generated by businesses are necessary for future budget allocations, she said.

Kiel’s priorities also include health care proposals, an area on which she has focused in her 10 years in the Legislature. Telehealth expands access to residents in greater Minnesota and should not be seen as a reaction to COVID-19, according to Kiel, who is calling for advances made in telehealth to be made permanent. She says the pandemic may have opened the eyes of other lawmakers.

“I couldn’t get anybody to hardly hear the (telehealth) bill four years ago,” she told the Herald.

Kiel said she will prioritize legislation allowing for medical advocates – a family member or trusted adviser who can accompany a patient and speak to their interests. The coronavirus has tightened who can enter health care facilities, out of concern for spreading the virus, but Kiel expressed confidence in allowing an advocate to safely enter the premises with a patient.

“I have found in dealing with health care issues, and pretty serious ones, a loved one, or somebody that you have prepared, would know your health issues and also what you want,” Kiel said.

A practical look at what telehealth is and needs to be to meet patients’ expectations

The St Paul Pioneer Press recently posted an interesting article on the future of telehealth. It’s a fun look at the practical and a look at the difference between online and in person service and expectations…

In a sterile hospital environment with little more than a magazine to keep them company, most patients are fairly forgiving, and can chalk up a 20- or even 30-minute delay to the demands of the profession.

But online? If virtual care is scheduled for 3:30 p.m., it had darn well better start at 3:30 p.m.

“That took me by surprise,” said Ingham, vice president of Health Information for Allina Health. “We’ve struggled a bit to deal with that. … They could literally be on their couch waiting, and they still get kind of perturbed if you’re running more than a couple minutes late.”

While waits were verboten, suddenly interpreters were easy (easier)…

Since the outset of the pandemic, linguistic interpreters — who once might have taken hours to be tracked down when needed — are entering clinical settings via video screen in a fraction of the time. Family members of immigrants are suddenly able to assist nurses and physicians bridge cultural and language barriers through three-way calling. Doctors are beaming into the living areas of their patients like an old-fashioned home visit or consulting with medical teams to provide in-patient care from across the state.

The COVID19 has been the impetus, but telehealth will outlast the pandemic…

The M Health Fairview system logged some 3,500 virtual care visits last January. That was before the pandemic. By April, with hospitals and clinics scrambling to find safe alternatives to in-person care, that number had grown to 120,000 virtual visits.

For M Health Fairview, which has completed more than 1 million virtual care encounters since March, telehealth in some months has accounted for 80 percent of outpatient service.

Health systems say it’s unlikely they’ll put the genie back into the bottle, even though there’s plenty of room for improvement.

Here are some of the advances and hurdles that will lead us forward….

  • In October, Minnesota-based 3M introduced the new Littmann CORE Digital Stethoscope — a device that makes it possible to listen to a patient’s heart sounds from anywhere, wirelessly, by recording or livestreaming data to a remote provider.
  • Hospitals and community health centers have rolled out team-based meetings by iPad and remote monitoring equipment that allows them to check on patients with chronic diseases such as diabetes and hypertension, to examine their blood levels and to adjust medication from afar.
    Nicholson said that’s an especially important innovation given that dexamethasone — a core treatment for COVID-19 — can raise blood sugar levels precipitously, and there’s not enough endocrinologists available to send to every hospital.
  • There are still plenty of hurdles to come. Using everyday communications technology like FaceTime, Skype and Zoom for patient visits requires a state and federal regulatory framework that allows Medicare reimbursement and other licensing, approvals that had to get rushed into place on a temporary basis in the early days of the pandemic.
    Those rules are still evolving, and in some cases being rolled back. Allina’s Ingham noted that many states require medical practitioners to be licensed in-state. Rules around in-state licensing that were relaxed for virtual care in the early days of the pandemic have since been widely reinstated.
  • “Historically, no one really wanted to pay for virtual visits,” Ingham said. “They would reimburse much much less, if they would reimburse at all. … We can’t work for free.”
    Given the experience of the pandemic, the federal Centers for Medicare and Medicaid Services appear willing to continue to reimburse providers for virtual care, but it’s unclear the degree to which the private market will do the same once the COVID crisis has passed.
  • Online care also requires that all parties have access to broadband internet, which can be challenging for rural and low-income residents.

Technology is a helper in getting access to mental health support during the holidays

The Minneapolis Star Tribune reports on the impact the pandemic is having on our mental health and offers some tips to help improve your mental health. Two of the three suggested actions include technology – the other two are recognize when you are feeling down and get some exercise. Here are the tech steps…

  • Telehealth appointments are available: Talk therapy can be well-suited to video or audio-only sessions, and a smartphone may allow more privacy than a home computer. An initial appointment will likely be a screening, potentially followed by a recommendation to start a course of therapy.
    “Telehealth is available. Would I say it’s pervasive? I think it’s working to become pervasive,” said Daniel H. Gillison Jr., CEO of NAMI.
  •  Connect with others: “Connection is a kind of antidepressant,” Duckworth said. Phone calls and video chats are good, but it doesn’t have to be with family — book clubs, Alcoholics Anonymous and grief support groups are all active online now. Don’t be afraid to break the ice for someone else who might benefit from more connection.
  • Use a helpline: Phone-based helplines include the National Suicide Prevention Lifeline, the Minnesota Warmline (651-288-0400) and the state Crisis Text Line (Text MN to 741741). The Minnesota Farmer and Rural Helpline is available at 1-833-600-2670 or by texting FARMSTRESS to 898211.

Pew looks at opinions of Americans on COVID and Technology

Pew has been surveying people about their use and opinion of technology during the pandemic…

Over the course of the COVID-19 outbreak in the United States, Pew Research Center has studied Americans’ attitudes about the role and effectiveness of various technologies and their views about digital privacy and data collection as it relates to the pandemic. Here is what we found.

The tables really say it all – so that’s what I’m going to include below. The table includes the dates that people were surveyed. Most seem to be April, but not all. I can’t wait to see how/if opinions change over time.

General…

Affordability…

    Technology as tool against COVID… 

MN Legislators look at ways to ease telehealth extensions

Owatonna’s People’s Press reports

Lawmakers on Tuesday discussed a proposal to extend the expiration of a 2020 change that allows insurance providers, and the Medical Assistance and MinnesotaCare programs, to cover telemedicine services that take place at a patient’s residence.

That was one of several pieces of proposed legislation considered during an informational hearing held by the House Health and Human Services Finance Division. No action was taken, but that could change if the proposals become bills that are introduced during the next special legislative session, expected to begin early next week.

“There are some matters that are a little bit on the urgent side that we hope to be able to take care of during the special session,” said Rep. Tina Liebling (DFL-Rochester), the division chair, adding that agreements have been reached or are being worked toward on each of the informal bills.

COVID is good excuse for farmers to go online to access mental health assistance – but not always the best reason

Ag Week reports on tele-mental health for farmers…

Along with farmer-specific helplines, farmers across the country can now seek help for mental stress through virtual counseling and online training, according to interviews with health professionals.

The COVID-19 pandemic forced many people to receive help virtually. According to a June report from the American Psychological Association, about 75% of clinicians were only treating patients remotely.

But the telehealth options for farmers have little to do with the pandemic. Instead, experts said, teletherapy can make mental health services more accessible and more confidential for farmers.

They don’t have to travel potentially long distances to receive help. Nor do they have to risk being seen at therapy, because there is a stigma of mental health issues in the farming community.

Minnesota has set up a hotline…

Several Midwestern states — including Wisconsin, Nebraska, Minnesota and Iowa — also have a hotline or helpline specifically for farmers.

Services are available by phone and broadband…

Monica McConkey, a counselor in Minnesota, is also doing many of her sessions virtually, but she said most of her clients prefer speaking on the phone rather than via Zoom or Facetime.

McConkey agreed that virtual counseling is easier for those who typically have to travel long distances to access care, especially in the fall when people are harvesting. She also said some people feel more protected on a virtual platform compared to in-person counseling.

“If emotional things do come up, they’re not sitting face-to-face with people,” McConkey said. “We know a lot of our farmers, even just showing the emotion of crying is really hard for them when there are other people present.”

When internet connections become spotty, a familiar experience in rural areas, people can call on the phone, McConkey said.

MN Legislators look at extending insurance to cover telehealth services

KNSI Radio reports…

Minnesota lawmakers opened discussions on a proposal to extend the expiration of a change that allows insurance providers to cover telemedicine services.

Representative Tina Liebling of Rochester is the chair of the House Health and Human Services Finance Division. She says telemedicine will be a significant issue during the 2021 legislative session. With a lot of work still to be done, she said, extending the sunset date for coverage will give lawmakers the time needed to find more permanent solutions.

The St. Cloud VA Medical Center says the use in telemedicine exploded due to the COVID-19 pandemic earlier this year with them seeing an over 1000% increase in telehealth visits.

Liebling hopes the proposal can become a bill when the legislature goes back into session Monday.

More than half of households used telehealth in 2019

NTIA reports

Telemedicine and telehealth-related activities are on the rise, according to NTIA’s November 2019 Internet Use Survey, which found that more households are using the Internet to communicate with health professionals, access health records, and research health information.

Because the survey was conducted prior to the outbreak of COVID-19, it provides an important baseline for understanding the prevalence of telehealth usage among American households and the importance of Internet access for essential services.

The proportion of households that accessed health or health insurance records online grew from 30 percent in 2017 to 34 percent in 2019 (see Figure 1). Households communicating with a doctor or other health professional online grew by two percentage points, and households that researched health information online grew by one percentage point between 2017 and 2019.

As someone who lives in the place between research and practice, I can tell you that statistics are always about a year (or more!) behind what I want. But this will be a good base to compare the impact of 2020 and the pandemic when those stats are collecting.

It also makes the point that statistics are not always linear. One disruption – positive or negative – can change the trajectory. Be that a pandemic or someone installing fiber throughout your town.