Medical practitioner to do something to make you feel better. It could be you have the flu, you are not feeling well, you do not want to go to the doctor, so you give them a call and they talk to you entry you. Ehealth is bought or telehealth is broader. You email your doctor, work it out without ever seeing them. It is broader. Telehealth,cine is but not all telehealth is telemedicine. Have probablyus experienced it from having your pharmacy call you or text you that your prescription is ready. Right that a is right. That is a common use of it. We also noticed that the or the importance of telemedicine was boosted in the recent package that passed congress, the 2 trillion care act. The law provides relief for health plans allowing coverage for Telehealth Services. Thee changes, and heels of , and the heels of the office tell usr general why that is important. Why do you think the administration included that . Been a flurryas of regulatory relief or actions by policymakers to clear away underbrush of government policy that is getting in the way of people using telehealth or pan or telemedicine during this demic call a doctor and see them anywhere. Overetimes talk to doctors the phone or video chat. When they are closed or have gone home, i get through to San Francisco doctors. That kind of regulatory relief matters because if you live in a to seeing are limited a doctor in the state where you live or where you are seeking care. These are the kinds of small things that get in the way of people being to access care when they needed. Impressive things about recent days is just how much everybody has come together on both sides of the aisle, congress, the administration and even states to find out what they can do to lift any barrier that might stop a patient seeing a doctor through health or telemedicine. Host you wrote, the golden age of telehealth is here. You write that only nine states have issued licenses that allow an outofstate medical professional to Render Services using telehealth. Why is that significant . Guest and limits the choices of people who would like to use telemedicine. Some telemedicine companies, all they do is telemedicine. You can work with them regardless of whether youre going to see them in person. If you work in a state that has allowed them to do that, you cant work with them. States that have large rural areas, this is a problem because perhaps they do not have enough doctors in the first place. Watch been fascinating to that there is a growing desire to act. We have seen governors take emergency actions. Something that we would encourage any state policy makers to look at. Our guest is Marie Fishpaw of policy studies from heritage foundation. We welcome your comments for those in the eastern, 202 7488000, mountain and pacific time zones is 202 7488001, and we also welcome medical professionals. That line is 202 7488002. What kind of challenges does using telehealth present for hipaa requirements or other privacy concerns . Guest any time you communicate with a doctor you want to know that the technology they are using is actually going to be compliant. The cares act that you mentioned earlier that Congress Passed in the last couple of weeks took some steps to call for making sure that the steps we are taking to make telemedicine easier had in fact and privacy protected. Most of the technology being used seems to be have a protected. Be protected. Be hipaa protected a physical therapist set one up last week and felt confident that it is hipaa protected. These are considerations to take. Just as with any phone call you make or any call you make video, you want to know that the only person you are talking to is the person on the other end. Host s soundbite for many medical practices that their main points of triage or first contact, and particularly with covid19, is not an in office visit. They want to do a phone or a video online assessment of you for you make any move to come to the office or go to the emergency room, correct . Guest that is right. We have seen so many news stories over the past week of the doctor saying please do not come in and please use our telemedicine and let us triage you. That makes sense on a lot of levels. It makes sense for you as a patient. If you are feeling symptoms are not feeling symptoms, the last thing you need to do if you need to see a doctor is goat near that Doctors Office and other people who are sick. They want to make sure they are routing you to the correct facility. If you have covid, they want to send you to a different place and not heavy with others and put them at risk. It is suited to the kinds of sacrifices we are being suited asked to make by staying at home. It is a good way to enable that while making sure you get the care you need. It is not just the people who think they might have covid who are coming down with the flu or Something Like that, it can be for people with chronic conditions and need to check in regularly. For example, people who need to see a psychologist. They can work with that psychologist over the phone without putting themselves at risk by leaving home. Host what have medical associations and doctors group, the American Medical Association and others, said broadly about the use of telemedicine and telehealth . Guest dr. Seem to be enthusiastic. If you look at the news reports doctors seem to be enthusiastic. If you look at news reports or even talk to a doctor, that is why i am excited you have a call in line to talk to doctors, there has been such an overwhelming reaction to setting things up. One knock i spoke to this past week said that 40 of his colleagues had been using telemedicine one doctor i spoke to this past week said that 40 of his colleagues had been using telemedicine before covid and that changed in a week. One practice didnt use it at all. Hadrding to a news report, 1500 visits a week and they set it up in 24 hours. Host lets get to calls good heard from mac in old town, maryland. Good morning. Caller good morning. And here ins old maryland, i would love to have telemedicine. There is no way i can do it. Trump andhave , talkedresident obama about us all getting highspeed and advanced selfservice. I dont even have Cell Phone Service here good i dont have highspeed internet and i am on satellite internet, but that does not do it. I cant go on skype. I had a doctor call me and say go on skype. I go on skype, it doesnt work. Can somebody do something to get us highspeed internet and Cell Phone Service . My government representative says i dont limit a rule area. Ral area. He is nuts. Host marie . Guest at least in the near term, if you have a phone, you can call your doctor. It is in the same if you have a Video Conference but you can speak to them. This is one of the regulatory barriers the Trump Administration cleared out of the way for medicare patients, making it clear you can call your doctor and your doctor can get paid for treating you over the phone. Ifgerterm, a lot of people you have a cell phone for iphone, that is one possibility. But one of the questions that will come out of this pandemic when you look back at Lessons Learned is do we have the systems in place to make sure that people can get care . You mentioned you are in a rural area, and that is one area that medicare cleared out of the way and they said they will pay a doctor for you to talk to them from the comfort of your home guard us of where you live. Your home regardless of where you live. Hear from jc in california. Caller good morning. I just want to give my opinion because i just recently started having phone calls with my doctors peered i have chronic conditions and one of them is a doctor. Yesterday, i had an appointment doctor and it was speaking through the phone like i am right now. It was so impersonal and lasted one minute. The conversation was over and i felt like i didnt have the time to speak my mind or ask any questions. My question is to the lady, respectfully speaking, they are trying to say with all the new things coming out is the new normal. Whosomebody it like me sometimes would like to speak facetoface with a professional, do we have to get calling or do we have the right to actually see our doctors facetoface . Thank you. Host ok. Guest i think you put your finger on something important, which is that telemedicine can help and obviously we have all had interactions with doctors that were too brief and that can happen in person or over the phone. Some of this is just making sure that we are connecting with the right doctor, which is independent how you talk to them. Whether this is the new norm and we are only going to see our doctors online, certainly not. Like i view telemedicine is a good supplement, it cannot fully replace in person. Sometimes you call a friend or you text a friend or you video call them. If it is your mom, you do all three, but it does replacing them in person. You needed we are human and are social creatures and need to be around people. At a time when we are being asked to social distance art when it doesnt make sense to go into the office, it is a great supplement and told that can be help to people. Catch 22 andbe a telehealth in rural areas. On this program, we have done a number of discussions about the ral medical centers and hospitals, and you are faced with the Technology Gap in some have internet not service how do you think that gets resolved . Guest i think it gets resolved in a couple of ways. Says 75 y pew research of americans are using broadband, but Many Americans this went to use the phones. Some of this is just making sure people have the right underlying tools to be able to access this technology. Some of the regulatory changes that have been made in recent weeks have made it easier, this doesnt work perfectly, but if you want to go to a Community Set up access the technology there, there are protocols that can be put in place to make sure that happens. We have vicki next call from tiffin, ohio. Asler i would like to say far as the telemedicine, i am all for it. I think it is good as far as if you dont have any major problems or whatever, it will keep you from getting a bug from someone else or whatever. So i think it is great. I wanted to ask do you know or can you tell me anything as far as all this is going on, do you have any idea about our dental care and how we are going to face that issue . That is good question. The ability to see a dentist over the phone is quite limited. Dentists have, you some of this has to do with protocols that doctors are putting in place. That seems to be highly varied. Telemedicine, while good for are notngs, dentists one of them. Host is said that telemedicine might be good for quick check ins to supplement what many are seen to boost their bottom line. What do you think . Guest it is interesting way of thinking about it. , sometimes costs telemedicine cost less in a regular come in person visit. There is an example that i am telemedicinehat visits will cost 50 and some reflects different resources being used. The Insurance Companies have asked people to use telemedicine during the pandemic because they want to triage people based on their first line of defense in terms of people getting sick. Of, you mentioned dding their bottom line, i think of this as differently, what is more convenient for the patient . There are circumstances, pandemic side, it is not more it is a lot more convenient to see a doctor online. When moms are people who work have to go see the doctor, you lose time. If you are a mom, you have to bundle the kids up and you make it the other kids sick taking them in. There are advantages that go beyond the dollar figure. Host we are joined by madeline on our line for medical professionals calling from wayne, pennsylvania. Caller i have practiced in this area for 30 years and i would like to say, and maybe you have already discussed it, about costeffectiveness. For patients who are medicare and Medicaid Living in health care facilities, many times the cost to get them to the subspecialists, they have been discharged readily from a University Setting or a community hospital, very expensive. And the frustration level of the facility having to hire a companion at times, tying up ambulance transport, arrival of people in the waiting area on a gurney. Possibly on their way back from the visit being stranded on the expressway depending on the day you have to understand that this is a great thing that has occurred and we will learn from it. It is called effective and the caretaker, the one receiving orders, south or a nurse, and implement the treatment plan more readily without the frustration. Bring thised to awareness that i hope this will last and and we will learn from what we are going through. Host thank you for sharing your experience. Guest that is a great experience. It is great to hear from medical providers because one of the things that has been so important in making telemedicine more available is providers and medical practitioners share their experiences and sharing with policymakers and regulators what is getting in the way of them being able to adopt this technology. We are in a time of pretty significant shifts and changes. The possibilities that might come out of this, we havent begun to imagine at this point. About,hnology we talked which is primarily videoconferencing, but there are other tools out there and are not adopted as widely but they do amount allow patients who are sick and did a lot of checking up, if you will, to do more of that at home. There is a device that can connect to a smart phone to let some and take an ekg from home. We can imagine a lot more uses. Ear infections are a common thing that moms have to deal with. Every time you have to go to the doctor to check that out, it is a big pain. Can imagining that a company could put a little camera in your childs ear to see if they have an infection. To bessibilities are yet fully explored, but probably endless. William in melbourne, florida. Caller i would like to know, lastong is it going to thethe pandemic covid pandemic . Ort is as a temporary thing the beginning of broader use of telemedicine . In twoi think of it ways. Most of the relief i have been talking about is tied to the pandemic. So congress and the administration largely made this temporary in order to make sure that people could use this in this time of crisis and unprecedented change. It begs the question like the color was saying of what comes next. In my view, what should come next is making most if not all of this permanent and probably going further. We talked a bit earlier about some of the barriers that still remain. So there are things that states can do and things that feds can do to clear away barriers. In my view, we should make it permanent. We want to have this be it Technology People can rely on Going Forward. There are so many uses right now and uses far beyond that. Host the cdc has called on health care facilities, hospitals, to adopt telemedicine to protect patients and staff at many large hospitals that are facing and racing to implement those guidances from the cdc. How are things coming, do you know . Guest they have been amazing. Doctors have been asked to do so much so weekly. ,here isnt really hard data because it is too soon to get that, but if you open the newspaper or talk to your doctor, there is so much going on so quickly. Some doctors have just been setting up practices in 48 hours and some in a week. The usage has really exploded. One Telemedicine Company said their use of their Services Grew 50 over the month before. Ofse are just examples statistics. One said they did 10 million minutes of visits in one day after they opened up a practice. It has been an overwhelming response and clearly a desire to do it and recognition by providers and medical providers of the value. It is something that has been set up quickly and is really impressive to see how people, when they needed to come up with something, they came up with it quickly. Host there is reporting on the downside of that with a headline of search in patients overwhelms Telehealth Services and they say it is stressing telehealth providers and the technical infrastructure. Arizona. Next in good morning. Concern is, i took care of aids patients for probably 15 years, and it was an ongoing problem. At this time, what do we do if . Ou do have this new virus is it a disease i will have to deal with for the rest of my life . Marie fishpaw, it might be a lot of your area of expertise, but do you want to answer the question . But i i am not a doctor, would suggest you check out the cdc. Written a lot about this. I would direct you to resources. My understanding is the answer is no, but i do not want to speak out of turn. Host we go to in vermont. Welcome. Caller good morning and thank you. Disclosure, i have been in the telemedicine business for four years and until now, people were not listening. We have to understand that they are overwhelmed now. Health Care Companies and state governments love the savings. Are getting a little confused, can you mute verio volume and mute your volume and had. And go ahead. Host mike in vermont, are you still there . Go ahead with your comment. I think you are still on the line. I think we lost him. It would have been nice to hear from a telehealth provider. We will go to hillsboro, new jersey. Knowr what i wanted to and i think this is important, since the covid virus has hit new york city and new york state and new jersey the hardest i believe so far, are those governors, Governor Cuomo and gov. Murphy, have the opted into the program of the idea that medicaid and medicare and private Health Insurers will cover the telemedicine . If they are not in, how is it going to be covered by telemedicine . Guest i think the answer is sort of twofold. Ofyou are on medicare, a lot regulatory barriers have been removed and they keep removing them as we find them. You can use that the one of your choice. If you live in those states and the doctor who you would access normally has set up a practice, you should be able to access that. The question of whether these governors have allowed you to , i doctors in other states dont want to answer that, because i am not completely sure.