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AADE Participates in Congressional Briefing, State of Technology Enabled Care

Apr 02, 2014

Special Guest Blog from Hope Warshaw, MMSc, RD, CDE, BC-ADM, Owner, Hope Warshaw Associates, LLC, Alexandria, VA, and Immediate past AADE member Board of Directors

On March 13, 2014, I had the privilege of representing AADE on Capitol Hill for a congressional briefing presented by the Health IT Coalition (link), of which AADE is a member. The goal of this briefing, The State of Technology Enabled Care, was to highlight the need for modernized telemedicine regulations. Other panel members were a Parkinson’s patient using telehealth with a distant provider and a psychiatrist who’s used telehealth for a decade. View an abridged version of the briefing.

The following summarizes my key points. Read them in their entirety here.   Also, consider reading Update Health IT Policy Now, an article by Joel White, executive director of HealthITNOW published in Roll Call.

- To offer examples of the use of novel communications in diabetes care I shared my experiences as an online weight management coach using a research-based intensive lifestyle intervention based on the Diabetes Prevention Program (DPP) with a population of people with and at risk of diabetes and weight related diseases. I also shared my experience as an insulin pump trainer and diabetes educator working with intensively managed clients virtually. I reinforced the point that research continually demonstrates that frequent clinician interaction with patients, including with a diabetes educator, increases successful outcomes.

- I reviewed key statistics: the numbers of Americans with diabetes, according to CDC estimates, and the American Diabetes Association estimates for diabetes-related cost expenditures. I then emphasized that research shows providing people with Diabetes Self-management Training (DSMT) can bend the healthcare cost curve.

- I described DSMT in detail including the common settings, the National Standards, accrediting bodies and Medicare reimbursement. I mentioned that CMS has recognized significant underutilization of the DSMT benefit and due in part to this factor has added DSMT to the list of available telehealth services.

- I then segued to the point that delivering DSMT using telehealth should be a natural evolution of healthcare delivery innovation noting it could address some of the hurdles people with diabetes currently have obtaining DSMT in person.

- I provided the three common sense actions AADE is encouraging Congress to consider to embrace teleheath and bring healthcare delivery into the 21st century:

1. Remove the geographic and provider barrier limitations. Today, under current law, Medicare can only reimburse DSMT delivered using telehealth for beneficiaries located outside city limits or in areas with a provider shortage. For people to make the critical and permanent healthy behavior and lifestyle changes they need frequent and continuous support. House bill (HR 3077) would help remove some of these barriers by facilitating interstate licensure for health care providers.

2. Remove the limitation of the physical setting for delivery. Today the list of sites where a service such as DSMT can be delivered via telehealth is a physician’s office, a hospital and a limited scope of other named facilities. Congress needs to widen the scope of approved venues for delivery of DSMT by telehealth.

3. Add federally qualified diabetes educators to the current list of practitioners for telehealth services. I requested support for our legislation, the Access to Quality Diabetes Education Act of 2013 (HR 1274/S 945)


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  1. Apr 05, 2014

    Dear Hope, Thank you for representing the needs of our patients and the forums needed to evoke change necessary in a changing world. I am grateful you were available and able to speak at the congressional on our behalf of AADE.I will be sharing your artilce with the director of the office of Policy in Harrisburg. Lisa Laird
  2. Apr 04, 2014

    Hope, I am certain you represented AADE well! As you stated, telehealth services must been approved for all, not just the rural areas. Many PWD's are not able to miss a day of work, let alone 10 hours to attend education. With AADE's DEAP programs, outpatient clinics can provide the education in community settings, such as a local school, place of worship or community centers. This allows PWD to receive the education they require to self-manage, and not miss work days. Thank you Hope! Tammi Boiko, BSN, RN, CDE Immediate Past Chair, California
  3. Apr 03, 2014

    Great post, Hope! Removing the geographic provider barrier seems like a "no brainer" when talking about telehealth. Medicare should reimburse DSMT without limitation to where the telehealth is being provided. Thanks for speaking out on this!

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