A group of Idaho telehealth experts are considering broadening the legal definition of the term to improve health care delivery during the COVID-19 pandemic.
The state Telehealth Task Force, assembled in July 2019 to analyze the state of telehealth in Idaho and craft recommendations for reform, is set to do more "homework" to consider ways it could tweak Idaho's definition of telehealth after its monthly meeting on Wednesday.
The pandemic laid bare how crucial telemedicine is to delivering health care, particularly in rural, expansive Idaho where remote areas often don't have many doctors nearby or reliable broadband connections. Telehealth reform in Idaho has been a yearslong process, involving a sweeping bill passed by the Legislature in 2015 — which it modified this year — and, just last month, an executive order by Gov. Brad Little that permanently lifted many telehealth restrictions.
But members of the state Telehealth Task Force think there's still room to improve.
Idaho's current telehealth laws define telehealth through a series of definitions. Taskforce co-chairwoman Kritsa Stadler, senior director for telehealth at St. Luke's Medical System, said "we continue to add things" to the law, "then we end up excluding stuff."
Some board members worried new technology or forms of delivering health care could surface, and that they might be excluded under a narrow legal definition for telehealth services.
Anticipating that more changes to health care would require Idaho's telehealth definition be updated again by state legislators, taskforce co-chairwoman Jenni Gudapati said a more broad definition could be somewhat future-proof.
"Much like we've learned, we don't know what's going to come around tomorrow," said Gudapati, who directs the Value-Based Healthcare Program at Boise State University.
Aleasha Eberly, benefits specialist at J.R. Simplot Company, said being intentionally broad in the law would allow for more choice in how health care is delivered.
"I want the provider and the patient to make the decision about whether this is a service that can and should be provided," Eberly said.
Susie Pouliot, director of the Idaho Medical Association, aired concerns that loose definitions could lead to lower quality of care. "There's a flipside to throwing everything open and saying everything is OK if the standard of care we have in Idaho for taking care of patients isn't maintained," she said.
If the task force recommends that Idaho tweak its definition of telehealth services, Stadler said that could come with a recommendation that standards of care are reviewed to align with the new definition.
"The state may like the granularity" in the existing definition, Stadler said, which means "we need to have a case for why we may want to consider broadening that within the Legislature, within the law."
The task force is set to make recommendations in the fall to a more general health care council, called the Healthcare Transformation Council of Idaho.
In addition to how telehealth is defined, the taskforce is also considering making recommendations on what telehealth services insurers cover, and what rate they cover them at (many are covering telehealth services at parity with in-person services right now, though the state doesn't require that) and expanding broadband access in remote parts of the state.
On broadband, the Idaho Department of Commerce is working to distribute $50 million in grant money from funds it received through CARES Act assistance.
Eric Forsch, broadband development manager at the department, told the task force that the department is sorting through 137 applications for projects that, cumulatively, would cost $80 million. The projects all have to be completed by Dec. 30 to comply with the CARES Act.