June 15, 2023
During the COVID-19 pandemic, telehealth went from being a bit player in health care to taking center stage. This wasn’t really a surprise to AMDA or Telehealth Subcommittee Chair Dallas Nelson, MD, FACP, CMD. “We used to spend a lot of time teaching people about the value of this technology, but we don’t have to do as much of that anymore,” Dr. Nelson said. “Access to telehealth has made a huge difference in our field, and during the pandemic, many more people were able to experience it.”
The group, which is under the umbrella of AMDA’s Public Policy Committee, has been busy. Among other efforts, the members have been monitoring and communicating updates about changes in telehealth billing and regulations. They created a resolution addressing post-pandemic restrictions on virtual compliance visits and proposing a solution for those nursing homes—especially rural ones—that can’t find practitioners to come to them. “We also are looking at other workforce/quality-related proposals and sending letters to CMS with our concerns and ideas,” said Dr. Nelson. “Our longstanding AMDA policy regarding telemedicine is that it should be governed by medical necessity and that practitioners should be allowed to use this technology for such visits and be paid appropriately for them.”
Dr. Nelson noted, “We support age-inclusive telemedicine principles and developed eight steps for this.” The subcommittee is also reviewing clinical standards for nursing home telehealth. She added, “We are currently debating the concept of virtual medical direction and potentially safer ways to do this in geographic areas of need.” This could potentially be of tremendous value, she suggested, for facilities that can’t find someone skilled and engaged to serve. The degree to which a virtual medical director can serve has been enhanced and accelerated, said Dr. Nelson, by the advancement and evolution of electronic medical records.
The subcommittee is here to stay, and it’s gaining momentum. Dr. Nelson said, “At a session about telemedicine at the PALTC23 Annual Conference in Tampa, I asked how many people in the audience used this technology during the pandemic; nearly every hand went up.” As COVID spread, she noted, “We proved that if you remove barriers to telemedicine, physicians will use it appropriately—not for convenience but for necessity. We just need to lower the barriers to its use.”
There is room on the subcommittee for interested practitioners. Dr. Nelson said, “We need people with experience in telemedicine. We want diverse experience to keep our voices advocating for the best telemedicine systems in our space.”
Busy with her demanding work, Dr. Nelson is pleased to make time for AMDA volunteer leadership. She said, “The research would say that happiness is related to finding purpose and meaning in life, and it is very satisfying for me to work to improve the system of patient care. It feeds my soul, and I am happy to dedicate my time to it.” During the pandemic, Dr. Nelson found another way to spend her very limited free time. “I started doing paint-by-numbers. It was a self-soothing activity and kept my hands busy. I am keeping some of the paintings as a positive memory of that time.”
