Nursing has long been associated with healing hands. Laying hands on patients’ bodies is personal and intimate, providing comfort, soothing reassurance, strength, and hope. It builds a sacred trust that engenders care. When that foundational element of nursing was removed to follow social distancing protocols during the COVID-19 coronavirus pandemic, nurses found a new avenue to connect with their patients—through the use of telehealth.
Nightingale created roles for her staff that reflected patient need, directing interventions based on her observations, patient response, and utilizing best practices to advance patient outcomes. Nightingale’s first nursing directives delivered compassion to patients through human touch and hygiene, as nurses began to bathe and clean the soldiers, clothe and wrap them with blankets supplied by from her inventory, and feed them nutritious foods.
In the first few weeks of 2021, the new 117th U.S. Congress introduced almost 10 pieces of legislation to expand and improve access to telehealth programs. Confronting the pandemic helped break down barriers to patient-centered care and generate bipartisan support for telehealth and other healthcare technologies.
During the pandemic’s first U.S. wave in March 2020, the Centers for Medicare and Medicaid Services issued temporary changes to its telehealth rules—and later made many of them permanent. Telehealth options give CMS-covered patients “easy-to-use, accessible benefits that can help keep them healthy while helping to contain the community spread of this virus.”
New Legislation Opens Accessibility Options
Now more than just a stopgap for temporary quarantine or social distancing restrictions, telehealth has become an expected and standard option to deliver many aspects of care. But what the past 18 months have shown is that although it removed some physical limitations to care, it uncovered others, such as lack of internet or broadband access, technology illiteracy, and reimbursement.
Regardless of party affiliation, the U.S. Congress galvanized committees and leadership to find ways to cut some regulation and streamline the process to introduce new legislation to remove barriers and increase access, including:
- Ensuring Telehealth Expansion Act of 2021: makes permanent several telehealth flexibilities that were initially authorized during the public health emergency relating to COVID-19, particularly with respect to Medicare coverage of telehealth services
- Protecting Access to Post–COVID-19 Telehealth Act of 2021: permanently allows federally qualified health centers and rural health clinics to serve as the distant site for telehealth services under Medicare
- Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act: provides funding to increase access to telehealth services and virtual visits in skilled and other nursing facilities during the pandemic
- Broadband Reserve Fund Act of 2021: funds broadband deployment to unserved areas, distance and remote learning, securing the telecommunications supply chain, and telehealth technologies
- Knowing the Efficiency and Efficacy of Permanent Telehealth Options Act of 2021: directs the Department of Health and Human Services, Medicare Payment Advisory Commission, and Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services during the pandemic
- Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act: permanently removes all geographic restrictions on telehealth and expands the list of originating sites to include the home and other sites, mandates studies of how telehealth has been used during the pandemic and the effectiveness of telehealth waivers, and encourages CMS’s Innovation Center to test more payment models that include telehealth
- Protecting Rural Telehealth Access Act: improves access to and coverage of connected health services in rural areas by allowing payment parity for audio-only telehealth services when clinically appropriate, expands coverage for asynchronous (store-and-forward) telehealth services, and allows critical access hospitals to directly bill for telehealth services
Although not all of the bills will become law, the lead sponsors may combine many aspects of the disparate draft legislation into a single, larger package to garner the majorities in each chamber. Telehealth is a rare bipartisan priority.
Nursing’s Role in Telehealth
Both ONS and the American Nurses Association (ANA) support the use of telehealth in nursing care. In its guide to telehealth visits, ONS said that “telemedicine strategies can be used in cancer practices for routine symptom management and other nonurgent follow-up or survivorship visits.” The Society emphasized that communication and patient education are critical components of virtual care.
“Use of connected health technologies does not alter the standards of professional practice when delivering health care, conducting research, or providing education,” ANA added.
Fresh terms like teleoncology describe the new approaches that oncology nurses use for virtual symptom management, patient education, genetic counseling, clinical trial enrollment and protocols, survivorship care, and care coordination. As telehealth expands, oncology nurses will have new roles and opportunities to collaborate.
The real question is “how telehealth will be used after the pandemic is in the balance, and no one wants to see new access to telehealth suddenly halted,” American Medical Association President Susan R. Bailey, MD, said. “The time is now for government officials, physicians, patients and other stakeholders to work together on a solid plan to support telehealth services going forward.”
Oncology nurses will have a seat at that discussion table, speaking, as always, for patient-centered care. Learn how you can join the conversation with ONS Voice.