Live now to discussion with main senator angus king who joins Healthcare Providers and Bipartisan Policy Center experts on the use of telehealth during the covid pandemic. Health team led by, Catherine Hayes and others. For those of you who may be unfamiliar with the Bipartisan Policy Center we were established a a little over a decade ago by four former majority leaders, senator bob dole, late senator howard baker on the republican side. Senator tom daschle and senator George Mitchell on the democratic side. Senator mitchell from the great state of maine which youll hear shortly his estate, very well represented here this morning. The country is indeed, indeed the world quite frankly is experiencing a once in a lifetime pandemic caused untold suffering and death. Doctors, nurses, hospitals, Healthcare Providers are struggling to provide Critical Care under some very difficult conditions. But if there is any good, and theres that much, but if theres any good to come out of this virus, it is that it has expedited the Digital Health transformation out there designed to help these providers deliver healthcare more quickly and efficiently. Covid19 has put up later focus on the use of telemedicine for diagnosing, delivery and treatment through Digital Health laser focus. Telemedicine was a tool available prior to the onset of this terrible virus but based on some recent data, telehealth claims have increased 3500 over this last year. As one of those who has grew up in a rural part of our country, where my family continues to farm today, i am personally very well aware of the challenges of providing healthcare in a Rural America. Bpc health team has been working in this area over the past many years. Last year bpc staff visited various rural Healthcare Facilities throughout the country including name with former senator olympia snowe. Resolve repeatedly the problems that Rural America face and accessing care, the long drives to the doctors offices, the shortages of both primary care clinicians and specialists, and the rash of hospital and clinic closures. We released recommendations from our Rural Health Task force earlier this year, chaired by former senators daschle and snow and former governors musgrove and tommy thompson. The task force recommended expanding broadband to rural committees. Its my understanding that nearly a quarter of Rural Communities and onethird of tribal communities lack any form of Broadband Access. We knew that broadband would be expensive and it will take time to implement. So the task force recommended to allow Rural Americans to take advantage of telehealth through other means, such as telephone, audio only consultations. We are proud here at bpc that some of the task forces recommendations have made into the final legislation enacted earlier this year, along with the department of health and Human Services rule action plan that the issued recently. But that emergency legislation, the cares act and its provision surrounding telehealth, are scheduled to end with the National Health emergency in which we hope will be soon. But this brings us to the question that we want to address today, and that is what is the future of telehealth . What have we learned from the increased use of telehealth during the pandemic, and what new flexibilities should become permanent . We had a wonderful group, excellent people here to address these questions, and it will be moderated by the honorable senator angus king. Let me introduce senator king and then the panel. Senator kaine is first elected to the senate in 2012. Hes in his second term. He is maines First IndependentUnited States senator, and he has played a significant role in keeping attention on telehealth. He introduced the improving telehealth for underserved communities act in june to provide patients receiving Telehealth Services through certain Rural Health Clinics and federally qualified Health Centers from having to have reduced medicare payments. Senator king, former governor, has served as a member of our bpc on a very Congressional Task force on rural health. Most important to us here at the Bipartisan Policy Center, senator king is a strong believer in bipartisanship and works hard to bring republicans and democrats together to find Common Sense Solutions to the challenges facing the country today. Before we turn this over to the senator, let me introduce the analyst who will be sharing their experience but also for all those who are doing out there, this discussion, if you wish to submit questions please submit them using the live chat function on your youtube, facebook or on twitter using bpclive. Again bpclive. So far panelists, scott oxley. Scott is Northern Light acadia hospital Senior Vice President and is president of Northern Light acadia hospital in bangor, maine. Welcome, scott. Dr. Jennifer lundblad is president and ceo of stratis health, and independent Nonprofit Organization based in minnesota, focusing on innovations to improve health. Dr. Lundblad is a a member of E National Rural policy Research Institute health panel. Shes also an adjunct professor in the Division Health policy and management at the school of Public Health at the university of minnesota. Welcome, dr. Lundblad. And then dena mcdonough, our own dena. She is bpc associate director of Health Policy. Dean to join bpc after serving as manager of payment policy for the American Academy of orthopedic surgeons. Prior to that she was a physician assistant i will say, not exactly a rural hospital, and orthopedic surgery at Mount Sinai Health system in new york city. Then dr. Lisa miller. Dr. Miller is a practicing primary care physician for all pages in her hometown of norway maine. She has been one of four physician late on the covid19 Hospital Incident Command Team where shes been at the Memorial Hospital since march. Finally but not least, Walter Panzirer is one of three trustees for the helms a charitable trust. He is grandson of Leona Helmsley and served as a paramedic, firefighter and Law Enforcement officer. This work has led him to create the rural healthcare and foldable children in Subsaharan Africa programs within the Helmsley Charitable trust organization. Helmsley trust by the way has been a supporter of our work your bpc, which we are very grateful of, that support. Thank you, walter. And with that, senator king, let me turn it over to you, and welcome you to this event, senator. Bill, its great to be you and want to thank the Bipartisan Policy Center. Votes and independent media should suggest to change the name to the nonpartisan policy center, just saying. But in any case its wonderful to be here and to join so many people on the panel and in the audience. This is one of those frequent occurrences for a u. S. Senator were you asked to speak to a topic and to an audience, all of whom know more about the topic and you do your eye humbly realize the level of expertise we have on the panel and in the audience but i think theres some very important issues to talk about today, and challenges and really enormous opportunities. As you mentioned one of the few Silver Linings of this pandemic has been the incredible acceleration of the adoption and expansion of the availability of telehealth. Particularly in rural areas, and that is close to my heart in the state of maine because we are predominately a rural state. As anyone knows, during the pandemic we have seen expansions both to the cares act and through the actions of cms and dhs a that have really facilitated telehealth, both in terms of being able to work from home to have home be part of the telehealth picture rather than just specially set up for health studio. The expansion of people who can provide the health, practitioners who can provide the help, and finally the recognition that in some cases taken when theres a lack of broadband, telephone, audio only is an important part of this. I dont think they can be stressed enough what an Important Development this is. It took, i guess it took the pandemic. We all know those of us whove been working on this for years, and i remember visiting early teleHealth Systems when i was governor of maine 25 years ago, but to see it expand to the level and everybody has heard the numbers. At the beginning of the pandemic, 12,000 telehealth visits a week. And by the middle of june, a million telehealth visits a week. Thats just an amazing, unbelievable change and its provided access, editing people are now realizing this kind of access is something that should continue and we should be sure to enable the policies and the Reimbursement Policies of all the other pieces that enable this to continue. Again particularly for people in rural areas. I cant speak for other states but i know in me one of the issues of people in our communities is transportation, particularly seniors i know in maine so say you can have an appointment at 3 00 on tuesday in bangor is nice for somebody that is in patton but thats pretty much an allday trip. And to be able to have the visit via telehealth or audio is a huge expansion of the accessibility that people have the medicine and its kind of treatment. The other thing thats very important about this is the use of telehealth for mental and Behavioral Health, and we will talk about this. I can remember again 25 years ago being told that was one of the areas we thought people thought had real promise and that is proven to be the case. Theres a wonderful article by the way i will share with you in the Washington Post just this morning, and long article about telehealth and expansion particularly in the field of Behavioral Health and how important it is to people to someone that they can reach out to and have contact with through the telehealth facility. The final thing in my introduction is broadband. Telephone of course pretty much works everywhere. Why . Because this country decided a long time ago that universal Telephone Service was fundamental to the economic, cultural, social and political wellbeing of the country. We made the same decision about electricity in the 30s. Franklin d. Roosevelt Rural Electrification act. Broadband has developed in a much more sort of herkyjerky and even way where we have terrific broadband mostly in urban areas, pretty good in suburban areas, okay in some rural areas, and not at all in others. I believe this has to be a comprehensive Major National priority come just as Rural Electrification was, just as telephonic communication was. Because the economy cant work in rural areas. People are not going to move to rural areas. Importantly what were talking about today, healthcare is based upon good connections. Thats sort of a separate issue but its really got to be part of this discussion because we can be talking about reimbursement rates and all those kinds of things but if people cant connect, it aint going to help them. I think we need to be, as many of you know, there are all kinds of federal initiatives on broadband in the sec and department of agriculture and others. We wouldnt get a comprehensive look to make this a clear and comprehensible National Policy involving states, the carriers, communities, coops, local people, whatever it takes. Weve got to overcome the issues of broadband. Those are some preliminary thoughts, and i want to call on some of our Panel Members to make a few opening remarks. I will start with scott oxley who is the head of acadia which is a Behavioral Health facility in eastern maine, in bangor, maine. Scott, share with us what you were saying, whats happening on the ground in terms of telehealth, particularly in te behavioral field in maine. Great come happy to, senator king, first of all thank you so much for being with us today and take you for your support of healthcare in rural maine and Rural America and support for those that are need of Mental Health services. So as the senator mentioned my releases Service President here at acadia hospital in in the se that is a lot of geography and not a lot of resources. Acadia hospital is news essential part of the state. We take care of about twothirds of the geography and about onethird of the population. So a lot of area again without a lot of resources to cover. There are not a lot of vets in the state of maine for acute Care Services support of our success, part of our strategy part of our mission adds is to work very close with folks in commute the Comp Committee partners and doing our very best to get to the folks in their local and in their home space, doing our very best to manage their Mental Illness which we all know is a chronic illness. And like any other chronic illness that makes all the sense in the world to help individuals in managing the compliance and overall quality of life. So to what are we seeing her on the ground, seeing just a huge swell in terms of need for Mental Health services. It would be physically impossible for us to keep up with that need, not just acadia hospital but the entire state of maine without the benefit of Telehealth Services. Telehealth services is just a fabulous job connecting to people in need of those services. Its not only a convenience but it really breaks away a lot of barriers for those folks that are struggling financially and am struggling with her illness to get out of their home and allowing as to connect directly with them. We have done a lot of experience with telehealth. We support 17 Emergency Departments in the state of maine which weve seen a a huge uptick of Mental Health patients needing services and they are seeking that service at least initially to the Emergency Departments here we are also in 42 primary care practices will also see an increase in Behavioral Health support. Most recently to the pandemic we converted most of her Outpatient Programs to the Telehealth Platform and at one point we are running nearly 100 of her Outpatient Programs to a Telehealth Platform and be happy to share more detail later on in the program but we see the need for Mental Health services and the accessibility rate to telehealth really on the increase, which we are very pleased and proud of. So thank you. Thank you, scott. Lisa miller is a a physician ad western maine. Its just a coincidence that a lot of maine people understand. I dont know how that happened. Lisa, you are practicing in a small town, norway, maine, in the western part of the state took again serving a rural population and i was on the phone with john thune from arkansas. These rural states, they all have the same kinds of issues. Were talking about broadband, but lisa, i guess let me ask a basic question. Does it work . Does telehealth work . Doesnt serve the clients . To the field well treated and confident in the system . Let me start with that fundamental question. It does work, senator king. I would also like to thank you for having here today to offer a clinical perspective on a topic i feel a tremendous impact on the practice of world medicine. I not only think it works but i think its been lifesaving for my patients. The benefits of it run very deep. Whether it is through a Mental Health visit with me or teleconferencing in with a specialist about new wants medical conditions, valley of telehealth spans every age group and level of medical complexity. I just had a telehealth visit last week in fact, with the 90yearold patient which went surprisingly well. She wasnt