c-span -- created by private industry. america's television company. brought to you today by your television provider. today, trump and members of the white house coronavirus task force hold a briefing on the federal government's response to the pandemic. we will have live coverage of the briefing on c-span. >> murray is domestic policy studies director. on the use of telemedicine and telehealth. as we started the conversation, define those terms. what to they mean? telemedicine is the use of any technology to talk to a

medical practitioner to do something to make you feel better. it could be you have the flu, you are not feeling well, you do not want to go to the doctor, so you give them a call and they talk to you entry you. --ehealth is bought or telehealth is broader. you email your doctor, work it out without ever seeing them. it is broader. telehealth,cine is but not all telehealth is telemedicine. have probablyus experienced it from having your pharmacy call you or text you that your prescription is ready. right -- that a is right. that is a common use of it. we also noticed that the or the importance of

telemedicine was boosted in the recent package that passed congress, the $2 trillion care act. the law provides relief for health plans allowing coverage for telehealth services. thee changes, and heels of --, and the heels of the office -- tell usr general why that is important. why do you think the administration included that? been a flurryas of regulatory relief or actions by policymakers to clear away underbrush of government policy that is getting in the way of people using telehealth or pan -- or telemedicine during this --demic

call a doctor and see them anywhere. overetimes talk to doctors the phone or video chat. when they are closed or have gone home, i get through to san francisco doctors. that kind of regulatory relief matters because if you live in a to seeing are limited a doctor in the state where you live or where you are seeking care. these are the kinds of small things that get in the way of people being to access care when they needed. impressive things about recent days is just how much everybody has come together on both sides of the aisle,

congress, the administration and even states to find out what they can do to lift any barrier that might stop a patient seeing a doctor through health or telemedicine. host: you wrote, the golden age of telehealth is here. you write that only nine states have issued licenses that allow an out-of-state medical professional to render services using telehealth. why is that significant? guest: and limits the choices of people who would like to use telemedicine. some telemedicine companies, all they do is telemedicine. you can work with them regardless of whether you're going to see them in person. if you work in a state that has allowed them to do that, you can't work with them.

states that have large rural areas, this is a problem because perhaps they do not have enough doctors in the first place. watch been fascinating to that there is a growing desire to act. we have seen governors take emergency actions. something that we would encourage any state policy makers to look at. our guest is marie fishpaw of policy studies from heritage foundation. we welcome your comments for those in the eastern, (202) 748-8000, mountain and pacific time zones is (202) 748-8001, and we also welcome medical professionals. that line is (202) 748-8002.

what kind of challenges does using telehealth present for hipaa requirements or other privacy concerns? guest: any time you communicate with a doctor you want to know that the technology they are using is actually going to be compliant. the cares act that you mentioned earlier that congress passed in the last couple of weeks took some steps to call for making sure that the steps we are taking to make telemedicine easier had in fact and privacy protected. most of the technology being used seems to be have a protected. -- be protected. .- be hipaa protected a physical therapist set one up

last week and felt confident that it is hipaa protected. these are considerations to take. just as with any phone call you make or any call you make video, you want to know that the only person you are talking to is the person on the other end. host:'s soundbite for many medical practices that their main points of triage or first contact, and particularly with covid-19, is not an in office visit. they want to do a phone or a video online assessment of you for you make any move to come to the office or go to the emergency room, correct? guest: that is right. we have seen so many news stories over the past week of the doctor saying please do not come in and please use our telemedicine and let us triage you. that makes sense on a lot of levels. it makes sense for you as a patient. if you are feeling symptoms are not feeling symptoms, the last thing you need to do if you need

to see a doctor is goat near that doctor's office and other people who are sick. they want to make sure they are routing you to the correct facility. if you have covid, they want to send you to a different place and not heavy with others and put them at risk. it is suited to the kinds of sacrifices we are being suited -- asked to make by staying at home. it is a good way to enable that while making sure you get the care you need. it is not just the people who think they might have covid who are coming down with the flu or something like that, it can be for people with chronic conditions and need to check in regularly. for example, people who need to see a psychologist. they can work with that psychologist over the phone without putting themselves at risk by leaving home. host: what have medical associations and doctors group, the american medical association and others, said broadly about the use of telemedicine and

telehealth? guest: dr. seem to be enthusiastic. if you look at the news reports -- doctors seem to be enthusiastic. if you look at news reports or even talk to a doctor, that is why i am excited you have a call in line to talk to doctors, there has been such an overwhelming reaction to setting things up. one knock i spoke to this past week said that 40% of his colleagues had been using telemedicine -- one doctor i spoke to this past week said that 40% of his colleagues had been using telemedicine before covid and that changed in a week. one practice didn't use it at all. hadrding to a news report, 1500 visits a week and they set it up in 24 hours. host: let's get to calls good heard from mac in old town,

maryland. good morning. caller: good morning. and here ins old maryland, i would love to have telemedicine. there is no way i can do it. -- trump andhave , talkedresident obama about us all getting high-speed and advanced self-service. i don't even have cell phone service here good i don't have high-speed internet and i am on satellite internet, but that does not do it. i can't go on skype. i had a doctor call me and say go on skype. i go on skype, it doesn't work. can somebody do something to get us high-speed internet and cell phone service? my government representative says i don't limit a rule area. ral area.

he is nuts. host: marie? guest: at least in the near term, if you have a phone, you can call your doctor. it is in the same if you have a video conference but you can speak to them. this is one of the regulatory barriers the trump administration cleared out of the way for medicare patients, making it clear you can call your doctor and your doctor can get paid for treating you over the phone. ifger-term, a lot of people you have a cell phone for iphone, that is one possibility. but one of the questions that will come out of this pandemic when you look back at lessons learned is -- do we have the systems in place to make sure that people can get care? you mentioned you are in a rural area, and that is one area that medicare cleared out of the way and they said they will pay a

doctor for you to talk to them from the comfort of your home guard us of where you live. -- your home regardless of where you live. hear from jc in california. caller: good morning. i just want to give my opinion because i just recently started having phone calls with my doctors peered i have chronic conditions and one of them is a doctor. yesterday, i had an appointment doctor and it was speaking through the phone like i am right now. it was so impersonal and lasted one minute.

the conversation was over and i felt like i didn't have the time to speak my mind or ask any questions. my question is to the lady, respectfully speaking, they are trying to say with all the new things coming out is the new normal. whosomebody it like me sometimes would like to speak face-to-face with a professional, do we have to get calling or do we have the right to actually see our doctors face-to-face? thank you. host: ok. guest: i think you put your finger on something important, which is that telemedicine can help and obviously we have all had interactions with doctors that were too brief and that can happen in person or over the phone. some of this is just making sure that we are connecting with the

right doctor, which is independent how you talk to them. whether this is the new norm and we are only going to see our doctors online, certainly not. like i view telemedicine is a good supplement, it cannot fully replace in person. sometimes you call a friend or you text a friend or you video call them. if it is your mom, you do all three, but it does replacing them in person. you needed -- we are human and are social creatures and need to be around people. at a time when we are being asked to social distance art when it doesn't make sense to go into the office, it is a great supplement and told that can be help to people. catch 22 andbe a telehealth in rural areas. on this program, we have done a

number of discussions about the ral medical centers and hospitals, and you are faced with the technology gap in some have internet not service -- how do you think that gets resolved? guest: i think it gets resolved in a couple of ways. says 75%y pew research of americans are using broadband, but many americans this went to use the phones. some of this is just making sure people have the right underlying tools to be able to access this technology. some of the regulatory changes that have been made in recent weeks have made it easier, this doesn't work perfectly, but if you want to go to a community set up access the technology there, there are protocols that can be put in place to make sure that happens.

we have vicki next call from tiffin, ohio. asler: i would like to say far as the telemedicine, i am all for it. i think it is good as far as if you don't have any major problems or whatever, it will keep you from getting a bug from someone else or whatever. so i think it is great. i wanted to ask -- do you know or can you tell me anything as far as all this is going on, do you have any idea about our dental care and how we are going to face that issue? that is good question. the ability to see a dentist over the phone is quite limited. dentists have, you -- some

of this has to do with protocols that doctors are putting in place. that seems to be highly varied. telemedicine, while good for are notngs, dentists one of them. host: is said that telemedicine might be good for quick check ins to supplement what many are seen to boost their bottom line. what do you think? guest: it is interesting way of thinking about it. , sometimes costs telemedicine cost less in a regular come in person visit. there is an example that i am telemedicinehat visits will cost $50 and some reflects different resources being used. the insurance companies have asked people to use telemedicine

during the pandemic because they want to triage people based on their first line of defense in terms of people getting sick. of, you mentioned dding their bottom line, i think of this as differently, what is more convenient for the patient? there are circumstances, pandemic side, it is not more -- it is a lot more convenient to see a doctor online. when moms are people who work have to go see the doctor, you lose time. if you are a mom, you have to bundle the kids up and you make it the other kids sick taking them in. there are advantages that go beyond the dollar figure. host: we are joined by madeline on our line for medical professionals calling from wayne, pennsylvania. caller: i have practiced in this

area for 30 years and i would like to say, and maybe you have already discussed it, about cost-effectiveness. for patients who are medicare and medicaid living in health care facilities, many times the cost to get them to the subspecialists, they have been discharged readily from a university setting or a community hospital, very expensive. and the frustration level of the facility having to hire a companion at times, tying up ambulance transport, arrival of people in the waiting area on a gurney. possibly on their way back from the visit being stranded on the expressway depending on the day you have to understand that this is a great thing that has occurred and we will learn from it. it is called effective and the

caretaker, the one receiving orders, south or a nurse, and implement the treatment plan more readily without the frustration. bring thised to awareness that i hope this will last and and we will learn from what we are going through. host: thank you for sharing your experience. guest: that is a great experience. it is great to hear from medical providers because one of the things that has been so important in making telemedicine more available is providers and medical practitioners share their experiences and sharing with policymakers and regulators what is getting in the way of them being able to adopt this technology. we are in a time of pretty significant shifts and changes. the possibilities that might come out of this, we haven't

begun to imagine at this point. about,hnology we talked which is primarily videoconferencing, but there are other tools out there and are not adopted as widely but they do amount -- allow patients who are sick and did a lot of checking up, if you will, to do more of that at home. there is a device that can connect to a smart phone to let some and take an ekg from home. we can imagine a lot more uses. ear infections are a common thing that moms have to deal with. every time you have to go to the doctor to check that out, it is a big pain. can imagining that a company could put a little camera in your child's ear to see if they have an infection. to bessibilities are yet fully explored, but probably endless. william in melbourne,

florida. caller: i would like to know, lastong is it going to -- thethe: pandemic covid pandemic? ort: is as a temporary thing the beginning of broader use of telemedicine? in twoi think of it ways. most of the relief i have been talking about is tied to the pandemic. so congress and the administration largely made this temporary in order to make sure that people could use this in this time of crisis and unprecedented change. it begs the question like the color was saying of what comes next. in my view, what should come next is making most if not all of this permanent and probably going further.

we talked a bit earlier about some of the barriers that still remain. so there are things that states can do and things that feds can do to clear away barriers. in my view, we should make it permanent. we want to have this be it technology people can rely on going forward. there are so many uses right now and uses far beyond that. host: the cdc has called on health care facilities, hospitals, to adopt telemedicine to protect patients and staff at many large hospitals that are facing and racing to implement those guidances from the cdc. how are things coming, do you know? guest: they have been amazing. doctors have been asked to do so much so weekly. ,here isn't really hard data because it is too soon to get that, but if you open the newspaper or talk to your doctor, there is so much going

on so quickly. some doctors have just been setting up practices in 48 hours and some in a week. the usage has really exploded. one telemedicine company said their use of their services grew 50% over the month before. ofse are just examples statistics. one said they did 10 million minutes of visits in one day after they opened up a practice. it has been an overwhelming response and clearly a desire to do it and recognition by providers and medical providers of the value. it is something that has been set up quickly and is really impressive to see how people, when they needed to come up with something, they came up with it quickly. host: there is reporting on the downside of that with a headline of search in patients overwhelms telehealth services and they say it is stressing telehealth

providers and the technical infrastructure. arizona.next in good morning. concern is, i took care of aids patients for probably 15 years, and it was an ongoing problem. at this time, what do we do if ?ou do have this new virus is it a disease i will have to deal with for the rest of my life? marie fishpaw, it might be a lot of your area of expertise, but do you want to answer the question? but i i am not a doctor, would suggest you check out the cdc. written a lot about this. i would direct you to resources.

my understanding is the answer is no, but i do not want to speak out of turn. host: we go to in vermont. welcome. caller: good morning and thank you. disclosure, i have been in the telemedicine business for four years and until now, people were not listening. we have to understand that they are overwhelmed now. health care companies and state governments love the savings. are getting a little confused, can you mute verio volume and -- mute your volume and had. -- and go ahead. host: mike in vermont, are you still there? go ahead with your comment. i think you are still on the line. i think we lost him. it would have been nice to hear from a telehealth provider. we will go to hillsboro, new jersey.

knowr: what i wanted to and i think this is important, since the covid virus has hit new york city and new york state and new jersey the hardest i believe so far, are those governors, governor cuomo and gov. murphy, have the opted into the program of the idea that medicaid and medicare and private health insurers will cover the telemedicine? if they are not in, how is it going to be covered by telemedicine? guest: i think the answer is sort of twofold. ofyou are on medicare, a lot regulatory barriers have been removed and they keep removing them as we find them. you can use that the one of your choice. if you live in those states and

the doctor who you would access normally has set up a practice, you should be able to access that. the question of whether these governors have allowed you to , i doctors in other states don't want to answer that, because i am not completely sure . i can direct you to do -- direct you to the telemedicine administration. they are tracking all of the changes. these things are changing so quickly that what is true today might not be true tomorrow. it seems like policymakers across the spectrum, whether at the state level, federal government, congress, has recognized the need to do this and want to. host: it may be early, but is there any data on any polling on patients' response to the use of telemedicine? are they happy with it? guest: there are two ways of looking at it, what are they doing before the pandemic and what are they doing now?

data before show that if you used telemedicine, you generally liked it. one study out of massachusetts said that 90% of patients who tried it really enjoyed it and wanted to keep using it. we see another survey that said 80% of people once they started using it look for doctors that have a practice. that is pre-pandemic. during the pandemic, i think unfolding.e one thing we will probably see is people who were using this before were largely millennials. these are the people, and this makes sense because this is the group that are on their phone anyway. this has opened up other groups of people to looking at using the tool. we keep hearing the conversation today about how many people are using it and that the demand is beyond the ability in some cases of doctors to meet it. the feeling people have about it

post pandemic to become known in the weeks ahead. host: will we see or have we seen the development of an area of specialty? as a doctor or nurse or telemedicine professional, someone trained specifically to work in this format? guest: that is an interesting way to look at it. there are companies who just do telemedicine. they have telemedicine practices and they will refer you on if needed. what i think is really interesting is doing more than just your face-to-face visit to talk about something that needs a quick check. the possibilities going forward have to deal with specialty care being delivered through telemedicine. there are ways to monitor diabetes.

you can get a blood test now at home and have that sent in and get the results by email. lots of possibilities to change how we are delivering care we need to receive. host: we will go to robert in oklahoma. my comment is -- i think that telemedicine is a great idea. here in oklahoma, often times when we go to see a physician, we are primarily uninsured here anyway, so we go to urgent care and see a nurse practitioner. if we could outsource our health care to the big call centers, there are a lot of doctors in india that could man the phone lines and just do telemedicine for the u.s. a lot of businesses, like engineering firms and things like that are outsourcing our engineering right now.

we have engineers on the payroll in india and you could pay those people a lot less and pay doctors a lot less in india. in general, their work ethic is astounding. they are just machines. idea.k it is a great i think we should explore it, because health care in this country is certainly not affordable at this moment. host: robert, thanks. marie fishpaw? telemedicine offers people to see a doctor no matter where they are located. the great things about the u.s. is the advanced nature of the quality. we want to make sure that everyone can see a doctor that is providing quality care, regardless of where they might be located. caller hit on a point about being able to save money by seeing a doctor online.

caredoctors, you can get and increase choices that might be more cost-effective. host: you mentioned millennials being comfortable on the screens all of the time. the story today in the "new york times," the screens one and we tried everything to stop staring at our devices, but now bring on the zoom cocktail hour. in terms of the use of not just telemedicine, but videos whether it's zune or other proprietary technology for medical practices, what can we look for? guest: that is a great way of putting it. blessing. is a mixed you have to make it work for you. your screento use to see a doctor and connect with someone, whether a friend or

family member, these are all good things. the more that we can -- we think about steps to make that possible -- the more policymakers can clear away regulatory underbrush adding in the way of people making decisions that work for them thet how to see a doctor, better off we will be. host: let's go to virginia. theer: my call is about, young lady mentioned that telemedicine, the doctors will be in companies. when you say companies and i hear that the person is working on the guidelines and constraints of the company, this doesn't allow them to do practice freely as they normally would do in their office. i think they would be more able withe their intellect touch, feel, smell, if they are with the patient. these are things that

professionals use when they are with patients. granted for some, maybe just a call to get prescription renewed or something like that, i can see it, but to use telemedicine for everything i think is preposterous. host: some final thoughts. guest: i think telemedicine -- it is a great question. telemedicine is a tool among many but will not replace seeing people in person. it can augmented and make things easier for people who can't go into the office as easily. but ashley wright, we will still need to talk to people -- but absolutely right, we will need to talk to people. we are humans and we will need to talk to and touch people. when it makes sense for telemedicine, it is a great tool to enhance that relationship.