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Indian Health Service Expands Telehealth Services During COVID-19 Response (HHS.gov)

Press Release, April 8, 2020.

Today, IHS is announcing its expansion of telehealth across IHS federal facilities. Telehealth services means patients can stay home and reduce their risk of infection and also keep healthcare workers and others in waiting rooms and emergency departments safe from COVID-19.

“Expanding telehealth allows more American Indians and Alaska Natives to access healthcare they need from their home, without worrying about putting themselves or others at risk during the COVID-19 pandemic,” said Health and Human Services Secretary Alex Azar. “Thanks to regulatory flexibility and hard work by IHS, providers will be allowed to use everyday technologies to hold appointments with their patients. Telehealth options ensure that heroic frontline IHS providers who may be under stress from responding to COVID-19 have maximum flexibility to provide the care patients need.”

Recently, the Trump Administration and the Department of Health and Human Services announced unprecedented steps to expand Americans' access to telehealth services during the COVID-19 pandemic. The Centers for Medicare & Medicaid Services expanded Medicare coverage for telehealth visits. The HHS Office for Civil Rights announced it will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the emergency.

Telehealth also gives providers access to services from locations other than hospitals and clinics, as in the case of self-quarantined clinicians. Providers can continue to practice medicine and remain available to their patients. They can also consult with their colleagues across the Indian health system.

“The current COVID-19 pandemic reminds us how important it is to be able to reach your healthcare team,” said Rear Adm. Michael D. Weahkee, IHS principal deputy director. “Telehealth will further protect our patients and employees by expanding services and increasing access to care, while doing our part to help stop the spread of COVID-19.”

On March 27, IHS issued additional guidance that allowed clinicians to use certain additional, non-public facing audio or video communications technologies to augment all clinical activities related to providing care to patients during the COVID-19 public health emergency. This applied to telehealth provided for any clinical reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19.

Beginning today, IHS service units and their clinicians who are using the system will obtain verbal consent from patients who meet with their provider via a telehealth appointment. Health care providers are required to verify the patient at the beginning of each encounter and are not authorized to record the session.

Six IHS sites in the Oklahoma City and Navajo Areas participated in a telehealth pilot project last week to test the Cisco Meeting system and share lessons learned. IHS then began training IHS employees across the agency on how to use the system. Cisco Meeting is a secure system that encrypts audio and video communications. IHS recognizes the importance of protecting the personally identifiable information and has built a robust program to safeguard this information.

The Cisco Meeting infrastructure is already used for telehealth in IHS, most commonly by the Telebehavioral Health Center of Excellence as well as the Albuquerque, Billings and Great Plains Areas.

The IHS, an agency in the U.S. Department of Health and Human Services provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives who belong to 574 federally recognized tribes in 37 states. 

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