[Congressional Record Volume 155, Number 164 (Thursday, November 5, 2009)]
[Senate]
[Pages S11216-S11217]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. UDALL, of New Mexico:
  S. 2741. A bill to establish telehealth pilot projects, expand access 
to stroke telehealth services under the Medicare program, improve 
access to ``store-and-forward'' telehealth services in facilities of 
the Indian Health Service and Federally qualified health centers, 
reimburse facilities of the Indian Health Service as originating sites, 
establish regulations to consider credentialing and privileging 
standards for originating sites with respect to receiving telehealth 
services, and for other purposes; to the Committee on Finance.
  Mr. UDALL of New Mexico. Mr. President, access to quality, affordable 
health care is an issue that impacts every American across our country. 
Whether someone is struggling to find coverage for themselves or their 
family members, or searching in vain for a doctor who is accepting new 
patients, or giving advice to a friend who has just lost his job and, 
and as a result, his health insurance, no American is spared.
  These problems hit particularly hard in America's rural communities. 
Residents there are more likely to be uninsured than their urban 
counterparts, have higher rates of chronic disease, and are often 
forced to travel hundreds of miles for preventive or emergency care, if 
they can find it at all.
  As we continue moving forward with health care reform, we must make 
sure we do not leave our rural communities behind. In my home State of 
New Mexico, for example, 30 of our 33 counties are designated as 
medically underserved. That is why I am please to introduce the Rural 
TECH Act of 2009, Rural Telemedicine Enhancing Community Health. 
Through this legislation, I propose that we use technology to connect 
experts with providers, facilities and patients in rural areas, and to 
extend critical health care services to underserved areas across the 
country.
  Telehealth technology can help diagnose and treat patients, provide 
education and training, and conduct community-based research. It uses 
video-conferencing, the Internet, and handheld mobile devices to 
provide consultation and case reviews, direct patient care and 
coordinate support groups, for example. There are many benefits with 
telehealth, including increased access to education and care, such as 
connecting remote generalists to urban specialists. This knowledge 
bridge will help remote areas retain health care providers, and improve 
the continuity of care. it also would allow patients to stay in their 
homes and communities, rather than spend precious time and money to 
travel for treatment and care. In New Mexico, Dr. Steve Adelsheim at 
the University of New Mexico has been using telehealth during the past 
few months to provide therapy to a Navajo teenager who is at high risk 
of suicide.

[[Page S11217]]

  My bill would create three telehealth pilot projects, expand access 
to stroke telehealth services, and improve access to ``store-and-
forward'' telehealth services in Indian Health Service, IHS, and 
Federally Qualified Health Centers, FQHCs. I'd like to tell you a bit 
about each today.
  First, the creation of three telehealth pilot projects. These 
projects would analyze tie clinical heath outcomes and cost-
effectiveness of telehealth systems in medically underserved and tribal 
areas. The first pilot project focuses on using telehealth for 
behavioral health interventions, such as post traumatic stress 
disorder. A second pilot project focuses on increasing the capacity of 
health care workers to provide health services in rural areas, using 
knowledge networks like New Mexico's Project ECHO. And lastly, I am 
proposing a pilot project for stroke rehabilitation using telehealth 
technology.

  Second, we will expand access to telehealth services for strokes, a 
leading cause of death and long-term disability. Travel time to 
hospitals and shortages of neurologists--especially in rural areas--are 
among the barriers to stroke treatment. However, Primary Stroke Centers 
are not accessible for much of the population. For example, there is 
only one certified Primary Stroke Center in my State, at the University 
of New Mexico Hospital. This bill would connect many more residents 
with needed services. In New Mexico alone, there are almost 173,000 
Medicare beneficiaries who would gain access to telestroke services.
  Third, we will improve access to store-and-forward telehealth 
services. These services allow rural health facilities to hold and 
share transmission of medical training, diagnostic information and 
other data, which is important for remote areas. This bill also would 
allow IHS facilities to be reimbursed as users of telehealth services. 
Finally, it would establish regulations for credentialing and 
privileging telehealth providers at rural sites, saving important 
resources and time as they accept telehealth services from an area of 
specialty.
  I am pleased to note that my bill is supported by the University of 
New Mexico Center for Telehealth and Cybermedicine Research, the 
American Telemedicine Association, and the Telehealth Leadership 
Initiative. In addition, it is supported by the New Mexico Stroke 
Advisory Committee, the American Heart Association/American Stroke 
Association, the American Academy of Neurology, the American Physical 
Therapy Association, the American Occupational Therapy Association, and 
the American Speech-Language-Hearing Association. I want to thank each 
of these groups for their support and encouragement.
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