Hello – It’s Your Healthcare Provider With an Important Message About Your Health

By Bill Lucia
(Mr. Lucia is chairman, president and CEO of HMS, a leading healthcare technology and analytics company and a Healthcare Leadership Council member)

Nobody wants to have their dinner interrupted by a telemarketer or to be hassled at work by a debt collector. But how many of you welcome a call or text message from your healthcare provider when it pertains to your care?

If you answered yes, then you’re with the more than 98% of people who opt to continue these messages via text and or phone calls spanning appointment and prescription drug reminders, prescription drug recall notices, chronic disease management information and post-operative instructions.  Right now, some patients may occasionally receive these communications from their physician, pharmacist or insurer, but more often than not these communications simply don’t occur.

So what’s the hang up you ask? A long-standing federal law, the Telecommunication Consumer Protection Act (TCPA) and its corresponding regulations.

Passed by Congress in 1991, the TCPA sought to limit unwanted telemarketing calls and solicitations. Since the enactment, the Federal Communications Commission (FCC) issued a 2015 Order that created an exemption for healthcare messages intended to facilitate rightful and legitimate communications with patients while preventing telemarketing and other unwanted solicitations. The Order has fallen far short of its promise, however, and continues, along with the many technical requirements it includes, to block valuable and wanted communication between healthcare entities and patients, including those participating in government administered programs.

The current coronavirus (COVID-19) pandemic has put a spotlight on the importance of healthcare-specific communications and outreach and the TCPA barriers that otherwise stand in the way. On March 20, 2020, the Federal Communications Commission (FCC) declared that COVID-19 was an “emergency” under the TCPA, thereby further enabling such healthcare outreach.  As a result, information regarding CDC guidelines and recommendations, how to access telehealth, behavioral and mental health services, extended prescription refill authorizations, and prescription mail order instructions have been sent to millions of patients – enabling continuity of care, encouraging social distancing, and ensuring capacity to treat those affected by COVID through alternative care pathways for non-COVID patients.

Pandemic aside – the benefits of such healthcare outreach are numerous, including patient empowerment and consumerism, better outcomes, improved quality and cost containment.  For example, vaccination rates can be improved by 30% – critically important as we anxiously await a COVID vaccine, but also to address the growing gap in other routine baby and well child vaccines for preventable diseases like the measles.  For the highest cost, most vulnerable populations such as individuals with diabetes, mental illness, or cardiovascular disease, medication adherence is critical. With outreach and engagement, adherence can be improved by 5% – 25%.

Make no mistake these communications are not robocalls, or even unwanted. Rather, only patients with a known relationship are contacted and on average, 86% of patients have said these calls and messages are valuable and approximately 90% continue the message when given the option. While the FCC and Congress seek to thwart robocall efforts, albeit through the TRACED Act and accompanying regulations or otherwise, it’s important that those efforts don’t directly or indirectly interfere with the authorized call reminding a diabetic patient to refill his or her life-sustaining insulin medication, the call informing a parent how to schedule a well-child visit and important immunizations for their child, or other appropriate (and often automated) calls and texts that healthcare providers and payers place to patients.

While the novel coronavirus has pressed the need and value of patient engagement, permanently expanding the TCPA healthcare exception beyond the emergency period is desperately needed. At the same time, efforts to thwart unwanted communications must be targeted verses broad so as not to block wanted healthcare outreach. Both will have a positive impact on patient health and public health at large.