Red Tape and Health Workers

From City Journal 
More Medical Innovation Less Regulation: Four practicing emergency physicians describe some practical fixes to make treating Covid-19 patients safer and more effective. 
Jason AdlerAmy ChoMark PappadakisTheresa Tassey, April 9, 2020 

We can solve many of our problems with rapid, innovative changes to our usual practices, significant reorganization, and implementation of commonplace technology. For example, the use of telehealth within hospitals can decrease both health-care-worker risk and PPE use. All entry into the patient’s room can be coordinated and consolidated. We estimate that for a “Covid rule-out” patient, using a combination of video intercom and changes to processes, we can decrease the number of N95 respirators used from nine to one, or even zero. Implementing these changes for inpatients can yield similar results.

Regulatory barriers to implementation have slowed these and other common-sense efforts. In addition to a lack of resources to purchase devices and get them working, hospitals and IT departments have been fearful of violating HIPAA patient privacy provisions with technology that has not been fully vetted. Billers worry that they will be prosecuted for Medicare fraud for violating technical definitions of telehealth. Physicians worry about violating EMTALA, a federal law regarding the stabilization of any patient entering an emergency room and incurring personal fines of more than $100,000 per violation.