Letter to NGA and NEMA on States’ Role in Utilizing Digital Healthcare Tools to Address COVID-19 National Emergency

April 15, 2020

Governor Larry Hogan, Chair
Governor Andrew Cuomo, Vice Chair
Members, Executive Committee
National Governors Association
444 N. Capitol St NW, Ste. 267
Washington, DC 20001

Ms. Sima Merick, President
National Emergency Management Association
Hall of the States
444 North Capitol Street, NW
Washington, DC 20001

RE: The States’ Role in Utilizing Digital Healthcare Tools to Address the COVID-19 National Emergency

The COVID-19 pandemic poses one of the greatest challenges to the American healthcare system in our Nation’s history. States must continue to lead in diagnosing and treating Americans with COVID-19, while taking further measures to flatten the infection curve, using the most innovative and effective solutions available to them. A cornerstone of states efforts to address the COVID-19 crisis must be the use of internet connected digital health technologies, including telehealth, remote patient monitoring, and artificial/augmented intelligence (AI), among others.

Representing a diverse coalition of stakeholders that span the healthcare and technology sectors, all of whom support the expanded use of connected health technologies in healthcare, we applaud the National Governors Association’s (NGA’s) development of recommendations for governors on ways to improve coverage and access to telehealth services.1 NGA’s recommendations reflect that internet connected digital health technologies improve patient outcomes while reducing system costs, particularly for the chronically and acutely ill. Connected health tools, increasingly powered by AI, leverage patient-generated health data (PGHD) and range from wireless health products, mobile medical devices, telehealth and preventive services, clinical decision support, chronic care management, and cloud-based patient portals. It is crucial that these tools are fully leveraged by clinicians in this time of emergency.

With increasing strains on the healthcare workforce during this time of crisis, states must take extraordinary steps to enable access to care for those in need. While interstate compacts have a key role in permitting digital healthcare delivery across state borders, we agree with the NGA’s recommendation that states should, for the duration of the COVID-19 crisis, waive state-specific professional licensure requirements or grant temporary licenses to enable cross-state connected health services in states that have declared a state of emergency or activated the Emergency Management Assistance Compact (EMAC). Where states have joined an interstate licensure compact, such actions should augment the capabilities that these compacts provide.

We also urge all states, including those that have not yet waived licensure restrictions on out-of-state health care providers or restrictions on modality and technology, to, through NGA, establish and promote, through the EMAC or otherwise, a uniform approach to utilizing the full range of digital healthcare tools available today to address the COVID-19 emergency. This effort should utilize a standardized approach such as the EMAC Telehealth Waiver Template, and address key issues including payment, that mitigates divergences between states’ requirements, enabling the scaling of innovative technology-driven solutions across modalities so that they can be used by clinicians and patients as soon as possible.


Alliance for Home Dialysis
American Academy of Neurology
American Association for Respiratory Care
American Association of Nurse Practitioners
American Psychological Association
American Telemedicine Association
America’s Physician Groups
Association for Behavioral Health and Wellness
California Telehealth Network
Cambia Health Solutions
College of Healthcare Information Management Executives (CHIME)
Compassion and Choices
Connected Health Initiative
Consumer Technology Association
CyMedica Orthopedics
Dogtown Media
EmPowerYu Inc.
Health Care Originals, Inc.
Healthcare Information and Management Systems Society (HIMSS)
InTouch Health
LifeWIRE Corp.
Medical Alley Association
Medical Society of Northern Virginia
National Coalition on Health Care
Neuro Rehab VR
Nex Cubed Healthcare
Nixon Law Group, LLC
Pillsy, Inc.

Reflexion Health
Remote Cardiac Services Provider Group
ResMed Inc.
Telehealth Suite
The Learning Corp.
The Omega Concern, LLC
VeruStat, Inc.

1 https://www.nga.org/wp-content/uploads/2020/03/COVID-19-Telehealth-Memo-20200320450pm.pdf
2 https://www.emacweb.org/index.php/resources/best-practices/using-emac-for-telehealth

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