Top of Page Clinial Innovtion Business Funding NMTHA Town Hall Experts in TH Videos & Webinars Telehealth by Topic: Clinical Innovation Business of Telehealth Funding NMTHA Town Hall Interviews: Experts in Telehealth ​ The Modern-Day House Call. Duke City’s Medic Buddy: House Call/Telemed Hybrid - August 24, 2022 Mark Maydew, CFO/COO and Kelly Spring, PA-C from Duke City Cares walk us through their Medic Buddy Mobile Medical Care service. Duke City Cares is not only making house calls but connecting patients when needed to physicians via telemedicine via this mobile service. ​ Performing a Physical via Telemedicine - April 15, 2022 Dr. Tarun Girotra, Clinical Educator and Assistant Professor of Neurology at the University of New Mexico Dr. Girotra presents on the various levels of physical exam documentation over telemedicine and demonstrates how to perform the best possible physical exam during a telehealth visit. ​ ​ CLIN ICAL ​ Leveraging Telehealth for Behavioral Health in Challenging Times December 14, 2022 Molly Brack, Clinical Director at the Agora Crisis Center and Wendy Linebrink-Allison, Program Manager of the NM Crisis Line and Elizabeth Glantz, 988 Project Manager with NM Behavioral Health Services Division. Presentation on how crisis line services can assist in closing gaps and build bridges for people who experience mental, emotional, and behavioral health and substance use concerns which do not replace community services, but fill in the gaps and create connections to support people in communities. ​ Performing a Physical via Telemedicine April 15, 2022 Dr. Tarun Girotra, Clinical Educator and Assistant Professor of Neurology at the University of New Mexico. Dr. Girotra presents on the various levels of physical exam documentation over telemedicine and demonstrates how to perform the best possible physical exam during a telehealth visit. ​ Addressing Provider Burnout December 01, 2021 Rick Vinnay, LCSW, CEAP - The Solutions Group EAP and Wellness Programs, and Pierce Ferriegel, CEO - The Community Lighthouse. Rick Vinnay and Pierce Ferriegel each have a different vantage point and discuss what their organization experienced and how they managed burnout. Telemedicine Clinical Specialties October 27, 2021 Dr. Randy Nederhoff, Neonatology, Dr. Rina Patel-Trujillo, Endocrinology, and Dr. David Phelps, Medical Director, PHS Urgent Care Clinics. For this webinar we bring you three medical specialists and their experience using telemedicine. They cover conducting a physical exam via telemed, using telemed for endocrinology, primary care, specialty care, surgical specialties and neonatal care. Telemedicine Clinical Specialties: Behavioral Health October 20, 2021 Lora Blazina, LPCC, Clinical Supervisor at The Mountain Center, Santa Fe’, Dr. Caroline Bonham, Vice Chair of Community Behavioral Health Policy, Department of Psychiatry and Behavioral Sciences, and Dr. Marita Campos-Melady, Clinical Psychologist and Director of Specialty Behavioral Health Therapy services at Presbyterian Medical Group. In this webinar we have three speakers as we explore tele behavioral health - the challenges, the successes and the innovations when using telehealth for serious mental illnesses, complex trauma, use in BH and medical settings and for adults as well as children. ​ Expanding Your Telemedicine Services September 29, 2021 Dr. Elizabeth Krupinski, Phd, Southwest Telehealth Resource Center, and Dr. Van Roper, University of New Mexico. Whether you have been using telemedicine for 1 year or 10, Drs. Krupinski and Roper have some ideas for making the most of your telemedicine services, which can contribute to further sustaining your practice. Telehealth and C OVID: Lessons Learned February 17, 2021 Van Roper, PhD, FNP-C, Associate Clinical Professor. This presentation covers telehealth basics, primary care specific applications, and lessons learned in the implementation of telehealth in small rural clinics during the COVID-19 pandemic. Care Integration in the Time of Covid: Focus on Patient Experience January 13, 2021 Elizabeth Krupinski, PhD, Southwest Telehealth Resource Center. This presentation focuses on ensuring patients have a positive experience during telemedicine encounters, starting from the first encounter at scheduling through the actual visit with the provider. Topics include incorporating the entire care team in telemedicine encounters and finding relevant quality indicators to measure success. ​ INNOVATION ​ The Ups and Downs of Digital Innovation in Healthcare November 16, 2022 Alex Carter, certified Physician Assistant, Presbyterian Healthcare Services’ Innovation Hub. A sought after speaker on this topic, Alex's presentation includes TytoCare as a case by which to discuss a system-wide Telehealth implementation, and get real with the many challenges they have. She weaves in other projects and tools as well. ​ Rethinking How We Connect Hospitals, Specialists and Patients September 21, 2022 Darcy Litzen, MS, BSN, RN, VP of Sales for AmplifyMD. Physician video visits became necessary during the pandemic and are now widely accepted. But what if we take them a step further and use virtual care to provide a holistic solution to the ever-present cost-of-care and network adequacy pressures on health systems and insurers, while also addressing physician burnout and the complexities of providing timely specialty care locally? All with built-in continuous improvement? The Modern-Day House Call. Duke City’s Medic Buddy: House Call/Telemed Hybrid August 24, 2022 Mark Maydew, CFO/COO and Kelly Spring, PA-C from Duke City Cares walk us through their Medic Buddy Mobile Medical Care service. Duke City Cares is not only making house calls but connecting patients when needed to physicians via telemedicine via this mobile service. Growing Peer Support in the Virtual World. How Presbyterian Healthcare Service’s Community Health Built a Virtual Peer Network March 17, 2022 Valerie V. Quintana, MA, PTP, and Donald M. Hume, CPSW with Presbyterian Health Services, Community Health. Presbyterian Healthcare Service's Community Health department stood up a virtual peer network. In this presentation, Valerie Quintana and Donald Hume describe what they built and bring us their experience - the challenges, the successes, and what they learned in creating this new network. BUSINESS OF TELEHEALTH Telehealth Needs & Opportunities: Emerging Findings from BH Providers December 08, 2021 Margy Wienbar, MS, and Renee G. Sussman, RN, MA, MSN. This presentation briefly reviews the findings of the report “Telehealth Needs & Opportunities: Findings from Nonprofit Behavioral Health Providers in Northern New Mexico” that was published by the New Mexico Telehealth Alliance and Anchorum St. Vincent in July of 2021. Participants will hear from three of the organizations that were interviewed and contributed to the report’s findings. Telemedicine Billing & Coding: What You Need to Know September 08, 2021 Steve DeSaulniers from Blue Cross Blue Shield of New Mexico, Jennifer Sandoval from Molina Healthcare, Julie Wohrlin from Western Sky Community Care, Dr. Denise Gonzales from Presbyterian Healthcare, Lorelei Kellogg, NM HSD, and Moderator: Stetson Berg, UNM Center for Telehealth This full panel of speakers present and answer questions from attendees. Delta Variant is on the Rise: Is Your Telemedicine Practice HIPAA Compliant? September 01, 2021 Michael Herrick, Founder & CEO Matterform. With the rise of the Delta Variant, you may be thinking that we will be relying on telehealth more this fall. Are you compliant? Do you have concerns about your platform? Have you been relying on tools that won't be compliant once the Public Emergency Health order ends? ​ Collective Learning of the Telehealth Learning Community March 31, 2021 Kate Gibbons, LCSW, LISW, Ph.D., of Janus LLC. A summation and update on the learning and data collected during the first cohort of the Telehealth Learning Community (TLC) for behavioral health providers. Show Me the Data: How COVID-19 Impacted Telehealth Claims & What Happens Next March 17, 2021 Stefany Goradia, MSIE-VP Health Analytics, RS21 Health Lab. COVID-19 caused a spike in telehealth as new payment models were approved and the healthcare industry pivoted rapidly to continue providing care via telehealth at the March onset. Since that time, organizations have witnessed declines in overall telehealth utilization, with some services slowly dwindling and others converting entirely back to in-person visits. In this case study, we will review an anonymized payer’s telehealth claim trends, services and conditions that were identified to be the most widely-adopted for telehealth between March and December 2020, and considerations for an ongoing telehealth strategy going into 2021. New Mexico’s Telehealth Stature Simplified: What You Need To Know March 10, 2021 Beth Landon, MBA, MHA-NMTHA Chair, and Stetson Berg, MHA-NMTHA Vice Chair. New Mexico enjoys one of the nation’s most progressive telehealth laws. Full payment parity and zero geographic restrictions comprise just part of the law; we also suffer zero limitations on eligible providers and no lifetime limits. This presentation and ensuing discussion intends to demystify the law, answer your questions, and gain your ideas on how to further improve the statute in subsequent legislative sessions. ​ Developing Telehealth Workflow for Best Possible Patient and Provider Experience February 10, 2021 Jen Gruger, PMI-PBA. Delivering a successful telehealth visit is as much about the step-by-step workflow and how each individual involved executes their portion, as it is about the technology used and the clinical outcome we desire. This session will cover three essential components of building (or repairing) an effective and efficient workflow for this type of visit regardless of the telehealth platform being used. ​ Using Remote Monitoring Technology to Improve Patient Outcomes & Retain Staff January 20, 2021 Arlene Maxim, RN. This presentation focuses on technology to augment home health care, an extremely valuable tool when clinicians use it effectively. Agency owners and managers are beginning to see the critical role that telehealth and remote care monitoring can play in keeping patients at home and improving patient satisfaction. Telehealth and remote care monitoring can also improve clinician satisfaction. During this session we discuss what to look for in a telehealth/remote care monitoring provider and how to market technology’s ability to improve patient outcomes and staff satisfaction. FUNDING FCC Rural Health Care Program Funding Opportunities March 24, 2021 Steve Constantine, SVP/CIO, Prairie Health Ventures & COO, and Marci L. White, FCC Rural Health Care Program Funding Specialist. The FCC Rural Health Care Programs provide funding opportunities for eligible healthcare providers across the U.S. to develop and grow their telemedicine programs. The two programs fund telecommunications and broadband services necessary for the provision of health care. In addition, the Healthcare Connect Fund allows opportunities for some urban participation as well as funding for data centers, administrative offices and certain network equipment. NMTHA TOWN HALL Town Hall: The Future of Telehealth September 22, 2021 Dr. Ronald S. Weinstein, national telemedicine pioneer, and Russell Toal, New Mexico Superintendent of Insurance and local community. This special 90-minute town hall explores the possibilities of where we go from here. The town hall features speakers from local and state leadership, healthcare and YOU. ​ EXPERTS IN TELEHEALTH ​ Elizabeth Krupinksi , PhD, Southwest Telehealth Resource Center Jen Gruger , PMI-PBA, EHR Support Department, Gerald Champion Regional Medical Center Geof Empey , Program Operations Director, University of New Mexico Center for Telehealth Kelly Schlegel , Director of the New Mexico Office of Broadband Access and Expansion ​ Clinial Innovtion Business Funding NMTHA Town Hall HIGHLIGHTED VIDEOS Experts in TH Webinars & Featured Videos FEATURED WEBINAR NMTHA Town Hall Event: The Future of Telehealth As our world changed due to the COVID-19 pandemic, so did the world of Telehealth. But what happens next? Featuring nationally recognized speaker and Telehealth pioneer Dr. Weinstein, plus Russel Toal from New Mexico's OSI. Access Video FEATURED SERIES Experts in Telehealth: An Interview Series NMTHA brings "Experts in Telehealth" a video series interviewing experts from various areas within the Telehealth arena. Access Video Video Access Past Webinar Series 10-week Educational Series Access Videos Still available from our 2021 10-week educational series are webinars focused on data, broadband in New Mexico, client engagement, and more! These webinars were hosted by the New Mexico Telehealth Alliance and made possible through funding by Health Resources and Services Administration Office for the Advancement of Telehealth and the Southwest Telehealth Resource Center. ​

New Mexico Telehealth Alliance TELEHEALTH RESOURCES | COMMUNITY | PROGRAM SUPPORT Connecting New Mexican's to Better Health. The New Mexico Telehealth Alliance (NMTHA) is a tax-exempt 501(c)(3) non-profit corporation dedicated to promoting telehealth solutions that deliver quality healthcare throughout the state. The NMTHA is a network of members representing a broad spectrum of public and private healthcare organizations. The NMTHA provides program support enabling members to effectively share resources. Board members and officers are all volunteers. ​ Vision: Through the efforts of the NMTHA’s work on policy, quality, and equitable access to telehealth services, New Mexicans will be able to get the care they need when they need it. Mission: To advance effective use, equitable access, and sustainability of delivering telehealth services in New Mexico. Why is an Alliance needed? Click here to learn more. About Special Announcement: AUDIO-ONLY Billing in New Mexico. View the NMTHA communication with the Office of the Superintendent of Insurance. See Details Be part of the solution! Join the New Mexico Telehealth Alliance Telehealth and telemedicine are no longer an innovative approach to healthcare - they are a necessary part of it. More than ever, access to quality healthcare, especially in New Mexico, is fundamental to the wellbeing of many communities, especially in rural and territorial areas. Supporting the New Mexico Telehealth Alliance through membership helps ensure access to meaningful information and supports the viability of telehealth services in New Mexico. Membership Matters Benefits of Membership Stay Connected! Stay connected with the NMTHA community. Sign up to receive updates and notifications on industry trends, latest Telehealth news, events, and more. Thanks for submitting! Submit

Q&A: How retail healthcare, telehealth trends could evolve in 2023 Sanjula Jain, senior vice president of market strategy and chief research officer at Trilliant Health, discusses the future of virtual care and how emerging retail players will affect the industry. December 16, 2022 Read More UCHealth slashes code blues up to 70% with telehealth technologies The academic medical center uses tele-sitter and virtual ICU platforms for a program it calls Virtual Deterioration. December 20, 2022 Read More Leveraging Telehealth Platforms to Enhance Provider Workflows, Adoption Implementing a telehealth platform can positively impact provider workflows in numerous ways, including easing administrative burdens, thereby leading to greater provider adoption and satisfaction. December 28, 2022 Read More Telehealth helps stop suicidal ideation for many patients, study finds One person dies from suicide every 11 minutes in the U.S. A new study shows that telemedicine can be used to treat more severe mental illness – contrary to previous thought. December 29, 2022 Read More Telehealth May Be Rural Healthcare’s Lifeline As a new year dawns, it seems like a stock-taking time in U.S. healthcare. Skyrocketing costs, underwater margins, a depleted workforce and sicker patients have most hospitals and systems thinking existential thoughts about 2023, none more so than rural facilities. December 28, 2022 Read More Industry News

Q&A: How retail healthcare, telehealth trends could evolve in 2023 Emily Olsen December 16, 2022 Sanjula Jain, senior vice president of market strategy and chief research officer at Trilliant Health, discusses the future of virtual care and how emerging retail players will affect the industry. As another year shaken by the lingering COVID-19 pandemic ends, stakeholders are still exploring how virtual care trends that accelerated in 2020 will affect the healthcare industry long term. Though telehealth use spiked out of necessity during the early months and remains higher than pre-pandemic levels, utilization has slowed over the past two years. Meanwhile, big retail companies and pharmacies are offering more care options to patients. Sanjula Jain, senior vice president of market strategy and chief research officer at Trilliant Health, sat down with MobiHealthNews to discuss the future of virtual care, how big retail entrants will affect the industry, and the importance of care coordination between traditional health systems and emerging retail players. MobiHealthNews: What are some of your big takeaways from 2022 when you're thinking about telehealth, digital health and other tech-enabled care? Sanjula Jain: A big thing that I'm thinking a lot about is that patients aren't coming back to care, despite all the investments in more supply or access points, whether that be virtual care access points or new retail entrants or traditional urgent care. We've just had this huge mismatch between supply and demand. We're kind of post-vaccines; we have Americans returning to work to some extent. A lot of folks are going into an office a couple of days a week, folks are traveling, yet they're not going back to see their doctors. We've tried to make care more convenient and more accessible. And some of these new supply points are lower cost, and yet, they're still not engaging. I think there are many reasons for that. COVID scared away a lot of patients, and I think we're starting to see signs of more distrust in the healthcare system. And then cost and affordability, with a lot of the price pressures and inflation and recession discussions. That's going to continue to be a factor. There's a lot of health consequences for when patients don't actually engage in necessary healthcare. MHN: What do you think is the future of virtual care when you're looking at 2023 and beyond? Jain: The market for virtual care is a commoditized market. So, we're seeing that generally it's being used amongst a discrete subset of the population. And we have to think about, who are the individuals who like to use virtual care and what are they using it for? Primarily, as a health economist, I think a lot about substitute goods. We are seeing that virtual care is really only a substitute good for behavioral health. It's both a clinical and financial substitute, right? Clinically, having some distance between you and your provider in a behavioral health interaction is probably preferred when you're talking about your feelings and being very vulnerable. And there's no lab work or poking and prodding that actually needs to happen. So it's a viable clinical alternative. Financially, we've been talking a lot about payment parity. Because behavioral health interactions often don't need imaging and lab work, you're kind of making the same amount for an office visit that you are in a virtual care environment. For other use cases like primary care, we see that's not actually the case. The patient goes in for a virtual care visit, and then what really ends up happening is the physician says, "I need you to come in to get some imaging done or get some lab work done." The payment parity, despite the policy incentives to increase telehealth payment rates, it's not true parity. And so, that's why we don't see the full substitute effect. When you boil the ocean down, you see that the market for telehealth continues to be pretty discrete and concentrated to a handful of consumers. That's really where I think the future is, thinking about whether they will continue to use it. The data shows that, in the pandemic, we've seen this tapering. When Americans are given the option for in-person or virtual, they're still preferring to go in-person with that exception of behavioral health. So, I think the market is going to have to be more realistic about the total addressable market size in terms of discrete number of users, the number of visits per user, and then invest accordingly. I think that's a large part of why we've seen a lot of struggling amongst some digital health players, because I think they've overestimated the amount of utilization of virtual care modalities. But the number of discrete users just isn't up to par with what individuals had estimated it to be. MHN: Going back to those retail entrants, Amazon made a ton of news this year. Walgreens, CVS, Walmart — they're also boosting their care delivery operations. How do you think these moves will affect the healthcare industry overall? Jain: It ultimately comes down to, who is your customer or your consumer or patient persona? Who is Amazon actually going after? Who is their target patient population, and for what services? Amazon is really focusing on more low-acuity services, and health systems are particularly good at the higher acuity things like surgeries. What Amazon and other new entrants mean is that they provide the consumer with more care options. But it also creates a need to coordinate care better and create these really strong referral relationships. To go back to my earlier point about patients not coming back, of the patients we do see coming back, we're seeing them really seek out care in these low-acuity, commoditized care settings. They're going in for flu and strep, but they're not getting their screenings. It's going to be really important for groups like Amazon to coordinate with health systems to actually get patients to go follow up for those necessary services and figure out how to refer them out. MHN: How do you think the growth of these retail players will affect patients? Jain: I think it's a bit of a toss up. For some patients, they're going to view it as a better experience, because they can get what they want when they want it. But I think from a clinical perspective, it creates a lot of risks and challenges for the health of the patient. There really isn't someone owning the care or steering the patient through their healthcare journey. Have you gotten this lab workup? Have you gotten this mammogram? For some of these more retail players, it's consumer-directed. You can walk into urgent care and you can go to a telehealth visit, and it's really up to the consumer. But healthcare is complicated, and the average consumer may not have all the necessary information to go make those decisions. I think that there's a lot of positives to retail players in terms of catering to consumer preferences and providing care in a more convenient way. But for a lot of complex care, acute care — that every American is going to need at some point in their life — there is a little bit more fragmentation. MHN: Do you think there's an appetite among health systems to partner with Walgreens or CVS or Amazon and say, "If you see someone, send them to me when they need a cancer screening?" Jain: Absolutely. So, I actually just this week was with one of the health systems, talking to their leadership team. That's very much a conversation that is happening in the boardrooms — what is the right partnership structure with some of these new entrants and primary care providers? I think the challenge is, you could have those great partnerships. But ultimately, it's the consumer and the patient that's still having to make the decision. Are they going to follow up on those recommendations? Where are they going to go next? So, I think it's something that we're going to have to spend more time thinking about as an industry, how to coordinate that care for that patient over time, but with more choice and options in the market. See original article: https://www.mobihealthnews.com/news/qa-how-retail-healthcare-telehealth-trends-could-evolve-2023 < Previous News Next News >

UCHealth slashes code blues up to 70% with telehealth technologies Bill Siwicki December 20, 2022 The academic medical center uses tele-sitter and virtual ICU platforms for a program it calls Virtual Deterioration. UCHealth is a non-profit healthcare organization based in Colorado made up of 12 hospitals across the state. THE PROBLEM The organization had a new use case for virtual care, a program called Virtual Deterioration. Essentially, it was trying to find patients who were deteriorating in the hospital sooner in order to provide rescue and treatment faster to give them the best outcome. "What we were seeing prior to this program was a lot of variability as we tried to detect deterioration, and then once we were detecting it, reaching out to the bedside caregivers as to what happened next," said Dr. Diana Breyer, chief medical officer of the Northern Region at UCHealth. "And so, this was very much a part of our plan to decrease that variability for patients that were staying in place for us to be able to monitor them consistently with more frequent vital signs to make sure we really had rescued them and utilized technology to keep an extra set of eyes on them," she added. PROPOSAL UCHealth already had implemented vendor AvaSure's TeleSitter platform for patient safety and the vendor's Verify for virtual ICU. It expanded use of these technologies to Virtual Deterioration. Prior to implementing the technology, the process for virtual deterioration involved staff in a remote clinical command center working in tandem with frontline staff. "And we did try a process before we employed the technology, where it was a lot of secure chat through our EHR, similar to texting, in addition to a lot of phone calls and not really being able to visualize our patients," said Amy Hassell, RN, senior director for the Virtual Health Center at UCHealth. "This approach created a lot of friction and interruption to the bedside staff who were trying to do hands-on tasks with the patient," she continued. "So we decided to bring in an audio-visual connection. We have mobile carts, and some of our hospitals have cameras in the ceiling so we can just turn on that camera when a deterioration event is occurring." With the camera in the room, physicians and nurses in the command center now can see and interact with the patient as well as the care team. "They're able to see what's occurring so that it's just like we're in the room with that care team member," Hassell explained. "When we do this, it helps us cut down on phone calls and interruptions at the bedside, allowing us to still participate and do our part of the program. "The program provides support and makes sure milestones of care are being met throughout that deterioration event, and help triage if needed," she continued. Because it's a clinical command center that operates a lot of equipment and different platforms, staff have a weekly operational meeting with the IT team that supports the area. "They were part of our planning phases; further, we did our own IT technical dress rehearsals ahead of implementation with the clinical folks each time we went live," Hassell explained. "IT is in lockstep with us and have been very helpful to getting this deployed by helping support us, navigate us through the bumps, as we push the envelope. They're great partners to us and have been since the very beginning." MARKETPLACE There are many vendors of telemedicine technology and services on the health IT market today. Healthcare IT News published a special report highlighting many of these vendors with detailed descriptions of their products. Click here to read the special report. MEETING THE CHALLENGE Today, the Virtual Deterioration technology is a separate platform. There's going to be context-aware linking soon, and that will help because then staff can go right in from the patient's chart through that portal. Clinicians at the bedside use this technology. Nursing staff and physician staff are the ones pulling the monitoring equipment into the room and using it at the bedside. On the reciprocal end, it's the remote clinical command staff who are accessing that camera to participate with the team and interact with them. UCHealth is in the midst of developing a new role called the "patient technology technician." "The patient technology technician is a staff member who brings the mobile device into the room so that nurses and physicians don't have to be responsible for setting it up, and they can remain focused on the patient," Hassell said. "That's been successful. We're really trying to get all of our folks operating at the top of their license. "This role will be very helpful as we continue to scale it, so the nursing staff aren't the ones having to bring monitoring equipment to that rapid response," she added. RESULTS When UCHealth started looking at this project, it looked for deterioration in particular, such as what are the metrics being sought. One of them that is well-established in the literature is around decreasing code events in the acute care setting, Breyer noted. "Those patients ideally are brought to the ICU and if they're going to code, code there, or if they're rescued," she said. "So we have seen improvement throughout the work that we've been doing around deterioration in this space both in the northern and southern region of UCHealth where we've implemented the solution. "And that's probably our biggest metric that we're able to measure," she continued. "I'll add that in the space of deterioration, it is sometimes difficult to measure what you're doing because you're trying to show that you're now doing something that you were previously not doing. And measuring that omission can be a challenge." The other thing staff are measuring as a process metric is for those patients who stay in place and are not being moved to a higher level of care at the time of their rapid response event. "We are measuring a consistent post-RRT intervention that we previously did not have," Breyer said. "That's another area that we're monitoring. Ultimately, we would like to see this improve mortality, but that's more of a lagging indicator, and that one is a little more variable in the literature as to how much they affect these deterioration events." Hassell stresses the organization is going to have to continue to trend this and the lagging indicator of mortality within the patient population being touched. "But we have early data where we've seen our rapid response rates increase anywhere from 26% up to about an 86% increase, depending on what location you're looking at as we've done this across our system," she reported. "And then, in early data again, we've seen our code blue events in our acute care areas go down by 25% to 70%. "We've seen our code blue events drop, which helps us know we're going in the right direction, we're detecting deterioration earlier, thus reducing a bad outcome from a code blue," she continued. To Breyer's point, UCHealth has seen the post-monitoring period, because it's leaving that camera in place for six hours and virtual staff are helping oversee and watch that patient in conjunction with the frontline staff who are very busy. "And so we've seen an increase in post-rapid response vitals anywhere from a 39% increase up to 152% increase of vitals being ordered, and then working on getting them completed," Hassell explained. "It's been a large range that we've seen, but a lot of intentionality because resources are tied up in that rapid response call. "Once the patient is stabilized, and they're staying on the floor, the nurses then go see other patients that they've not seen for a while," she continued. "And so we've got to make sure that we're taking time to watch over the patient in that kind of fragile window when they still could continue to deteriorate and need a higher level of care. That's where we put a lot of focus and energy, and those are some of our early metrics." ADVICE FOR OTHERS The piece Hassell likes about the technology currently in use is that staff have been able to flex it for a different use case that's been highly valuable. "We're still working on making it an improved platform with the company, but I also think that it's been instrumental and opened up pathways for us that we wouldn't have previously had," she noted. "We weren't seeing the success that we're seeing now until we introduced the camera piece because it solved those issues we mentioned. "And so if you are considering any sort of hybrid approach from, for example, a clinical command center or nursing workflows, you want to have a great platform that you feel your staff can use and interact with seamlessly and with ease," she advised. From a technology standpoint, having it be easy and seamless for the bedside team is key, Breyer said. "While there are now great technology solutions to some of these problems, the heavy lift is the change management with your bedside team, the non-technology piece," she concluded. "And so that's where a lot of the energy for a successful project must be." Follow Bill's HIT coverage on LinkedIn: Bill Siwicki Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/uchealth-slashes-code-blues-70-telehealth-technologies?utm_source=twitter&utm_medium=social&utm_campaign=womeninhit < Previous News Next News >

Leveraging Telehealth Platforms to Enhance Provider Workflows, Adoption eVisit December 28, 2022 Implementing a telehealth platform can positively impact provider workflows in numerous ways, including easing administrative burdens, thereby leading to greater provider adoption and satisfaction. The pandemic drove telehealth use to new heights. Even though usage appears to be stabilizing, healthcare stakeholders largely agree that telehealth is here to stay, and they are making virtual care a vital part of their care delivery model. Polls conducted by the American Medical Association show that 80 percent of physicians said they were using telehealth tools in 2022, up from 28 percent in 2019 and only 14 percent in 2016. Further, in 2022, about 75 percent of physicians said being able to offer remote care was an important reason to use digital health tools, up from 60 percent in 2016. From the patient perspective, the benefits of telehealth, such as improved healthcare quality and patient experience, have become increasingly apparent. Epic conducted a research study analyzing 35 million telehealth visits between March 1, 2020, and May 31, 2022. They found that "in nearly every specialty studied, most patients who had a telehealth visit did not require an in-person follow-up appointment in that specialty in the next three months." Only two of the 31 specialties — fertility and obstetrics — saw in-person follow-up rates above 50 percent, while genetics, nutrition, endocrinology, and mental health/psychiatry had in-person follow-up rates of 15 percent or less. But, as telehealth is integrated alongside in-person care, provider organizations must ensure they are selecting the right platform for their facility's unique needs and implementing them in a way that addresses — rather than adds to — clinician workflow challenges. KEY TELEHEALTH CAPABILITIES TO IMPROVE PROVIDER WORKFLOWS Amid the rapid rise in the adoption and use of telehealth during the pandemic, providers have faced several challenges in setting up telehealth programs. One of the most significant difficulties is related to the technology available, notes Eric Thrailkill, Venture Partner, Founder of the Telehealth Academy, and Chairman of Project Healthcare at the Nashville Entrepreneur Center. "While these solutions 'worked' per se, they were not designed to help health systems facilitate a hybrid care model with a goal to provide personalized care, regardless of location," he says. "During the shutdowns, almost all provider organizations were completely dedicated to supporting COVID-related patients and/or working through the backlog of previously scheduled appointments. Telehealth, due to the relaxation of certain federal and state regulatory requirements, consisted of phone-based services and two-way video technologies — speed to deploy was the operating mantra." Provider organizations succeeded in rapidly deploying new technologies, but they did not have time to optimize their workflows to account for certain processes — like documentation and revenue cycle — and support overarching population health and chronic care goals. During the pandemic, 'offering telehealth' could simply mean offering a two-way video solution. But now, with a couple of years of experience and data to pull from, providers are able to build robust telehealth programs to pair with in-person care. In short, a telehealth program looks at creating both a personal and efficient experience for the provider and patient before, during, and after the visit. Two-way video technology is just one piece of the puzzle. "Telehealth platforms should contain a virtual triage where location and assignment of a provider could occur," Thrailkill says. "This would also enable an appropriate assessment to ensure higher acuity visits are prioritized over lower acuity visits." For effective triage, relevant care teams must be able to easily coordinate their team and the patients in the virtual waiting room, chat with the patient ahead of, during, and post-visit, access the appointment, and interact with the patients while accurately documenting the encounter in their EHR and scheduling follow-up appointments. The digital experience should be smooth and the UI/UX strong to support adoption and satisfaction. Anything captured by the telehealth platform, say an image or an attachment, must have bidirectional clinical data flows enabled with the EHR to ensure the complete patient picture is captured for the patient's health record and billing and reporting purposes. Additionally, Thrailkill notes that as provider organizations become increasingly focused on addressing social determinants of health needs, they should consider telehealth platforms that can ingest data from multiple sources. Having this data at their fingertips at the point of care can help clinicians provide wraparound care services, including connecting patients with social services and community resources. Not only is a platform's ability to gather data from various sources essential to the success of hybrid care models, but so is seamless data exchange, which helps ensure continuity of care. "Continuity of care is the set of processes whereby the patient and his/her physician-led care team are involved and cooperating over time to achieve the highest level of quality of care," Thrailkill says. "This is difficult, if not impossible, given the fragmentation and healthcare data silos that exist today — both outside and inside provider organizations and health systems." Thus, telehealth platforms should have integration capabilities that provide clinicians with data from prior visits and information from facilities outside the organization where the patient has received care. But Thrailkill also cautions that providers should keep in mind patient rights regarding consent, privacy, and security when developing hybrid care models that leverage telehealth. IMPROVING WORKFLOWS ENHANCES PROVIDER SATISFACTION Selecting the right platform can help healthcare organizations optimize provider workflows, thereby boosting provider adoption and satisfaction. Providers at every level want to practice at "the top of their license," that is, utilize the highest level of their education and experience to deliver care, Thrailkill notes. For physicians, the health system's most expensive clinician, tasks like documentation and prior authorization processes can get in the way of this goal. Prior authorization, in particular, is a critical pain point, as some healthcare payers have complex processes that require much time and effort. "All of these administrative burdens are no doubt contributing to workforce challenges present today across essentially every professional level," Thrailkill says. But by using telehealth platforms with integration capabilities and Fast Healthcare Interoperability Resources (FHIR)-based application programming interface structures, provider organizations can reduce administrative burdens like prior authorization processes through automation and enable them to lean on their medical assistants during the triage process of the telehealth visit. This increases the time available for patient care and optimizes capacity for the clinical team, he adds. Further, when implementing telehealth into hybrid care models, healthcare organizations should take a long-term view rather than regard telemedicine as a replacement for in-person care. "This will challenge the organization to think about the role of medical assistants, nurses, and specialty consult providers — not as follow-on activity, but incorporated into the visit," Thrailkill says. "This will ultimately lead to operational efficiencies and reduce the amount of administrative burden existing in early deployments of telehealth." As noted above, reducing administrative burdens and improving care delivery processes can lead to higher provider satisfaction, engagement levels, and adoption of virtual care across the health system. Incorporating telehealth is not a passing phase, and demand will likely grow in the years ahead. But to ensure its success, provider organizations must select technology that enhances provider workflows, thereby improving satisfaction and adoption. About eVisit eVisit is an enterprise virtual care delivery platform built for health systems and hospitals. It delivers innovative virtual experiences in care navigation, care delivery, and care engagement, improving margins at scale without sacrificing quality or patient and provider satisfaction. eVisit works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue. Based in Phoenix, Ariz., eVisit helps healthcare organizations innovate and succeed in today’s changing healthcare market. See original article: https://mhealthintelligence.com/news/leveraging-telehealth-platforms-to-enhance-provider-workflows-adoption < Previous News Next News >

Telehealth helps stop suicidal ideation for many patients, study finds Bill Siwicki December 29, 2022 One person dies from suicide every 11 minutes in the U.S. A new study shows that telemedicine can be used to treat more severe mental illness – contrary to previous thought. Recently, the Journal of Medical Internet Research published some significant data highlighting the efficacy of psychiatric care delivered through telehealth: Those in the treatment group were 4.3 times more likely to have suicidal ideation remission. This is noteworthy because telehealth has not traditionally been equipped to treat those with the most severe symptoms of mental health due to the oversight necessary to actually provide safe, effective treatment, said Dr. Mimi Winsberg, chief medical officer at Brightside Health, which led the study. We spoke with Winsberg to get an in-depth look at this study and what the results mean for the future of telehealth and mental healthcare. Q. Please talk about your new study that examines the impact of telepsychiatry on reduction in suicidal ideation over time. Who was involved? What kind of care did they receive? What role did technology play? A. The study, which was published in JMIR Formative Research, sought to determine if Brightside Health's telehealth platform, which is equipped with precision prescribing clinical decision support, could successfully reduce suicidal ideation among enrolled patients, versus a control group who tracked their symptoms on the platform without receiving care. Another goal of the study was to describe the symptom clusters of patients who present with suicidal ideation in order to better understand the psychiatric symptoms associated with suicidal feelings. The study was large scale including participants of diverse geography and social demographics. It included a total of 8,581 people who completed a digital intake on the Brightside platform. Of those, 8,366 elected to receive psychiatric care from Brightside, while 215 tracked their symptoms on the platform without receiving care. Those who elected to receive psychiatric care through Brightside received a minimum of 12 weeks of treatment that included video visits with their providers, asynchronous messaging, and a prescription of at least one psychiatric medication. Brightside's technology platform was used to deliver clinically validated measures of depression and anxiety, as well as questions about clinical presentation, medical history and demographics. The proprietary precision-prescribing platform embedded in the tech platform analyzes these data points using an empirically derived algorithm to provide real-time care guidelines and clinical decision support to its providers using a computerized symptom cluster analysis. Q. The study led to some very promising outcomes. Please describe them and the success you achieved with telemedicine. A. The study found that patients enrolled in Brightside Health's telehealth platform had reduced suicidal ideation after 12 weeks of treatment. Patients who received treatment via Brightside Health were also 4.3 times more likely to have remission of their suicidal ideation than the control group who were monitored on the platform but did not receive care. The results demonstrated that a telehealth platform equipped with clinical decision support was an effective intervention for the symptom of suicidal ideation. In addition, we found that suicidal ideation had higher correlations with cognitive symptoms of hopelessness and poor feelings of self-worth, than with the physical symptoms of depression such as disrupted sleep and low energy. Q. Telehealth hasn't traditionally been equipped to treat these kinds of patients. What made the difference here? A. Historically, we have not relied on telehealth solutions to address more serious symptoms of depression. Clinicians are hesitant to treat individuals with suicidal ideation over telehealth because of the perceived risks. However, the results of this study are significant because they demonstrate effectiveness in treating these symptoms through a telehealth platform with clinical decision support, which may help alleviate concerns about the use of telehealth in addressing suicidal ideation. Telehealth can involve more than simply connecting a provider and patient via video camera. The telehealth platform used for the study was equipped with novel features such as remote patient monitoring and clinical decision support. A sophisticated telehealth intervention can assiduously track symptom presentation and outcomes with measurement-based care and offer real-time interventions along with machine learning and algorithmically based clinical decision support to select the best treatment. Q. What does all of this mean for the future of telemedicine and mental health? A. The future of mental health via telemedicine promises more widespread adoption of solutions for the majority of behavioral health conditions, even those with increasing severity of symptoms. We may see telehealth deployed for more serious mental illness, particularly when the telehealth platform can incorporate novel technologies to optimize care delivery. Additionally, as payers and providers collaborate to deliver more effective care, telehealth will likely become more than a means to deliver care, but also a way to enhance care delivery and provide highly effective care to those who need it most with expediency. At Brightside Health, we will continue to research the impact of telehealth treatment across the spectrum of mental health conditions, including those on the higher end of the severity axis. To that end, we are launching Crisis Care, a first of its kind program delivered nationally and over telehealth to treat patients with active suicidal ideation. The program is grounded in the evidence-based Collaborative Assessment and Management of Suicidality (CAMS) framework. This study in JMIR Formative Research laid the foundation for this program, and we are seeing an obvious need for such a national program in the U.S., where one person dies from suicide every 11 minutes. We look forward to furthering this important – and life-saving – work. Follow Bill's HIT coverage on LinkedIn: Bill Siwicki Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/telehealth-helps-stop-suicidal-ideation-many-patients-study-finds < Previous News Next News >

Telehealth May Be Rural Healthcare’s Lifeline Corey Scurlock December 28, 2022 As a new year dawns, it seems like a stock-taking time in U.S. healthcare. Skyrocketing costs, underwater margins, a depleted workforce and sicker patients have most hospitals and systems thinking existential thoughts about 2023, none more so than rural facilities. According to a report by the Bipartisan Policy Center (BPC), a Washington, D.C.-based think tank, 116 rural hospitals across 31 states closed between 2010 and 2019. Many of them were small critical access hospitals. Federal Covid-19 relief funding is believed to have prevented additional closures—only two rural hospitals closed in 2021. Now, though, 631 rural hospitals are threatened with possible closure within the next few years, according to the Center for Healthcare Quality and Payment Reform. As the CEO and founder of an acute care telehealth company, I’ve observed firsthand that workforce needs are one of the primary drivers of telehealth adoption. What was once a staff shortage is now a crisis, particularly in nursing, but also among physicians. From 2020 to 2021, the total supply of registered nurses decreased by over 100,000, the largest drop in four decades. By 2025, there could be a shortage of 200,000 to 450,000 nurses in the U.S. Rural hospitals are at a particular disadvantage since they tend to have worse workforce shortages than urban hospitals. According to the BPC, “urban areas have 30.8 physicians per 10,000 residents; rural ones have 10.9 physicians per 10,000.” There are also often fewer specialists—such as cardiologists, psychiatrists, radiologists and obstetricians—in rural areas. Opportunities To Improve Care Rural hospitals have for years contracted with academic medical centers for remote episodic help with patients with clinically complex conditions, such as stroke and sepsis. To make care more affordable, we’re seeing more rural healthcare leaders embracing telehealth for supplemental care, filling in coverage gaps or for specialized consultations on complex cases so that people get the right care at the right time in the right setting. In previous articles, I wrote about how telehealth can provide clinical expertise, how telehealth specialists target “hot spots” along the patient care journey and about virtual nursing, in which veteran RNs with specialty expertise guide bedside staff and patients through the care process. Rural hospitals are in dire need of expert care at patient transition points. Virtual care often starts in what is now the front door of a hospital: the emergency room. Rural and critical access hospitals often have to park patients in the hallway as they triage. A remote intensivist steeped in critical care medicine can track the vital signs of patients and do the intake, often guiding inexperienced staff to the right site of care and helping them through tests, diagnoses and procedures. Inappropriate patient transfers are a source of inefficiencies and poor-quality care. Patients may be sent to intensive care who don’t need to be. Some can be easily treated in the ER and sent home. Others may need a complex operation, for which a transfer to a level 1 trauma center is needed. Outcomes for ER patients with delayed care are, not surprisingly, poorer. Maximizing A Stretched Workforce The BPC examined three evidence-based programs that involve using digital technology—one of which was tele-ICU—to see how they could optimize a stretched healthcare workforce and ensure that patients receive quality care in their local hospitals. Tele-ICU programs can be episodic, such as enabling two-way audiovisual communication between telehealth providers and local ICUs to get answers to questions, or they can be continuous, where a remote physician has complete access to electronic medical records, imaging systems and other databases to get timely information that informs decisions about a patient’s care. According to the BPC, “studies have demonstrated that tele-ICU programs enhanced care plans, improved clinical outcomes, reduced hospital transfers, and were associated with increased best-practice adherence.” Telehealth also facilitates the mentoring of young nurses and assesses where there are gaps in current knowledge. The BPC report mentions a study that found that 27% of hospitals with ICUs have tele-ICU capabilities. Such capabilities can potentially lead to substantial savings: The report cites a 2019 cost-benefit analysis that found that a telehealth ICU program saved $3.14 million over six months by “reducing ICU variable costs per case, decreasing length of stays and decreasing ICU mortality.” It’s a fairly straightforward story: Remote intensivists can monitor dozens of patients remotely at a time, while tele-ICU nurses can keep track of 30 to 50 patients simultaneously, compared with just three for a bedside RN. Bedside clinicians typically can deal with only one emergency at a time, while remote intensivists can handle up to four codes at once. A Path Forward Pretty soon, the pressures of the workforce shortage will likely compel many, if not most, acute care providers to adopt some virtual care across the enterprise. So it’s crucial for rural hospitals to take steps now to ingrain telehealth into their operations and make it part of the fabric of care—that way, it’s there when they need it. Here are some things for rural hospitals to think about when choosing a telehealth partner. • There are many entities offering telehealth services, ranging from large academic medical centers to consortiums of providers to vendors large and small. Make sure you have complete trust in your chosen partner. • Ensure that all of the entity’s physicians are licensed to practice medicine in your state(s). If not, they cannot order tests, prescribe medications or do anything but recommend a course of action. • Does the telehealth provider have a network of specialists in every area? For example, many vendors lack psychiatrists, who are in short supply nationally amid the explosion in demand for mental health services. • Make sure your telehealth partner understands patient flow optimization techniques that support level-loading and optimized bed utilization. Final Thoughts Through my travels and in conversations with executives across the nation, I’ve found that the word “telehealth” doesn’t sound techy anymore and that the understanding of the benefits delivered by digitally enabled care is more mature. Telehealth is now recognized as a tool that, as part of a strategic process to remedy gaps in care delivery, can be combined with change management to drive real value. Soon, in fact, “telehealth” may be replaced by “health” when we look at the evolution of care through technology. Dr. Corey Scurlock MD, MBA is the CEO & founder of Equum Medical. See original article: https://www.forbes.com/sites/forbesbusinesscouncil/2022/12/28/telehealth-may-be-rural-healthcares-lifeline/?sh=1f7657be3e9d < Previous News Next News >

Congress' last-minute $1.7 trillion omnibus package: 8 healthcare takeaways Molly Gamble December 20, 2022 Lawmakers rolled out a roughly $1.7 trillion year-end spending bill Dec. 20 to fund the U.S. government through most of 2023, tacking on proposals to extend telehealth and hospital-at-home flexibilities while leaving out other healthcare asks. Lawmakers have until the end of Dec. 23 to clear the 2023 Omnibus Appropriations bill or federal funds are set to run out, bringing key agencies and programs to a halt. The package consists of all 12 annual appropriations bills Congress must pass and would fund the government through the remainder of fiscal 2023, which runs through September. Eight healthcare- and hospital-specific notes out of the 4,155-page bill: 1. The legislation curbs a scheduled cut of nearly 4.5 percent to the Medicare physician fee schedule that was set to take effect in 2023, narrowing the cut to 2 percentage points in the year ahead with a scheduled cut of 3.25 percentage points in 2024. The American Medical Association, which lobbied against the cuts, said it is "extremely disappointed and dismayed" with the cuts that made it to the bill. 2. While physicians did not get the relief they sought with complete aversion of fee schedule payment cuts, the spending bill would avert the 4 percent Statutory Pay-As-You-Go reduction, which would have amounted to cuts of approximately $36 billion, from taking effect in 2023. 3. The legislation extends incentives under the alternative payment model, which were set to expire this year, but reduces the amount from 5 percent to 3.5 percent. The incentive is designed to offset losses in revenue physicians may incur as they move from fee-for-service to participation in value-based care models. 4. The package extends Medicare telehealth flexibilities through 2024. The deadline for these flexibilities has been tied to 151 days after the end of the COVID-19 public health emergency, meaning the precise date was unclear as HHS has continued to renew the PHE in 90-day increments. Under the legislation, providers would be able to lean on flexibilities guaranteed throughout 2024. 5. The package extends acute hospital care at home waivers and flexibilities for two years through 2024. Similar to telehealth flexibilities, the deadline for hospital care at home waivers was tied to the status of the PHE. CMS has approved more than 250 hospitals to participate in the acute hospital care at home program. 6. The legislation extends the low-volume hospital payment adjustment and Medicare-dependent hospital programs through fiscal year 2024, or Sept. 30, 2024. 7. The legislation includes $118.7 billion — a 22 percent increase — for VA medical care. Other healthcare end medical allotments include $47.5 billion for the National Institutes of Health (a 5.6 percent increase); $9.2 billion for the CDC; $1.5 billion for NIH's second-year Advanced Research Projects Agency for Health and $950 million for the Biomedical Advanced Research and Development Authority, according to Senate Appropriations Committee Chairman Patrick Leahy. 8. The American Hospital Association expressed satisfaction with a number of measures in the legislation, including the extension of telehealth, hospital-at-home and programs to help rural hospitals, but signaled toward the work that remains to garner funding for hospitals. "In the new year, we will continue to advocate for Congress and the administration to take action to address patient discharge backlogs, support our current workforce and increase the pipeline into the future, hold commercial health insurers accountable for policies that compromise patient safety and add burden to care providers, and strengthen hospitals that care for a disproportionate number of patients covered by government programs or are uninsured, to name a few of our priorities," association President and CEO Rick Pollack said in a statement shared with Becker's. See original article: https://www.beckershospitalreview.com/finance/congress-last-minute-1-7-trillion-omnibus-package-8-healthcare-takeaways.html < Previous News Next News >

Membership COMING SOON: NEW MEMBERSHIP BENEFITS Thank you for your interest in joining the New Mexico Telehealth Alliance. The newly formed Membership Co mmittee and the NMTHA Board of Directors are revising the Membership section of this website. If you have any questions please contact us HERE .

Membership Levels For plans that include multiple users click here to learn how to add additional users to membership plan. For login instructions click here . Individual $ 150 150$ Every year Select No cost webinars, training videos, events and archives Engage in community forum Access to exclusive content 1 person Group Practice $ 450 450$ Every year Includes medical, behavioral, specialty clinics & FQHC's Select No cost webinars, training videos, events and archives Engage in community forum Access to exclusive content Up to 3 people Associations $ 450 450$ Every year Select No cost webinars, training videos, events and archives Engage in community forum Access exclusive content Up to 3 people Hospital $ 500 500$ Every year Select No cost webinars, training videos, events and archives Engage in community forum Access exclusive content Up to 4 people Health System $ 1000 1000$ Every year Select No cost webinars, training videos, events and archives Engage in community forum Access exclusive content Up to 6 people Health Plan $ 1000 1000$ Every year Select No cost webinars, training videos, events and archives Engage in community forum Access exclusive content Up to 6 people

Spending Bill to Extend Telehealth, Hospital-at-Home Waivers for 2 Years Anuja Vaidya December 20, 2022 The year-end package includes two-year extensions for Medicare telehealth flexibilities enacted during the pandemic and the Acute Hospital Care at Home Program. The year-end $1.7 trillion spending bill includes provisions to extend pandemic-era telehealth and hospital-at-home waivers for two years. The legislation, released Tuesday, aims to avert a government shutdown and includes several healthcare provisions, including reducing the 2023 Medicare payment cuts to 2 percent from 4.5 percent. In a win for telehealth proponents, the sweeping bill also includes a two-year extension of telehealth-related regulatory flexibilities for Medicare beneficiaries put in place during the COVID-19 pandemic. A previous bill extended these flexibilities for five months after the public health emergency expires. Now, the waivers will remain in place through Dec. 31, 2024, if the legislation passes both the House and Senate and is enacted into law. The flexibilities include eliminating geographic restrictions on originating sites for telehealth services, enabling Medicare beneficiaries to receive services from any location, and allowing federally qualified health centers and rural health centers to continue providing telehealth services. Further, the waivers lift the initial in-person care requirements for those receiving mental healthcare through telehealth and allow for continued coverage of audio-only telehealth services. In addition to extending the Medicare telehealth waivers, the new legislation includes a two-year extension of the Acute Hospital Care at Home Program. Introduced in November 2020 by the Centers for Medicare and Medicaid Services, the Acute Hospital Care at Home Program allows treatment for common acute conditions in home settings. As of Dec. 16, 259 hospitals across 37 states were participating in the program. The safe harbor for telehealth coverage for those with high deductible health plans (HDHPs) with health savings accounts (HSAs) will also be extended by two years if the new bill passes. The safe harbor provision enables people with HDHP-HSAs to receive telehealth coverage without meeting their annual deductible first. "Today, our Congressional telehealth champions on both sides of the aisle came through for the American people and for ATA and ATA Action members, by meeting our plea for more certainty around telehealth access for the next two years, while we continue to work with policymakers to make telehealth access a permanent part of our healthcare delivery for the future," said Kyle Zebley, senior vice president of public policy at American Telemedicine Association and executive director of the association's advocacy arm, ATA Action, in an emailed press release. But the new legislation does not include a similar two-year extension for the waiver of the Ryan Haight Act. The Ryan Haight Act of 2008 required providers to meet with a patient in person before being allowed to prescribe controlled substances for that person via telehealth. The in-person visit requirement was temporarily lifted during the COVID-19 pandemic. Since then, several stakeholders, including the American Telemedicine Association and American Psychiatric Association, have asked that Congress permanently eliminate the Ryan Haight Act. The latest spending bill does, however, direct the Drug Enforcement Administration (DEA) to create final regulations regarding the circumstances under which a special registration for telemedicine may be issued. Providers obtaining a special registration for telemedicine would be allowed to waive the in-person visit requirement. Earlier this month, the American Hospital Association had also asked that the DEA clarify regulations for the special registration process and provide recommendations for an interim plan. "…the hard work continues, as we persist in pressing telehealth permanency and creating a lasting roadblock to the 'telehealth cliff,'" said Zebley. "Additionally, we will continue to work with Congress and the Biden administration to make sure that a predictable and preventable public health crisis never occurs by giving needed certainty to the huge number of Americans relying on the clinically appropriate care achieved through the Ryan Haight in-person waiver." See original article: https://mhealthintelligence.com/news/spending-bill-to-extend-telehealth-hospital-at-home-waivers-by-2-years < Previous News Next News >

Report: Telehealth Programs Increase Workload for Nurses and Support Staff Katie Adams December 20, 2022 Many providers think their telehealth program increases the workload for nurses and support staff, according to a recent report. In 2023, hospitals and physician practices will have to focus on making their telehealth workflows more efficient, which may involve partnering with third-party administrators. Telehealth isn’t as widely utilized as it was at the dawn of the pandemic, but the care modality is definitely here to stay. However, many providers believe their telehealth program increases the workload for nurses and support staff, according to a recent report from research firm Sage Growth Partners. Providers also said they don’t think physicians enjoy using telehealth visits to treat patients. In 2023, hospitals and physician practices will have to focus on making their telehealth workflows more efficient, which may involve partnering with third-party administrators, the report said. In September, Sage Growth Partners surveyed 95 health system executives and 75 leaders of physician practices. Practices with fewer than five physicians were excluded from the survey. Most respondents said that their organizations will focus on optimizing and sustaining their current telehealth programs in 2023 rather than expanding them. In fact, only about 10% of participants — 11% of hospitals and 8% of practices — said they are looking to grow their telehealth offerings next year. Health system executives were more likely than practice leaders to say that telehealth visits should make up a higher percentage of their ideal in-person-to-telehealth visit mix. Health system leaders said the mix should be 30% telehealth and 70% office. Among practice leaders, the ideal mix looks more like 20% and 80%. Their difference of opinion also extended to another question on how they think telehealth utilization will grow by visit type over the next two years. Health system leaders said that utilization will fall slightly for most visit types — even behavioral health. They said that 36% of behavioral health visits were delivered via telehealth in September, but they expect this to fall to 33% in September 2024. Urgent care and telepathology were the two visit types for which health systems leaders predicted telehealth growth — they expect telehealth utilization to increase from 3% to 7% for urgent care and from 2% to 4% for telepathology. Practice leaders expected telehealth utilization to increase slightly or remain the same for most visit types. Specialty care was the only exception — for this visit type, practice leaders predicted utilization to fall from 23% to 20% over the next two years. Both groups agreed that telehealth actually increases burden on staff though practice leaders seem to feel it more acutely. More than half of practice leaders said telehealth has increased support staff’s workload, and 28% said it generates more work for nurses. Among health system executives, 35% said telehealth increased support staff’s workload, and 30% said it creates more work for nurses. Additionally, less than half of total respondents (46% of hospitals and 47% of practices) agreed that telehealth increases physician satisfaction and physicians like using telehealth visits to treat patients. A key reason for this is that many providers are operating their telehealth programs using inefficient workflows, according to the report. Nearly 60% of survey respondents said they have not yet created new workflows for telehealth visits. Instead, hospitals and physician practices are still relying on workflows that mirror in-person visits. In 2023, providers will need to improve these workflows, and many will consider bringing on the help of third-party telehealth administrators, such as Amwell or Caregility, the report said. Hospitals are more than twice as likely to use third-party partners to administer telehealth services — with 20% of hospitals doing this compared to 9% of practices. Hospitals were also more likely to say they would change their telehealth administering party over the next two years — with 44% of hospitals saying this compared to 25% of practices. Photo: Anastasia Usenko, Getty Images See original article: https://medcitynews.com/2022/12/report-telehealth-programs-increase-workload-for-nurses-and-support-staff/ < Previous News Next News >

A staffing expert shows how telehealth is stepping in to fill the staffing shortage Bill Siwicki December 19, 2022 "As clinicians are passionate about patients receiving quality healthcare delivered in a timely manner, I see telehealth programs being the key to improving patient outcomes and the overall healthcare experience," he says. The staffing shortage is a huge challenge in healthcare today. Another challenge is finding a solution to this vexing problem. But telehealth may be becoming an emerging strategy to help fill in gaps within hospitals and health systems, contended Chris Franklin, president of LocumTenens.com, a self-service job board and a full-service physician and advanced practice recruitment agency working in high-demand medical specialties. Healthcare IT News sat down with Franklin to discuss changes occurring in healthcare staffing, what he calls hybrid staffing strategies, and the results of a new LocumTenens.com survey. Q. Overall, what changes are you seeing occurring in healthcare staffing? A. The changes we've seen in the broader economy regarding contingent employment over the past three years are incredibly impactful on healthcare staffing. There are a few key numbers that tell the story. There currently are 3.5 million fewer workers in the U.S. than there were two years ago. Since February 2020, job openings have gone up by 50%, while total employment in the U.S. has gone slightly down. Because demand is outpacing the available supply, workers are demanding not just increases in pay, but also more choice and control over when, how and where they work. This is incredibly true in healthcare, based on every indicator we watch. New data shows more than 300,000 healthcare workers dropped out of the workforce in the last two years. Physicians report they are choosing early retirement or leaving the full-time practice of medicine for other kinds of work, in and outside of our industry. Nurses on the frontline have made the news due to the difficulties they have experienced, and also because of the freedoms they are newly experiencing due to the uptick in travel nursing. According to a 2021 study from Health Affairs, nearly 100,000 nurses exited the profession last year – most of them under the age of 50. Another 32% of nurses have said they may leave the profession. The Bureau of Labor Statistics estimates we'll need to fill nearly 200,000 nurse vacancies a year until 2030. Patients are sicker than they have ever been. Over the past year, nearly every hospital has seen increases in patient acuity, largely driven by care that was delayed during the [COVID-19] pandemic. And chronic disease and obesity continue to be primary drivers of healthcare consumption in the U.S. Even though it's been on the horizon for years, the impact of a big population of aging baby boomers – the oldest turned 75 this year – is finally here, and demand for healthcare is about to increase dramatically as a result. Burnout also is at an all-time high. A recent survey from MGMA and Jackson Physician Search highlights a sobering pair of statistics: Nearly two-thirds of physicians (65%) report they are experiencing burnout in 2022, up four percentage points from the 2021 study. Of those experiencing burnout, more than one in three physicians (35%) said their levels of burnout significantly increased in 2022. All of this points to a big, industrywide shake-up, and we are seeing first-hand that traditional workforce staffing models are no longer working, especially in healthcare. What's emerging is something very different – hybrid models that anticipate both permanent and contingent workers, an uptick in models that combine site-based care with a robust telehealth presence, an increase in APP staffing overall, and in general, a growing commitment to giving providers access to the kind of work-life balance they are desperately seeking. Q. You say you are seeing a hybrid staffing strategy that includes elements of locum tenens, more advanced practice providers and more telehealth coverage. Please elaborate on this. A. Healthcare leaders are looking for new and creative solutions now more than ever – and all amidst this backdrop of healthcare workforce shortages. We have seen first-hand the impact the gig economy is directly having on the healthcare workforce and know the biggest concerns for healthcare facilities are attracting talent, retaining talent, and avoiding or mitigating burnout. To help clinicians' desire to achieve a more viable work-life balance, healthcare leaders are evolving their hiring models to reflect a new appreciation for the flexibility that hybrid staffing models represent. Solely relying on traditional staffing models and solutions just won't work anymore. Through staffing innovation, hospitals and healthcare organizations are actively seeking options to improve access to care with more sustainable models. Healthcare staffing is complex and there's never a one-size-fits-all solution, but we are seeing an increase in interest in alternative models of staffing, including a growing use of locum tenens staff and improving patient access to care with advanced practice providers (APPs) and telehealth expansion. Awareness of and interest in locum tenens are at an all-time high for both healthcare organizations and clinicians. People are actually taking their own well-being into account in terms of their employment, opting into contingent work as a way to manage their levels of stress and burnout. We had a locum tenens physician tell an audience at a recent conference: "If you have burnout in locums, you are not doing it right." There's no doubt flexibility of locum tenens offers a desirable outcome on what physicians are wanting out of life. According to the recent survey: Nearly 90% of healthcare facilities already use locum tenens staffing. Nearly 57% of facilities that have not used locum tenens staffing in the past are planning to use it in the next year. According to a recent survey we conducted on innovation and flexibility in staffing, when most administrators consider locum tenens, they most commonly think about onsite physician care. Data shows hospitals utilize onsite locum tenens more than three times as often as telehealth, but that is starting to change. Facilities that were previously reliant on onsite are now embracing telehealth. COVID-19 expedited this adoption, as hospitals looked beyond traditional models to meet their patients' needs. In some cases, hospitals are taking a flexible, hybrid approach that integrates telehealth and onsite care, providing the best of both worlds and delivering value to patients. Additionally, the use of APPs in combination with physicians as a strategy is growing, with 73.9% affirmatively responding to the question, "Do you plan to expand APP coverage?" Q. Your company recently did a survey of hospital administrators to get a clearer view of the challenges in today's landscape. What did you learn as it relates to telehealth? A. Our recent survey results – which are detailed in the Innovation & Flexibility: Journey to Sustainable Healthcare Report – revealed that hospital administrators have strong feedback when it comes to managing today's challenging landscape. With regard to how it relates to telehealth, more facilities are using telehealth than ever before. COVID-19 expedited this adoption, but over the coming year, most hospitals expect to expand their use of telehealth even further – there is no turning back. Patients across the board now are more comfortable using telehealth as the COVID-19 pandemic drove a surge in virtual visits, including those who have historically hesitated to use technology. Traditionally, psychiatric services dominated locum tenens telehealth services, with behavioral health accounting for 79% of telehealth services for LocumTenens.com. However, utilization has started to shift as hospitals look at other specialties, including oncology, cardiology and physiatry. By expanding telehealth offerings, facilities can expand access to care and reach more patients in new locations. Over the past year, many facilities have been able to deliver a higher level of specialty care to satellite or remote locations through telehealth. Going forward, better reconciling reimbursements to align with the level of care provided in a telehealth setting will lead to broader adoption. Q. Where do you see the telehealth component of staffing in five years? A. The feedback we have gotten shows that more than half (60%) of those surveyed plan to expand telehealth. Through innovation, healthcare providers will continue to adapt to flexibility and improved access to care. These flexible solutions create a more sustainable model to provide quality care to patients and their communities. As clinicians are passionate about patients receiving quality healthcare delivered in a timely manner, I see telehealth programs being the key to improving patient outcomes and the overall healthcare experience. The beauty of telehealth is that it provides access to a qualified provider at any time. For example, we have a client that provides psychiatric services across the country. During a busy day, a patient presented who was experiencing domestic violence trauma, and she wasn't comfortable talking with a male doctor. The problem was there were only male psychiatrists on call at her presenting hospital. The hospital contacted our team, and we in turn reached out to two privileged and credentialed female providers that weren't on-call that day. Although one was heading out to attend a wedding, she accepted the assignment to immediately provide care for this patient. So, even though this psychiatrist worked five states away from the hospital, she was able to provide care because of the access to telehealth. The result: The patient received the "right care" that she needed at the right time with an experienced provider. Follow Bill's HIT coverage on LinkedIn: Bill Siwicki Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/staffing-expert-shows-how-telehealth-stepping-fill-staffing-shortage < Previous News Next News >

CONGRESS UNVEILS TWO YEAR EXTENSION OF TELEHEALTH FLEXIBILITIES – AS URGED BY THE ATA AND ATA ACTION – AS PART OF OMNIBUS BILL The American Telemedicine Association December 20, 2022 Today, the American Telemedicine Association (ATA) and ATA Action express their gratitude to the U.S. Congress for unveiling a bipartisan, bicameral omnibus appropriations bill that includes a two-year extension for Medicare telehealth provisions put in place during the COVID-19 public health emergency (PHE). The omnibus package also includes a two-year delay in implementing the Medicare telemental health in-person requirement, a two-year extension of the safe harbor to offer telehealth in High Deductible Health Plans (HDHPs) with Health Savings Account (HSAs), and a two-year extension of the Acute Hospital Care at Home Program. Congress is expected to vote on the omnibus bill and send it to President Biden to be signed into law within the next week. The omnibus did not include a comparable extension past the end of the PHE of the Ryan Haight in-person waiver for the remote prescription of controlled substances. However, the legislation does include language directing the Drug Enforcement Administration (DEA) to promulgate final regulations specifying the circumstances in which a Special Registration for telemedicine may be issued and the procedure for obtaining the registration. “The ATA and ATA Action never wavered from our appeal to Congress, to provide stability around the life-saving telehealth flexibilities that have become a relied upon and valued option for healthcare providers and patients. Today, our Congressional telehealth champions on both sides of the aisle came through for the American people and for ATA and ATA Action members, by meeting our plea for more certainty around telehealth access for the next two years, while we continue to work with policymakers to make telehealth access a permanent part of our healthcare delivery for the future,” said Kyle Zebley, senior vice president, public policy, American Telemedicine Association, and executive director, ATA Action. “We asked Congress and they listened. We are truly grateful for their staunch support of telehealth. It’s now time to swiftly bring this bill to the President, for passage into law before year-end.” Stakeholder Letter to Congressional Leadership – Urging Extension of Telehealth Flexibilities Stakeholder Letter Urging Congress to Act on the Telehealth High Deductible Health Plan Safe Harbor Tax Provision ATA’s Recommendation’s for Acute Hospital Care at Home Program Stakeholder Letter Urging the DEA to Act on the Prescription of Controlled Substances via Telehealth Before the PHE Expires “We greatly appreciate Congress including extensions the High Deductible Health Plan (HDHP) and Health Savings Account (HSA) telehealth tax provision, giving American workers continued access to needed telehealth coverage without first having to meet annual deductibles, including telemental health services. Further, the extension to the Acute Hospital Care at Home Program ensures continued access to this patient-centered care delivery model that is proving to effectively lower cost of care while improving patient health outcomes and satisfaction. “The ATA and ATA Action are delivering on our promise, to advocate for permanent access for telehealth services and today marks a significant milestone towards that goal. But the hard work continues, as we persist in pressing telehealth permanency and creating a lasting roadblock to the ‘telehealth cliff.’ Additionally, we will continue to work with Congress and the Biden administration to make sure that a predictable and preventable public health crisis never occurs by giving needed certainty to the huge number of Americans relying on the clinically appropriate care achieved through the Ryan Haight in-person waiver.” About ATA Action ATA Action recognizes that telehealth and virtual care have the potential to transform the healthcare delivery system by improving patient outcomes, enhancing the safety and effectiveness of care, addressing health disparities, and reducing costs. ATA Action is a registered 501c6 company and an affiliated trade organization of the ATA. About the ATA As the only organization completely focused on advancing telehealth, theAmerican Telemedicine Association is committed to ensuring that everyone has access to safe, affordable, and appropriate care when and where they need it, enabling the system to do more good for more people. The ATA represents a broad and inclusive member network of leading healthcare delivery systems, academic institutions, technology solution providers and payers, as well as partner organizations and alliances, working to advance industry adoption of telehealth, promote responsible policy, advocate for government and market normalization, and provide education and resources to help integrate virtual care into emerging value-based delivery models. See original article: https://www.americantelemed.org/press-releases/congress-unveils-two-year-extension-of-telehealth-flexibilities-as-urged-by-the-ata-and-ata-action-as-part-of-omnibus-bill/ < Previous News Next News >

Citing Medicaid misery, 25 governors push for PHE's end in April Molly Gamble December 21, 2022 In a letter sent to President Joe Biden this week, 25 governors ask for the end of the COVID-19 public health emergency in April. HHS last renewed the federal PHE in October for another increment of 90 days — until January 11 — with the pledge to provide states with 60 days' notice if it decided to terminate the declaration or allow it to expire. Since those 60 days came and went without notice, states are operating under the assumption the PHE will be renewed for another 90 days and expire in April, unless extended again. "We ask that you allow the PHE to expire in April and provide states with much needed certainty well in advance of its expiration," the governors urged Mr. Biden in their Dec. 19 letter. The governors claim the PHE hurts states, largely through the Medicaid flexibilities costing states "hundreds of millions of dollars." Under the continuous coverage requirement of the Families First Coronavirus Response Act, state Medicaid agencies are barred from disenrolling people during the PHE — unless they request it — in exchange for an enhanced federal match. HHS estimates up to 15 million people will be disenrolled from Medicaid and the Children's Health Insurance Program when the PHE ends. "While the enhanced federal match provides some assistance to blunt the increasing costs due to higher enrollment numbers in our Medicaid programs, states are required to increase our non-federal match to adequately cover all enrollees and cannot disenroll members from the program unless they do so voluntarily," the governors wrote to Mr. Biden. "Making the situation worse, we know that a considerable number of individuals have returned to employer sponsored coverage or are receiving coverage through the individual market, and yet states still must still account and pay for their Medicaid enrollment in our non-federal share." The governors sent their letter a day before Congress released its omnibus spending bill, which contains working language for states to be able to start evaluating Medicaid enrollees' eligibility as of April 1 in a redetermination process that would take place over at least 12 months. The measure also calls for phasing down the enhanced federal Medicaid funding through December 31, 2023, though states would have to meet certain conditions during that period. The American Hospital Association advocated for the latest extension of the PHE in October, noting that the majority of the hospital members it polled said they still depend on the flexibilities provided by the PHE waivers to deliver care. The letter was initiated by Chris Sununu, governor of New Hampshire, and signed by the following: Kay Ivey, Alabama Mike Dunleavy, Alaska Asa Hutchinson, Arkansas Doug Ducey, Arizona Ron DeSantis, Florida Brian Kemp, Georgia Brad Little, Idaho Eric Holcomb, Indiana Kim Reynolds, Iowa Charlie Baker, Massachusetts Tate Reeves, Mississippi Mike Parson, Missouri Greg Gianforte, Montana Pete Ricketts, Nebraska Doug Burgum, North Dakota Mike DeWine, Ohio Kevin Stitt, Oklahoma Henry McMaster, South Carolina Kristi Noem, South Dakota Bill Lee, Tennessee Greg Abbott, Texas Spencer Cox, Utah Glenn Youngkin, Virginia Mark Gordon, Wyoming See original article: https://www.beckershospitalreview.com/finance/citing-medicaid-misery-25-governors-push-for-phes-end-in-april.html?utm_medium=email&utm_content=newsletter < Previous News Next News >

Congress’ Last Minute Holiday Gift to Telehealth: The Omnibus Budget for FY 2023 Has Passed! CCHP December 23, 2022 Earlier today, Congress passed HR 2617, The Performance Enhancement Reform Act, the omnibus budget for FY 2023. HR 2617 includes several provisions impacting telehealth, including extending some of the telehealth COVID-19 telehealth flexibilities. In the budget bill passed for FY 2022, Congress had included a 151-day extension after the end of the public health emergency (PHE) for some COVID-19 telehealth flexibilities. However, with the passage of HR 2617, these flexibilities will now last until December 31, 2024. The main telehealth provisions in the bill include: For Medicare: Some telehealth flexibilities in Medicare are extended to December 31, 2024. These flexibilities include: temporary suspension of the geographic site requirement, continuing to allow the home as an eligible originating site, allowing certain providers, including FQHCs and RHCs to continue to be eligible telehealth providers during this period, delaying the in-person mental health visit requirement for services that take place when the patient is not in a geographically eligible location or at home that is found in non-pandemic telehealth policies, and continuing to allow audio-only to be used to provide some services. A study on telehealth and Medicare program integrity that will include a medical record review of claims from January 1, 2022 to December 31, 2024. Elements to be examined include the types of services furnished, where they were furnished, and duration of services. For the VA: Development of a strategic plan to ensure effectiveness of telehealth delivered by the VA to their enrollees. Other Items: Extension of safe harbor for absence of deductible for telehealth in health savings accounts for another 2 years (for plans after December 31, 2022 and before January 1, 2025). President Biden is expected to sign the bill which will allow telehealth providers and patients to have a little more clarity on the end date of federal telehealth provisions. For more information read HR 2617 in its entirety. Wishing a wonderful holiday season and a happy new year to all! See original article: https://mailchi.mp/cchpca/congress-last-minute-holiday-gift-to-telehealth-the-omnibus-budget-for-fy-2023-has-passed < Previous News Next News >

CCHP Leadership Provides A Look Back at Telehealth Policy in 2022: Yes...The Year is Almost Over! Mei Kwong December 20, 2022 As another full year of living under the public health emergency (PHE) for COVID-19 comes to an end, we are taking a look back to see what has happened this year with telehealth policy on both the federal and state level. Since the PHE is still in place and likely to continue into 2023, permanent changes on the federal level have been fewer in comparison to what many states have been doing. In fact, some states began making permanent telehealth policy changes as early as late 2020. Other states have taken similar actions to their federal counterparts and put a definitive future expiration date on temporary telehealth policies. FEDERAL The most significant federal legislative telehealth policy action seen this year took place in the Budget Act of 2022 which included language extending some of the temporary waivers to telehealth in Medicare for an additional 151 days after the PHE. This statutory change led to additional clarifications that the Centers for Medicare and Medicaid Services (CMS) made in their Physician Fee Schedule for 2023 (PFS). CCHP also recently released a fact sheet on the relevant telehealth policies. The final result as the policy stands now is: For 151 Days After the PHE: Certain providers including federally qualified health centers (FQHCs), Rural Health Clinics (RHCs), occupational therapists, and physical therapists may continue to provide eligible services via telehealth under the Medicare program. The list of temporary services eligible to be delivered via telehealth and covered by the Medicare program will continue to be available during this 151-day period. The geographic limitations under permanent telehealth Medicare policy will be suspended during this 151-day period and the home will continue to be an eligible originating site for all eligible services during the extension. Audio-only can continue to be used as a modality for eligible services during the 151-day extension. Permanent policy requirements such as a previous in-person visit for mental health services taking place in a non-geographically eligible location, in the home or via audio-only is suspended during this 151-day period. Certain other federal waivers that exist under the PHE are currently not included in this 151-day grace period. This includes the Office of Civil Rights (OCR) exercising discretion in enforcing HIPAA which OCR has noted will expire when the PHE is declared over or expires, whichever comes first. As can be seen by the foregoing, very little has changed this year regarding permanent policy, just what will happen in the immediate aftermath of the end of the PHE. There have been some indications that Congress may pass legislation to extend the federal waivers, or at least some of them, beyond the 151-day period. HR 4040 authored by Representative Liz Cheney (R, WY) passed the House earlier this year, but no further action was taken. That bill would have extended some of the temporary waivers for an additional two years. However, what might be considered by Congress now is rumored to be only a one-year extension. It remains to be seen if some additional action will be taken legislatively. Feeding into the federal policymakers’ decision-making process have been several reports from various federal agencies in the past year. The Office of the Inspector General (OIG) released several reports around telehealth in 2022 including: Telehealth Was Critical for Providing Services to Medicare Beneficiaries During the First Year of the COVID-19 Pandemic Certain Medicare Beneficiaries, Such as Urban and Hispanic Beneficiaries, Were More Likely Than Others to Use Telehealth During the First Year of the COVID-19 Pandemic Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks The last study listed above is important to take note of given the concerns raised by policymakers for the potential of abuse and fraud. However, the OIG report noted that in the first year of COVID-19, less than 1% of telehealth claims made to Medicare raised flags for potential fraud, which should provide some reassurance to policymakers. Broadband has been an issue both on federal and state policymakers’ minds. While connectivity is a greater issue beyond how it impacts telehealth, it cannot be denied that telehealth will simply not work if the patient and provider cannot connect, although policy expansions related to audio-only have sought to mitigate this gap to a certain extent. In 2022, the Federal Communications Commission transitioned the Emergency Broadband Benefit Program into the Affordable Connectivity Program which provides assistance in paying for connectivity. The National Telecommunications and Information Administration (NTIA) compiled federal funding opportunities that support broadband planning, digital inclusion and deployment projects on one site. States have also been gearing up activity around broadband, some of it funded by the federal government such as NTIA awards to Nebraska to develop strategic plans to expand high-speed broadband and other investments made by the state itself. No doubt, broadband will continue to be a significant issue in 2023. STATES As CCHP’s recent Legislative Roundup newsletter noted, 2022 was another active year for state telehealth policy legislation, though not as robust as it was in 2021. Overall, in 2022, of the bills enacted and subjects CCHP tracked, licensure proved to be the most popular policy issue addressed with 61 bills across the states passing. This was followed by 27 enacted bills related to professional regulations and telehealth, many having to do with prescribing and 18 bills for pilot/studies/demonstrations. Enacted Medicaid and private payer reimbursement bills were 17 and 12, respectively. The licensure focus is of particular interest to note. While many of the pieces of legislation passed related to joining licensure compacts, states also made exceptions to licensure for specific situations. States are starting to address the various situations usually involving an already established relationship between patients and providers that prior to the pandemic had remained grey areas. A common concern raised during the pandemic related to licensure involved a patient temporarily re-locating to another state, perhaps as a college student, going on vacation or caring for a family member, but still wanting to receive services from their own provider in their home state. Kentucky passed HB 188 that forbids a regulatory board from promulgating regulations related to telehealth that prohibit “the delivery of telehealth services to a person who is not a permanent resident of Kentucky who is temporarily located in Kentucky by a provider who is credentialed by a professional licensure board in the person’s state of permanent residence.” While clarity is always welcomed, the exceptions individual states are passing will create more complexity in the telehealth policy landscape particularly for practitioners who provide services in multiple jurisdictions. Reimbursement is an area that generates significant interest. For Medicaid related legislation, the type of modality used and services that would be covered under the program were popular issues addressed through legislation. For example, Virginia SB 426 requires the Medicaid state plan be amended to allow for remote patient monitoring (RPM) services for patients with certain types of medical conditions such as high-risk pregnancy and transplant patients when there is evidence that use of RPM is likely to prevent readmission to a hospital. Private payer telehealth legislation can also be quite specific. Louisiana HB 304 now requires telehealth coverage and payment parity equivalent to in-person services for physical therapy in particular. However, what we also saw were legislators moving towards ensuring there were patient protections/choice codified in state laws related to private payer plans and telehealth. Mississippi SB 2738, among other things, states that insurers cannot limit coverage of services to select third-party organizations. Commercial plans only offering telehealth delivered services to enrollees through a third party and not allowing their in-network providers to use telehealth has been a concern that was growing even prior to the pandemic. This stems from concerns raised by policymakers regarding patient choice or patients being “forced” to use telehealth and continuity of care concerns that continue to exist today. Overall, the number of states expanding telehealth policies increased. As noted in CCHP’s latest update to its 50 State Telehealth Policy Summary Report, Fall 2022, compared to its Fall 2021 update, three more state Medicaid programs are covering store-and-forward telehealth, five more states are covering RPM under Medicaid, and state Medicaid programs covering audio-only went up from 22 states to 34 states and DC. Additionally, three states have added payment parity requirements to their private payer laws. WHAT’S NEXT FOR 2023? As noted above, rumors have swirled around that there may be movement on the federal level to extend some of the telehealth waivers beyond the 151-day grace period, similar to what was proposed in the Cheney bill. However, it is likely that any such change will be included in a larger bill, such as the budget bill, rather than a standalone telehealth bill. There are also several outstanding issues that continue to not be addressed such as the registry for telehealth that the Drug Enforcement Administration (DEA) was to finalize regulations for in 2019. Some may recall that among the list of exceptions to allowing telehealth to be used to prescribe a controlled substance without the telehealth provider having examined the patient in-person included when a PHE was declared and the creation of a registry. For the registry, presumably once a provider is qualified to be on the registry, they need not have to meet any of the other narrow exceptions to prescribe via telehealth. That registry has never been created, though Congress had directed the DEA to finalize regulations by the end of 2019. On the state level, we likely can expect to see continued action around coverage, licensure, and professional regulations, as well as continued discussion around patient choice. During this past year, there has been increased discussions regarding “telehealth-first” health plans and the impact on patient choice. Whether policymakers take a more active role in regulating these plans remains to be seen, but the discussion around patient choice protections will continue. One thing is clear: the telehealth policy landscape is by no means “settled” as 2022 draws to a close. Outstanding questions around temporary policies still remain and even settled policies implemented a year or so ago have been tweaked in some states. To hear more about what's occurred in 2022, plus what we can anticipate for 2023, watch CCHP's newest short video. As we head into 2023 we can be certain that the telehealth policy landscape will continue to evolve and change, and we look forward to having you continue on this journey alongside CCHP. Have a Happy New Year and see everyone in 2023! Mei Kwong, CCHP Executive Director See original article: https://mailchi.mp/cchpca/cchp-leadership-provides-a-look-back-at-telehealth-policy-in-2022-yesthe-year-is-almost-over < Previous News Next News >

Telehealth Remains Key Modality for Behavioral Healthcare Delivery eVista December 19, 2022 A Michigan-based provider leveraged a telehealth solution to expand critical access to behavioral healthcare as demand for these services skyrocketed during the COVID-19 pandemic. After reaching new heights during the first year of the COVID-19 pandemic, telehealth use is leveling off in several clinical care areas. But there is one prominent exception: behavioral healthcare. Healthcare stakeholders are continuing to flock to telehealth for behavioral health services. An analysis of data from January 2020 to March 2022 shows that mental health conditions were the most common telehealth diagnoses at the national level. In addition, data shows that amid a drop in overall telehealth use since 2020, telemental healthcare has grown. In the first quarter of 2019, 32.4 percent of all telehealth visits were related to behavioral healthcare, according to a market research report. That figure jumped to 59.9 percent by Q1 2022. This data, along with the ongoing mental health crisis in America, signifies the importance of providing virtual care options for behavioral healthcare. At Michigan-based Easterseals MORC, telehealth has been integral to behavioral healthcare delivery since 2019. Then, amid the pandemic, the organization saw its virtual visit volumes skyrocket, and they continue to show no signs of slowing down. "We went from 25 telehealth users before the pandemic to 300," says Clarissa Hulleza, Chief Information Officer of Easterseals MORC. "Those numbers are still going up. We're not seeing any decrease." WHY THE ORGANIZATION IMPLEMENTED TELEHEALTH Easterseals MORC, an affiliate of the national Easterseals organization, serves over 21,000 individuals annually. It provides a wide array of behavioral health services, including therapy, psychiatric care, and substance abuse treatment, as well as long-term care for those with intellectual and developmental disabilities. In 2019, the organization decided to implement a telehealth solution. One of the key goals of the move was to expand access to behavioral healthcare across the state. “The reason we pursued a telehealth solution was so that people who couldn't get to us regularly or at all, could be provided the opportunity to still receive care," says Hulleza. "We serve all of Michigan, and not all of Michigan has access to transportation, or maybe their closest local provider is 20 miles away. So, it was really creating more opportunities for access." Additionally, telemedicine was already becoming popular as a mode of physical healthcare delivery, prompting behavioral healthcare providers to catch up. "It was one of those, 'well, why aren't we doing the same?'" Hulleza says. Easterseals MORC partnered with eVisit to launch a telehealth pilot program in May 2019. A little under a year later, the COVID-19 pandemic hit, compelling providers across the country to rapidly scale up their telehealth programs. According to Hulleza, already having a telehealth solution and vendor partnership in place enabled Easterseals MORC to expand virtual care use seamlessly. "I would say that the absolute benefit was that we never had to close our doors," she adds. "In a time that people needed behavioral healthcare the most, we were able to provide it." IMPLEMENTATION CHALLENGES AND KEY LESSONS LEARNED Easterseals MORC leverages telehealth for nearly all of its services, including case management, one-on-one and group therapy. The organization even provided Applied Behavior Analysis (ABA) therapy virtually, which aims to improve social behaviors using interventions. But implementing a telehealth solution for behavioral healthcare has its challenges. For Easterseals MORC, those challenges ranged from clinician training to technology issues among those receiving services. Clinicians were not only providing care in a new way, they also had to become tech support in helping those they served navigate the new technology. Training is a critical aspect of telehealth technology implementation. If training is not provided proactively, it can result in clinicians avoiding virtual care use as they might find it difficult and overwhelming. “Pilot testing the solution before a full rollout was critical to ensuring that clinicians had adequate training to use the technology and that workflows were not negatively impacted,” Hulleza says. Partnering with the right vendor was a vital aspect of this effort, as the vendor was able to provide clinician training resources as well as suggest new policies and processes required to promote and support the telehealth program. “Ultimately, we selected our vendor because we were looking for a partnership that would improve the overall behavioral healthcare delivery experience. This meant that we needed a tool that offered more than a two-way video solution — one that integrated with, and empowered, the clinical workflow with value-added technology,” Hulleza shares. “There were multiple tools in the marketplace that solved the video connection challenge, but Easterseals MORC was looking to do more than simply move the clinical interaction to a video screen.” Further, choosing the right partner and then piloting the telehealth solution allowed the organization to test the supporting technology infrastructure before a full rollout. Easterseals MORC tested laptop specifications and made sure the solution worked equally well on different devices, including mobile phones and tablets. "We even went as far as making sure our bandwidth at all of our locations was increased so that if we had 20 people doing telehealth at the same time, there wouldn't be any degradation in services," Hulleza says. On the side of those receiving services, Easterseals MORC had to consider the digital divide facing its population. "[The people we serve] don't always have the newest phones, the best bandwidth," she says. "They don't have the luxury of going to a bedroom and closing the door. They might have shared living arrangements. We had to make sure we were accommodating all of those things." To address individuals' technology access needs, the organization applied for various grants and used those to provide iPads and iPhones with built-in data plans. Another essential aspect of closing the digital divide is identifying the viability of an individual to receive services via telehealth. Easterseals MORC uses a checklist tool provided by the telehealth vendor to identify these individuals and the barriers they face. "Do you have a private place? Do you have a microphone? What model phone do you have or mobile device?" Hulleza adds. "The tool goes through all of these questions and allows providers to evaluate if telehealth is an option." Easterseals MORC plans to solidify telehealth as a key behavioral health delivery mechanism within its business. It is unclear if Congress will make the temporary telehealth flexibilities enacted during the pandemic permanent — but for Hulleza, there is no going back. "I absolutely want to grow telehealth here," she says. "The need amplified because of the pandemic, but telehealth was going to exist for our organization even if the pandemic didn’t happen." ____________________________ About eVisit eVisit is an enterprise virtual care delivery platform built for health systems and hospitals. It delivers innovative virtual experiences in care navigation, care delivery, and care engagement, improving margins at scale without sacrificing quality or patient and provider satisfaction. eVisit works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue. Based in Phoenix, Ariz., eVisit helps healthcare organizations innovate and succeed in today’s changing healthcare market. See original article: https://mhealthintelligence.com/news/telehealth-remains-key-modality-for-behavioral-healthcare-delivery < Previous News Next News >

Epic research shows telehealth efficacy, makes case for more reimbursement Andrea Fox December 15, 2022 The study of 35 million telehealth visits found that most patients did not require in-person visits within 90 days of online appointments, indicating virtual visits as an effective "alternative, rather than duplicative" care modality. A dual team study of in-person, same-specialty follow-up rates after telehealth appointments published by Epic Research examined the cadence of care and found virtual medicine to be an effective tool. WHY IT MATTERS Analyzing the effectiveness of different methods for delivering care is important to guide decisions about how to allocate resources, according to the study's key findings report. To determine which specialties were able to fulfill patient needs using telehealth and which required in-person follow-up visits more often, two teams of researchers examined more than 35 million telehealth visits conducted between March 1, 2020, and May 31, 2022. What they found, according to the report, is that high in-person follow-up rates within three months were present only in specialties that require regular hands-on care, such as obstetrics and surgery. Follow-up visits within 90 days of telehealth appointments were not, by and large, instances of duplicative care, but a method of care delivery that can increase healthcare access, the researchers say. "Healthcare providers should continue to educate policymakers and administrators on the function telehealth plays as an alternative, rather than duplicative, encounter," they said in the report, adding that payers should extend telehealth visit coverage. The researchers also found that genetics and nutrition are the specialties that made the most efficient use of telemedicine. And while 15% of mental healthcare and psychiatry telehealth appointments required in-person follow-up in the next three months, that specialty had the largest volume of all studied for telehealth utilization. Of the more than 4.3 million telehealth visits during the study period, nearly 3.7 million mental health and psychiatry telehealth visits did not require in-person follow-up. THE LARGER TREND While telehealth use increased during the COVID-19 pandemic, one study of 40.7 million adults found telehealth comparable for chronic conditions. However, some experts quickly found telemedicine well-suited for use in behavioral health after the onset of the pandemic. Also, the COVID-19 public health emergency eliminated the requirement to have an in-person visit with a patient before prescribing medication-assisted treatment (MAT) for opioid use disorder (OUD). While an end to the PHE would signal a return to the in-person visit requirement for OUD prescriptions, several healthcare organizations have urged the U.S. Justice Department and the Drug Enforcement Agency to revise telehealth controlled substance rules. In rural areas, telehealth has increased access to care, including the ability to treat OUD with MAT. "Telehealth flexibilities and ePrescribing waivers have been crucial in enabling providers to care for patients during the pandemic and have greatly expanded access to care in situations where patients were unable or unwilling to travel to a physical location," Dr. Maroof Ahmed, co-founder of Quit Genius, told Healthcare IT News by email in October. ON THE RECORD "These findings suggest that, for many specialties, telehealth visits are typically an efficient use of resources and are unlikely to require in-person follow-up care," according to the researchers' key findings report. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS publication. See original article: https://www.healthcareitnews.com/news/epic-research-shows-telehealth-efficacy-makes-case-more-reimbursement < Previous News Next News >