Telehealth, physical therapy and the pandemic: Lessons for all Bill Siwicki February 14, 2022 A University of Washington clinical instructor explains the benefits and challenges of therapy and technology. For vulnerable patient populations – and for those who just prefer the convenience of care at home – telemedicine has been a success. But it still has its limitations. For example, the precise movements and exercises involved in physical therapy rehab are hard for a patient to accomplish remotely. A provider on a video call may seem about as valuable as a YouTube video. But there are new technologies and strategies that link patients, safely, to at-home physical therapy care that balances telemedicine with in-person visits. Many experts say this is the future of telemedicine: a hybrid of in-person and virtual care. To read the entire article: https://www.healthcareitnews.com/news/telehealth-physical-therapy-and-pandemic-lessons-all < Previous News Next News >

Making Telemedicine Feasible for Everyone – Especially Those With Physical Challenges Elizabeth A. Krupinski, Southwest Telehealth Resource Center August 2021 In the context of healthcare, nondiscrimination on the basis of disability means equal access to available health care services, whether those services are provided in-person or via telehealth. Telemedicine has for years been touted as providing access to healthcare for everyone, anywhere, anytime and it has been quite successful in doing so in many respects but disparities still exist among a number of patient populations. In particular, those who traditionally have challenges accessing healthcare due to physical challenges often experience similar or even greater challenges with telemedicine. Think about for a minute. Telemedicine is predominantly provided using audio and/or video-based telecommunications technologies. This fundamental fact of how telemedicine visits occur can actually exacerbate digital disparities. According to the Americans with Disabilities Act (ADA), an individual with a disability is defined as: 1. a person who has a physical or mental impairment that substantially limits one or more major activities; or 2. a person who has a history or record of such an impairment; or 3. a person who is perceived by others as having such an impairment Under Section 504 of the 1973 Rehabilitation Act, no qualified individual with a disability shall, by reason of his or her disability, be excluded from the participation in, denied the benefits of, or subjected to discrimination under any services, programs, or activities of the covered entity (e.g., healthcare providers). In the context of healthcare, nondiscrimination on the basis of disability means equal access to available health care services, whether those services are provided in-person or via telehealth. Some basic facts highlight the problem. About 15% of American adults (37.5 million) over 18 report some trouble hearing, 2 to 3 per 1,000 US children are born with detectable hearing loss in one or both ears and overall 1 in 8 people (13%) 12 years or older has hearing loss in both ears. Interestingly, non-Hispanic white adults are more likely than other racial/ethnic groups to have hearing loss and non-Hispanic black adults have the lowest prevalence among adults aged 20-69. Rates increase with age. The statistics for vision impairments are equally high. About 12 million people over 40 years have a vision impairment, with 1 million who are blind and 6.8% of children younger than 18 have a diagnosed eye and vision condition. The annual economic impact of major vision problems for those over 40 is over $145 billion! For blindness, access to healthcare is especially critical as 90% of blindness caused by diabetes is preventable and early detection and treatment of conditions such as diabetic retinopathy is efficacious and cost effective. So what can we do in the telemedicine community to help ameliorate these disparities? The National Consortium of Telehealth Resource Centers has developed a fact sheet to help providers. Some of the key recommendations are actually fairly easy to carry out. Inventory products, services, and factors required to provide effective telehealth services to patients and ensure they meet basic accessibility requirements for people with disabilities. Consider compatibility of assistive technology (e.g., alternative keyboards) and whether they can work effectively with your chosen telehealth modality. Learn about and incorporate accessibility features (e.g., close-captioning) of software programs you use. Be sure to include the patient’s caregiver, family member, or home health aide during telehealth visits. Increase your knowledge and awareness on cultural competency and linguistic sensitivity. The easiest thing to do ask patients with disabilities about their accessibility requirements! Some additional aids to consider may take a little more effort but are worth it. For those with hearing loss consider: qualified sign language interpreter, qualified cued-speech interpreter, qualified tactile interpreter, real-time captioning or communication access real-time translation (CART), video remote interpreting (VRI), use written materials, ensure the patient has access to headphones or a headset, confirm participants are wearing their hearing aids or amplification device, and use video whenever possible to allow lip reading and provide visual clues like gestures. For those with vision loss consider: a qualified reader, information in large print, Braille, or electronically for use with a computer screen-reading program, have an audio recording of printed information, be aware of your background - there needs to be contrast between you and your background and blurring the background may make it challenging for the patient, ensure lighting is bright enough for patients to clearly see your face, use simplified and enlarged text, ensure patients have a computer-screen reading program for transmission of electronic information and try providing an audio recording of printed information provided during the appointment. Additional ideas and tips can be found on the Health & Human Services (HHS) website There is also good news in terms of funding. The Federal Communications Commission (FCC) recently announced that under the National Deaf-Blind Equipment Distribution Program (NDBEDP), also called “iCanConnect,” may provide up to $10 million annually from the interstate telecommunications relay service fund (TRS Fund) to support local programs that distribute equipment to eligible low-income individuals who are deafblind to access telecommunications service, Internet access service, and advanced communications services. This is clearly a boon for telemedicine applications. The announcement includes a state-by-state list of the initial allocations for the 56 covered jurisdictions. Hearing and vision loss are just two common challenges deal with. Other physical, mental and behavioral challenges are very common as well, and many of the tips above can be adapted to these patients as well, especially simply reaching out and asking them what their needs are and how you can help meet them as well as involving the patient’s caregiver, family member, or home health aide during telehealth visits. Basically telemedicine must be available to any patient and programs should make it a priority to develop strategies and tools to empower all patients no matter what their resources and capabilities to access safe, effective and efficient care. < Previous News Next News >

RPM Programs Benefit Women's Health & Reduce Hospital Readmissions Center for Connected Health Policy April 27, 2021 Several remote patient monitoring (RPM) programs have found best practices and benefits related to utilization of this particular telehealth modality. In recent months several remote patient monitoring (RPM) programs have found best practices and benefits related to utilization of this particular telehealth modality. Tracking this data has become even more important moving forward, as policymakers evaluate the future of telehealth policy and push for more study around the quality of care provided via telehealth. For instance, the University of Pittsburgh Medical Center (UPMC) has found that a unique remote patient monitoring (RPM) program launched in 2018 and tailored to women with hypertension is both feasible and effective. The program enrolls postpartum women at the time of hospital discharge and provides enrolled patients with a blood pressure monitoring cuff. Patients’ blood pressure data are collected and sent to UPMC providers and researchers for 6 weeks post-discharge. Early results show high compliance among women enrolled in the program and the ability for providers to identify the trajectory of hypertension and detect racial disparities between Black and White women. To learn more about the UPMC program, please visit this recent HealthcareITNews article or UPMC’s program website. Recently, two other RPM programs tailored to specific patient groups have shown the ability to reduce hospital readmission rates. According to a recent article in mHealth Intelligence, Deaconess Health in Indiana created a program for chronic care patients and those with COVID-19 that estimates a savings of $6.5 million in total costs of care through the program’s ability to cut the hospital’s 30-day readmission rate in half from 14% to under 7%. Meanwhile, according to surveys, over 90% of patients are satisfied with the program and care they get to receive at home. Baptist Health in Kentucky piloted a RPM program toward the end of 2019 for congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) patients, pivoting their strategy to monitor COVID-19 patients at home as well, once hospitals began struggling with surges due to the pandemic. Using an integrated RPM platform, Baptist Health enrolled 270 COVID-19 patients from March to November 2020 and achieved zero hospital readmissions post-discharge. More details on the program are provided in this article from HealthcareITNews. Since the cost-effectiveness of telehealth remains a focus of policymakers as well, such studies show not only the potential benefits of telehealth for patient health outcomes, but health systems as a whole. HealthcareITNews article: https://www.healthcareitnews.com/news/upmc-uses-rpm-study-postpartum-hypertension-among-black-and-white-women#:~:text=on%20Health%20Equity-,UPMC%20uses%20RPM%20to%20study%20postpartum%20hypertension%20among%20Black%20and,between%20women%20of%20both%20races. University of Pittsburgh Medical Center (UPMC): https://www.upmc.com/media/news/091019-hauspurg-home-bp mHealth Intelligence: https://mhealthintelligence.com/ Baptist Health article: https://www.healthcareitnews.com/news/remote-patient-monitoring-helps-baptist-health-achieve-zero-readmissions-covid-19-patients < Previous News Next News >

The 13 telehealth platforms physicians use the most Katie Adams March 24, 2022 Telephone and Zoom are the two telehealth platforms physicians use the most, according to survey results released March 23 by the American Medical Association. Between Nov. 1 and Dec. 31, the AMA presented 1,657 physicians with a list of telehealth platforms and asked them to identify which ones they have used. Here are those platforms, along with the number of physicians who use them: 1. Audio-only telephone visits (723) 2. Zoom (600) 3. Doximity Video (439) 4. EHR telehealth module or tools (433) 5. Doxy.me (344) 6. Telehealth vendor (340) 7. FaceTime (269) 8. Patient Portal (234) 9. Microsoft Teams (92) 10. Texting (89) 11. Skype (48) 12. Remote patient monitoring tools (46) 13. Asynchronous messaging app (30) Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy. < Previous News Next News >

Amazon rolls out its telehealth service nationwide Annie Palmer, Bertha Coombs February 8, 2022 Amazon is launching its telehealth program, known as Amazon Care, nationwide and has signed up a handful of new companies to use its services. Amazon is rolling out its telehealth service, known as Amazon Care, nationwide, the company announced Tuesday. Amazon Care launched in 2019 as a pilot program for employees in and around the company's Seattle headquarters. The program provides virtual-care visits, as well as free telehealth consultations and in-home visits for a fee from nurses for testing and vaccinations. It has since expanded into more of a primary care service. To read this full article: https://www-cnbc-com.cdn.ampproject.org/c/s/www.cnbc.com/amp/2022/02/08/amazon-care-telehealth-service-launches-nationwide.html < Previous News Next News >

Membership Benefits 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 .

Health Care Disparities and Access to Video Visits Before and After the COVID-19 Pandemic: Findings from a Patient Survey in Primary Care Emily C. Webber, Brock D. McMillen, and Deanna R. Willis May 11, 2022 Abstract Background:In 2020, the Centers for Medicare & Medicaid Services reimbursement structure was relaxed to aid in the rapid adoption nationally of telemedicine during the COVID-19 pandemic. Due to limited access to internet service, cellular phone data, and appropriate devices, many patients may be excluded from telemedicine services. Methods:In this study, we present the findings of a survey of patients at an urban primary care clinic regarding their access to the tools needed for telemedicine before and after the COVID-19 pandemic. Patients provided information about their access to internet services, phone and data plans, and their perceived access to and interest in telemedicine. The survey was conducted in 2019 and then again in September of 2020 after expansion of telemedicine services. Results:In 2019, 168 patients were surveyed; and in 2020, 99 patients participated. In both surveys, 30% of respondents had limited phone data, no data, or no phone at all. In 2019, the patient responses showed a statistically significant difference in phone plan types between patients with different insurance plans (p < 0.10), with a higher proportion (39%) of patients with Medicaid or Medicaid waiver having a prepaid phone or no phone at all compared with patients with commercial insurance (26%). The overall awareness rate increased from 17% to 43% in the 2020 survey. Conclusions:This survey illustrated that not all patients had access to devices, cellular data, and internet service, which are all needed to conduct telemedicine. In this survey, patients with Medicaid or Medicaid waiver insurance were less likely to have these tools than those with a commercial payor. Finally, patients' access to these telemedicine tools correlated with their interest in using telemedicine visits. Providing equitable telemedicine care requires attention to and mitigation strategies for these gaps in access. Introduction Telemedicine and virtual care expanded rapidly during the COVID-19 pandemic of 2020. Fueled by necessity among health care providers and systems to deliver patient care, adoption was also driven by removal of barriers and expanded Centers for Medicare & Medicaid Services (CMS) reimbursement models. In March 2020, CMS authorized Medicare beneficiaries to receive telehealth at any location, including their homes.1 Subsequent waivers increased the scope of Medicare telehealth services, including a wider array of practitioners. Finally, the Department of Health and Human Services Office for Civil Rights announced that it would waive penalties for Health Insurance Portability and Accountability Act (HIPAA) violations against health care providers who were using everyday communication technologies to provide telehealth services.2 These combined changes resulted in millions of additional telehealth visits. CMS data from March and June of 2020 showed an increase from 13,000 beneficiaries using telehealth before the public health emergency to 1.7 million in the last week of April 2020.3 These CMS expansions were made permanent in January 2021.4 Despite these expansions, not all patients are positioned to take advantage of the adoption of telemedicine and virtual care. The digital divide or lack of access to reliable high-speed internet is a well-described gap, made worse in 2020, as many entities turned to virtual solutions to work, study, and conduct business as usual. Nearly 42 million people in the United States may not have the ability to purchase broadband internet as of February 2020,5 disproportionately impacting communities of color as well as low socioeconomic status.6 Finally, according to BroadbandNow, an estimated 1.35 million (20%) residents in Indiana are unserved by broadband internet providers at their home address.7 At the height of the COVID-19 pandemic, precautions such as stay-at-home orders and business, municipal, and school shutdowns eliminated public options for internet access. Addressing these gaps is a critical step in preventing worsening inequities in access to care.8 In this study, we surveyed patients in an urban primary care clinic to determine their access to internet and devices, readiness, and barriers to utilizing telemedicine and virtual health care. Methods In August 2019, patients from a primary care clinic located in central Indianapolis, Indiana, participated in a 10-question quality improvement survey. The Institutional Review Board reviewed and determined the survey to be exempt. Each patient arriving at the clinic over a 2-day period was given the chance to participate. The paper survey included questions about home internet and device access, phone plan and phone data adequacy, and interest in virtual visits (see Supplementary Data for full survey). The patient's insurance coverage information was captured on the paper survey form by the staff before handing the form to the patient. The results were assessed using chi-square tests to determine differences between payor groups. A linear regression model was utilized to analyze the association of phone plan data adequacy with interest in video visits. Following the results of the first survey, efforts to improve adoption of virtual visits were undertaken, including office signage promoting virtual visits, offering a virtual visit follow-up at checkout, visual cues to prompt providers to schedule virtual follow-ups, and scripting for appointment schedulers to include offering virtual visits at the time of scheduling. In September 2020, the same quality improvement survey was repeated from the same clinic during an active time period of COVID-19 to see if additional quality improvement efforts were warranted. One additional question was added to the 2020 survey: “How has your ability to do a video visit changed since the onset of COVID-19?” The results were assessed using chi-square tests between payor groups. A linear regression model was utilized to analyze the association of phone plan data adequacy with interest in video visits. Scheduled appointments were tracked weekly by type and audited for completion throughout the study period. Video visits that could not be completed using video were converted to telephone visits and counted as telephone visits. For FULL article: https://www.liebertpub.com/doi/10.1089/tmj.2021.0126 Published Online:11 May 2022https://doi.org/10.1089/tmj.2021.0126 < Previous News Next News >

CMS Warns Providers to Bill Correctly Center for Connected Health Policy May 2021 OIG is currently conducting several audits on telehealth In mid-April, CMS sent out a Medicare Learning Network (MLN) Connects Newsletter with a reminder to providers to bill correctly for telehealth services. In the short section in their newsletter, CMS cites a 2018 Office of Inspector General (OIG) report that found that there was a significant amount of telehealth claims that were improperly paid, and thus not billed correctly. As the OIG is currently conducting several audits on telehealth, it is possible that they may come to a similar conclusion again. The section also refers providers to several resources to ensure they are billing correctly, including the: Telehealth Services MLN booklet: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TelehealthSrvcsfctsht.pdf Medicare Claims Processing Manual: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf Telehealth Payment Eligibility Analyzer https://data.hrsa.gov/tools/medicare/telehealth List of Covered Telehealth Services https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes For policies specific to the public health emergency (PHE), CCHP also recommends providers review the CMS resources listed in the Federal COVID-19 section in CCHP’s Policy Finder, as there are several telehealth flexibilities currently in place as a result of the PHE. CCHP's Policy Finder: https://www.cchpca.org/federal/?category=covid-19&topic=originating-site < Previous News Next News >

Telehealth integrated into EHR is the way to go for CarDon & Associates Bill Siwicki October 19, 2021 The skilled nursing organization has a 90% treat-in-place rate for all telehealth encounters, and data from its platform has helped identify areas for improvement. Just before the COVID-19 pandemic struck, CarDon & Associates, which operates 20 senior housing/skilled nursing communities in the Midwest, was exploring different ideas to give its staff time back, improve resident outcomes and reduce rehospitalizations. THE PROBLEM The organization wanted an effective telehealth platform with new technologies to streamline the process for contacting physicians and improving documentation in its system of record. It also wanted to give its nurses a sense of confidence with technology that could guide them through assessments to keep residents in-house. "Once the pandemic started, we had to act fast and implement new portable devices and temporary solutions to provide virtual physician and consult visits as well as provide our residents a way to connect with their families and friends," said Brandy Armstrong, RN, director of clinical information at CarDon & Associates. "The swift implementation worked, but we still wanted a better, more secure solution that would assist our staff and provide quality care for our residents. The pandemic made searching for a telehealth platform a higher priority." PROPOSAL CarDon & Associates turned to Third Eye Health for a telehealth solution. The telehealth technology offered fast connectivity with access to board-certified, state-licensed physicians who are trained to provide care in a post-acute setting. Coverage includes nights, weekends and holidays. "The solution includes a care coordination team that facilitates communication between our care team and their physicians," Armstrong explained. "Our care team could communicate with telehealth physicians and the care coordination team through the platform. The system sends alerts to the user's email for new messages, watch lists and new encounters. "The purpose of the platform was to provide an easy-to-use application on a portable device that would give our nurses quick access to physicians to treat our residents in-house, improve documentation and provide reporting and analytics." Brandy Armstrong, RN, CarDon & Associates "They also offer a cloud-based, HIPAA-compliant platform that integrates with our EHR," she continued. "All telehealth-generated documentation includes a wet signature that imports from their platform into our system of record." Lastly, the vendor offers reporting and analytics that measure clinical performance, usage, resident encounters treated in place and chief complaints. "The purpose of the platform was to provide an easy-to-use application on a portable device that would give our nurses quick access to physicians to treat our residents in-house, improve documentation and provide reporting and analytics," she said. MARKETPLACE There are many vendors of telemedicine technologies and services on the health IT market today. Healthcare IT News has published a special report detailing many of the vendors and their offerings. Click here to read the special report. MEETING THE CHALLENGE Before implementing the telehealth solution, CarDon & Associates distributed iPads to all nurses and CNAs, so it was already starting to transition to a more mobile workflow. After it deployed portable devices, the organization started implementing the new telehealth solution with training provided by vendor staff. "Our nurses use the telehealth platform heavily as part of their everyday workflow during the evening and weekend coverage time," Armstrong noted. "The nurses have a portable device to use specifically for telehealth encounters. They sign in at the beginning of their shift and contact the telehealth provider when needed. "The nurses use the platform for new admissions, readmissions, bridging scripts and changes in condition," she added. "They can have video encounters with the touch of a button and interact with a physician within two minutes." The telehealth solution is integrated with the organization's system of record from vendor MatrixCare. The organization collaborates with telehealth vendor staff along with MatrixCare staff to ensure successful integration with each facility at which it implements the technology, she said. RESULTS To date, CarDon & Associates has a 90% treat-in-place rate for all telehealth encounters. Out of 2,090 consults, 1,826 residents were treated in place. Using the data in the telehealth platform, the organization was able to identify areas for improvement. And improved documentation has been integrated with the system of record. ADVICE FOR OTHERS Armstrong has a variety of tips for healthcare organizations considering similar telehealth systems integrated with EHR technology: Identify what problems you are trying to solve, what goals you are trying to meet and how you will evaluate outcomes. Determine who in your organization will develop a policy and procedure, and who will be involved with planning, implementation and evaluation. Involve frontline staff in discussions to get their input, insight and buy-in. Buy-in will be necessary for the implementation phase. Consider appointing a champion to help with ongoing education to ensure the technology is being used the way it was intended. Share your outcomes with staff members within your organization. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication https://www.healthcareitnews.com/news/telehealth-integrated-ehr-way-go-cardon-associates < Previous News Next News >

Supreme Court Limits Medication Abortion via Telehealth Center for Connected Health Policy April 2021 Last month the U.S. Supreme Court reinstated a U.S. Food and Drug Administration (FDA) rule that requires in-person visits for patients seeking medication abortion, eliminating patient access to the abortion pill mifepristone via telehealth. Last month the U.S. Supreme Court reinstated a U.S. Food and Drug Administration (FDA) rule that requires in-person visits for patients seeking medication abortion, eliminating patient access to the abortion pill mifepristone via telehealth. Last summer, a federal district court decision suspended the FDA rule during the pandemic, allowing providers to mail the pill to patients after a telehealth visit. While a recent study showed no difference in safety and efficacy, the ruling reignited political controversy around the subject of abortion and medication abortion in particular, leading the Trump Administration to request the reversal. The lower court ruled that the in-person requirement “imposed a ‘substantial obstacle’ to abortion care that is likely unconstitutional” however, in his concurrence, Chief Justice John Roberts stated that the issue was not related to constitutionality, but whether the lower court had the authority to remove the restriction due to their own determinations related to the risks of COVID-19, when they should defer to entities with the appropriate “background, competence, and expertise to assess public health.” Justice Sonia Sotomayor and Justice Elena Kagan dissented the decision, stating that it places patients at risk, particularly minority and low-income populations, and puts “an unnecessary and undue burden on their right to abortion.” Advocacy groups, providers, and policymakers are now requesting that the Biden Administration remove the previous Administration’s policy and FDA restriction. Meanwhile, even if the federal in-person requirement is removed, 19 states have their own in-person requirements, which will continue to prohibit the ability to provide medication abortion via telehealth. < Previous News Next News >

Endocrine Society Provides Guidance for Appropriate Use of Telehealth Mark Melchionna October 07, 2022 The Endocrine Society published a policy perspective covering various factors, such as clinical and patient factors, which could help determine subjective care needs and whether telehealth use is appropriate. October 07, 2022 - Aiming to enhance personalized care, the Endocrine Society created a policy perspective containing five aspects of care that can help clinicians decide when using telehealth is appropriate. With 18,000 members spread across 122 countries, the Endocrine Society is focused on promoting efforts to treat all hormone-related conditions, including diabetes, obesity, and hormone-related cancers. Amid the rapid growth of telehealth that resulted from the COVID-19 pandemic, healthcare stakeholders anticipate that telehealth will continue to pave its way into various aspects of clinical care. Published in The Journal of Clinical Endocrinology & Metabolism, the Endocrine Society policy perspective describes five aspects of care that can assist the process of determining when telehealth is appropriate. “Clinicians will need to draw upon their own knowledge of each patient and their clinical goals to decide when to incorporate telehealth into their care,” said the policy perspective's first author Varsha G. Vimalananda, MD, a physician-scientist at the VA Bedford Healthcare System and an associate professor of medicine at Boston University School of Medicine, in a press release. “Telehealth visits can be considered as an option each time we schedule an appointment. Patient preference should be elicited, and decisions guided by weighing the factors we describe in the perspective piece.” The five aspects of care to be considered when deciding whether telehealth is appropriate for a patient are clinical factors including whether an in-person exam is necessary, patient factors such as access to transportation and comfort level with technology, the patient-clinician relationship, the physical surroundings of the clinician, and the availability of infrastructure needed for telehealth visits. Telehealth is playing an increasingly valuable role in a personalized healthcare, but physicians and patients need to discuss how it fits into the care plan they are deciding on, according to the policy perspective. "Moving forward, endocrine care is likely to involve a hybrid of in-person and telehealth visits, and thus the decision to use telehealth for any given patient will not be made at a single time point but rather considered in a longitudinal context," the perspective states. Previous studies have indicated that various benefits that arose from telehealth expansion. For example, a study published in September found that increased telehealth use during the pandemic led to a drop in opioid overdose risk. Researchers studied data from before and during the pandemic, which indicated that the likelihood of receiving opioid use disorder services and medications was higher in the mid-pandemic patient group that had increased access to telehealth. Further, telehealth continues to be used widely across the country. Recent data from FAIR Health shows that telehealth use rose 1.9 percent nationally from June to July and that it increased in three of the four US census regions: the Midwest, the South, and the West. See original article: https://mhealthintelligence.com/news/endocrine-society-provides-guidance-for-appropriate-use-of-telehealth < Previous News Next News >

Closing 2022 with New Telehealth G-Codes for HHAs, Uncertainty for Telehealth Startups, Plus State & Federal Telehealth Developments (and much more!) CCHP December 13, 2022 New G-Code Reporting Requirements for HHAs under CY 2023 CMS PPS Rule The Centers for Medicare and Medicaid Services (CMS) has finalized new G-codes to report use of telecommunications technology under the home health benefit for Home Health Agencies (HHAs) under their finalized Calendar Year (CY) 2023 Home Health Prospective Payment System (PPS) Rate Update. HHAs are asked to voluntarily start reporting on January 1, 2023, and the requirement to report would kick in July 2023. CMS notes that in 2020 the home health benefit was temporarily altered due to COVID-19 (and made permanent in 2021) requiring any provision of remote patient monitoring or other services furnished via a telecommunications system to be included in the plan of care. The telecommunication service, however is not allowed to substitute for a home visit ordered by the plan of care or for purposes of eligibility or payment. Reporting of the new G-codes will allow CMS to analyze the characteristics of beneficiaries utilizing services remotely and have a broader understanding of the social determinants that affect who benefits most from these services. The codes HHAs will be asked to submit are detailed in a Medicare Learning Network (MLN) document, and include: G0320: Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system G0321: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system G0322: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (for example, remote patient monitoring) For more details on the G-codes and reporting expectations, see the full MLN Guidance and the full text of the finalized CY 2023 Home Health PPS Rate Rule. Falling Investment for Telehealth Startups A recent article in Politico [subscription required] brings to light the stark decrease in investment in telehealth companies in 2022 (compared to 2021), as the pandemic subsides and a recession likely kicks in. In fact, while telehealth funding for digital health in the US peaked in 2021 with $11 billion dollars, that has fallen to only $3 billion by the third quarter of 2022. The effects of this slow down in capital is bound to ripple across the industry. As a result, many startups are laying off workers and focusing on just a few key offerings. Adding to the uncertainty of the future for these companies is how telehealth policies will impact them moving forward as state and federal governments shift from pandemic era temporary policies to often stricter permanent telehealth requirements with greater oversight. Cerebral, a digital mental health company, for example is currently under federal investigation for over-prescribing ADHD medication. This is the type of occurrence other telehealth companies may take note of and may shape the way they think about the future of their products and services in order to avoid such situations. Additionally, consumer demand has shifted post-pandemic. While consumers were enthusiastic about utilizing telehealth for most forms of healthcare in order to avoid crowded doctors’ offices and hospitals at the height of the pandemic, they now prefer to use it for check-ins with their doctors, mental health visits and addiction treatment, according a survey by the American Medical Association. This necessitates a shift for many telehealth start-ups, and according to Megan Zweig, COO of Rock Health, many companies are struggling with this. For more information, read the full Politico article [subscription required]. World Health Organization Telemedicine Implementation Guidance In November the World Health Organization (WHO) released a telemedicine implementation guide based on knowledge and learnings the WHO has gathered since releasing their first report on telemedicine in 2010. The set of recommendations within the new guide is aimed at optimizing the implementation of telemedicine services by providing an overview of key planning, implementation and maintenance processes to inform an investment plan and support countries across different stages in developing telehealth solutions. The guide contains three phases to developing a successful telehealth program, including (1) a situational assessment; (2) planning the implementation; and (3) monitoring and evaluation, and continuous improvement. There are a total of eleven steps within the three phases, including tasks such as performing a landscape analysis, establishing standard operating procedures, developing a budget and determining monitoring and evaluation goals, as well as an adaptive management plan for improvement. Several case studies from different countries, including India, Cabo Verde, Indonesia, Qatar and Mali are also provided in the annex section of the document. Download the full telemedicine implementation document from the WHO’s website for all the detailed steps outlined in their recommended procedures for telemedicine implementation. See full article: https://mailchi.mp/cchpca/closing-2022-with-new-telehealth-g-codes-for-hhas-uncertainty-for-telehealth-startups-plus-state-federal-telehealth-developments-and-much-more < Previous News Next News >

Emergency telemedicine poised to grow in pandemic’s new phase Tanya Albert Henry, Contributing News Writer May 23, 2022 Emergency medicine is likely not the first specialty that comes to mind when thinking about the clinical areas that can benefit greatly from telehealth. But this digitally enabled mode of health care delivery that took off at the pandemic’s onset was helping in the emergency medicine setting before COVID-19 and will only continue to grow. An AMA Telehealth Immersion Program event co-hosted with the American College of Emergency Physicians (ACEP) provided an overview of the innovative ways telemedicine is being used in emergency settings and discussed how telehealth can continue to help physicians provide better care for patients. Emergency medicine doesn’t take place in one spot in the hospital and emergency physicians are trained to take care of emerging acute care situations in any setting, said Aditi U. Joshi, MD, chair of ACEP’s telehealth section. That includes the kind of asynchronous care that can be part of telehealth. Triage involves determining which kind of care presenting patients require. “Can they stay at home, do they need to go to an urgent care, primary care, or do they need to come into the emergency department?” she said. “We are uniquely skilled in that.” Telestroke was another form of telehealth in use before the COVID-19 pandemic, and telehealth was in use at freestanding emergency departments and urgent care centers. And here are a few ways that virtual care is poised to continue to grow: Triage. This can include, for example, talking to the emergency medical services unit on the way to the hospital, long-term acute care (LTAC) triage, and telemedicine screening exams. Direct, acute unscheduled care. For example, virtual urgent care, ED consults to help with things such as transfer stabilization treatment advice, LTAC, correctional medicine, or skilled nursing facility consults. Virtual (out of ED) observation. For example, post-ED follow-up visits, remote home monitoring, and hospital at home. The AMA helps guide physicians, practices and health systems in optimizing and sustaining telehealth at their organizations through the AMA Telehealth Immersion Program. The program builds on The Telehealth Initiative and is part of the AMA STEPS Forward® Innovation Academy, which enables physicians to learn from peers and experts and discover ways to implement time-saving practice innovation strategies. Benefits in the rural setting Over the past decade, 120 U.S. hospitals closed and 31 states have seen at least one rural hospital among those closures. With 20% of the population living and working in a rural area where hospitals often have limited staff, wait times for EDs in the rural hospitals are higher than the national average that is already at 24 minutes—and that is to see a nonphysician such as a nurse practitioner or physician assistant. It’s not uncommon for a physician to have to be called to come in from home at night because there are not enough doctors to staff the hospital 24/7. Emergency physician Kelly Rhone, MD, interim chief medical officer and vice president of innovation and outreach at Avel eCare, said their virtual health system—started in 1993—works with rural hospitals across the country to provide emergency care. They are hard-wired into EDs where health professionals with the push of a button can connect to their virtual emergency department, staffed with emergency physicians and nurses, to direct those who have their hands on the patients who may be in cardiac arrest, suffering from a stroke or facing other life-threatening injuries. “We are making a difference in rural health and bringing cutting-edge emergency medicine to the bedside,” Dr. Rhone said. Emergency telehealth in big cities too Telemedicine in the ED setting has benefits in large urban areas such as Los Angeles, too. Moshen Saidinejad, MD, directs pediatric emergency medicine at Ronald Reagan UCLA Medical Center, and said many children go to EDs that aren’t set up for pediatric patients and telemedicine allows those trained in pediatric emergency medicine to consult with those treating a child. The benefits of expanded telemedicine are clear. Join physicians who are advocating to permanently expand virtual care coverage. For more information see full article: https://www.ama-assn.org/practice-management/digital/emergency-telemedicine-poised-grow-pandemic-s-new-phase?smclient=f760e669-8538-11ec-83c8-18cf24ce389f&utm_source=salesmanago&utm_medium=email&utm_campaign=default < Previous News Next News >

Video Archives Telehealth Educational Series - 2021 Play Video Share Whole Channel This Video Facebook Twitter Pinterest Tumblr Copy Link Link Copied Search videos Search video... Now Playing 53:29 Play Video FCC Rural Health Care Program Funding Opportunities Now Playing 01:00:09 Play Video New Mexico’s Telehealth Statute Simplified: What You Need to Know Now Playing 55:32 Play Video New Mexico Broadband A Brighter Future by Gar Clarke Now Playing 57:44 Play Video Show Me the Data: How COVID-19 Impacted Telehealth Claims & What's Next Now Playing 01:02:42 Play Video Telehealth and COVID - Lessons Learned by Van Roper, PhD Now Playing 01:00:26 Play Video HIPAA still applies: Safeguarding patient data in a work-from-anywhere world Now Playing 57:21 Play Video Developing Telehealth Workflow for the Best Possible Patient and Provider Experience Now Playing 56:01 Play Video Care Integration in the Time of Covid: Focus on Patient Experience Now Playing 01:00:43 Play Video Using Remote Monitoring Technology to Improve Patient Outcomes & Retain Staff

Prescribing via Telehealth Post-Pandemic Center for Connected Health Policy July 2021 Another result of telehealth policies being in flux is uncertainty around the long-term landscape in terms of prescribing controlled substances post-pandemic. Another result of telehealth policies being in flux is uncertainty around the long-term landscape in terms of prescribing controlled substances post-pandemic. Existing federal law, mainly the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, restricts the prescribing of controlled substances via telemedicine except in very specific and limiting circumstances. Given these federal restrictions, this may be a telehealth policy barrier states have trouble tackling completely on their own. There is a potential pathway for the prescribing of certain controlled substances without an in-person exam post-PHE, which is if the U.S. Drug Enforcement Administration (DEA) creates the telemedicine special registry they were mandated to establish rules for by October 2019 but never did. Thus, the specific medications and the criteria to qualify for the registry is yet to be seen. In the first official mention of the long awaited regulations since December 2019, last month the DEA said in response to comments on a recently proposed (yet unrelated) rule about narcotics: “Although these comments regarding telemedicine special registration are beyond the scope of this rule, DEA understands commenters' frustration with the delay. DEA intends to promulgate regulations for the telemedicine special registration in the near future.” In addition, a few of the current federal bills CCHP is tracking that would alter the Ryan Haight Act include: * S. 445/HR 1384 – Makes exceptions for narcotic drugs in schedules II, IV, or V for community health aides or community health practitioners prescribing to an individual for treatment or detoxification * S. 340 – Allows for a telehealth evaluation for schedule III or IV drugs under certain circumstance * S 1457 – Similar language to S. 340 is in Sec. 205 of bill. CCHP will continue to track this issue and provide updates as they occur. Existing federal laws around prescribing can be found on CCHP’s website through both the policy finder tool and the pending federal legislation page at https://www.cchpca.org/federal/pending-legislation/. < Previous News Next News >

New Coding Modifier Offers Opportunity To Investigate Audio-Only Telehealth Alexander Beschloss, Ryan Van Ramshorst, Chethan Bachireddy, Christopher Chen, Andrey Ostrovsky November 18, 2022 Prior to the pandemic, Medicaid program coverage of audio-only telehealth services was limited. During the early stages of the pandemic, Medicaid beneficiaries were significantly less likely to complete telehealth visits compared to commercially insured patients. This was likely due to a series of obstacles, including: lack of access to high-quality broadband, a device with video capability, requisite digital skills, and private space to conduct the visit. For example, in 2019, roughly one in four Medicaid enrollees lived in a home without internet or with limited computer access. That said, Medicaid beneficiaries do not have significantly less access to devices with video capability (such as smartphones) than other patient populations, suggesting network connectivity poses more of a barrier than device access. Even further, nearly 50 percent of low-income patients in the US may not have requisite digital health literacy to use virtual telehealth. However, considering that 86 percent of Medicaid beneficiaries own a smartphone, it may be inferred that many more have sufficient digital literacy to engage in audio-only care rather than audio-visual telehealth. Network connectivity and low rates of digital literacy are two barriers that highlight the importance of creating the infrastructure to deliver and measure audio-only visits is of increased necessity. It was in this context that, once the pandemic struck, Medicaid agencies changed policies to augment access to telehealth services. For example, 17 state Medicaid agencies expanded reimbursement to include multiple modalities of telehealth, including audio-only. These changes particularly supported patient populations who had transportation, childcare, employment, or income barriers that prevent in-person care—challenges that are more prevalent in the Medicaid population. These policy innovations narrowed the reimbursement gap among in-person, audio-only, and audio-visual visits. In fact, the Department of Health and Human Services (HHS) recently investigated differences in patient populations who receive telehealth audio-only versus audiovisual use in 2021. For telehealth visits, Medicaid beneficiaries were more likely to use audio-only care than were privately insured patients (35.1 percent versus 45.5 percent). They discovered that compared to White patients, who used audio-only care for 38.1 percent of their telehealth visits, Latino, Black, and Asian patients did so at rates of 49.3 percent, 46.4 percent, and 48.7 percent, respectively. Patients with less than a high school education used it at 61.9 percent of their telehealth visits, compared to those with greater than a bachelor’s degree, who did such at a rate of only 32.6 percent. Across income brackets, there is an inverse relationship between household income and audio-only telehealth use. As the use of audio-only telehealth became more widespread among Medicaid beneficiaries, state Medicaid leaders needed a mechanism to measure clinical outcomes, health care costs, and patient experiences related to audio-only telehealth. Providers also needed a dedicated billing construct that could be used across public and private payers to streamline billing processes. Until recently, such mechanisms simply did not exist. And so, due to these insufficient coding constructs, several Medicaid medical directors spearheaded an application to the American Medical Association (AMA) to create a Current Procedural Terminology (CPT) modifier that would specifically designate audio-only services. In September 2021, the AMA CPT Editorial Panel accepted the addition of the CPT Modifier 93 code for synchronous audio-only telehealth, and the code became active on January 1, 2022. This article provides an overview of the rationale for and process of creating the CPT Modifier 93 code. Potential Benefits Of Audio-Only CPT Modifier Why was the creation of a new audio-only modifier necessary? Several reasons: data collection, policy implementation, health care equity, widespread need, and service specificity. The CPT 93 modifier permits differentiation among audio-only, audiovisual, and in-person care at the administrative level, which subsequently allows health service researchers to monitor and evaluate the use and clinical efficacy among these methods of care delivery. Prior to the introduction of this modifier, such high-quality analyses were impossible to do at scale. Along with the increase in all modalities of telehealth use since the COVID-19 public health emergency (63 fold increase year over year between 2019 and 2020), a survey performed by HHS (across all 50 states and the District of Columbia) discovered that 45.5 percent of all telehealth usage amongst Medicaid beneficiaries was audio-only. Taking things one step farther, several state legislatures including Washington, Connecticut, and New York have recently passed laws mandating or allowing coverage for audio-only services. Audio-only telehealth is being highly used, therefore having a mechanism to collect related data is vital. Implementing this modifier will serve as a tool for policy makers to make informed adjustments in policy around patients who use audio-only services. Implementation of this modifier will also enable claims-based research to monitor for disparities between audiovisual and audio-only care to ensure that all modalities of telehealth are provided in a sustainable, equitable, and high-quality fashion. Additionally, because different states have implemented varying strategies to cover audio-only services during the COVID-19 public health emergency (PHE), the CPT 93 modifier will help health services researchers and policy makers discern the differences between coverage approaches, information that will be crucial in standardizing telehealth data collection/storage across states. From a coding perspective, adding an audio-only modifier to existing and widely used CPT codes is a far more feasible option than alternatives such as individual payers developing their own coding modifiers. That approach would become unreasonably burdensome on providers who would subsequently have to learn and bill using the system established by each payer. Previous Codes Did Not Suffice While CPT codes for services provided through telephone exist, they do not specify the enormous range of behavioral health services, therapies, maternity-related care, post-operative guidance, and other services that have been successfully delivered via audio-only technology since the COVID-19 PHE. For example, CPT code 99441 represents a “telephone evaluation and management service; 5–10 minutes of medical discussion,” which gives no specificity regarding what type of care was delivered. In comparison, the CPT 93 modifier can be attached to theoretically any billing code that is permitted under law, thus allowing for more precise tracking and more useful follow-up research. Prior to the introduction of the CPT 93 modifier, there were seldom CPT codes that could be used to represent audio-only telehealth for specific services. Even though audio-only telehealth has been delivered at high rates, states have only been able to use temporary or workaround solutions to bill for audio-only services. For example, the Healthcare Common Procedure Coding System (HCPCS) Level II code for crisis response (CR) has been used by some states to support audio-only services during the COVID-19 pandemic. In the two and a half years since the pandemic began, however, the use of audio-only to provide health services has become normalized and may in fact now be expected by Medicaid providers and beneficiaries—a reality for which the CR code, and its temporary application, was not designed. The CPT 93 solves this challenge on a national scale. Another prior attempt to capture audio-only telehealth was the CPT modifier 95 that only indicated a telehealth service and did not differentiate between audio-only and audio-visual care. HCPCS Level II code “G0” has also been used; however, it indicates a telehealth service for diagnosis, evaluation, or treatment specific to symptoms of an acute stroke. Furthermore, CPT code 99401 can be used to reflect counseling services that may be provided via audio-only care; however, this code failed to capture all the nuance of the amount of time of care was delivered. At the end of the COVID-19 PHE, the Centers for Medicare and Medicaid Services (CMS) plans to add the “FQ” modifier on claims for HCPCS code G2080 for counseling and therapy provided using audio-only telecommunications. The HCPCS G2080 code refers to when one provides therapy services that largely exceed the amount listed in the patient’s individualized treatment plan for medication assisted treatment for opioid use disorder. This modifier exists solely for CMS’s Opioid Treatment Program and fails to account for other indications for audio-only telehealth. Creating a CPT modifier that is applicable to all service types simplifies the codification and measurement of audio-only care across all payer types. Conduct More Research On Audio-Only Telehealth Researchers, provider organizations, and policy makers must investigate and ensure that audio-only telehealth drives strong clinical outcomes. Telephone-focused care has been an important part of primary care; however, much of it was after hours, unmeasured, and not reimbursed. There is strong evidence on audio-only telehealth’s efficacy in prenatal visits and insomnia, for example. A randomized clinical control trial in a patient population of the Kaiser Permanente Washington system received audio-only cognitive behavioral therapy through the telephone demonstrated a significant benefit in improving sleep, fatigue, and osteoarthritis-associated pain. A cohort study amongst pregnant women in the Parkland Health System in Texas found that audio-only perinatal visits were not associated with changes in perinatal outcomes when compared to in-person visits in a vulnerable population. While these data are encouraging, they are sparse. Measurement of a CPT modifier may streamline the research methods used in these studies. Researchers must continue to investigate the efficacy of specific therapies when delivered via audio-only modalities. While audio-only telehealth solves several problems in health care, there are also several risks such as its potential use for inappropriate clinical indications and the risk that some may see an opportunity to overbill. An audio-only modifier—and therefore a more granular characterization of telehealth modalities—may help assuage concerns about fraud, waste, and abuse, removing existing ambiguity about the impact of different telehealth modalities on outcomes. We also know that the quality and value of these delivery modalities may vary according to the different demographics being served, including factors such as age, insurance status, payer, income, and region, among many others. Such modalities will likely vary between acuity of patient’s indication for care. Only by studying these differences amongst modalities and the populations served, can we ensure that the care delivered is equitable and valuable. Implementing the 93 modifier is a vital step toward enabling health services researchers to urgently pursue research questions that inform evidence-based policy about the best use of audio-only telehealth—especially amongst the Medicaid population. It is also essential to ensuring that the growth of audio-only health care does not create a two-tiered system between private insurance and Medicaid. For example, audio-only care may in fact be lower quality or lower value compared to audiovisual care or in-person care—although, further investigation is necessary to understand these differences. Considering that audio-only care helps remove barriers to care for underresourced patient populations, inappropriate use of audio-only care may further exacerbate the already large inequities in health care—a concern raised by both clinicians and patients. This reliance on audio-only care may also hamstring innovations that can improve the quality and access to audiovisual telehealth or in-person care. Clearly, there are legitimate concerns about the equity of audio-only health. To resolve them, more precise data and extensive investigations are necessary: Both of which will be enabled by the implementation of the CPT 93 modifier. An Opportunity For Action The new audio-only CPT 93 modifier provides meaningful potential benefits to combat barriers to care that were compounded during the COVID-19 pandemic. The new code creates a potent opportunity for conducting rigorous research into audio-only telehealth to inform federal- and state-level policy around equitable telehealth delivery. But to make the most of this opportunity, regulators, payers, providers, and researchers must take steps to increase adoption and evaluation of the audio-only modifier. To catalyze this work, large health systems should consider leading the adoption of the CPT 93 modifier while also encouraging local private providers to do the same. Payers and purchasers should consider requiring modifier submission, a step that would also facilitate further research into the field with minimal additional administrative burden on providers. Federal health agencies have a role as well. For example, the Agency for Healthcare Research and Quality (AHRQ) may increase awareness of the modifiers amongst affiliated researchers or those who use AHRQ databases while the Health Resources and Services Agency may require community health centers they fund to use the new modifier. Authors’ Note The authors would like to thank Dr. John Morgan and Amanda Brodt for their contributions to preparing this paper. Dr. Ostrovsky is an investor in the following companies, some of which provide telehealth services: https://www.socialinnovationventures.com . However, there are no direct conflicts of interest. See original article: https://www.healthaffairs.org/content/forefront/new-coding-modifier-offers-opportunity-investigate-audio-only-telehealth#.Y3feKa9vXhA.twitter < Previous News Next News >

Studies Show How Telehealth Can Increase Equitable Access to Care Center for Connected Health Policy May 24, 2022 Focus on the relationship between telehealth and disparities in access to care continues to result in new research examining pandemic era data and the use of telehealth among disadvantaged populations. While policymakers and studies often try to put findings into two groups, whether telehealth increases or decreases inequities, recent research shows that the study framework used and considerations made may impact outcomes more so than telehealth itself. For instance, this month a new study published in Health Affairs found that as a result of emergency federal telemedicine coverage expansions access increased for all Medicare populations, including those in the most disadvantaged areas. The study was framed to examine the impact of expanded telehealth coverage policies on different populations, rather than looking at access generally where inequities have unfortunately always existed. Comparing pre-COVID temporary waiver data with post-waiver implementation data, the authors discovered that the highest odds of utilization were among those in disadvantaged and metropolitan areas. As reported in a Managed Healthcare Executive article on the study, the Johns Hopkins researchers concluded that the results suggest that increased Medicare telemedicine coverage policies improve access to underserved populations without worsening disparities. An additional study just published in Telemedicine Journal and e-Health and covered in a healthleaders article showed that a virtual care program at Penn Medicine is reducing barriers to access specifically for Black patients and eliminating historic disparities. The authors looked at approximately one million appointments per year in both 2019 and 2020 for Philadelphia area patients and found that Black patients used telehealth more than non-Black patients and that appointment completion gaps between Black and non-Black patients closed. Also recently released, the National Committee for Quality Assurance (NCQA) produced a white paper titled The Future of Telehealth Roundtable: The Potential Impact of Emerging Technologies on Health Equity, which focuses on how to ensure telehealth increases equitable access to care. Following up on its previous pandemic telehealth work, in late 2021 NCQA pulled together a multidisciplinary panel of equity and technology experts for a discussion on equitable access and virtual health care delivery. Reviewing hypothetical case studies and responding to various questions, participants highlighted potential challenges and identified three primary ways to ensure equitable access in telehealth delivery: Tailoring Telehealth Use and Access to Individual Preferences and Needs Addressing Regulatory, Policy and Infrastructure Barriers to Fair Telehealth Access Leveraging Telehealth and Digital Technologies to Promote Equitable Care Delivery The white paper suggests the need to prioritize language and cultural humility, address digital literacy, and optimize telehealth for people with disabilities. In addition, in terms of barriers, the authors stress the need to address broadband infrastructure and licensure limitations, while also updating laws and regulations that restrict telehealth use, including payment policies. Another Health Affairs article published this month, Policy Considerations to Ensure Telemedicine Equity, also looked at various factors that must be taken into account to allow telehealth to increase equitable access to care. The author clarifies that equity is a matter beyond telehealth and is related to patient-level barriers that include family, community, and general health care delivery level factors, such as issues related to the digital divide. In addition, the article cautions against policies focusing on increased utilization concerns, stating that increased use may mean that patients are finally attaining the care they need, in addition to the fact that increased access may reduce overall health care costs. Therefore, policies seeking to reduce reimbursement or limit audio-only modalities to address utilization and cost concerns may instead primarily reduce clinicians’ willingness to offer telehealth and modalities that mitigate access barriers for historically excluded groups. The article also highlights how varying payer policies, such as those that allow reimbursement for telehealth visits with new patients versus those that do not, creates inequities, and that differing medical licensing and/or prescribing regulations by state can create inequitable access issues on top of differing coverage policies. These policy considerations are key to ensuring telemedicine mitigates inequities rather than exacerbates them. While the pandemic generally has highlighted and exacerbated existing inequities, it has also provided the information necessary to show telehealth’s ability to address disparities and increase equitable access to care. It is important that policymakers take such findings and opportunities from studies on telehealth equity into account when looking to potentially make pandemic policies permanent in order to properly preserve telehealth’s positive impacts. It is also important that the framework used in the study be placed in context to help explain why some research speaks to telehealth disparities, or health care disparities, versus how telehealth is decreasing health care disparities. As shown in the aforementioned studies and articles, the difference in framing showcases that telehealth in and of itself does not create or exacerbate disparities, rather it is a tool that can be utilized to decrease disparities in access to care. The tool has to be allowed to be effective, however, and that is where the role of public policy comes in. Policies must support broadband and telehealth infrastructure and promote the use of technology to deliver care equal to the delivery of in-person care. For instance, Medicaid policies that limit when telehealth can be used and/or certain allowable modalities can create inequities in comparison to more expansive commercial policies that guarantee better telehealth access to non-Medicaid patients. Therefore, policymakers must recognize that regulatory restrictions around telehealth cannot prevent already existing general access disparities, rather it is often the regulatory restrictions around telehealth that lead to exacerbating disparities. It becomes vital that research be put into context so that subsequent policies are implemented that allow telehealth to reach its full potential to reduce disparities. For full article: https://mailchi.mp/cchpca/the-latest-telehealth-research-studies-show-how-telehealth-can-increase-equitable-access-to-care < Previous News Next News >

The future of telemedicine: purpose-built, integrated platforms Zoll Data Systems March 1, 2022 Integrated telemedicine solutions can address current pain points. By: Businessperson with tablet pointing to AI and data graphics Maximizing provider returns with big data Stethoscope and calculator on graphs How Emergency Medicine Physicians Can Increase Revenue in 2021 with Medicare PFS Cuts Looming person holding an insurance card. Billing Medicare and Private Payers for Telehealth Visits: What to Expect Post-Public Health Emergency Doctor talking to mother and daughter at reception desk Insurance Verification Technology Prevents Errors that Cause Costly Denials SPONSORED Global Edition Telehealth The future of telemedicine: purpose-built, integrated platforms Integrated telemedicine solutions can address current pain points. By: March 01, 2022 10:27 AM Photo Credit: adamkaz/Getty Images Propelled into mainstream use by the COVID-19 pandemic, telemedicine is becoming standard practice for many healthcare providers. According to David Ernst, MD, president of telemedicine innovator EPOWERdoc, these solutions will transform access to care and continue to drive more cost-effective delivery models, particularly at the EMS and emergency medicine level. Telemedicine’s technological pain points While telemedicine has undoubtedly come a long way, it still has significant limitations. One of the biggest limitations is provider usability. Often, telemedicine “platforms” are actually several disparate solutions cobbled together. These may include a video conferencing app, patient registration portal for demographic and insurance information, EMR, e-prescription app and discharge system. Consequently, providers must toggle between separate software programs to review and enter patient data for a single encounter. This inefficient approach can introduce errors, create frustration for patients and providers, and jeopardize the continuity of care. There is hope, however: Telemedicine technology is making rapid advancements through purpose-built platforms. Read full article here: https://www.healthcareitnews.com/news/future-telemedicine-purpose-built-integrated-platforms < Previous News Next News >

Advances in telemedicine are on the way in 2022 Bill Siwicki Dec. 20, 2021 A physician expert in virtual care talks technological advances, reimbursement legislation and the continued evolution of remote patient monitoring. 2020 and 2021 saw the mainstreaming of telehealth and the rise of remote patient monitoring. These changes to the healthcare landscape were helped partly by requirements of the COVID-19 pandemic and partly by the subsequent loosening of telemedicine reimbursement and licensure regulations by the government. But what's to happen in 2022? Will the government and commercial payers continue to reimburse for telemedicine? Will new virtual-care legislation pass? Will there be technological advances that push the care paradigm further forward? And what of the future of remote patient monitoring? Healthcare IT News sat down with Dr. Ian Tong, chief medical officer at Included Health, a telehealth technology and services company, to get his read on these questions and his predictions for telehealth in 2022 and beyond. Q. What do you see in the realm of technological advances in telemedicine in 2022? A. While 2021 saw many healthcare technology mergers and acquisitions in response to the pandemic, and growing virtual-care adoption among payers, providers and consumers, much of the technology of these combined entities remains fractured. Though promoted as one offering, consumers still are having to navigate two or more platforms and work to connect the dots themselves. The technology needs to become invisible – so good that you don't even realize it's there. The technology for virtual-care appointments also will continue to advance beyond 1:1 doctor-patient video conferencing. For example, in response to the rising behavioral health provider shortage, we can expect to see technology that can enable group sessions with multiple patients receiving counsel and support at once. Whether it's behavioral, acute or chronic care, the most important role that technology will play is enabling all physicians to have the same window into a patient's medical history and care plan so they can provide integrated, longitudinal care. The technology is what will enable this industry to realize the full potential of virtual care beyond transactional, one-time interactions. Q. All the temporary reimbursement moves by government and payers for the sake of the pandemic really pushed telehealth into the mainstream. What do you foresee happening with reimbursement for virtual care in 2022? Will it become permanent? Will it be expanded? A. With usage rates 38 times higher than pre-pandemic, and the inarguable value for the people who need it most – seniors and the immunocompromised who can't afford in-person exposure – I believe the government will and should expand virtual-care access. Pre-pandemic virtual care was used for urgent, low-complexity issues – cough, cold, rashes. But today, the real value is for integrated chronic-disease management or ongoing behavioral-health therapy, where people need not be burdened by the constant travel in and out of doctors' offices. The more care that shifts to virtual, the less burden of disease the patients will have, which will lead to better outcomes. This is an opportunity that should be afforded to everyone, especially our most vulnerable and historically underserved communities. Q. Remote patient monitoring is a form of telehealth that is of growing interest to healthcare provider organizations. What do you see happening with RPM in 2022? A. Adoption of remote patient monitoring devices continues to rise, and we don't see it slowing down any time soon. Today, one third of consumers are more likely to choose a provider that allows them to share data from a connected health device, which only promotes more positive outcomes. The more real-time data that we can collect in the comfort of people's homes, the more personalized, data-driven virtual care we can provide. However, to really launch adoption in this sector, the costs of these devices need to come down. As costs come down, health plans can more easily find an ROI [return on investment] to subsidize the use of these devices. https://www.healthcareitnews.com/news/advances-telemedicine-are-way-2022 < Previous News Next News >

Telehealth QA – Is it all it’s QAcked up to be? Trudy Bearden, PA-C, MPAS February 16, 2022 In hopes of sparking renewed commitment to applying improvement science to telehealth, we offer this Telehealth QI and QA Miniseries. Today is the fourth in the series. Require expertise and excellence in telehealth service delivery. Expertise with telehealth requires deliberate practice which builds on or modifies existing skills, usually with the help and guidance of a coach or teacher with targeted feedback on what to improve and how to improve those skills. Send staff through telehealth training either internally or externally. The California Telehealth Resource Center Telehealth Course Finder is a great place to start for external telehealth trainings. Provide peer review of telehealth sessions by inviting a trusted clinician to join a telehealth visit – with patient permission. Debrief after the session to provide feedback and to discuss what went well, what did not go well and what changes can be made to improve Implement written triage protocols that are easily accessible by all staff to clarify which patients or patient issues are appropriate for telehealth and which need to be seen in person. Make a commitment to exceptional service delivery. Solicit and act on patient and staff feedback. Consider including a patient partner or advisor in these efforts. Below are some sample staff and clinician satisfaction survey questions. Some institutions may already incorporate some of these into their existing patient feedback systems (e.g., Press Ganey) so check to see if they are before duplicating efforts. Sometimes it’s best to collect feedback simply and in real time by asking, “How was your visit? What could have gone better?” Read full article here: https://southwesttrc.org/blog/2022/telehealth-qa-it-all-it-s-qacked-be < Previous News Next News >