Libraries Add Telehealth to the Rural Communities They Serve Mari Herreras October 20, 2022 In the early days of the Covid pandemic, Dianne Connery realized something needed to be done for people in her rural Texas community to help connect folks to their medical appointments. Connery, director of the Pottsboro Area Library in Pottsboro, Texas, said it started when one woman with pulmonary disease came to the library for help, desperate to meet with her doctor but too high risk to come to his office—a two-hour drive south to Dallas. “Libraries are such perfect places for this because often we have the fastest internet in town, and we are used to helping people with technology,” Connery said. Connery and her fellow librarians sprang into action—creating a private space in Connery’s office with her laptop that had a camera. That gesture allowed the woman to meet with her doctor and go over recent MRI results. “I had never lived in a rural town until 2010 and didn’t realize how hard it is to access digital technology. You need a solid infrastructure for robust internet. Rural communities like ours don’t have that,” she said. From that first telehealth appointment in Connery’s office grew the library’s telehealth program that’s received national recognition. However, it never would have happened without Connery, with support from the town council, having fiber installed to support a teen eSports program long before the start of the pandemic. More community members used Connery’s office those early telehealth appointments, but through a National Library of Medicine grant and a community appeal, she was able to create a private appointment space from an old junk room and purchase the needed hardware and equipment. The next step was a unique partnership she developed with the University of North Texas Health Sciences Center to pair patients with the medical providers they needed. People can be seen two days a week for those using Medicare and Medicaid. Another day of the week is reserved for behavioral health appointments and another day is reserved for folks seeing their regular health providers. Connery’s work on the telehealth program doesn’t end there. The American Heart Association recently provided her library with blood pressure kits members of the community can check out. They also received a grant to hire a community health care worker to do outreach and education at the library and community spaces like the American Legion and the VFW. Now she’s focused on developing a digital literacy curriculum with the help of a three-year grant that helped her hire a digital navigator. Connery said she’s excited to see other rural libraries in Texas start telehealth programs but hopes more funding loops back to libraries desperate for increases in their own budgets. Connery is part of a national consortium of libraries who meet monthly to discuss telehealth programming—a growing interest in other rural communities beyond her Texas borders. Last month, a new telehealth program recently launched at two rural Pima County Library branches in Ajo and Arivaca—the first of its kind in Arizona—allowing folks with transportation or internet issues access to their doctors without having to drive several hours across the desert to nearby Tucson. “A huge sense of relief,” is how one Ajo resident recently described her experience that helped her connect with her primary care doctor in Tucson about worrisome symptoms she experienced after recovering from Covid. At the Salazar-Ajo Library she was able to collect the vitals her doctor needed using equipment provided by the library. And in the privacy of the library’s meeting room, she met with her doctor via a laptop and the internet provided by the library to go over her symptoms and vitals. “Being able to take my vitals and provide those to my doctor seems really important,” the Ajo resident said. “… while I was on my call with her, she had me do my vitals. We started with the blood pressure cuff, and how to apply it. Then my oxygen with the pulse rate oximeter.” The end of the appointment her doctor determined that the symptoms were not uncommon for someone who has had Covid, allowing the Ajo resident some relief and a better understanding of her recovery. Daniela Buchberger, Pima County Library’s Ajo branch managing librarian, said the new program, Health Connect, provides a private room for telehealth medical appointments. Inside is a laptop with a camera and equipment needed for a patient to take their own vitals: a digital scale, a thermometer, a blood pressure cuff, and a pulse rate oximeter. A patient will need to have the link provided by their doctor, usually via email. Library staff, due to privacy restrictions, aren’t going to be able to help someone log-on or use the equipment although the patient can bring someone with them to their appointment in the study room. Each library has written instructions on laminated cards as well as easy-to-follow visuals to help guide their experience. According to the Pima County Library, Health Connect is made possible by the Arizona State Library, Archives, and Public Records, a division of the Secretary of State, with federal funds from the Institute of Museum and Library Services. It is a joint effort between the Library, Pima County Health Department, University of Arizona’s College of Nursing, the Arizona Telemedicine Program, and United Community Health Care. "Access to telehealth is essential for people to get the care they need when traveling to an in-person visit isn't possible,” said Ken Zambos, program manager for Workforce and Economic Development in Pima County. “By providing this service, the library is providing access to equipment that transforms healthcare delivery and positively affects healthcare outcomes." Buchberger said a library card isn’t needed to use the room. However, reservations are needed and available in hour and half increments. Each person using a room is expected to clean all equipment after use with alcohol wipes provided. A fan in the room will be used to provide white noise to help with privacy as much as possible. “We may not have as much traffic as other libraries, but we are an important part of the community. The library is free, so is the internet,” Buchberger said. “Not everyone here has a car or a computer, but they have us.” About the Author Mari Herreras is the newest member of the Arizona Telemedicine Program and Southwest Telehealth Resource Center teams, serving as Communications Manager. She has worked in marketing and communications in publishing and nonprofits, as well as an award-winning journalism career for community and alternative newsweeklies in Tucson, Los Angeles, Seattle, and Wenatchee, Washington. See original article: https://southwesttrc.org/blog/2022/libraries-add-telehealth-rural-communities-they-serve < Previous News Next News >

Review of Veterans Health Administration’s Use of Telehealth During Pandemic Center for Connected Health Policy April 2021 Veteran’s Affairs Office of the Inspector General (OIG) assessed the Veterans Health Administration’s virtual primary care response to the COVID-19 pandemic. From February 7 to June 16, 2020, the Veteran’s Affairs Office of the Inspector General (OIG) assessed the Veterans Health Administration’s virtual primary care response to the COVID-19 pandemic, based upon reviewing primary care encounter data, interviews with VHA leaders, and use of primary care provider questionnaires. In its report, the OIG found that face-to-face primary care visits decreased by 75% and contact by telephone represented 81% of all primary care encounters. In regards to VA Video Connect (VVC), providers stated that not only were there technical complications related to specifically scheduling VVC visits, but many patients didn’t have internet access or the appropriate equipment needed for video calls. The OIG identified the need for additional training and support for veterans and test visits with patients and staff to walk through the process before the visit. In addition, the OIG recommended the Under Secretary for Health evaluate veteran access to reliable internet connectivity necessary for use of VVC and take appropriate action. Department of Veterans Affairs, Office of Inspector General: https://www.va.gov/oig/ Veterans Health Administration: https://www.va.gov/health/ < Previous News Next News >

The Data Challenge to Prove Telehealth’s Importance Continues Jan Ground, PT, MBA November 17, 2022 A group of telehealth leaders from 18 states worked the past two years on proving the value of telehealth with data to convince payors and legislators that continuing reimbursement post-COVID 19 is the right thing to do. Over the course of two years, 40 people, including five physicians, four nurses, four other clinicians, and 27 telehealth leaders in provider organizations, contributed to the effort. The group chose to focus initially on video visits for those in need of mental health care. We succeeded in step one: we surveyed 16 mental health provider organizations to find out what data they were collecting, and how success was being measured in 2020. The organizations ranged from large university medical centers to private practices in nine states. Not surprisingly, the data and metrics varied widely, even across large university-based systems. For example, in response to the question “What, if anything, is being measured regarding clinical outcomes?” Four organizations reported no clinical outcomes measurements Four organizations used a wide variety of validated and commonly used clinical outcome metrics: PHQ-9 (used by 3 of 4 ) Patient Health Questionnaire (columbia.edu) GAD7 (used by 2 of 4) GAD-7 (General Anxiety Disorder-7) - MDCalc BASIS-24 (use) BASIS-24® — eBASIS ACES ACE.pdf (odmhsas.org) Adverse Childhood Experiences Study EDE-Q PDFfiller - ede q online(1).pdf (uslegalforms.com) Eating Disorder Examination Questionnaire OCI-R Obsessive Compulsive Inventory - Revised (OCI-R) (psychology-tools.com) SF-12 The SF-12v2 PRO Health Survey (qualitymetric.com) Short Form Health Survey BAI beck-anxiety-inventory.pdf (jolietcenter.com) EDE-Q ede-q_quesionnaire.pdf (corc.uk.net) Eating Disorder Examination Questionnaire EDY-Q Microsoft Word - Hilbert, van Dyck_EDY-Q_English Version_2016 (harvard.edu) Eating Disorders in Youth Questionnaire McMaster Family Assessment Device STAI-C-S State-Trait Anxiety Inventory for Children (STAI-CH) - Assessments, Tests | Mind Garden - Mind Garden State Trait Anxiety Inventory – Child Version – State only DERS Difficulties in Emotion Regulation Scale (DERS) (novopsych.com.au) PCL-5 PTSD Checklist for DSM-5 (PCL-5) - Fillable Form (va.gov) Post-traumatic Checklist In another question on cost savings, the survey question was “What, if anything, is being measured regarding cost savings?” 13 organizations reported no cost savings measurements Two of the three organizations reported savings measurements shared the following metrics (video visits vs in person visits) Handouts, parking vouchers, meal vouchers In person clinicians paid salary, video visit clinicians paid per hour, Future: space cost savings (video visit clinicians providing care from home) In our next effort we wanted to add payor leaders or legislators to join the conversation to determine which, if any of the metrics being used and data being collected, might convince them to support continued reimbursement post-COVID 19. The 40 participants were all associated with provider organizations with insufficient connections with payors/legislators to successfully bring them into the conversation. The group took a break and then decided on a new approach. We came up with what we THINK would be most important to payors/legislators, based on our understanding of what drives their success. Here’s the list: Compare the following data for specific groups of mental health patients (e.g., based on location, disorder, gender, age, first time vs return patients, newly diagnosed vs existing patient, prior telemedicine use, other relevant demographics, and characteristics), with or without access to care by video: number of ED visits number of hospitalizations suicide rates survey results that measure mental health status using validated tools (e.g., PHQ9) timing to access -(i.e., length of time to get patients in front of provider for first visit) provider and patient satisfaction and retention (i.e., remain in care) Interestingly, I have since learned that, in fact, there are many data sources on these topics with many peer-reviewed articles based on well-controlled studies. That leads me to a different question: Why were none of the 40 participants, including me, aware of these data sources and how to access them? It perhaps has its roots in the type of data available. Much of the data available comes from academic institutions reporting on research studies and publishing in peer-reviewed journals. These can be readily found through a PubMed or Google Scholar search using appropriate search terms (e.g., telemental health, outcomes, cost) but if one is unfamiliar with conducting this type of search these articles will not be available to review. Other sources of information include websites of the professional societies of which the providers are members (e.g., American Psychiatric Association) and government websites (e.g., Substance Abuse and Mental Health Services Administration, but one has to know about these before they can be searched. Finally is the fact that although many healthcare systems and funders collect data, they use these data for internal purposes only and simply do not publish or share them. We are currently in search of a few provider organizations interested in/willing to collect some of these data. We have not had success. If you are interested in joining this collaborative effort, please contact me at: janground@gmail.com https://www.linkedin.com/in/jan-ground-3089742/ A new thought is to focus on a current hot topic in the US, such as COVID 19, to identify data to prove (or not!) the value of care by video. Perhaps we could find an organization willing to provide some funding to more likely successfully identify organizations willing to collect the data. It should not have to be this hard! About the Author Jan Ground PT, MBA, led innovation and virtual care at Kaiser Permanente Colorado, where she worked for 18 years. She is the Colorado Liaison to the Southwest Telehealth Resource Center and the Colorado Ambassador to Telehealth and Medicine Today, an online peer-reviewed journal. Active in the American Telemedicine Association, Jan leads a group looking to prove, with data, that telehealth is worth paying for. Jan’s expertise is in leading change, and in clearly defining a problem before implementing a new approach to care. Her greatest passion is to lower the cost of the American healthcare system without lowering clinical outcomes. See original article: https://southwesttrc.org/blog/2022/data-challenge-prove-telehealth-s-importance-continues < Previous News Next News >

Why is an Alliance needed? NMTHA assists with ensuring telehealth program dollars are applied effectively and efficiently through : Clinical coordination Technical coordination Health information technology Administrative Services Federal, State, and private funds are spent on telehealth programs with little or no attention to coordination with other programs, efficient reuse of existing resources, and delivering the best level of cost-effective services. Existing and proposed programs create a patchwork of telehealth solutions with overlaps, gaps, and little long-term accountability. No entity coordinates telehealth statewide and ensures that telehealth programs and dollars generate the best possible health benefits for New Mexicans. How can New Mexico ensure dollars spent on telehealth programs are applied effectively and efficiently? New Mexico needs an organization to provide the following telehealth-related services: Clinical Coordination: Identifying healthcare delivery needs, finding organizations to deliver healthcare services, monitoring the delivery, and ensuring improved health outcomes. Technical Coordination: Identifying the proper technical solution for healthcare service delivery including equipment evaluation, telecommunications connectivity, reuse of existing resources, scheduling, network management, support, and maintenance. Health Information Technology: Managing information exchange among healthcare providers and ensuring compliance with federal, state, and other standards. Administrative Services: Reimbursement issues, administrative policy and procedures, legislative issues, and general management of the telehealth process. Every dollar spent on coordination ensures that dollars spent on specific telehealth programs generate the greatest improvement in health across all programs and regions of the State. Be part of the solution! Join the New Mexico Telehealth Alliance JOIN NOW

CONNECT for Health Act Recently Reintroduced Center for Connected Health Policy May 2021 CCHP Breaks Down Key Elements in New Fact Sheet * < Previous News Next News >

Athena Health Telehealth Adoption Report Center for Connected Health Policy May 2021 How providers are taking advantage of virtual care and their perceived benefits Athena Health began conducting research in 2020 on de-identified data from across their healthcare network (which spans the nation) to understand how providers are feeling about the increased adoption of telehealth. With the onset of COVID-19, the use of telehealth has skyrocketed, and beyond understanding the increased utilization numbers, it’s also important to understand provider adoption rates, their attitudes toward telehealth, which specialties and what services telehealth is being used in the most. An interactive infographic tool on their website can be utilized to identify the amount of care across their system that has gone virtual by specialty (primary care, mental health, cardiology, pediatrics, OB/GYN or all specialties). Users can also view by specialty how providers are taking advantage of virtual care and their perceived benefits (for example, virtual appointments are more convenient), and the reasons why providers are turning to telehealth to keep their practices running. For a complete breakdown of their findings, visit Athena Health’s interactive webpage: https://www.athenahealth.com/knowledge-hub/clinical-trends/the-athenahealth-telehealth-insights-dashboard. < 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 >

Nation's 1st telehealth chair on changing culture Georgina Gonzalez February 17, 2022 Sarah Rush, MD, serves as the chief medical information officer of Akron (Ohio) Children's Hospital, and in May 2020, she became what is believed to be the first endowed chair of telehealth in the nation. She spoke to Becker's about the creation of the role and what it has meant for the hospital. The chair position, made possible by a $1 million donation from philanthropist Marci Matthews, was spurred by the telehealth boom brought on by the pandemic. In 2019, Akron Children's had just 275 telehealth appointments, but in 2020 had completed over 55,000 virtual visits. Also, in spite of the general national decline in telehealth usage, Akron completed around 45,000 telehealth visits in 2021. Despite the hospital's previous efforts to integrate telehealth into behavioral and emergency department care, Dr. Rush said it was the pandemic that caused the change. "I think, conceptually, people had not been able to really wrap their brains around what telehealth could do," she said. "I think organically through the process of doing and seeing and both sides of it, the providers learning how to do it, the patient learning how to do it, it just sort of naturally happened. Now I think it's become really ingrained in a way that I don't think it would have had we not been put into that situation of having to do it." Read full article here: https://www.beckershospitalreview.com/telehealth/nation-s-1st-telehealth-chair-on-changing-culture.html?origin=CIOE&utm_source=CIOE&utm_medium=email&utm_content=newsletter&oly_enc_id=1372I2146745E8F < Previous News Next News >

How Amazon, Walmart & 7 Others are Expanding Their Telehealth Business Katie Adams, Becker's Hospital Review July 2021 Companies are remaining active in their efforts to grow their telehealth businesses. It's unclear how widely telehealth services will be used once the pandemic subsides, but companies are remaining active in their efforts to grow their telehealth businesses. Below are updates on how nine companies are expanding their telehealth business, as covered by Becker's Hospital Review during the past three months. UnitedHealth Group subsidiary Optum on April 15 deployed a new telehealth product across all 50 states. The product, dubbed Optum Virtual Care, aims to integrate physical care, virtual care, home care and behavioral care. Amwell on April 28 unveiled its new Converge telehealth platform, which can host and operate digital offerings from Cleveland Clinic, Google Cloud and others. Ro, a direct-to-consumer telehealth app for pharmacy services, inked its first retail collaboration with Walmart April 28. Under the new partnership, Ro will launch its Roman health and wellness products and digital services in more than 4,600 Walmart stores across the country. On May 19, Ro acquired reproductive health company Modern Fertility for more than $225 million. Amazon on May 5 signed its first enterprise client for its telehealth service, Amazon Care. It has since secured multiple companies as clients for the telehealth service, and it is eyeing expansion into rural markets. Walmart Health on May 6 entered an agreement to acquire on-demand, multispecialty telehealth provider MeMD. By acquiring MeMD, Walmart will begin providing virtual care services for urgent, behavioral and primary care to complement its in-person Walmart Health Centers. Telehealth provider Doctor On Demand and clinical navigation platform Grand Rounds completed their merger May 11. On May 26, the combined company signed a definitive agreement to acquire Included Health, a comprehensive healthcare platform for patients who are LGBTQ and BIPOC. Teladoc Health on May 11 launched its new mental healthcare service MyStrength Complete, which offers personalized mental health services to consumers as an integration of Teladoc's virtual platform. On July 14, Teladoc integrated its hospital telehealth platform with Microsoft Teams. The Clinic, a joint digital health venture between Cleveland Clinic and Amwell, on May 18 launched new health offerings as part of its virtual second opinion service. The offering expansion is for patients with brain tumors and prostate cancers, since there are multiple treatment options for these conditions. Membership-based primary care network One Medical on June 7 entered an agreement to acquire Iora Health, a tech-powered primary care provider focusing on serving Medicare patients. The acquisition will allow One Medical to offer 24/7 digital and in-person care, as well as extend the provider into full-risk Medicare reimbursement models. < Previous News Next News >

The value of telehealth and the move to digitally enabled care — 3 insights Becker's Hospital Review In Collaboration with American Medical Association Nov. 1, 2021 During the pandemic, healthcare organizations embraced telehealth to ensure they could provide access and high quality care to their patients. Now, nearly two years later, organizations are contemplating how best to move forward, including how to safeguard and optimize opportunities to move towards digitally enabled care. During the pandemic, healthcare organizations embraced telehealth to ensure they could provide access and high quality care to their patients. Now, nearly two years later, organizations are contemplating how best to move forward, including how to safeguard and optimize opportunities to move towards digitally enabled care. During Becker's 6th Annual Health IT + Revenue Cycle Virtual Conference, the American Medical Association sponsored a roundtable discussion on this topic. The AMA's Lori Prestesater, Vice President of Health Solutions, and Meg Barron, Vice President of Digital Health Innovations, talked with healthcare executives from around the country about their digital health successes and challenges. Three insights: 1. Providers want virtual care to continue as long as their key concerns are addressed. "Physicians are enthusiastic about digital health technologies," Ms. Barron said. "However, that enthusiasm is directly tied to a solution's ability to help them take better care of patients or reduce their administrative burdens." Four key concerns consistently expressed by physicians when evaluating digital solutions are whether a solution works and has an evidence base, how providers will be compensated, what liability and privacy issues exist, and how implementation and change management will occur. 2. One of the major advantages of telehealth is improved access. Access can be widely defined; virtual technology has made significant inroads in improving access in multiple ways: COVID-19 access. The department chair of a hospital in the Northeast noted that telehealth helped them provide quick access and treatment to patients during the pandemic. "It worked extremely well in this emergency situation," he said. "Patients would call in and report symptoms, and we could make decisions about their care. We provided pulse oximeters and followed up via telehealth." Specialty access. A CMO from a Midwestern health network — who is the father of a daughter with a chronic illness — shared his personal experience with specialty care from multiple systems. "I can't imagine how my daughter could receive specialty care without telehealth. Care that was previously siloed can now be accessed nationally, if not internationally." Behavioral health access. A chief population health officer from a health system in the Midwest said telehealth access to mental health services was a big success. "Patients found the pandemic very rough, and many needed some behavioral health services, but they didn't necessarily want to try to see somebody because of the stigma associated with it," she said. "Being able to offer telebehavioral health services to our patients, and frankly, even to our employees, was a great success." 3. Challenges such as patient hesitancy, bandwidth issues and measurement of value remain. Although patients are generally positive about telehealth, some have found it difficult to onboard to telehealth platforms. One provider in the Northeast said younger patients love the ability to text and connect virtually, but elderly patients often prefer in-person visits for the human connection. Also, many healthcare organizations have faced connection issues. A West Coast CMO explained, "We have 24 hospitals, and many of them are in rural areas. We really struggled with bandwidth." Finally, measuring the value of these technologies remains a challenge. Ms. Prestesater pointed out that it can be a "many-year equation to evaluate the value for a chronically ill patient." AMA has a recently released Return on Health value framework that can help an organization quantify the comprehensive value of virtual care. Although some participants warned that virtual care may not be less expensive, it can be hard to quantify savings from things like avoiding emergency care. A Midwest hospital executive said, "Home-based care has led to a substantial reduction in visits to the emergency room and days in the hospital for us. The problem in the whole equation is it's hard to measure something that doesn't happen." < Previous News Next News >

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 >

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 >

Telemedicine and diagnosis Adriana Albini September 27, 2022 The adoption of telemedicine and its range of applications grew exponentially in the early days of the Covid-19 pandemic, and the general consensus now is that it is here to stay, albeit perhaps with a more hybrid bias of in-person and remote visits. Telediagnosis, or TeleDx, i.e., the identification of a disease at a site remote from the patient, has expanded to include primary care, revolutionising the way in which patients and doctors communicate with each other and establish rapport. It is still early days to fully evaluate the effect of virtual vs in-person visit on diagnostic error, but there are guidelines for health professionals to conduct effective virtual examinations, and many best practice examples, both in terms of ways to gather information from the patient (from wording of questionnaires to digital records, home environment, and so on) and technological innovations. In cancer care, pathology plays a central role in the final diagnosis upon which clinicians will develop treatment for their patient, and remote pathology can offer many advantages, such as easier access to pathology experts, consultation among specialists, timely and secure availability of images, and so on. Up until the 1990s, pathologists worked almost entirely within the constraints of the analogue world, with physical glass slides and microscopes. Some attempts were made at capturing virtual images of slides through a tiling method, which was time consuming and prone to error, as it required accurate placing and extensive stitching together of images. But at the end of that decade, engineer Dirk G. Soenksen (founder, and CEO of Aperio) devised a much more efficient system based on a linear scanner, the ScanScope, that allowed for tightly focussed and fast slide image capture, opening a new era for the practice of pathology. Whole slide imaging, or WSI, was first employed in education and research but in recent years, with the improvement of its technology, it has received regulatory approval by the FDA and around the world for diagnostic use as well. The potential for feeding AI algorithms to provide diagnostical support is massive, as virtual slides are accumulating fast and standardised databases are being built. “Telemedicine in Cancer Care Continuum: implementation and integration”, was an online conference developed by the SPCC in collaboration with the American Society of Clinical Oncology (ASCO), which took place on 6-7 May 2022. In his presentation, Liron Pantanowitz, Professor of Pathology, and Director of Anatomical Pathology at the University of Michigan, talked about telepathology in both its non-acute and acute settings, focussing more extensively on the latter. The term ‘telepathology’ was coined by Ronald S. Weinstein in 1986, after he organised the first public event of satellite-enabled dynamic-robotic distant pathology, but the very first live telepathology ever performed dates as far back as to 1968. Massachusetts General Hospital set up a two-way television link with Boston’s Logan Airport that enabled doctors at the hospital to remotely study blood smears, urine samples and X-rays for patients at the airport, and even listen to their heartbeat with an electronic stethoscope. However, as in the case of telehealth in general, the adoption of digital pathology had to wait until the Covid-19 pandemic to be widely implemented. To facilitate continuity of healthcare while social distancing, certain restrictions were lifted, such as CLIA in the US, allowing pathologists to work from home and sign out cases. The first use of telepathology Prof. Pantanowitz looked at was for frozen section consultation. There are several challenges when a pathologist is asked to provide an intraoperative consultation. The pathology specimen is fresh, not easy to cut. The frozen section itself is difficult to prepare and is often filled with artifacts. These artifacts not only make it hard to read the glass slides but can compound the problem when using digital images. The turnaround time needs to be rapid. Usually, pathologists strive for less than 20 minutes to provide the surgeon with an answer. And they are under serious diagnostic pressure because if they get it wrong, it is difficult to reverse the surgical decision that has been made based on their diagnosis. Over the past 54 years different modes of practising telepathology have been developed. A pathologist on site can take static images, which is easy but too time-consuming. There is also video microscopy, live streaming from one pathologist to another. If there is no pathologist present on site to read the slides, there are systems such as robotic microscopy, where the pathologist can remotely take control of the functions on a microscope, such as navigation and focus. And there is also Whole Slide Imaging, which is the entire digitization of a slide to be remotely reviewed. Thanks to advancements in technology, hybrid devices are now available from many vendors with robotics and Whole Slide Imaging functions in one scanner. See full article: https://cancerworld.net/telemedicine-and-diagnosis/ < Previous News Next News >

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HHS to maintain COVID-19 public health emergency past January Jakob Emerson November 11, 2022 The U.S. will extend the COVID-19 public health emergency past January 11, 2023, CNBC reported Nov. 11. A 12th extension of the PHE since the first in January 2020 is also likely because of a lack of public statement from HHS warning about a termination. The agency last renewed the PHE Oct. 13 for an additional 90 days to Jan. 11, 2023 — it also told states it would provide a notice 60 days before if it did decide to end it, or Nov. 11. The PHE allows the country to continue operating under pandemic-era policies, which led to a complete overhaul of telehealth and who can use it, fast-tracked approvals of COVID-19 vaccines and treatments, and preserved healthcare coverage for millions of Medicaid beneficiaries nationwide. Eleven states also still have coinciding public health emergency orders in place. As of now, Medicare telehealth flexibilities will end 151 days after the PHE expires. In July, the House passed The Advancing Telehealth Beyond COVID-19 Act, but the legislation must still be approved by the Senate for Medicare patients to continue using telehealth through 2024. "It's not that we necessarily want to continue the PHE for a long period of time," Nancy Foster, AHA's vice president of quality and patient safety, told Becker's in October. "What has not yet happened is fully thinking through how to unwind some of the [telehealth] flexibilities we currently have, and how to perhaps make permanent some of the others." In addition, the end of the PHE will trigger a Medicaid redetermination process that will cause a major disenrollment of beneficiaries. Over the course of about a year, HHS estimates up to 15 million people could lose health coverage. Payers are prepping for the redetermination period, as they expect to lose Medicaid members and hope to switch some to ACA coverage. With the Inflation Reduction Act's extension of ACA premium tax credits through the end of 2025, the nation's largest insurers have all recently announced plans to majorly expand exchange offerings in 2023, including UnitedHealthcare, Elevance, Aetna, Cigna and Centene. The extension of the federal emergency past January may have been unexpected for insurers, as UnitedHealth Group executives told investors Oct. 14 they thought the PHE would end in January. "Our tailwinds will be weighed against one known headwind, and that is the membership attrition and related impacts on our Medicaid business as eligibility redeterminations are conducted over the course of the next year," Elevance Health's CFO John Gallina told investors Oct. 19. The extension also comes amid uncertainty around public health as winter looms. New Omicron strains — dubbed "escape variants" for their immune evasiveness — have become the dominant strains in the U.S., accounting for 40 percent of all cases in the week ending Nov. 12. Daily cases in the country are expected to grow 39 percent from Nov. 3-17. Hospital admissions trends are expected to remain stable or be more uncertain, with 1,300 to 7,300 new admissions likely reported on Nov. 25, according to the CDC. As of Nov. 4, the nation's seven-day average of new hospital admissions was 3,273. See original article: https://www.beckerspayer.com/policy-updates/hhs-to-extend-covid-19-public-health-emergency-through-april.html < Previous News Next News >

Elo and 19Labs Partner To Offer Next Generation Telehealth Kiosks PR Newswire and 19 Labs July 2021 The partnership allows pharmacies, schools, and rural communities to go beyond just video calls and deploy eClinics with smart diagnostic devices and remote monitoring. The hospital-at-home trend is rapidly changing the healthcare industry. COVID-19 has accelerated telehealth technology's rate of innovation, and the industry has advanced by more than five years in just five months. Healthcare companies are now moving quickly to provide care in new locations and serve new use cases, bringing healthcare access not just to the home but also to other places like rural communities, schools, and pharmacies. 19Labs and Elo are working together to bring eClinics to these new locations globally. 19Labs' GALE eClinics are next generation point-of-care platforms that seamlessly integrate leading mobile and healthcare technologies into cost-effective and smart solutions such as telehealth carts, healthcare kiosks, or portable telehealth kits. They are highly secure, easily deployable, and can be operated by anyone with minimal training. "19Labs' eClinics enable our customers to easily deploy enhanced telehealth using the world's most advanced diagnostic devices: from ultrasound, ECGs, and even blood pressure," said Dan Ludwick, Chief Product Officer, Elo. "The eClinics do more than just video calls. They bring together Zoom, Amwell, custom wellness applications, and remote patient monitoring into a solution that can be easily used by anyone, which can drastically reduce operating and deployment costs." "Elo has been a great partner," says Ram Fish, 19Labs CEO & Founder. "They are a dynamic, innovative company with global reach, and we are happy to work with them in making healthcare more accessible worldwide. Their Android-based touchscreen systems are beautiful, well-engineered, and provide a unique, affordable solution to deploying kiosks in different form factors within the healthcare industry. Elo's tablets are built-to-last and highly reliable. Their commercial-grade hardware is complemented by great Android implementation. These make Elo's solutions perfect for enhanced telehealth." In Oaxaca, Mexico, the state's health ministry has been rapidly deploying 19Labs' eClinics. Dr. Lorena Ocampo, Chief Coordinator of Telemedicine at Oaxaca's Ministry of Health, says the next generation healthcare kiosks will significantly increase healthcare accessibility and quality in the region. "It's been a pleasure working with 19Labs and Elo. The impact these units have on the healthcare conditions within the community, and the ability to easily access advanced medical care, radically improves the quality of service that we are able to provide." About Elo As a leading global supplier of interactive solutions, #EloIsEverywhere. To date, we have deployed more than 25 million installations in over 80 countries. A new Elo touchscreen is installed every 21 seconds, on average, somewhere in the world. Built on a unified architecture, Elo's broad portfolio allows our customers to easily Choose, Configure and Connect & Control to create a unique experience. Choose from all-in-one systems, open-frame monitors and touchscreen monitors ranging from 10 to 70 inches. Configure with our unique Elo Edge Connect peripherals that allow use-specific solutions. Connect & Control with EloView®, a secure cloud-based platform for Android-powered devices. EloView enables secure deployment and management of a large network of interactive systems designed to reduce operating costs while increasing up-time and security. Consumers can find Elo touchscreen solutions in self-service kiosks, point-of-sale terminals, interactive signage, gaming machines, hospitality systems, point-of-care displays and transportation applications—to name a few. Learn more at EloTouch.com. About 19Labs 19Labs is the creator of GALE, Next Generation Point-of-Care platform for pharmacies, schools, and rural communities. GALE brings together "best of breed" diagnostic technologies from industry leaders like Zoom, Elo, Amwell, Eko, Samsung Mobile, MIR, Omron, Viasat, and many others in one smart, efficient, and cost-effective platform. It was designed from the ground up to be operated by non-healthcare professionals, in locations with limited infrastructure and optimized for low bandwidth and intermittent connectivity. To learn more about GALE, please visit www.19labs.com/platform. < Previous News Next News >

Top of Page Video Access Highlighted Webinars Clincal Innovation Business Funding NMTHA Town Hall Experts in TH Webinars, Interviews, & Videos Video Access Featured Webinar & Video Series Highlighted Videos NMTHA provi des videos by topic: Clinical Innovation Business Funding Town Hall Meeting Expert Interviews Webinars 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. View Webinar 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. View Series Featured 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 various levels of physical exam documentation over telemedicine and demonstrates how to perform the best possible physical exam during a telehealth visit. CLINICAL 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 COVID: 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: F indings 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, na tional telemedicine pioneer, and Russell Toal, New Mexico Superintendent of Ins urance 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. INTERVIEWS: TELEH EA LTH EXPERTS Elizabeth Krupinksi , PhD, Southwest Telehealth Resource Center Jen Gruger , PMI-PBA, EHR Sup port Dept., Gerald Champion Regional Medical Center Geof Empey , Progra m Operations Director, University of New Mexico Center for Telehealth Kelly Schlegel , Director of the New Mexico Office of Broadband Access and Expansion Clincal Innovation Business Funding NMTHA Town Hall Highlighted Videos Experts in TH Highlighted NMTHA Webinar Series 10-week Educational Series From our 2021 10-week educational series, 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. View Webinar Fall 2021 Webinar Series Topics include the future of telehealth, billing, using telehealth for clinical specialties, and more. View Webinar Webinars

KFF Report on Telehealth - Medicare Use Offers Future Policy Implications Center for Connected Health Policy June 2021 Given the limitations around Medicare telehealth coverage pre-pandemic, many of these individuals had little experience with telehealth previously, offering an important perspective to inform ongoing telehealth policy considerations. More work will need to be done to further education around telehealth and ensure its availability to all communities. A Kaiser Family Foundation brief presents new information and analysis of Medicare beneficiaries’ utilization of telehealth using Centers for Medicare & Medicaid Services (CMS) survey data from between summer and fall of 2020 while CMS emergency telehealth expansions were in effect. Given the limitations around Medicare telehealth coverage pre-pandemic, many of these individuals had little experience with telehealth previously, offering an important perspective to inform ongoing telehealth policy considerations. For instance, while 64% of beneficiaries said their provider currently offers telehealth appointments, only 18% said their provider offered telehealth prior to the pandemic. However, nearly a quarter of beneficiaries said they don’t know if their provider offers telehealth appointments, with the percentage even larger among rural beneficiaries. Therefore, while expanded policies appear to have increased access to services via telehealth, more work will need to be done to further education around telehealth and ensure its availability to all communities. Additional findings from the study include: -Over 1 in 4 (27% or 15 million) of Medicare beneficiaries had a telehealth visit between the summer and fall of 2020 -The majority of Medicare beneficiaries (56%) used telephone only *Video was 28% *Both video and telephone was 16% -The share of Medicare beneficiaries who had a telehealth visit using telephone only was higher among: *Those age 75 and older (65%) *Hispanic beneficiaries (61%) *Those living in rural areas (65%) *Those enrolled in both Medicare and Medicaid (67%) The report also found that rural Medicare beneficiaries were less likely than urban beneficiaries to have a telehealth visit with a doctor or other health professional (21% vs. 28%, respectively). However, among Medicare beneficiaries with a usual source of care and whose usual provider offers telehealth, they found no significant difference between the share of rural and urban Medicare beneficiaries who had a telehealth visit (43% and 45%, respectively). They note this difference is likely driven by the fact that rural Medicare beneficiaries were more likely than urban Medicare beneficiaries to say they do not know if their usual provider offers telehealth (30% vs. 21%, respectively). Similarly, among Medicare beneficiaries with a usual source of care whose usual provider offers telehealth, they found that a larger share of Black and Hispanic beneficiaries had a telehealth visit compared to White beneficiaries (52%, 52%, and 43%). However, among the total Medicare population, the difference in the share of Black and White beneficiaries who reported having a telehealth visit was not statistically significant (30% vs. 26%), while a larger share of Hispanic beneficiaries than White beneficiaries had a telehealth visit (33% vs. 26%). They note that for Black Medicare beneficiaries, this result is likely related to the fact that nearly a quarter of Black beneficiaries overall (23%) say their usual provider does not offer telehealth appointments, compared to 12% of White beneficiaries and 15% of Hispanic beneficiaries. Looking forward, the authors suggest that since they found greater usage of telehealth amongst those with disabilities, low incomes, and in communities of color, the temporary expansions of coverage may be helping more disadvantaged populations access care. In addition, since most services are being provided via audio-only, they state going back to requiring two-way video could be a barrier for many subgroups of the Medicare population. As policymakers continue to request data on telehealth and consider making certain emergency policies permanent, many are looking to Medicare to lead the way, and this information further confirms the importance of maintaining access to all telehealth modalities in all communities, or risk potentially exacerbating existing disparities even further post-pandemic. Additional expansion and education of telehealth availability will continue to remain necessary as well. More information on the survey and analysis can be found in the full issue brief - https://www.kff.org/medicare/issue-brief/medicare-and-telehealth-coverage-and-use-during-the-covid-19-pandemic-and-options-for-the-future/. < Previous News Next News >

Biden’s American Jobs Plan Increases Investments in Broadband Infrastructure Center for Connected Health Policy April 13, 2021 President Biden’s recently released American Jobs Plan includes $100 billion to increase access to affordable, reliable, and high-speed broadband throughout the country. President Biden’s recently released American Jobs Plan includes $100 billion to increase access to affordable, reliable, and high-speed broadband throughout the country. Comparing digital infrastructure today to affordable access to electricity in the 1930s, the Fact Sheet on the Plan released by the White House states how the pandemic has highlighted existing disparities related to the digital divide and the lack of broadband access to more than 30 million Americans. The $100 billion investment will prioritize broadband infrastructure in unserved and underserved areas to reach 100% high-speed broadband coverage. It also sets aside funds for tribal lands and promotes broadband providers less focused on profits, such as those affiliated with municipalities, and seeks to improve price transparency and competition among internet service providers. The plan will include internet subsidies to low-income consumers, but states that in the long-term, the President is committed to working with Congress to reduce internet prices negating the need for such short-term solutions. The full Fact Sheet on The American Jobs Plan can be accessed on the White House website, https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/31/fact-sheet-the-american-jobs-plan/. < Previous News Next News >

Consumer Survey Data Supports Use of Virtual Visits Center for Connected Health Policy July 2021 The top reasons patients said they liked having their appointments virtually was because of the ease in attending, reduced chance of getting COVID-19, and that it made scheduling and sharing medical information easier. The Deloitte Center for Technology, Media & Telecommunications released the second edition of their Connectivity and & Mobile Trends 2021 survey, which gathered information from consumers about their relevant experiences during the pandemic. Using an online methodology of over two thousand consumers surveyed in March 2021, the report looks broadly at how the pandemic has influenced innovation and the “digital home,” including the increase in virtual doctor visits and patient telehealth preferences. In regard to telehealth, they found that over half of Americans had a virtual visit, 80% of those patients were satisfied with their experiences, and 62% were likely to schedule future telehealth visits post-pandemic. Almost 30% of consumers reported assisting someone else in their household with a telehealth visit. The top reasons patients said they liked having their appointments virtually was because of the ease in attending, reduced chance of getting COVID-19, and that it made scheduling and sharing medical information easier. While 30% of consumers reported no challenges, others did report they found the lack of human connection challenging, as well as the inability to have their vitals collected which was indicated more frequently among older patients. The report also looked at individual use of “wearables” to advance health and wellness, presuming their ability to support health care providers will continue to grow along with telehealth – although the authors also stated both will likely require the evolution of the regulatory landscape. Interestingly enough, use of wearables was actually found to be mixed during the pandemic and 39% said cost is the primary reason they haven’t bought one. Also, of note for those that had used wearables was that 60% claimed not to be concerned about privacy of their wearable-generated data, which is often raised as one of the main regulatory concerns related to increased innovation in health care. To review additional details about the information gathered, please view the findings in their entirety - https://www2.deloitte.com/content/dam/insights/articles/6978_TMT-Connectivity-and-mobile-trends/DI_TMT-Connectivity-and-mobile-trends.pdf#page=8. < Previous News Next News >