Telemedicine & Telehealth: For Allied Health Professionals, Too Faith Lane April 20, 2022 With more and more people using telehealth applications since the pandemic, one education expert asked how to expand training to include Physical Therapists and Occupational Therapists According to a recent study, one in five adults polled about health care during the coronavirus pandemic said that they or someone in their household delayed receiving medical care or were unable to get care, due to office closures or shutdowns. Although the pollsters focused questions about doctor or dental appointments, providers across the board experienced disruption in their specialty areas, including Peggy Stein, OTD, OTR/L, CHT, an Occupational Therapist in Oregon. Occupational therapy, or OT, focuses on how people perform activities that are most important to their daily lives, so for people who need it, missing out affects quality of life, according to Stein. “OT is important to assess the ability of people to participate in usual activities. Work is important and many people equate occupation with work. However, life involves more than work. Participating in life includes taking care of ourselves, our family and friends, pets, home, yard, or attending to community. These are all ‘occupations’,” Stein said. “The state did halt therapy for a few weeks, and many providers had upheaval for several months,” she said. And while Stein eventually returned to her practice, the buzz surrounding providing telehealth continued in the medical and therapeutic communities. “Back in March 2020, we hosted a webinar. We had numerous occupational therapists, physical therapists (PTs) and speech language pathologists (SLPs) in attendance; more than we have previously seen attending our telemedicine training programs,” said Melanie Esher-Blair, MAdm, Distance Education & Event Coordinator for the Southwest Telehealth Resource Center (SWTRC) and the Arizona Telemedicine Program (ATP). “They wanted more information on how to put the ‘tele’ into their scope of practice to maintain continuity of care for their clients,” said Esher-Blair. She said she knew the SWTRC and the ATP had the experts for developing a program. Both OT and PT national associations have information regarding how telehealth fits into the scope of practice, so attendees of the March webinar agreed creating a training around telehealth was important. An interdisciplinary team worked together to come up with the Occupational and Physical Therapy Webinar Series. For full post and access to video: https://southwesttrc.org/blog/2022/telemedicine-telehealth-allied-health-professionals-too < Previous News Next News >

TELEHEALTH: THE JOURNEY FROM VIDEO VISITS TO STRATEGIC BUSINESS TOOL By Mandy Roth at HealthLeaders April 6, 2021 New approaches to telehealth can help organizations meet their key objectives. KEY TAKEAWAYS: *Asynchronous communication increases provider efficiency and provides a way to address physician shortages. *Virtual hospitals reduce healthcare costs and support the transition to value-based care. *A cloud-based platform enables 24/7 personalized care, moving care upstream to improve outcomes and reduce the cost of care. 2020 was a remarkable year for healthcare innovation, and telehealth finally achieved scale across the industry. Driven by a need to deliver healthcare at a distance, hospitals and health systems stood up new services seemingly overnight, fanned the flames under languishing programs, or found new uses for thriving virtual care initiatives. Now that telehealth has become a fixture in the healthcare delivery firmament, it's time to examine what comes next. While current use predominantly focuses on televisits between providers and patients, and mysteries remain about reimbursement and licensure issues after COVID-19, forward-thinking healthcare executives are using the technology to enable new models of care. Health systems are employing telehealth to transform healthcare delivery in ways that address strategic business objectives: improve outcomes, reduce provider burden, enhance patient experience, improve access, and ameliorate workforce labor issues. HealthLeaders spoke to visionary leaders and digital healthcare experts who shared their insights and perspectives about what organizations should focus on now, next, and in the future to unlock the potential of telehealth. Coverage includes case studies about asynchronous care, remote monitoring, and a futuristic cloud-based platform fueled by artificial intelligence. Health systems shared details about how these initiatives work and how they evaluated the return on investment. These new approaches to telehealth can help organizations meet their strategic objectives and provide information to inspire other organizations on their own telehealth journeys. WHAT'S NOW: PRESBYTERIAN HEALTHCARE SERVICES ENHANCES EFFICIENCY WITH ASYNCHRONOUS COMMUNICATION Strategic Objectives: *Increase provider efficiency and address physician shortages *Reduce costs per patient encounter *Reduce ER and urgent care utilization At the beginning of 2020, physicians and consumers had not yet fully embraced the concept of virtual video visits; many were skeptical about the ability to deliver care effectively in this manner. Yet after the pandemic forced the adoption of virtual visits, their reputation and usage forever changed. Today, asynchronous communication faces the same hurdles. Providers and patients don't understand how it works and question its value. "It's a technology whose time has not yet come," says Oliver Lignell, vice president of virtual health at health system consultancy AVIA, which helps members accelerate their digital transformation initiatives. "It's not yet mainstream, but it should be." Presbyterian Healthcare Services, an Albuquerque, New Mexico–based nonprofit integrated healthcare delivery system, began investigating this approach to healthcare four years ago. "It's been incredibly effective," says Ries Robinson, MD, senior vice president and chief innovation officer. Between the system's nine hospitals and a health plan it offers, the organization serves a third of the state's residents. With a shortage of practitioners in New Mexico, and 70% of the care it provides covered by capitated contracts, Presbyterian needed to find a way to operate more efficiently. Asynchronous communication worked. Last year, a designated group of employed urgent care physicians handled 50,000 asynchronous visits for low-acuity care, and spent an average of two minutes on each encounter—far less than the 15–18 minutes it takes to conduct a typical video call. This form of care does not occur in real time. Depending on the platform used, a patient completes and submits an online form via secure email, text, or an app, detailing his or her complaint and relevant history. A physician receives the information, processes it, and sends a response back to the patient with instructions and prescriptions, if necessary. Presbyterian physicians usually respond within 15 minutes; some health systems using asynchronous communication allow up to 24 hours. There is no direct audio or video exchange with the patient unless the physician thinks it is warranted and escalates the encounter. Asynchronous communication offers some distinct advantages to health systems, say the experts. Synchronous care, which includes video, audio, and in-person visits, comes with an Achilles' heel: Regardless of venue, the physician spends about the same amount of one-to-one time with the patient, says digital medicine expert Ashish Atreja, MD, MPH, chief information and digital health officer at UC Davis Health in Sacramento, California. "The real growth you're going to see in value," he says, "is the ability to deliver one-to-many care." Asynchronous communication is a step in that direction. "One of the most important things asynchronous communication does is help scale response," says Ann Mond Johnson, MBA, MHA, CEO of the American Telemedicine Association. In addition, because patients can use it with a phone or the internet, it can address issues of access, she says. Robinson says the SmartExam™ platform Presbyterian is using, made by Bright.md, includes features that appeal to its physicians. It automatically enters chart-ready SOAP (Subjective, Objective, Assessment, and Plan) notes into the electronic medical record (EMR), creates billing files, and manages patient follow-up communications. "It's extremely elegant," says Robinson. SmartExam's design, which asks patients questions in an interview-style exchange, and advanced logic has earned the trust of the physicians who use it, he says. "I remember the first time [physicians] said, 'I trust it'; I thought that was kind of a funny term to use," Robinson recalls. When he asked the doctors what they meant, they explained that the tool is thorough and consistent in a way humans cannot replicate. "That's what the providers really like." Even the best medical assistant, he says, may vary in how they ask questions of patients, forget to include certain details, or package assessments differently. While Robinson says the health system has detailed financial models that justify the cost of the platform, he declines to disclose the figures, but notes, "It hasn't been an astronomical investment by any stretch of the imagination." Expenses include a one-time cost for EMR integration, ongoing charges for using the platform on a per-patient per-use basis, and marketing and promotion. He also provides formulas to calculate estimated cost savings. They include: *Better utilization of providers' time and related staffing expenses, by reducing each of 50,000 encounters from 15–18 minutes for a video encounter to two minutes for an asynchronous visit. *More appropriate ER usage. Out of 50,000 patients, 8% were redirected away from the ER. This figure is based on patient survey responses indicating they would have visited the ER had the platform not been available. With an average ER visit costing more than $500, says Robinson, "there's a significant savings." *Reduced workload at urgent care facilities. "Just assume 20,000 [of these patients] would have gone to an urgent care that we own," he says. The time and expense of urgent care staffing is used to calculate the savings. Patients also save money, says AVIA's Lignell. Nationally, he says the typical cost for an asynchronous visit is about $20, and many health systems offer these visits for free. This compares to a national average cost of $50 for a video visit and $125 for an in-person visit. There is one additional element that has contributed to the success of asynchronous visits for Presbyterian: a digital front door. Patients visit the pres.today webpage, enter their condition and insurance information, and are automatically directed to the appropriate level of care, one of which includes the option for online visits (using asynchronous care). Because of the asynchronous initiative's success, the health system is expanding its use beyond low-acuity care. Future plans involve developing new uses for the platform, capturing symptoms and history to create greater efficiencies for video visits and even in-person care. "We have gotten religion around the idea of capturing as much information as you can in a sophisticated manner before the visit," says Robinson. "You maximize the quality of care and the efficiency of the visit. We're taking that idea and pushing it forward in multiple avenues of care here at Presbyterian." Value-based care will drive further adoption of these models, says Lignell. "The advantages from a total cost of care standpoint are huge," he says. "It's much less expensive to deliver care this way." While the bulk of growth has been in low-acuity primary care, he says asynchronous care is now being explored in specialty and higher-acuity care, as well as in e-consults between providers. "The asynchronous model is proving to be incredibly efficient for health systems," says Lignell. "That's one of the reasons why it has so much promise." WHAT'S NEXT: ATRIUM HEALTH LAUNCHES A VIRTUAL HOSPITAL Strategic Objectives: *Increase bed capacity, limit staff and patient exposure to COVID-19, and conserve PPE *Reduce costs and support the transition to value-based care *Improve patient satisfaction and experience "Remote patient management is widening the aperture from the episodic-based healthcare reality that we've known for decades towards a 24/7, always-on ubiquitous reality," says Rasu Shrestha, MD, MBA, executive vice president and chief strategy and transformation officer at Atrium Health. Long before COVID-19 hit American shores, health systems began launching remote monitoring programs, particularly to manage chronic diseases. Hospital at home initiatives, or virtual hospitals, are a robust manifestation of this endeavor. While these models have demonstrated cost savings, adoption has been slow due to reimbursement issues. The pandemic offered a trifecta of motivating factors to accelerate adoption of the virtual hospital model: bed capacity issues, a need to limit staff and patient exposure, and dwindling supplies of personal protective equipment (PPE). With these issues in mind, during March 2020 a handful of clinicians approached Atrium Health administrators, suggesting that the 42-hospital Charlotte, North Carolina–based nonprofit health system consider launching a hospital at home initiative. Two weeks later it was operational, says Scott Rissmiller, MD, executive vice president and chief physician executive. In the first 10 months, the virtual hospital admitted 51,000 patients. "We are able to keep patients in their homes, protect our teammates from infection, and also protect patients," Rissmiller says. "It freed up a good bit of capacity in our acute facility," enabling the health system to reserve that space for its more acute COVID-19 patients. The virtual hospital maintains two "floors." The first floor functions as an observation unit; the second floor is reserved for patients requiring more intensive care, says Rissmiller. Any COVID-19-positive patient is admitted to the first floor of the virtual hospital and receives digital tools to monitor temperature, blood pressure, pulse, and oxygen levels. These devices deliver data via Bluetooth® to a smartphone app developed by the health system's IT department. That data feeds into the patient's EMR, fully integrating into the patient's continuum of care, Rissmiller explains. In a bunker back at Atrium Health's call center, a team of clinicians monitors data and checks in with first-floor patients daily. Second-floor virtual patients have the same home monitoring tools, but receive "much more intensive management" and frequent check-ins, he says. In addition, community-based paramedics visit homes to administer IV fluids, IV antibiotics, breathing treatments, EKGs, and other interventions. This arrangement created additional opportunities to reduce hospital bed capacity. "We were one of the first in the nation to get in-home remdesivir, one of the COVID treatments," says Rissmiller. "To receive remdesivir, you have to be on oxygen therapy, so these patients are sick." In a 10-month period, Atrium Health administered about 150 therapeutic rounds of the drug, he says, which saved about 500 hospital days that would have been required if those patients had been hospitalized. "From a quality standpoint, we do not view this any differently than if these patients were within the walls of our hospital," says Rissmiller. All measures, including length of stay as well as readmission, transfer, and mortality rates, have been almost identical to inpatient stats, and patient satisfaction has been "extremely high," he says. "Patients really would rather be in their home surrounded by their loved ones and support system." The hospital at home initiative has been a "costly endeavor," says Rissmiller. "When we realized this pandemic was going to be significant, our CEO [and President Eugene Woods, MBA, MHA, FACHE] called me and said, 'Scott, whatever you need to care for our patients and communities—do it. We'll figure out the costs later.' It freed us up to be able to do things like this." As it turned out, costs have been offset by funds from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which enable Atrium Health to bill for many of the services provided. The organization also is one of a handful of healthcare systems that are doing a pilot with the Centers for Medicare & Medicaid Services, which views virtual beds as real hospital beds. "The reimbursement is similar because of the level of service we're providing," says Rissmiller. Initially, though, "it was all upfront costs for us, but the return was in bed days." A focus on reimbursement continues "as we are now maturing the program," he says. "Our concern is that the reimbursement will go away once those [pandemic] emergency orders expire. We're working with the state, our payers, Medicare, and others to make sure that this continues to be reimbursed at a level that allows us to continue to grow it and cover our costs." "Out of necessity, COVID ultimately accelerated health systems' desire to think through their digital strategies and determine how digital fits into their overall care and business models," says Brian Kalis, MBA, managing director of digital health and innovation in consulting firm Accenture's health practice. "New models are starting to pop up, and care is shifting to the home." Strategic goals include producing outcomes that equal or exceed inpatient care, while also improving labor productivity, Kalis says. "A majority of health systems coming out of COVID are putting care at home as a key strategic focus. That requires a collection of new models to deliver care, putting different care team compositions in place, and [utilizing] technology to help a broad range of conditions for pre-acute, acute, and post-acute care." Atrium's virtual hospital has already expanded beyond COVID-19 patients. Once the surge diminished in July, Rissmiller "challenged the team to look at [the initiative] through the lens of a non-COVID world. Can this become a new way of caring for patients that makes sense to the patient and to us as a healthcare system?" There is now a list of 10 diagnoses to be considered for hospital at home care, and congestive heart failure patients have already been admitted into the virtual facility. "We're starting to branch out," he says. "We're also starting to focus on different communities to make sure that we're doing this in a way that helps with our underserved populations and gives them the resources they need to manage care at home rather than coming through the emergency department." While Atrium Health rolled out its program in two weeks, Rissmiller says, "this is something that would be incredibly hard to start up on your own if you hadn't had the 10 years of virtual experience that we've had building these capabilities, but also the confidence to be able to deliver these kinds of services at home. It takes a while for clinicians to understand that care can be delivered safely virtually. We also have a culture at Atrium Health that really enables our clinical leaders to lead and their voices to be heard. That, more than anything, is the secret sauce that's allowed for innovations like hospital at home." WHAT'S IN THE FUTURE: HIGHMARK HEALTH DEVELOPS PLATFORM TO DRIVE 24/7 CARE Strategic Objectives: *Move care upstream to improve outcomes *Reduce cost of care, patient traffic, and volume *Enable 24/7 personalized care Unleashing the potential of virtual care requires strategic innovation fueled by imagination. Highmark Health is one organization traveling along this path. To understand the power of an initiative now underway at the Pittsburgh-based payer-provider system, one must imagine the potential to do something that is currently not possible. For example, take the hypothetical case of an individual living independently at home with six medical conditions. What if real-time data alerts her care team that her health status has subtly changed? What if this alert takes the complexity of her medical history into account and offers decision-support tools to accelerate clinical action before her health deteriorates? The Living Health Model, fueled by the Living Health Dynamic Platform—a Google Cloud–based technology infused with artificial intelligence and advanced analytics—could be the missing link that will enable care to move upstream. The concept revolutionizes the current perception of telehealth and enables 24/7 care. It aims to connect the provider, patient, and payer in novel ways to improve health outcomes, reduce clinician administrative burdens, enhance patient engagement, and reduce costs, says Karen Hanlon, executive vice president and chief operating officer at Highmark Health. "We believe that we have the capabilities and resources to pull it together," says Tony Farah, MD, FACC, FSCAI, Highmark Health's executive vice president and chief medical and clinical transformation officer, who is also a practicing cardiologist. The platform will amplify the impact of remote monitoring tools, which many health systems already use for chronic disease management. By adding sophisticated data analytics, machine learning, decision support, and patient education tools, the system will support comprehensive care rather than managing diseases in silos, Farah says. "Our partnership with Google Cloud is going to not only accelerate our strategy, but also help us scale it." Data will be constantly mined to determine the "next best action" required to proactively care for a patient and formulate a personalized care plan that delivers a "curated" experience based on the patient's personal needs, says Hanlon. For patients with no apparent health conditions, the system may focus on wellness. While full realization of this concept may be years down the road, Hanlon says the first iteration of the platform will be functional at the end of 2021. Accenture cloud expert Geoff Schmidt, managing director, global lead—life sciences technology, says Highmark Health's plans align with what he's seeing in the life sciences sector. Health leaders should not think of the cloud as a capability or an IT initiative, he says; "think of it as a business transformation enabler." Cloud technology is accelerating companies' three- to five-year strategic plans, compressing those timelines down to 12 to 18 months. "We're seeing dramatic transformations and acceleration of CEO agendas because of the capability that the cloud can provide." Partnering with an outside player is a smart move for health systems that want to expedite their transformation initiatives, says Schmidt. "Major technology partners are innovating at a scale that is, just frankly, hard for payers or providers to keep up with." Prior to its partnership with Google Cloud, Highmark Health piloted "analog" proofs of concept, according to Farah. These pilots involved addressing healthcare for several patient populations, including high-risk patients with multiple comorbidities as well as individual chronic conditions like COPD, heart failure, diabetes, and hypertension. Physicians were asked to improve health outcomes in 12 months. "The patient experience went through the roof, and in almost every case—with the exception of diabetes—the total cost of care came down," says Farah. "I would say physician engagement was our secret sauce." "Consumer engagement is also a key component," says Hanlon. "There are a lot of solutions out there. They're very siloed and they're not integrated. We can have the best solutions in the world, but if the consumer and the clinician are not using them, they will have no impact." While Highmark Health does not disclose the company's investment in this platform, "you can guess that it is a fair amount," says Hanlon. In addition to activating the initiative at Allegheny Health Network, a nonprofit health system that Highmark owns and operates, "at the same time we're a health plan serving 5.6 million members," she says. "The ability to interact with all of those members is incredibly important to us. When you look across our book of business, we're probably managing somewhere in the neighborhood of $26 billion in healthcare costs a year. When we look at the investments that are needed to support that base of membership and that level of healthcare spend, we feel it's appropriate and we can justify the investment." Being both a payer and a provider imbues Highmark Health with the motivation and influence to transform healthcare delivery in this way, Hanlon says. The company is a Blue Cross Blue Shield–affiliated payer operating in three states, and also functions as a provider through the Allegheny Health Network. "By having both of those assets in the portfolio," says Hanlon, "it's easier for us to align on the path forward and the economic model." But to characterize this venture merely as a mechanism to save money misses the point, she says. The model is designed to improve patient outcomes by moving care upstream, explains Farah. "Conditions that exist today will be prevented from deteriorating, and conditions that haven't developed will be prevented—or, at a minimum, be delayed in development. That's the primary goal, and it results in a reduction in total cost of care. It flips the equation from focusing on finances to focusing on health." In addition, for the Living Health Model to be effective, it must work with entities outside of the facilities owned by the Highmark Health system, which provides health plans in Pennsylvania, Delaware, and West Virginia. Allegheny Health Network operates facilities in 29 Pennsylvania counties and portions of New York, Ohio, and West Virginia. "We're looking to have impact across all of the markets that we serve as our insurance company, not just where we own a provider asset," says Hanlon. "The progression of value-based care has been a slow march. I think this platform will be a tool to enable providers to continue down that path. Part of our focus is developing other tools we believe will be necessary for the providers to succeed in a value-based environment. We recognize that we're going to have to be a leader in helping others to move down that path." A FRAMEWORK FOR MOVING FORWARD Planning for the future of telehealth requires rethinking the present. "If the only way that you look at telehealth is as a way to replace one-to-one physical visits with a telehealth visit, you're not changing the world; you're just creating a little bit more convenience," says Roy Schoenberg, MD, MPH, president and CEO of Amwell, a Boston-based technology company that provides telehealth technology to health systems. "If you look at telehealth as a product, you're going to end up behind the competitive landscape curve. If you look at telehealth as an operating system, [it becomes a] mechanism for the digital distribution of care." Transforming the way healthcare is delivered requires changing, from the ground up, the way health systems think about their relationships with patients, Schoenberg says. Telehealth can alter dynamics related to patient traffic and volume, patient flow, transitions of care, and assumption of risk. "When you equip yourself with telehealth capabilities," Schoenberg says, "you should ask yourself, 'Does the system that I buy allow me to create new applications for telehealth that the vendor didn't think about?' [You] should imagine plans for patients that incorporate and take advantage of telehealth. The result of that is a completely different beast." This article appears in the March/April 2021 edition of HealthLeaders magazine. - https://www.healthleadersmedia.com/telehealth/telehealth-journey-video-visits-strategic-business-tool < Previous News Next News >

The challenges of telemental health, and how they can be overcome Bill Siwicki June 14, 2022 Mental healthcare may be among the more intuitive specialties to deliver via telemedicine – but privacy demands, technology difficulties and the need for safe places deter some from taking advantage. Of all the medical specialties impacted by telemedicine during the course of the pandemic, perhaps the one with the most wholesale and lasting effects is behavioral and mental health. Mental health appointments do not typically involve any collection of vitals or specimens, nor do they absolutely require a face-to-face meeting, although therapists can observe physical cues from the whole body in person. Just talking via video, or even just audio, is enough. We talked with Dr. Janice Johnston, chief medical officer and cofounder of Redirect Health, a telehealth technology and services company, to get her expert observations regarding: The biggest ways telehealth is changing America's treatment of mental health. What impact increased telehealth accessibility has had on mental health treatment. The challenges telehealth presents in treating mental health. The improvements that can be made to telehealth for the treatment of mental health. Q. What are the biggest ways telehealth is changing the U.S.'s treatment of mental health issues? A. Before COVID-19 and historically in the U.S., there has been a negative stigma around receiving mental healthcare. While there have been a lot of movements and campaigns attempting to try and stamp out the stigma, many people have been deterred from seeking professional help due to a lack of coverage in healthcare plans, high copays and fear. As telehealth widens, the availability of mental health services continues to grow and is more accessible than ever. Gone are the days of driving to appointments and sitting in a waiting room, with the feeling that all eyes are on you. Social networks also have created a platform for mental health activists and we are seeing, in real time, an increase in people looking for treatment or routine mental care. COVID-19 accelerated the need for more access and new ways of treating mental health, such as telehealth. As a result of the COVID-19 pandemic, we also have seen many major insurance companies offer permanent or temporary plan benefits that include mental health services. Telehealth has made it easier for insurers to include these benefits in their plans with less out-of-pocket costs for patients. In many cases, insurance providers even waived the entire cost for visits when using telehealth. While most people don't want to be thought of or treated differently because they choose to seek mental health treatment, the stigma around it can make them feel judged, and they avoid choosing care. Telehealth has made it possible for people to now access care from the privacy of their homes, making the decision to seek care much easier and more comfortable. Being able to speak with a mental health professional from home has provided patients the ability to choose a setting that provides the most comfort, making the process of opening up and sharing concerns with a new person much easier. Q. What impact has increased telehealth accessibility had on mental health treatment in the U.S.? A. The COVID-19 pandemic forced changes for Americans across the country that have affected mental wellbeing, such as working from home, quarantine enforcements, lack of spending time with friends and family, and feeling isolated. This led to a surge in mental health issues with most non-emergency medical treatments shut down due to safety concerns and quarantine enforcements. Telehealth was a necessity we didn't see coming, and the pandemic accelerated this service due to the timely needs that were arising. With the higher demand for mental healthcare, telehealth has been the answer for many. People living in rural communities or underserved areas, specifically, experience limited access to specialty healthcare services, especially mental health. One of the key impacts of increased telehealth accessibility is that these communities have been able to turn to telehealth as an option when they may not have had an alternative. Different from rural or underserved communities, many urban populations see that finding in-person care isn't the difficult part, but affording it and getting to their appointment can be. Another key impact of increased accessibility is that telehealth tends to be a much more cost-effective option, as in-person care can regularly be more than double the cost. Think of all the money and time wasted having to take off work, which can result in lost wages, needing to hire a babysitter, or paying for gas when commuting to and from appointments. With telehealth, patients are able to afford their scheduled appointment at a time that is convenient and works for them. Additionally, while most offices provide services in standard office hours, many telemental health services provide care before and after work hours as well, so patients have more scheduling flexibility. There also are a lot of cultural barriers and health inequities that many minority communities experience that may deter them from seeking mental healthcare. During the pandemic, these communities experienced a rise in telemental health usage. While there are several reasons why this rise has occurred, we have seen that telehealth has been able to combat some of the barriers these groups have had to overcome. For one, telehealth affordability has made services much more accessible to minority groups or lower income individuals, enabling them to include mental healthcare into their budgets. Additionally, minority groups have experienced higher rates of depression and anxiety, only exacerbated by the pandemic, so the demand from these communities, along with the decrease in negative stigma around mental care through telehealth, has driven them to these options. Lastly, telehealth allows those with language barriers in the U.S. to have access to a broader group of mental health professionals who can provide a better understanding of their cultural backgrounds, partnered with the ability to speak in their preferred language. Q. What are some of the challenges telehealth presents in treating mental health issues, and instances when in-person care must be sought? A. While telehealth has expanded access to mental healthcare for so many across the country, there are still limitations that may lead some to favor in-person care. First, privacy. While many patients prefer telehealth so they can have their appointment in the privacy of their homes, there are situations where people may not have that same privacy in their home. Some people may live in multi-generational homes where others are home and in earshot, or they could share a room with others with privacy not immediately available. This may leave patients taking their calls from their car, which is not always comfortable or preferred. As a result, people in these settings may prefer care in person. Second, safe places. While some people prefer their care virtual for a variety of reasons, others feel that virtual mental healthcare is cold and distant, and favor in-person care in order to feel more engaged with their mental health provider. Sometimes being removed from their normal home setting can help create a safe place for the patient to discuss their mental health concerns. This is especially a factor with live support groups, which can be more engaging and easier in person than virtually. Many times, live support groups are used for people looking to overcoming addictions, and being able to separate them from their traditional setting can be helpful for pulling them out of their environment, even momentarily. And third, technology. Some individuals may not understand the technology behind apps or websites that provide mental health services. They may not know how to access video links or use their phone to connect to a provider, which could result in a sub-par session, where they do not feel comfortable or at ease. Patients also do not want to see time consumed or wasted during their appointment because of technical struggles and may prefer to see their providers in person to avoid the hassle of these situations. Q. What improvements can be made to telehealth specifically for the treatment of mental health issues? A. We can look to the current challenges of the telehealth space to find where to start with improving the telehealth experience for everyone. For starters, creating wider access to the internet allows telehealth to reach more people who may not have any options available to them today. In fact, the Biden administration recently secured commitments from 20 leading internet service providers to either reduce prices or increase speeds to serve low-income households. This is a great step in the right direction. Better cellular and internet speeds allow for more telemental health experiences to be held over video, and not telephonically, where mental health professionals can better assess their patient through both verbal and nonverbal cues. With all the advancements and changes we have seen in technology in just the last few decades, there is a lot for patients and providers to keep up with. Education is key to making sure telehealth sticks around and continues to rise in its availability. Many providers are willing to learn new technology, but need to be trained by the people that thoroughly understand the ins and outs of these systems. As new standards of care are set by technological advancements, providers and patients alike need to be provided the education to keep up with these evolving standards. It is important for those implementing new systems to deliver the proper education providers need to learn the technology, as well as assist their patients. Another thing to consider is how to assist patients with disabilities through telehealth. There are laws in place in the U.S. to ensure equality in care for those with and without disabilities, and therefore considerations need to be made in telehealth situations as well, such as providing additional instructions or scheduling longer appointment times. Sometimes added support or modifications need to be made to technology systems in order to support these patients as well. Telehealth systems should meet accessibility requirements and should provide resources that are available in multiple formats, like audio recordings or large text sizes. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. For more information: https://www.healthcareitnews.com/news/challenges-telemental-health-and-how-they-can-be-improved < Previous News Next News >

Celebrating 2021 National Rural Health Day Southwest Telehealth Resource Center Dec. 1, 2021 Since 2010 the National Organization of State Offices of Rural Health has designated the 3rd Thursday in November as National Rural Health Day to celebrate the rural leaders and champions in rural communities. This year the Arizona Telemedicine Program and the SWTRC joined with the Arizona Rural Health Association and the Arizona State Office of Rural Health to kick it off in Arizona with a “2021 Mid-Year Rural Health Policy Roundup” webinar by Alan Morgan, CEO of the National Rural Health Association. Since 2010 the National Organization of State Offices of Rural Health has designated the 3rd Thursday in November as National Rural Health Day to celebrate the rural leaders and champions in rural communities. This year the Arizona Telemedicine Program and the SWTRC joined with the Arizona Rural Health Association and the Arizona State Office of Rural Health to kick it off in Arizona with a “2021 Mid-Year Rural Health Policy Roundup” webinar by Alan Morgan, CEO of the National Rural Health Association. This webinar streamed live to a national audience on November 15th and the recording and presentation slides are available at: https://telemedicine.arizona.edu/webinars/previous for on-demand playback. Each year the National Organization of State Offices of Rural Health selects a Community Star from each of the 50 states. The 2021 Community Star report, https://en.calameo.com/read/0045723395dc12ef8ac48, includes stories of how each Community Star is working to improve life in their rural community. Congratulations to all of the 2021 Community Stars! Matthew Probst, PA-C Chief Quality Officer and Medical Director El Centro Family Health Mathew Probst is the Chief Quality Officer and Medical Director for a Federally Qualified Health Center located Northeast of Albuquerque, New Mexico. Under his leadership, Mr. Probst was able to implement initiatives at the start of the pandemic which resulted in his county having one of the lowest fatality rates and one of the highest vaccination rates in the county. Read more about why Mr. Probst was featured in an award-winning documentary named The Providers: https://en.calameo.com/read/0045723395dc12ef8ac48 < Previous News Next News >

FCC Announces Application Filing Window for Round Two of COVID-19 Telehealth Program Center for Connected Health Policy April 27, 2021 The application filing window for the second round of the COVID-19 Telehealth Program will open Thursday, April 29, 2021 at 12:00 PM ET The application filing window for the second round of the COVID-19 Telehealth Program will open Thursday, April 29, 2021 at 12:00 PM ET. Running one week, the filing window will close Thursday, May 6, 2021. The Program under the Federal Communications Commission was first established in April 2020 and provided with $200 million through the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Congress provided an additional $249.95 million to the Program late last year through the Consolidated Appropriations Act, to support this second round of funding and further assist health care providers setting up the infrastructure necessary to provide services via telehealth. The new round of the program will be administered by the Universal Service Administrative Company (USAC). Applications for the Program may be filed through a dedicated application portal, available on the COVID-19 Telehealth Program webpage. Round 1 applicants that were not funded will need to submit a new application. For additional information on Round 2, please refer to the Universal Service Administrative Company’s website. If you have specific questions regarding the Round 2 application process, please reach out to USAC at Round2TelehealthApplicationSupport@usac.org . COVID-19 Telehealth Program (Invoices & Reimbursements): https://www.fcc.gov/covid-19-telehealth-program-invoices-reimbursements Universal Service Administrative Company: https://www.usac.org/about/covid-19-telehealth-program/ < Previous News Next News >

City of Hope advances cancer care with hybrid telehealth and in-person visits. Bill Siwicki November 29, 2021 City of Hope envisions expanding the use of telemedicine to include telegenetic consultations, remote chemotherapy support, remote monitoring via wearables and palliative care. City of Hope, based near Los Angeles, is a research and treatment organization for cancer, diabetes and other life-threatening diseases. In 2018, it made strategic moves to more easily meet the needs of its patients and communities by investing in telehealth. Part of that strategic direction was working with technology companies to ensure that City of Hope leveraged telehealth in a high-quality, patient-centric way, while easing the burden of travel times for patients undergoing treatment. With every visit, the organization's team evaluates whether patients are best served by either a virtual or an in-person appointment. THE PROBLEM Then COVID-19 emerged. Suddenly, City of Hope needed to rapidly scale its telehealth infrastructure to meet the needs of patients. In doing so, its work with telemedicine technology and services vendor Amwell helped the healthcare provider organization reimagine the delivery of oncology services. "For example, when a physician delivers a cancer diagnosis to a patient, it can be a lot easier to do so when the patient is at home, in a space that feels comfortable, surrounded by family," noted Dr. Paul Fu, chief medical information officer at City of Hope. "At a time when the American Cancer Society estimates 87% of cancer patients and survivors had their care disrupted due to the coronavirus, City of Hope offered uninterrupted cancer care and used telehealth when appropriate to evaluate patients, manage side effects of treatment, review labs and scans, answer questions, and offer reassurance to patients and their families." Even when patients came in person, City of Hope used telehealth to include family members and other members of a patient's care team seamlessly in the visits. It's an approach that has enabled the organization to more easily and conveniently surround patients with specialized cancer care and eliminate unnecessary travel. "Moving forward, City of Hope envisions expanding our use of telehealth to include services such as telegenetic consultations, remote chemotherapy support, remote monitoring using wearables, expedited condition triage and palliative care," Fu said. "By fully addressing each patient's needs, we're making a deep impact on personalized patient care and satisfaction." PROPOSAL Prior to working with Amwell, City of Hope delivered telehealth services, but the technology it used was not integrated with other systems, leaving room for an improved care journey for patients and providers. "We started with Amwell by launching our patient app to enable virtual connections between our patients and their providers," Fu explained. "Since launching our app, we've been able to rapidly scale up our telehealth program both in terms of patients and providers using it and in terms of use cases and modalities. "We've also been able to integrate the platform with other systems we have in place to improve the patient experience," he continued. "These were key elements – scalability and integration capabilities – that we looked for in selecting our telehealth provider as we knew we would want to grow the program." MARKETPLACE There is a wide variety of telehealth technology and services vendors on the health IT market today. Healthcare IT News published a special report listing these vendors and details about their offerings. Click here to read the special report. MEETING THE CHALLENGE Having a well-integrated telehealth platform enabled City of Hope to develop consistent workflows around telehealth that supported an enhanced patient experience. Further, an integrated platform allows the organization to track telehealth visits within the same quality improvement framework that it uses for in-person visits. "We integrated the Amwell platform with our Epic EHR to provide a more seamless experience for patients and our provider teams," Fu noted. "Now, physicians can simply click a video icon in Epic to get to the telehealth screen and start their session. "Before each visit, nurses or medical assistants initiate the session, talking with patients to gather the information needed to inform the session. When an interpreter is needed, the platform makes it easy to incorporate these services during a live session with the click of a button." City of Hope also uses the Doximity Dialer to facilitate patient telephone calls straight from the Epic Haiku mobile app with a caller ID registered to City of Hope. This gives patients a greater feeling of trust from the start of the call, knowing that the telehealth call is a legitimate service coming from their healthcare institution. "Another crucial technology feature is the ability to easily bring other members of the care team into the video encounter," Fu said. "It's not uncommon for our patients to have a person they want to be involved in the discussion, such as a family member or other caregiver – even interpreters can be added to visits. This feature, which allows the sharing of screens, significantly enhances satisfaction among our patients. "However, what really makes our telehealth service unique is the network of services the patient receives via telehealth," he continued. "City of Hope offers concierge-like specialized healthcare services that help patients navigate their care journey and gain answers to questions about medication management, alternative treatments that can reduce side effects and more." The organization also connects patients with supportive care services that deliver in-person support when needed, such as when patients face mobility issues or when child life specialists can work with the children of adult patients or the siblings of pediatric patients. RESULTS "We looked at several different success metrics and largely chose to focus on process measures, including how likely patients are to recommend our telehealth services," Fu said. "We also looked at the number of successful completions to ensure our process and the use of the technology was easy for patients, as well as satisfaction with the use of telehealth services. "We're now beginning to look at health outcomes achieved via telehealth," he added. "Early data show that similar to many organizations, cancer screening procedures dropped during the pandemic, but we observed that the decrease was uneven across specialties." To measure clinical outcomes, City of Hope is tracking its patients as well as referrals into its system who had delayed screening. Based on the data it receives, City of Hope continually refines and improves its virtual care services to meet patients' needs, Fu said. ADVICE FOR OTHERS "When launching or expanding a telehealth program, ensure patients are kept at the center," Fu advised. "Telehealth services should be deployed in such a way that they cause the least amount of stress for patients, especially those who are dealing with complex conditions. "This can be achieved by mapping out the patient journey for both virtual and in-person care and looking for opportunities to strengthen care coordination and management, the quality of care that patients receive, and more." Even during the madness of the first months of COVID-19, City of Hope's patient-centric approach to cancer care, including use of telemedicine, strengthened its ability to optimize patient outcomes, improve the patient experience and provide uninterrupted cancer care, Fu added. "Our telemedicine use is just one of the ways City of Hope has expanded our reach beyond patients in the Los Angeles area," he concluded. "We reach cancer patients around the globe, including those taking part in clinical trials. In an era of digitally augmented patient care, a continual focus on meeting a patient's holistic care needs will become a competitive differentiator for healthcare providers." Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication https://www.healthcareitnews.com/news/city-hope-advances-cancer-care-hybrid-telehealth-and-person-visits < Previous News Next News >

Biden-Harris Administration Announces Availability of Up To $500 Million in Emergency Rural Health Care Funds Under the American Rescue Plan U.S. Department of Agriculture August 2021 Funding Will Expand Access to COVID-19 Vaccines, Health Care Services and Food Assistance in Rural America The Biden-Harris Administration today announced that the United States Department of Agriculture (USDA) is making up to $500 million available in grants to help rural health care facilities, tribes and communities expand access to COVID-19 vaccines, health care services and nutrition assistance. President Biden’s comprehensive plan to recover the economy and deliver relief to the American people is changing the course of the pandemic and providing immediate relief to millions of households, growing the economy and addressing the stark, intergenerational inequities that have worsened in the wake of COVID-19. “Under the leadership of President Biden and Vice President Harris, USDA is playing a critical role to help rural America build back better and equitably as the nation continues to respond to the pandemic,” Agriculture Secretary Tom Vilsack said. “Through the Emergency Rural Health Care Grants, USDA will help rural hospitals and local communities increase access to COVID-19 vaccines and testing, medical supplies, telehealth, and food assistance, and support the construction or renovation of rural health care facilities. These investments will also help improve the long-term viability of rural health care providers across the nation.” Background: Beginning today, applicants may apply for two types of assistance: Recovery Grants and Impact Grants. The Biden-Harris Administration is making Recovery Grants available to help public bodies, nonprofit organizations and tribes provide immediate COVID-19 relief to support rural hospitals, health care clinics and local communities. These funds may be used to increase COVID-19 vaccine distribution and telehealth capabilities; purchase medical supplies; replace revenue lost during the pandemic; build and rehabilitate temporary or permanent structures for health care services; support staffing needs for vaccine administration and testing; and support facility and operations expenses associated with food banks and food distribution facilities. Recovery Grant applications will be accepted on a continual basis until funds are expended. The Administration also is making Impact Grants available to help regional partnerships, public bodies, nonprofits and tribes solve regional rural health care problems and build a stronger, more sustainable rural health care system in response to the pandemic. USDA encourages applicants to plan and implement strategies to: -develop health care systems that offer a blend of behavioral care, primary care and other medical services; -support health care as an anchor institution in small communities; and -expand telehealth, electronic health data sharing, workforce development, transportation, paramedicine, obstetrics, behavioral health, farmworker health care and cooperative home care. Impact Grant applications must be submitted to your local USDA Rural Development State Office by 4:00 p.m. local time on Oct. 12, 2021. For additional information, please see the notice (PDF, 343 KB) in today’s Federal Register. USDA encourages potential applicants to review the application guide at www.rd.usda.gov/erhc. USDA Rural Development is prioritizing projects that will support key priorities under the Biden-Harris Administration to help rural America build back better and stronger. Key priorities include combatting the COVID-19 pandemic; addressing the impacts of climate change; and advancing equity in rural America. For more information, visit www.rd.usda.gov/priority-points. Under the Biden-Harris Administration, Rural Development provides loans and grants to help expand economic opportunities, create jobs and improve the quality of life for millions of Americans in rural areas. This assistance supports infrastructure improvements; business development; housing; community facilities such as schools, public safety and health care; and high-speed internet access in rural, tribal and high-poverty areas. For more information, visit www.rd.usda.gov . If you’d like to subscribe to USDA Rural Development updates, visit our GovDelivery subscriber page. USDA touches the lives of all Americans each day in so many positive ways. Under the Biden-Harris Administration, USDA is transforming America’s food system with a greater focus on more resilient local and regional food production, fairer markets for all producers, ensuring access to safe, healthy and nutritious food in all communities, building new markets and streams of income for farmers and producers using climate smart food and forestry practices, making historic investments in infrastructure and clean energy capabilities in rural America, and committing to equity across the Department by removing systemic barriers and building a workforce more representative of America. To learn more, visit www.usda.gov . < Previous News Next News >

Amazon Healthcare Building a National Telehealth Business Dr. Maheu, Telehealt.org January 2021 Amazon Care recently announced that it will expand nationally to all Amazon workers and other interested companies across the country in the summer of 2021. Amazon, the $1.6 trillion shipping giant, is launching a new service to provide essential medical services through Amazon Healthcare as a national telehealth business. Amazon Care uses an app that allows consumers to connect with doctors, nurse practitioners, and nurses virtually, 24 hours a day, via in-app chat or video. Initially launched and tested with Washington-based employees, Amazon Care recently announced that it will expand nationally to all Amazon workers and other interested companies across the country in the summer of 2021. “Making this available to other employers is a big step,” Amazon Care Director Kristen Helton said. “It’s an opportunity for other forward-thinking employers to offer a service that helps bring high-quality care, convenience and peace of mind.” Notice the last three descriptors: “high-quality care, convenience and peace of mind.” From the perspective of many healthcare providers, healthcare in the US has been lacking in each of these three areas. For employers registering for the service, which has partnered with Care Medical, employees near their headquarters will get online and in-person doctor visits. Employees elsewhere will get just the virtual components. Through Care Medical, Amazon Care currently offers an app to connect employees to a medical professional for a video consultation. It also offers follow-up care in the home for patients. The goal is to lower healthcare costs internally for Amazon and externally for some of the world’s most influential companies, using telehealth to meet people on their terms, with good care, wherever they are. Amazon’s Multi-Layered Business Strategy Anyone watching Amazon over the last year will be well acquainted with its accelerating moves to provide the early inklings of healthcare. Early Amazon Healthcare efforts were announced by Telehealth.org’s Telehealth News on 6/4/2020. In that article, it was reported that Amazon Health announced a pilot program offering virtual medical services to employees and their families. Amazon then expanded the presence of Alexa voice assistant, announcing that it was making it possible for voice assistant developers to offer HIPAA-compliant services for the Alexa platform. Amazon Pharmacy, a drug-delivering business in 48 states with steep discounts for Prime members was also released in November of 2020. Most recently Amazon has launched another offering called Amazon HealthLake, a HIPAA-compliant service that allows healthcare providers, health insurance companies, and pharmaceutical companies to store, transform, and analyze health data at a petabyte scale. As described on the Amazon HealthLake website: Amazon HealthLake removes the heavy lifting of organizing, indexing, and structuring patient information to provide a complete view of the health of individual patients and entire patient populations in a secure, compliant, and auditable manner. Using the HealthLake APIs, healthcare organizations can easily copy health data in the Fast Healthcare Interoperability Resources (FHIR) industry standard format from on-premises systems to a secure data lake in the cloud. HealthLake transforms unstructured data using specialized machine learning models, like natural language processing, to automatically extract meaningful medical information from the data and provides powerful query and search capabilities. Organizations can use advanced analytics and ML models, such as Amazon QuickSight and Amazon SageMaker to analyze and understand relationships, identify trends, and make predictions from the newly normalized and structured data. From early detection of disease to population health trends, organizations can use Amazon HealthLake to conduct clinical data analysis powered by machine learning to improve care and reduce costs. < Previous News Next News >

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

CB Insights Report: Global Telehealth Investment is Still on The Rise Kat Jercich, Healthcare IT News August 2021 Researchers found a 169% year-over-year increase in global telehealth investment, with the top five deals alone worth $1.5 billion. A new report from CB Insights found that global telehealth investment rose for the fourth consecutive quarter in Q2 of 2021 – with teletherapy deals representing a substantial share. The State Of Telehealth report found that much of the growth was pushed by accelerating digital transformation initiatives, as well as patient experience prioritization. At the same time, stakeholders and thought leaders voiced concerns about health inequity, and lobbyists mounted the pressure for long-term regulatory reform. WHY IT MATTERS The telehealth train has continued to chug along, despite dire warnings from health advocates about what might happen if the public health emergency expires without any action from Congress. Indeed, the CB Insights report was optimistic from a financial perspective: It found that global telehealth investment grew 17% quarter-over-quarter compared to Q1 of 2021, and 169% year-over-year, to reach a record high of $5 billion across 163 deals. As far as segments go, telemedicine providers, platforms and marketplaces saw their first decline in six quarters, with mergers and acquisitions at a record high. Meanwhile, teletherapy – especially with regard to mental health and chronic diseases – was an investor hotspot, and virtual care enablement companies saw a funding high. Remote monitoring and diagnostics companies raised $841 million across 33 deals, with decentralized lab tests and vital sign monitors flagged as notable business development areas. And telepharmacy had a strong funding quarter, particularly when it came to direct-to-consumer brands. The report also found that telehealth visits appear to be stabilizing at levels above those pre-pandemic, although they are still below the rates seen in March and April 2020. THE LARGER TREND Retail giants in the United States appear to be betting big on telehealth, even amidst looming uncertainty about its regulatory future. Walmart Health and Amazon Care have both signaled their plans to expand virtual care throughout the country, while established telemedicine vendor Amwell announced two acquisitions this week. But it's not all rosy: Amwell competitor Teladoc reported a $133 million net loss this past quarter. ON THE RECORD "While all telehealth segments saw acquisitions during the quarter, the two biggest hot spots were virtual/digital care enablement and telemedicine providers, platforms and marketplaces," observed CB Insights researchers. < Previous News Next News >

Joint Commission Updates Telemedicine Accreditation Rules Center for Connected Health Policy April 2021 Before a practitioner may provide services in a hospital, he or she must have their qualifications evaluated and verified. According to an article in The National Law Review, The Joint Commission recently announced slightly revised ‘credentialing by proxy rules’. Before a practitioner may provide services in a hospital, he or she must have their qualifications evaluated and verified. This process, known as credentialing, ensures an individual possesses the necessary qualifications to provide medical services to patients. ‘Credentialing by proxy’ allows a hospital receiving services to accept the distant site hospital’s credentialing and privileging decisions. Certain criteria must be met in order for a hospital to qualify to utilize credentialing by proxy. Previously, this included requiring both the originating site hospital and distant site hospital to be accredited with the Joint Commission. The new change allows the distant site telemedicine entity to be accredited with The Joint Commission or, alternatively, enrolled in the Medicare program. The affected standard is MS.13.01.01, EP 1, and is reflected in the Joint Commission’s 2021 update to their Comprehensive Accreditation Manuals. Comprehensive Accreditation Manuals: https://store.jcrinc.com/2021-comprehensive-accreditation-manuals/ < Previous News Next News >

Join Pivotal NM & The Grant Plant for an Overview of FCC's COVID-19 Telehealth Program Application Joohee Rand April 23, 2021 Pivotal NM is hosting an urgent info session this Friday April 23rd, 10am to provide an overview so that more providers will be ready for application from New Mexico. Anchorum St. Vincent has partnered with PIVOTAL NM to provide technical assistance in applying for the FCC’s Covid-19 Telehealth Program in 2021. $250M in total funding is available through this program this year, and FCC just announced that the application will be open from April 29 – May 6th, for just one week. Pivotal NM is hosting an urgent info session this Friday April 23rd, 10am to provide an overview so that more providers will be ready for application from New Mexico. Pivotal New Mexico will be also hosting additional office hours in the following week and can be available for further support in applications. Registration: https://mailchi.mp/pivotalnm.org/join-us-to-learn-about-fccs-telehealth-grant-app?e=95bb6af734 < Previous News Next News >

Sparrow Health System uses pandemic lessons to expand its virtual care strategic plan Bill Siwicki September 28, 2022 Today, the Michigan health system is seeing more than 1,000 e-visits per month, making greater use of its patient portal and successfully addressing the behavioral health caregiver shortage. Sparrow Health System in Lansing, Michigan, began developing a virtual care strategy in October 2019 – well before COVID-19 struck – with the hope of leveraging the technology as a tool to support patient care and the organizational strategy, rather than as a stand-alone strategy in and of itself. Sparrow's initial goal was to launch on-demand, virtual urgent care to increase access and provide another front door into the health system. It intended to go live in July 2020, using Amwell as the technology and services vendor for virtual urgent care for an estimated 1,500 visits in the first year. Telehealth plans quickly changed But then, COVID-19 hit, and plans quickly changed. "With most of our practices closed in late March of 2020, we needed an immediate solution that couldn't wait until July," said Patrick Sustrich, director of retail healthcare at Sparrow Health System. "What we thought would take months took us days, and we leveraged the capability of our Epic EHR to stand up on-demand and scheduled video visits using Zoom for Healthcare and our own providers. "In the first month, we surpassed our one-year goal of 1,500 virtual visits – telephone and video," he continued. "The benefit of staffing this ourselves was that it allowed our providers to access the patient's medical record, document directly into the chart and accept all the same insurance we do for in-person visits." Once the practices reopened, most thought they would resume normal operations and transition all their visits back to in-person. But this did not happen. Patients enjoyed virtual care "Not only was COVID not over, but patients enjoyed the convenience of virtual visits, and providers saw the value of this tool," Sustrich said. "Through August 2022, we have successfully completed more than 144,000 virtual visits. "Additionally, our health system has embarked on a strategy to tend to a situation that has plagued providers since the inception of the patient portal – the overwhelming number of medical advice requests," he continued. In fact, more than 16,000 medical advice requests are received each month. This uncompensated care takes hours out of a provider's day, and a solution was badly needed. Sparrow took a multi-tiered approach to resolve this issue. "The first approach was to leverage Epic to triage medical advice requests to the correct location – one direction for billing/finance, another for medication refills and another for scheduling questions/issues," he explained. "This significantly reduced the number of medical advice requests to the provider. "Next, we launched both patient- and caregiver-initiated e-visits in an effort to convert messages requiring medical decision-making into billable visits," he said. "Monthly reports were generated to providers showing them precisely the opportunity to convert medical advice requests into e-visits." More than 1,000 e-visits per month Although caregiver-initiated e-visits have only been available since Q2 of this year, Sparrow is averaging more than 1,000 e-visits per month. Additionally, a pilot is being conducted to evaluate the impact of using a centralized nurse triage process to resolve minor patient issues, freeing up providers' time to increase access. "Our main hospital campus struggled with LOS and a lack of beds, as most hospitals did during COVID," Sustrich recalled. "We needed to leverage the bed capacity of our community hospitals. We quickly looked for a telehealth solution to prevent unnecessary transfers and keep care local. "iPads with a Zoom video link provided patient-to-provider and provider-to-provider connections," he continued. "FCC funding we received has enabled us to purchase five telemedicine carts from Amwell, allowing an offsite provider to control the camera's pan/tilt/zoom features and access a digital stethoscope." Sparrow intends to place these carts at all five offsite ED locations. In the future, it plans on expanding specialist resources to provide care across the health system. Specialists such as those focused on pulmonology, behavioral health and infectious disease could never be supported at one community hospital, but collectively, and with the help of virtual care, these specialists can serve the entire health system, he stated. Staffing a 24/7 platform "Our current 24/7 on-demand platform's wait time is under 19 minutes, with an average completion rate of more than 80%," Sustrich reported. "It is rare to find a health system staffing its own 24/7 platform while having access to the patient's medical record and the ability to document within the EHR. "Many others have contracted this service out to a third-party vendor, which I believe sacrifices patient care quality and safety," he added. Additionally, Sparrow providers staffing this platform respond to e-visits from patients without a primary care provider, conduct COVID follow-up calls, and perform QR validation in the MySparrow Portal for patients who have received the COVID vaccination outside of the health system. After-hours coverage (8 p.m. – 8 a.m.) is conducted by three ED locations offsite from the main campus. "Another metric I am very proud of is our MySparrow Portal activation rates," Sustrich noted. "Early in the pandemic, it became apparent that patient success with our virtual health services was high in patients who already had a portal account. "In response, a campaign across Sparrow's entire medical group was launched to increase MySparrow Portal activation rates," he continued. "Patient tutorials were created, and the campaign began within ambulatory practices; each practice was given a goal, implemented best practices and shared a monthly scorecard." Caregivers hitting their goals Caregivers were rewarded with gift cards when their practice hit their goal, and the hospital's foundation funded the gift cards. Within two years (April 2020 to March 2022), Sparrow saw a 152% increase in its active MySparrow Portal users (146,768 to 369,916) and increased the percentage of patients with a portal account from 55.2% to 78.8%. The challenges Sparrow faced were similar to those of most other health systems, and this caused Sparrow to build the plane while in flight and struggle with training and experience gaps, Sustrich said. "Our assets included an engaged leadership team that supported our virtual health strategy and was willing to invest in it," he said. "We also leverage Epic and its ongoing development of virtual health tools. And I would be remiss if I didn't mention the resilience of our caregivers." Sustrich points to various signs of success: • More than 70,000 successfully completed video visits in the first two years. • More than $8 million in video visit revenue. • 40,000 hours of patient drive-time saved. • A 10% increase in the SUS Score. • Patient satisfaction went from 80% to 89%. • A 20% shift from telephone to video visits. A major FCC telehealth grant "Sparrow had the top FCC grant application in Michigan and was among 62 healthcare facilities nationwide that received funding from the FCC in Round 2 of its COVID-19 telehealth grant program," Sustrich reported. "The $586,000 was used for ambulatory virtual health hardware deployment, a virtual behavioral health program to expand access and cart technology to increase communication and improve care to our community hospitals out in the region. "Hardware purchased included 115 docking stations, 140 Bluetooth digital scales, 350 headsets, 230 monitors, 115 and keyboards with mouse," he continued. "This standardized virtual health equipment across our health system makes video visits accessible to a larger number of providers, thereby positively impacting patients and increasing access to care." Because of the nationwide shortage of psychiatrists and behavioral therapists, patients find it more difficult to access mental health services. "A portion of the FCC money purchased 40 iPads housed in five emergency rooms and throughout each inpatient floor at the main hospital to access virtual behavioral health services," Sustrich said. "Additionally, psychiatrists at Sparrow's St. Lawrence campus can virtually connect with patients in the adult psychiatric, geriatric psychiatric and outpatient units through an audio/video connection. "This will decrease wait time and increase access to behavioral health services," he concluded. "Additionally, bed capacity will increase from 60% to 85% occupancy." Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/sparrow-health-system-uses-pandemic-lessons-expand-its-virtual-care-strategic-plan < Previous News Next News >

What You Need to Know About the Telehealth Extension and Evaluation Act Dr. Maheu February 24, 2022 The Telehealth Extension and Evaluation Act was introduced on February 7, 2022, to ensure a continuation of public access to telehealth after the end of a public health emergency. If passed, it will allow time to gather data concerning virtual care utilization and prevent a sudden drop-off in access to care, also known as the telehealth cliff. What is the Telehealth Extension and Evaluation Act? The Telehealth Extension and Evaluation Act establishes a two-year extension for certain coronavirus-related telehealth waivers. It will extend geographic and site restrictions waivers and allow Medicare beneficiaries to access telehealth from various locations. It also provides flexibility for prescribing drugs via telehealth and extends flexible Medicare payment plans for Rural Health Centers (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs). The bill follows an advocacy letter signed by 336 organizations, co-led by the American Telemedicine Association (ATA) and others, urging Congressional leaders to continue the current telehealth waivers and pass permanent, evidence-based telehealth legislation for implementation in 2024. Key Takeaways for the Telehealth Industry The telehealth industry should be aware of the critical points of the Telehealth Extension and Evaluation Act. Extension of Medicare Payment for Telehealth Services. The CARES ACT allowed the Centers for Medicare and Medicaid Services (CMS) to waive specific Medicare coverage and payment limitations, allowing Medicare beneficiaries to receive telehealth care at home. If the Telehealth Extension and Evaluation passes, it will extend certain telehealth coverage waivers on originating site and geographic location limitations, expand the list of telehealth providers, and increase the availability of audio-only telehealth services to Medicare beneficiaries for two years after the public health emergency ends. Telemedicine Drug Prescribing. The Ryan Haight Act prohibits the prescribing of medicine without an in-person visit. Federal law allowed DEA registered practitioners to prescribe to patients without in-person visits during the pandemic. See TBHI’s previous article Telehealth Opioids, and Ryan Haight Act Update, for more information. The proposed legislation would extend this flexibility two years after the public health emergency. Extension of FQHCs and RHCs. Before the pandemic, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) could only provide telehealth services to patients near their locations. The CARES Act allowed these facilities to provide care to patients in distant areas, a practice the legislation would continue for two years after the public health emergency expires. Extension for CAHs. The 2020 Hospitals Without Walls program allowed hospitals to provide telehealth care during a public health emergency. The proposed legislation would add Critical Access Hospitals (CAHs) as distant site providers of telehealth services to continue offering off-site care. Restrictions for Certain DMEs and Lab Tests. The legislation would require an ordering physician to conduct an in-person examination of a patient no more than 12 months before ordering specific high-cost lab tests and Durable Medical Equipment (DME) products via telehealth. It would also instruct Medicare Administrative Contractors to audit practitioners and clinicians who do 90% or more of their orders of DME and lab tests via telehealth. This would continue for two years after the health emergency ends. It is meant to reduce instances of fraud and abuse. NPI Number for Telehealth Billing. Healthcare providers need a national provider identifier (NPI) number to bill Medicare directly. Under certain conditions, Medicare pays for services billed by physicians but performed by non-physician staff acting under the physician’s supervision. This practice is known as “incident to” billing. The proposed legislation requires all practitioners to obtain an NPI number to receive Medicare payment for telehealth services two years after the public health emergency. Your Advocacy Is Needed The pandemic has caused an increased reliance on the telehealth industry. If passed, the Telehealth Extension and Evaluation Act will ensure that patients can continue to access the virtual care they need. Contact your elected officials at the federal level to ask them to support this crucial bill. https://telehealth.org/what-you-need-to-know-about-the-telehealth-extension-and-evaluation-act/?smclient=f760e669-8538-11ec-83c8-18cf24ce389f&smconv=5bc4c379-a4c1-484f-a411-33ec93777504&smlid=9&utm_source=salesmanago&utm_medium=email&utm_campaign=default < Previous News Next News >

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 >

Broadband Funding Frameworks and Updates Center for Connected Health Policy July 2021 The report released last month suggests the need for $106 - $179 billion to future-proof networks and get higher broadband speeds to those that currently need them. Addressing Gaps in Broadband Infrastructure Availability and Service Adoption: A Cost Estimation & Prioritization Framework is an analysis conducted by ACA Connects, an association representing small and rural broadband providers which projects that broadband funding levels should be higher than recent federal funding proposals offer. The report released last month suggests the need for $106 - $179 billion to future-proof networks and get higher broadband speeds to those that currently need them. Although President Biden’s initial proposal put $100 billion toward broadband, the latest bipartisan agreement, or Bipartisan Infrastructure Framework, currently only designates $65 billion to broadband. The details of the new agreement are still unclear and issues of contention remain. It is also, uncertain how the funding is proposed to be allocated. Some articles and insiders suggest the majority of the funding will be given to states and the rest split between smaller federal programs, leaving out the FCC, which is the main agency currently administering broadband programs. In addition, the White House recently released fact sheets for each individual state, to show the needs and impacts the framework proposes to provide across the country. As additional details come together, the ACA Connects study framework could be helpful for policymakers in determining both appropriate funding levels and allocations to truly improve and expand broadband access. In particular, the report recommends policymakers look at their funding priorities through an availability lens and an adoption lens, both of which require setting eligibility thresholds. For instance, how will “unserved” be defined and which households should be eligible for support. In addition, they suggest funding allocations be determined by what subsidy amount would actually be needed by each household and how many are likely to participate. Using such calculations, the analysis provides sample funding approaches and cost assessments in addition to its overall estimate. The report suggests that with $35-67 billion the U.S. could increase broadband availability to 19 million locations. Whether policymakers will consider the analysis remains as unknown as whether they will complete the current federal infrastructure deal as proposed. One thing does remain clear - even if a deal is finalized and passed, how the funding is targeted will remain vital to its success at improving broadband access. For more information review the ACA Connects full analysis - https://acaconnects.org/wp-content/uploads/2021/06/Addressing-Gaps-in-Broadband-Infrastructure-Availability-and-Service-Adoption-ACA-Connects-and-Cartesian-June2021.pdf. < Previous News Next News >

Study: Teletherapy program reduces OCD symptoms Emily Olsen May 23, 2022 Researchers found a 43.4% mean reduction in patient-rated obsessive-compulsive symptoms. A teletherapy program reduced symptoms of obsessive-compulsive disorder, and most patients maintained improvements up to a year later, according to a study published in JMIR. The treatment, from digital mental health company NOCD, included twice-weekly video appointments that used exposure and response prevention (ERP) therapy for three weeks. Patients then underwent six weeks of weekly half-hour video check-ins. Researchers followed up with the patients three, six, nine and twelve months after the therapy program. The study found a 43.4% mean reduction in patient-rated obsessive-compulsive symptoms as well as a 44.2% mean reduction in depression, a 47.8% mean reduction in anxiety and a 37.3% mean reduction in stress symptoms. Of the more than 3,500 patients included in the study, more than 1,600 participated in follow-up surveys. The study's authors were employed by NOCD or reported they had received payments from NOCD while conducting the study. "The effect size was large and similar to studies of in-person ERP. This technology-assisted remote treatment is readily accessible for patients, offering an advancement in the field in the dissemination of effective evidence-based care for OCD," researchers wrote. WHY IT MATTERS The study's authors noted the virtual intervention took about 12 weeks and fewer than 11 therapist hours. "Technology assistance likely played an important role in this treatment’s ability to both engage and treat a large number of patients in wide-ranging geographic locations and to achieve a high mean rate of symptom improvement and a high rate of treatment response," they wrote. "Teletherapy using video allows people in remote locations to access treatment and to be able to complete, in-session, in vivo exercises in places and situations that are most relevant to, or triggering of, their symptoms." THE LARGER TREND NOCD announced it had raised $33 million in Series B funding in September last year. That brought its total financing to $50 million, according to Crunchbase. Mental health technology funding increased 139% globally in 2021, compared with 2020, bringing in $5.5 billion, according to a CB Insights report. Meanwhile, mental healthcare makes up a large portion of telehealth utilization in the U.S. Though utilization fell nationally in February, mental health diagnoses still made up more than 64% of telehealth claim lines, according to FAIR Health's tracker. For original article: https://www.mobihealthnews.com/news/study-teletherapy-program-reduces-ocd-symptoms < Previous News Next News >

Is telemedicine an answer to physician burnout and staffing shortages? Bill Siwicki May 24, 2022 A physician who works full time via telehealth – and in brick-and-mortar ERs on the side – discusses the benefits to herself and the industry. With the huge initial swell in the use of virtual care in the rearview mirror, many industry experts – from health plans to big tech and practicing clinicians – are considering whether a doubling down on telehealth is just what the doctor ordered for the future of patient care. Many clinicians are hungry for new opportunities that allow them to continue to serve patients without dealing with long-standing administrative burdens and the aftermath of burnout from COVID-19 in their hospitals, health systems and doctor's offices. With too many clinicians continuing to stress that they've lost passion in their careers and considering quitting their jobs altogether, experts say change is needed. The healthcare industry can't afford to lose these highly skilled clinical workers to other industries. On this note, Healthcare IT News interviewed Dr. Pooja Aysola, a practicing emergency department clinician in Boston and senior director of clinical operations at Wheel, a virtual care company. She talks about physicians' newfound familiarity with telehealth and what it means for the future, the possibility of physicians working full time in telemedicine, and how virtual care can help with staffing shortages in healthcare. Q. With the massive uptake in telemedicine during the past two years of the pandemic, clinicians have grown accustomed to delivering care virtually. What do you think this familiarity means for clinicians moving forward? A. I hadn't ever considered a career in virtual care until a few months into the pandemic. I was working in an emergency room in Boston when my shifts were cut after the hospital rolled back elective procedures. I started working in telemedicine as a temporary solution, but I ended up loving the flexibility to see patients at home and on my own schedule. I also quickly realized I didn't have to be in the same room as my patients to deliver great care. I can treat conditions such as UTIs through a screen and provide immediate value to my patients. I'm not alone in my sudden pivot from virtual-care skeptic to virtual-care advocate. Two in three clinicians now say treating patients in virtual only or hybrid care settings best fits their lifestyle, despite a significant lack of interest in telehealth before the pandemic. I'm hopeful this new trend will allow more clinicians to create career paths that work for them, rather than against them. Clinicians should have the flexibility to decide when they want to work, where they want to work, and how they want to work. If we're moving toward a hybrid care model, then we should enable clinicians to adopt hybrid careers, if that's what works best for them. In medical school, we're taught there's only one track you can follow: in-person care. But that's not the case anymore. I want every doctor and nurse to feel empowered to follow the career path that works best for them. Q. You seem to suggest that physicians looking for a change, perhaps due to burnout, can switch to telehealth full time. What would a move to virtual care look like for a physician? A. The past few years have been incredibly tough for clinicians. Burnout, frustration and fatigue are some of the many challenges facing clinicians today. Recent data shows more than half of clinicians have lost passion for their careers because of stress – and close to half believe burnout is the biggest threat to patient care today. Working in virtual care was a less-than-traditional career path before the pandemic. But now, many clinicians are considering working in virtual care to help combat burnout and increase flexibility. A move to virtual care will look different for everyone. For example, some clinicians enjoy having a set schedule each week to see patients. Others enjoy having more flexibility, where they can easily sign on after dropping their kids off at school, sign off before running an errand, or even split their time between virtual and in-person care. At Wheel, more than half of clinicians still work in a brick-and-mortar setting. One of our clinicians currently is driving around the country with her partner in an RV. She customizes her schedule based on her travel plans that day. She can see patients in the morning and go for a hike in the afternoon, or spend a few hours on the road before pulling over and seeing patients in the afternoon. Clinicians interested in telehealth should look for opportunities that prioritize and personalize their experience as clinicians. Some specific factors to consider include: What kind of electronic health record does the company use? And was the EHR created with your experience in mind? Do they offer ongoing training? And provide resources on important topics, such as "webside" manner and guidance on managing state licenses? Do they have a robust clinical quality program in place? How do they provide feedback on quality of care? Q. How can telehealth help with the staffing shortage in healthcare? A. Our current clinician staffing shortage is a national crisis. And it's only expected to get worse. According to an Elsevier study, almost half of U.S. clinicians plan to leave their jobs within the next few years. I've seen firsthand the impact shortages are having on clinician burnout and patient care. And I firmly believe this is a crisis that the entire industry must address. Ensuring clinicians feel encouraged to explore careers in virtual care, if that's what works best for them, is one of many steps to take. Another way for telehealth to help address staffing shortages is by powering the transition to what we call "virtual-first care." With virtual-first care, patients can start their care journey with telemedicine. By leaning on technology, healthcare organizations can more easily triage the patient's care needs and determine the best care setting – virtual, in-person or hybrid care. This is a more efficient way to approach care delivery while simultaneously increasing access to care. While telehealth alone is not the only solution, it is one of many steps we can take to help address staffing shortages and help ensure timely patient access to care. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/telemedicine-answer-physician-burnout-and-staffing-shortages < Previous News Next News >

Recent DOJ Fraud Charges Include Few Details and Links to Telehealth Center for Connected Health Policy June 2021 The Department of Justice (DOJ) recently announced criminal charges against a variety of individuals related to various alleged COVID-19 fraud schemes. One of the kickback schemes does appear to include a telehealth element. The Department of Justice (DOJ) recently announced criminal charges against a variety of individuals related to various alleged COVID-19 fraud schemes. Most of the new cases appear to be related to fraudulent testing claims and kickback schemes, although one of the kickback schemes does appear to include a telehealth element. According to the DOJ press release, two Florida men – a consultant as well as a Texas laboratory owner – allegedly exploited temporary telehealth waivers by offering providers access to Medicare beneficiaries for whom they could bill consultations. In return, the providers referred the patients to that laboratory for potentially unnecessary cancer and cardiovascular genetic testing. Despite potentially misleading headlines, most charges appear to only be against executives and additional details directly tying the fraud to telehealth and the correspondence, billing, and waivers in question have yet to be released. As one updated mHealth Intelligence article later noted, “the charges try to link fraud cases to telehealth coverage, but are more closely aligned with telefraud.” For more information read the full DOJ press release - https://www.justice.gov/opa/pr/doj-announces-coordinated-law-enforcement-action-combat-health-care-fraud-related-covid-19. < Previous News Next News >

Telehealth Mini-Grants NM BHSD March 16, 2021 BHSD would like to announce the release of funding in the form of telehealth mini-grants. Deadline for receipt of letters of interest: 5 pm April 9, 2021 Please send letters of interest to: Cynthia Melugin at cynthia.melugin@state.nm.us To CYFD and BHSD Non-Medicaid Providers: Dear New Mexico Providers: BHSD would like to announce the release of funding in the form of telehealth mini-grants. When the COVID-19 public health emergency ends, BHSD will no longer be able to support behavioral health providers who are delivering behavioral health services through telehealth systems that are not HIPAA compliant. We are now offering funding to help providers come into compliance so that critical behavioral health services will not be disrupted. If your agency is currently delivering services using the telephone and/or another non-HIPAA compliant system, this grant could help you make the transition. BHSD is seeking letters of interest that respond to this question: what is your current telehealth system, and what do you need to become HIPAA compliant? Funding is available in amounts of up to $50,000 per agency, and all work must be completed by the end of 2021, which is when the PHE is currently set to expire. Letters of interest should include: • Specific hardware and/or software and costs • Training for staff and administrators and costs • Anticipated changes to practice model • How many practitioners/staff members do you expect to train • How many clients do you anticipate serving with your new system • Timeframe for making changes BHSD will expect any agency that receives funding to report back on progress made on each of these points. Deadline for receipt of letters of interest: 5 pm April 9, 2021 Please send letters of interest to: Cynthia Melugin at cynthia.melugin@state.nm.us < Previous News Next News >