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 >

DOJ Prosecutes Several Telemedicine Fraud Cases Center for Connected Health Policy May 2021 Department of Justice is currently on an offensive against telemedicine fraud According to an article in the National Law Review, the Department of Justice is currently on an offensive against telemedicine fraud. The article cites the following DOJ operations as evidence of the current crack down on telemedicine: *Operation Brace Yourself targeting an international fraud ring that defrauded $1 billion from Medicare for unnecessary devices. *A series of telemedicine fraud prosecutions that occurred in 2020 that found more than $1.5 billion in fraudulent Medicare billing. *On April 22, 2021 the latest crackdown came to light with charges for the owners of orthotic brace suppliers and some marketing companies for a $65 million nationwide kickback and bribery conspiracy. The scheme involved call centers soliciting customers to accept braces even though they didn’t need them and charging Medicare, Medicaid and Tricare. The telemedicine companies involved were paid illegal kickback and bribes for their doctors signing the brace orders and swearing to their medical necessity. These types of incidents are what makes some regulators warry of telehealth. With the increased widespread use of telehealth due to the pandemic, incidents of fraud will likely increase for telehealth. The key will be to ensure that the bad actions of a few don’t interfere with a modality of care that increases access and quality care for so many. Read the full National Law Review article for more information on these fraud cases. Full National Law Review article: https://www.natlawreview.com/article/doj-telemedicine-offensive-pushes-forward-new-charges < Previous News Next News >

Telehealth Elements in American Rescue Plan COVID Relief Bill Center for Connected Health Policy April 2021 $50 million in grants for local behavioral health services, including via telehealth, and $140 million for information technology, telehealth and electronic health records at the Indian Health Service. March marked the passage of the third major COVID-9 relief bill (HR 1319), titled the American Rescue Plan. While the bill didn’t include significant changes in telehealth policy as past relief legislation has, it did have some nuggets for telehealth. For example, it establishes an Emergency Rural Development for Rural Healthcare Grant pilot that would, among other things, support telehealth programs. The bill also allots $50 million in grants for local behavioral health services, including via telehealth, and sets aside $140 million for information technology, telehealth and electronic health records at the Indian Health Service. To learn more, see the full text of the bill. American Rescue Plan: https://www.congress.gov/117/bills/hr1319/BILLS-117hr1319enr.pdf Indian Health Services: https://www.ihs.gov/ < Previous News Next News >

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

The Punctuated Equilibrium Of Telemedicine: Digital Health Solutions And Government’s Role Richard Schwabacher September 14, 2022 As Covid-19 took hold in our communities, the increase in demand and need for telehealth and other virtual care options accelerated at an unprecedented pace. As Covid-19 took hold in our communities, the increase in demand and need for telehealth and other virtual care options accelerated at an unprecedented pace. Action was taken at the state and federal levels, as well as by payers and employers, to make telehealth easily accessible. Nearly overnight, swift changes in payment, reimbursement, coverage and licensing policies were made as the pandemic disrupted every facet of life. Telehelth benefits have proven to be popular, so much so that Congress recently voted 416-12 to extend benefits. Simultaneously, investment in the digital health market has soared to a record $29.1 billion in 2021 to transform a healthcare system that could support digital capabilities. Patients, already accustomed to digital services, like banking, quickly adapted to the change. When radical change occurs in a short period of time and then finds a new balance, we call that a punctuated equilibrium. With respect to telemedicine, we don’t expect to return to life as we knew it before Covid-19 or, at the other end of the spectrum, settle in a place where high rates of telemedicine adoption were during the surges. Ultimately, there will be a new equilibrium that nestles between those two polar opposites. Despite overwhelming investment and adoption of virtual care and telehealth options by patients and providers, barriers still exist. There are specific actions government and businesses can take and should, to support healthcare programs born out of the pandemic—but only if the economics and incentives are aligned. Spotlight Moment For Laboratory Diagnostics Laboratory diagnostics has always been a critical component of healthcare—diagnosis, prevention, management, and so forth—but the pandemic put lab testing and access to it squarely in the spotlight. It became an urgent need that nearly everyone had. The value and role of laboratory diagnostics cannot be understated. According to the CDC, 70% of high-quality care depends on diagnostic testing to make medical decisions by equipping providers with the necessary information to properly address patient needs. Diagnostics are most often the healthcare tools providers rely on when diagnosing, managing and treating a variety of diseases and conditions; for instance, 12 of the 15 most clinically and economically significant disease categories in the U.S. dictate using laboratory diagnostics as the standard of care. Lack of access to laboratory diagnostics for patients has wide-ranging effects, including implications for medication nonadherence that will continue to grow as the burden of chronic diseases grows. The Role Of Government Policy The patchwork approach to solving these problems will not suffice in the long run, which is why the role of government in the sustained expansion of virtual care services is so important. Healthcare policy ought to keep pace with the evolution of healthcare technology. It’s encouraging to see the current administration invest in and promote innovation with information technology to better serve community health. The investment not only includes $34 billion initially invested through the HITECH sections of the American Recovery and Reinvestment Act but also many billions of dollars expended by U.S. industries, including laboratories. Three specific policies can help direct and reward innovation leading to better outcomes. • Ensure that all patient data needed by clinicians for individual and population care is available. While the CURES Act and the ONC CURES Act Final Rules aim to prevent data blocking, business practices among providers and payers sometimes serve as effective barriers to serving patients in their communities. ONC and CMS can refine the rules to ensure data is available in all EHRs from all appropriate sources, facilitating timely availability of all patient data wherever it is needed. • CMS should develop companion coding for telemedicine services and home-based specimen collection for lab testing. The value of telehealth is compromised if the patient must travel to a distant site for lab testing in support of the telehealth intervention. • While the government can mandate that providers report specified data, the results from home-administered testing are not available in standardized electronic formats and do not get reported. This has created barriers to public health responses in communities most at risk. What Can Businesses Do? There are ways for businesses and the government to collaborate that can improve the telemedicine landscape that benefits patients and consumers, as the clear, quantifiable health outcomes speak for themselves and can help influence further adoption and integration. For instance, the number of Medicare beneficiary telehealth visits increased 63-fold in 2020 to more than 52.7 million. While at the Mayo Clinic, ambulatory management of Covid-19 showed effective use of remote patient monitoring with a 78.9% engagement rate. These are just two examples that illustrate the increased adoption and success of making telemedicine an integral part of healthcare protocols. Companies that move to a value-based incentive model from a fee-for-service model and move toward reimbursement models that reward quality can be an alternative to the status quo. Telemedicine can be part of the solution when addressing inequities in access to care, including specialty care and at-risk populations. We already know that lack of access to laboratory diagnostics for patients has wide-ranging effects that will continue to grow as the burden of chronic diseases grows. Virtual Care Is Here To Stay Digital healthcare models are changing the landscape of the healthcare system as we know it, and this is good news for patients and providers. The changes empower patients to take more control of their health, give them more options that cater more to their needs, lower costs for “virtual-first” or “hybrid care” healthcare plans and improve access. Our collective experience during the pandemic has shown that people need healthcare and clear access points. The expanded use, adoption and successful integration of digital healthcare solutions have been received positively and have encouraged more participation. We need to continue to expand telehealth and remote options with policy that supports it—to backtrack on the progress we’ve made would be a mistake. See original article: https://www.forbes.com/sites/forbestechcouncil/2022/09/14/the-punctuated-equilibrium-of-telemedicine-digital-health-solutions-and-governments-role/?sh=523fd49e2deb < Previous News Next News >

Apply Now: $250 M in Telehealth Grants National Council for Behavioral Health April 30, 2021 Telehealth Grants - Apply Now Yesterday, the Federal Communications Commission (FCC) opened its second phase of the COVID-19 Telehealth Program with an additional $250 million available to eligible providers, including community mental health and substance use organizations. Organizations are strongly encouraged to apply for the grants that may be used to fund technology and equipment to bolster service delivery via telehealth. The application will close at 12:00pm ET on May 6, 2021. Read more and reach out here with any specific questions on the application process. COVID-19 Telehealth Program Application Resources: https://www.usac.org/about/covid-19-telehealth-program/covid-19-telehealth-program-application-resources/?mkt_tok=NzczLU1KRi0zNzkAAAF8wn-qjbshy_rZnI19Utm_szbXLRtL_Em1obbBZMPGjL8UcKptxsAQkufy8_qpLAJ8F7YLbidFX_B4uUKtfjz1Xqfb00kuVsv-2qjkBEx3 COVID-19 Telehealth Program (Invoices & Reimbursements): https://www.fcc.gov/covid-19-telehealth-program-invoices-reimbursements?mkt_tok=NzczLU1KRi0zNzkAAAF8wn-qjeRoIRGRmJOwVOAO8DxtchsnKpit1UbNY_hCbZZVDnK6jxX-VTendryRdaw0BeLxWnFcR90xotZs6ikzMrcjjvHZgcWX3tpv1reh Questions: Round2TelehealthApplicationSupport@usac.org < Previous News Next News >

The Center for Connected Health Policy (CCHP) released its bi-annual summary of state telehealth policy changes for Spring 2022 Center for Connected Health Policy Spring 2022 The Center for Connected Health Policy’s (CCHP) Spring 2022 analysis and summary of telehealth policies is based on its online Policy Finder. It highlights the changes that have taken place in state telehealth policy between the Fall 2021 Summary Report, and Spring 2022. The research for this Spring 2022 executive summary was conducted between January and April 2022. This summary offers policymakers, health advocates, and other interested health care professionals an overview of telehealth policy trends throughout the nation. For detailed information by state, see CCHP’s telehealth Policy Finder which breaks down policy for all 50 states and the District of Columbia. The Center for Connected Health Policy (CCHP) is releasing its Spring 2022 Summary Report of the state telehealth laws and Medicaid program policies catalogued in CCHP’s online Policy Finder tool. Prior to Spring 2021, this same information was released at least twice a year in the form of a 500+ page PDF report titled, “the State Telehealth Laws and Reimbursement Report” since 2012. With the transition to the online Policy Finder, users are able to navigate each state’s updated information as soon as CCHP makes it available. Additionally, the information from the online tool can be exported for each state into a PDF document using the most current information available on CCHP’s website. CCHP plans to continue to produce these bi-annual summary reports of the status of telehealth policies across the United States in the Spring and Fall each year to provide a snapshot of the progress made in the past six months. CCHP is committed to providing timely policy information that is easy for users to navigate and understand through our Policy Finder. The information for this summary report covers updates in state telehealth policy made between January and mid-April 2022. For full report: https://www.cchpca.org/2022/05/Spring2022_ExecutiveSummaryfinal.pdf < Previous News Next News >

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

New Study Pitches Telehealth as Safer Than the Doctor’s Office Eric Wicklund, mhealthintelligence August 2021 In a nod to the value of telehealth in primary care, researchers have found that a person visiting the doctor's office shortly after a visit from someone with the flu has a much higher chance of getting the flu as well. A new study makes a strong case for telehealth as an alternative to the doctor’s office, particularly during flu season. Researchers from the University of Minnesota School of Public Health, Harvard Medical School and the university’s T.H. Chan School of Public Health and athenahealth have found that people who visit their doctor’s office after someone infected with the flu has visited that office are much more likely to come down with the flu themselves. That same increase wasn’t seen in people seeking treatment for issues like urinary tract infections. The study, published this month in Health Affairs, suggests that primary care providers embrace virtual visits as a means of reducing that chance of infection. “It’s a widely accepted fact that patients can acquire infections in hospital settings, but we show that infection transmission can happen when you visit your doctor’s office, too,” Hannah Neprash, an assistant professor at UM’s School of Public Health and one of the study’s authors, said in a news release issued by the university. “Our findings highlight the importance of infection control practices and continued access to telemedicine services, as health care begins to return to pre-pandemic patterns,” she added. "In-person outpatient care for influenza may promote nontrivial transmission of these viruses. This may be true for other endemic respiratory illnesses too, including COVID-19, but more research is needed." The study, which tracked office visits from a national sample of insurance claims and EHR data compiled by athenahealth, is reportedly the first to connect the dots between office visits and the progression of a flu outbreak. According to that data, patients visits their primary care provider were almost 32 percent more likely to contract the flu within two weeks if that PCP had seen someone with the flu within the previous two weeks. In addition, that office would then serve as an incubator for the flu, infecting more patients over time. Neprash and her fellow researchers say their study supports the need for “triage to telemedicine” policies in clinics and medical offices when a patient shows signs of a contagious viral infection like the flu. “Given that upper respiratory symptoms are among the most common reasons for any patient to see a physician, these results highlight the importance of protocols to mitigate the risk for transmission,” the study notes. “Clinically, many of these patients will be at low risk for complications with telemedicine evaluation.” It also suggests that care providers develop “strict infection control practices” whenever a patient showing signs of the flu or a similar virus need to be seen in person. This would include mask-wearing, hand hygiene and putting patients in separate exam rooms that can be decontaminated after a visit. Finally, the study makes a case for continued support for telehealth coverage at a rate equal to in-person care. “Lawmakers in Congress are actively debating the future of telemedicine policy and how it should be reimbursed after the worst of the COVID-19 pandemic recedes,” the study notes. “It is possible that telemedicine reimbursement after the pandemic will be restricted to certain specialties or diagnoses or reimbursed at a rate low enough that many clinicians decide to forgo telemedicine as a mechanism for care delivery. Our results argue that clinically, for infection control, telemedicine should remain a financially viable option for clinicians to provide care for viral respiratory symptoms. < Previous News Next News >

New Mexico Telehealth Alliance TELEHEALTH RESOURCES | COMMUNITY | PROGRAM SUPPORT Connecting New Mexicans to Better Health. The New Mexico Telehealth Alliance (NMTHA) is a tax-exempt 501(c)(3) non-profit corporation dedicated to promoting telehealth solutions that deliver quality healthcare throughout the State. The NMTHA is a network of members representing a broad spectrum of public and private healthcare organizations. The NMTHA provides program support enabling members to eff ectively share resources. Board members and officers are all volunteers. Vision: Through the efforts of the NMTHA’s work on policy, quality, and equitable access to telehealth services, New Mexicans will be able to get the care they need when they need it. Mission: Advance effective use, equitable access, and sustainable telehealth service delivery in New Mexico. About Innovating Remote Access to Care Bridging Health Equity Gaps / Disparities AI + Digital Innovation Medicare Telehealth HCA/Turquoise Care Vision & Strategies View Presentations Why does New Mexico need a Telehealth Alliance? Click HERE to learn more... Be part of the solution! Join the Ne w Mexico Telehe alth Alliance Telehealth and telemedicine are no longer an innovative approach to healthcare - they are a necessary part of it. More than ever, access to quality healthcare, especially in New Mexico, is fundamental to the well-being of many communities, especially in rural and territorial areas. Supporting the New Mexico Telehealth Alliance through membership helps ensure access to meaningful information and supports the viability of telehealth services in New Mexico. Membership matters! Benefits of Membership Stay Connected! Stay connected with the NMTHA community by signing up to receive updates and notifications on industry trends, the latest telehealth news, events, and more. Thanks for connecting with NMTHA! Submit

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 >

Telehealth Requires Efforts to Improve Access to Reach Full Potential Mark Melchionna November 29, 2022 New research found that telehealth expansion lacks benefits when efforts to improve access are not present, which may often lead to health disparities. Regions with limited healthcare resources may not benefit from telehealth expansion, prompting the need for efforts to improve access, a new JAMA Network Open study finds. Throughout the recent expansion of telehealth, researchers continuously gained insight into new methods for reaching areas with limited amounts of healthcare resources, highlighting many areas and populations facing limited healthcare resources. The fact and theories about the relationship between telehealth and health disparities led researchers to conduct a cross-sectional study containing 2015 to 2019 American Community Survey data which was linked to national, state, and county-level metrics of healthcare access. Prior to the study, the authors hypothesized that internet access was poor in areas that lacked sufficient access to traditional healthcare resources. Known as healthcare deserts, communities with limited healthcare services such as pharmacies, hospitals, PCPs, and low-cost health centers were reviewed for the study. The data sources included dataQ and GoodRx databases for 60,249 pharmacies, federal information on primary care health professional shortage areas, and geospatial information. Researchers calculated the proportion of populations with internet access and the expected number of healthcare deserts, which represented the population-weighted mean number of deserts in a given region. They also noted statistics for metropolitan status for each state. Among 3,140 counties reviewed in the study, researchers determined that healthcare access and internet service availability corresponded with one another. They found that the states with the largest percentage of households without internet service were Mississippi, Arkansas, Louisiana, New Mexico, West Virginia, and Alabama. The states with the lowest number of households without internet service and the lowest fitted number of healthcare deserts were Washington, New Hampshire, Colorado, Utah, California, and Maryland. Rural areas were more likely to have more health deserts and less internet service availability —78 percent compared to 26 percent of urban counties. Based on these findings, researchers concluded that telehealth expansion may not produce benefits within counties where telehealth is highly needed. Key factors that contribute to rural-urban health disparities in the US may include telehealth expansion without improving internet access as well as clinician shortages. Despite this conclusion, researchers noted limitations, which mainly related to the lack of digital literacy data that may have increased urban-rural disparities, along with the co-occurrence of poor internet and healthcare access across six domains. Previously, however, efforts have been made to support rural communities in obtaining telehealth resources. In September, Equum Medical worked with the National Rural Health Association to provide underserved rural communities with virtual resources. The goal of the collaboration was to assist rural hospitals as they aim to fill gaps in specialty care through tools such as of patient transfer assistance, remote patient monitoring, and help with telehealth implementation. See original article: https://mhealthintelligence.com/news/telehealth-requires-efforts-to-improve-access-to-reach-full-potential < Previous News Next News >

HIMSSCast: How emerging tech is opening new avenues in telehealth, RPM Mike Miliard October 28, 2022 Virtual therapeutics, voice recognition and fast-evolving artificial intelligence tools are transforming home-based care, says Robin Farmanfarmaian, co-author of the new book How AI Can Democratize Healthcare. Remote patient monitoring and other forms of virtual care are fast finding footholds in healthcare as patients get acquainted with these new care modalities, and as health systems learn to appreciate the cost efficiencies they offer. But telehealth and RPM are still in their early days, and fast-changing as they're augmented with other new and emerging digital health and artificial intelligence technologies. Robin Farmanfarmaian, a longtime Silicon Valley entrepreneur and co-author of the new book, How AI Can Democratize Healthcare, joined us recently to discuss how the growing momentum toward home-based care is being impacted by leading-edge innovations such as natural language processing, digital therapeutics and more. leading-edge-technologies-are-transforming-telehealth-and-rpm (1).mp3 Talking points: Where remote patient monitoring is now, and where it's headed How AI is changing how virtual care is delivered New approaches to patient engagement and experience What's next for digital therapeutics and other app-based interventions Innovative use cases for NLP and machine learning models More about this episode: The intersection of remote patient monitoring and AI How remote patient monitoring is moving into the mainstream AI-powered telehealth improves PT care at Essen Health Care Mayo Clinic working with Memora Health on virtual postpartum care AI-powered RPM can help address the rural neonatal care crisis How remote patient monitoring improves care, saves money AI and IoT device connects with concierge platform for RPM Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Healthcare IT News is a HIMSS publication. See original podcast: https://www.healthcareitnews.com/news/himsscast-how-emerging-tech-opening-new-avenues-telehealth-rpm < Previous News Next News >

Member & Sponsor Levels NMTHA offers multiple benefit levels: Membership Pricing structure based on organization size All Member benefits included Sponsorship Available to members and non-members All Sponsor benefits included Does not include member benefits Membership is not required for sponsorship Member benefits NMTHA Member benefits include: Tax-deductible annual dues as donation to 501(c)(3) organization NMTHA Committee membership and leadership opportunities Inform and influence local/state/national telehealth policy Gain industry insight, knowledge, professional development Networking, community forum, special events e-Newsletter, email updates, workshop notifications On-demand webinars, training videos, interviews View job postings, resume builder, skill-building content Members Select the plan that fits your organization type Health Systems, Health Plans $ 1,000 1,000$ Every year Provides access for up to 6 people Select Hospitals, Associations, Group Practices $ 500 500$ Every year Provides access for up to 4 people Select Individuals $ 150 150$ Every year Provides access for up to 1 person Select Students, Equity Members $ 20 20$ Every year Provides access for up to 1 person Select Membership dues renew annually until cancelled. For plans that include multiple users, click HERE to learn how to add users to your membership plan. For login instructions, click HERE . NMTHA Sponsor benefits include: Tax-deductible sponsorship is donation to 501(c)(3) organization Organization featured on NMTHA's dedicated Sponsor webpage Webinar presentation to NMTHA Board of Directors Poster presentation at NMTHA's Annual Town Hall Sponsor benefits Sponsors For Members and Non-Members NMTHA Sponsors (Membership not required) $2,500 $ 2,500 (Member benefits not included. Membership is available separately.) Valid for one year Select

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

The Centers for Medicare and Medicaid Services (CMS) released its final CY 2022 Physician Fee Schedule (PFS) policies for Medicare last week. Centers for Medicare and Medicaid Services Nov. 10, 2021 CY 2022 Physician Fee Schedule (PFS) policies for Medicare The Centers for Medicare and Medicaid Services (CMS) released its final CY 2022 Physician Fee Schedule (PFS) policies for Medicare last week. Unless otherwise noted, the policies will take effect on January 1, 2022. Much of the proposals published in July 2021 for public commentary remain intact, but CMS did make several modifications and clarifications. https://public-inspection.federalregister.gov/2021-23972.pdf < Previous News Next News >

Medicare Physicians Fee Schedule 2023 draft and the Impact on Rural Health Arizona Telemedicine Program August 16, 2022 Request a copy of the full report by navigating to the original article link. For original article: https://telemedicine.arizona.edu//event/webinar/2022-08-16-medicare-physicians-fee-schedule-2023-draft-and-impact-rural-health < Previous News Next News >

My Story: A Patient’s Perspective Tara Barry January 27, 2022 The pandemic has created a lot of new realities throughout the world, telemedicine being one of them. As someone with thyroid disease and other ailments, I have to get regular check-ups (sometimes every month when it’s really flaring up). With my health issues, I see multiple different doctors (primary, cardiologist, endocrinologist, allergist), and it’s often very hard for me to find time to fit them all in to my already jam-packed schedule. Telemedicine has been such a welcome adaption for me, as it has truly taken a lot of the usual “appointment” stress, like commute time, completely out of the equation. During the pandemic, I’ve been particularly cautious about in-person appointments. Since I am someone with a weakened immune system, it makes me nervous going into such a historically germ-filled location such as a doctors’ office. Telemedicine appointments truly put me at ease. I have had experience with ‘televisits’ for both primary care and specialty care. I’ve been able to have a quick appointment on my lunch break and sometimes even during a short 15-minute break. When I made my first appointment I was a little nervous about how it would be. I didn’t know if I’d feel more rushed and like they were just squeezing me into their busy day or not. It was a relief to find that wasn’t the case at all. I find these appointments to actually be much more conversational than in-person visits, and also feel like they really get down to the issues faster. You can learn about treatment options in mere minutes and have your prescriptions sent in while you’re still on the call! I am someone who is technologically savvy so I wasn’t too worried about being able to successfully hop on to a telemedicine call. I think the various systems different doctor’s offices use make all the difference. In my experience, I have always been given the telehealth links ahead of time and the instructions have been very clear and concise. Typically, the medical assistant will call prior to the appointment to go over your medical history, insurance information, what your appointment will be focused on, and the instructions to get on the call. Sure, there’s been a few times we’ve had some connection issues, but they always seem to resolve themselves quickly and don’t take away from the appointment itself. To read full article: https://telemedicine.arizona.edu/blog/my-story-patient-s-perspective < Previous News Next News >

Transforming Homes And Communities Into Healthcare Hubs In The Post-Covid Future Ryan Hullinger and Sarah Markovitz August 2021 Hospital design experts Ryan Hullinger and Sarah Markovitz discuss the inevitable shifts in healthcare delivery as technology leads to new care settings and rethinking hospitals. The explosion of telehealth prompted by the Covid-19 pandemic has accelerated a shift in care delivery away from the hospital and clinic and into homes and communities. While hospitals have historically been the main hub of care, technology and new care models are enabling a different approach to care delivery. Rather than episodic preventative care, in which a patient periodically goes to a physician or hospital with a health concern, this new model of care is continuous and ubiquitous—with ongoing care reinforced in the home, office, school and throughout the community. There are three key aspects to this shift: advancing technology, new care settings, and the future evolution of hospitals. Advancing Technology Healthcare may follow a familiar path blazed by online retail. It was not that long ago that virtually everyone preferred in-person retail experiences to shopping online. The technology that would later make online shopping experiences superior to brick and mortar just didn’t exist. Telehealth, by comparison, is still in the dial-up days. It’s difficult to imagine now, but based on the patterns we have seen clearly in other technology sectors, it’s probable that some healthcare experiences will be better remotely than in-person—more convenient, and less stressful and time consuming. The technology that will transform telehealth is on the horizon. It will take several R&D cycles, but it will come. In fact, there’s evidence that in areas like behavioral health telehealth is already comparable in efficacy to in-person care. What might the next generation of telehealth look like? For one, rather than sequential visits with separate specialists, patients may be able to connect to a suite of caregivers, all working collaboratively to provide more coordinated, effective care. The type of continuous, convenient touch-bases and flow of information enabled by telehealth and wearable devices could be particularly effective for the elderly and those with chronic conditions, where communication and ensuring compliance with medication and preventive care are often an issue. There will also likely be an expansion in the types of care and services that can be provided, including everything from post-surgical appointments, to ED triaging, and eventually more complex tests as new diagnostic technologies emerge. Automated technologies and artificial intelligence will also play an increasingly vital role in improving health throughout the community. AI technologies are being used to scan patient records, identify patients with hypertension and diabetes, and remind physicians to check in regularly with them. Hospitals have already shown good results using telehealth, texting and improved monitoring to help vulnerable populations and those with chronic conditions. Improved telehealth and health data capabilities could extend widescale efforts like these, improving population health efforts. New Care Settings With technology acting as a facilitator, more and more forms of care, especially routine procedures, will migrate away from hospitals and clinics. The home could become the new healthcare hub, with prefabricated telehealth units for the home that integrate medical technologies with telehealth capabilities. The explosion of smart home, home health and health monitoring devices, encompassing everything from sensors that detect sudden falls to smart watches that monitor heart rate and O2 levels, is only the tip of the iceberg. With the ability to monitor health data and communicate effectively with caregivers, the home could be a crucial site for preventive medicine, chronic disease management and ongoing care. The home health model is only one possible model—the technologies that enable it may have shortcomings, or prove unaffordable to large segments of the population, further exacerbating health inequities and the digital divide. But healthcare can still be provided in a wide range of locations distributed throughout communities. Libraries, schools, community centers, homeless shelters and pharmacies could become hubs for telehealth resources and care, serving a vital role in improving the health of communities. A key consideration will be access and location—ensuring that healthy equity and care for vulnerable populations drives where these new care hubs emerge. How Hospitals May Evolve As care becomes increasingly continuous and ubiquitous, the role of the hospital may evolve. Rather than serving as a destination for all patient types, it will become increasingly specialized and streamlined, focusing on high acuity cases. They may expand their capabilities and efficiency in areas like perioperative and high-end imaging that are not available in community settings. In the process, hospitals are likely to become more compact, high performing and efficient by narrowing their focus. As part of this evolution, hospitals may also need to bolster their ability to expand capacity by 50-100% in anticipation of emergencies like epidemics, mass casualties and weather-related crises. In the last 20 years, many hospitals have invested heavily in improving patient comfort and satisfaction, and have even borrowed processes and designs directly from the hospitality industry—creating patient environments that nearly resemble hotel lobbies and guestrooms. Patient satisfaction will continue to be a driver, but the environments that promote satisfaction are likely to change drastically. New environments that convey a sense of safety and cleanness will begin to feel more comfortable than the hospitality-informed designs of the past. As this shift and gradual downsizing takes place, there may be opportunities to adapt existing space for other uses. The Covid-19 pandemic has demonstrated the dramatic impact of stress on healthcare workers. Hospitals now have an opportunity to provide sufficient and appropriate space for staff, helping to build resiliency to counter staff burnout and ensure the well-being of these truly essential workers. Hospitals could also aim to provide more community, patient and staff resources, such as spaces to demonstrate telehealth technologies and how to use them, or new hybrid offices equipped for telehealth. As technologies, new care settings, and hospitals evolve, care will become more embedded in our daily lives. The pandemic may have spurred new interest in telehealth, but the trends shaping the future of care predate social distancing. They will continue to transform how and where care is delivered, ushering in a new era of ubiquitous healthcare. Source: https://www.forbes.com/sites/coronavirusfrontlines/2020/10/26/transforming-homes-and-communities-into-healthcare-hubs-in-the-post-covid-future/?sh=133370e04153 < Previous News Next News >

22 States Changed Telemedicine Laws During the Pandemic Kat Jercich June 2021 Most pursued changes via administrative action, according to a new Commonwealth Fund report, which may not be a permanent solution after the COVID-19 public health emergency ends. The Commonwealth Fund released an issue brief this week reviewing state actions to expand individual and group health insurance coverage of telemedicine between March 2020 and March 2021. It found that 22 states changed laws or policies during that time period to require more robust insurance coverage of telemedicine. "If telemedicine proves to be a less costly way to deliver care, payers and consumers may benefit from expanding coverage of telemedicine after the pandemic," wrote report authors. WHY IT MATTERS In March 2020, federal regulators temporarily relaxed restrictions for telemedicine visits for Medicare patients, raising payments to the same level as in-person visits and reducing cost-sharing, among other changes. Officials encouraged states and insurers to provide similar flexibility under private insurance – and many took that encouragement to heart. Of the 22 states that expanded access to telemedicine during the pandemic, the report found that most pursued changes via administrative action. "Use of executive authority allowed states to move relatively quickly during the crisis, though it has meant that the new telemedicine coverage requirements are temporary," wrote the researchers. They noted, for example, that seven governors included specific telemedicine coverage requirements in executive orders, which will expire after the public health emergency. Some states used bulletins, notices, or executive orders from the department of insurance or a similar agency to enhance coverage. New legislation, which takes more time, but is necessary for permanent changes, passed in eight states. Utah, Illinois, West Virginia, New Hampshire and Massachusetts – which had not previously required coverage – changed their policies during the pandemic. At this point, 40 states require coverage. These policies do not all carry equal impact. Eighteen states required coverage of audio-only services for the first time during the pandemic, bringing the total number up to 21. Four states eliminated cost-sharing for telemedicine services, and three added a requirement that cost sharing not exceed in-person identical services. And 10 states newly required insurers to pay providers the same for telemedicine and in-person visits. Report authors noted that insurers were cooperative with these changes, but longer-term adoption of policies like reimbursement parity "would likely be contentious." They pointed out the states will need data to inform debates on how best to regulate telemedicine. In 2021, at least 30 states have weighed legislation that would revise telemedicine coverage standards, found the Commonwealth Fund. Despite the known benefits of telemedicine, researchers also cautioned that it has not been equally beneficial to all patients. "Research shows telemedicine use is lower in communities with higher rates of poverty and among patients with limited English proficiency, potentially undermining goals of expanding access to underserved communities and exacerbating health inequities," read the report. THE LARGER TREND As the report notes, multiple states have implemented pro-telehealth policies to enable access during and beyond the COVID-19 public health emergency. But a major question remains regarding federal legislation, which could fill in many state-by-state gaps and prevent a so-called "telehealth cliff." "If Congress does not act before the public health emergency ends, regulatory flexibilities that now ensure all Medicare beneficiaries maintain access to telehealth will go away," said Kyle Zebley, director of public policy at the American Telemedicine Association, during a conference panel earlier this month. ON THE RECORD "Whether telemedicine reduces overall healthcare costs depends on how services are reimbursed and if virtual visits reduce other services or simply add to utilization," said Commonwealth researchers. "Having access to data can help stakeholders understand how longer-term expansion of telemedicine affects access, cost, and quality of care." Source: https://www.healthcareitnews.com/news/22-states-changed-telemedicine-laws-during-pandemic < Previous News Next News >