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

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

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

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

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

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

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

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

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

New Nationwide Poll Shows an Increased Popularity for Telehealth Services Center for Connected Health Policy June 2021 Expansion of telehealth is welcomed by most Americans. The American Psychiatric Association (APA) completed a new national public opinion poll finding that expansion of telehealth is welcomed by most Americans. Nearly 4 in 10 reported having used telehealth services, nearly 6 in 10 said they would use telehealth for mental health services, and more than 1 in 3 said they prefer telehealth. In addition, more individuals seem to have used telehealth via video (69%) than via phone (38%). Perception of the quality of telehealth appears to have improved as well, at 45% up from 40% last year. The results came from a recent online survey of 1,000 adults – additional information on the poll and its findings can be accessed on the APA website - https://www.psychiatry.org/newsroom/news-releases/New-Nationwide-Poll-Shows-an-Increased-Popularity-for-Telehealth-Services. < 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 >

New ULC Uniform Telehealth Act Highlights Important Policy Considerations & Licensure Trends Center for Connected Health Policy August 2022 The new Uniform Telehealth Act states that services can be provided via telehealth consistent with existing practitioner standards of care and it also establishes a registration process allowing out-of-state providers to deliver services through telehealth to patients in states that choose to adopt the Act. For full post see: https://www.cchpca.org/resources/new-ulc-uniform-telehealth-act-highlights-important-policy-considerations-licensure-trends/ < 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 >

HHS to put $35M toward telehealth for family planning Kat Jercich November 29, 2021 The agency plans to use the funds to award about 60 one-time grants to Title X family planning providers, who must apply by February of next year. The U.S. Department of Health and Human Services announced that it would make $35 million in American Rescue Plan funding available for Title X family planning providers to strengthen their telehealth infrastructure and capacity. Title X family planning clinics help to insure access to a broad range of reproductive health services for low-income or uninsured individuals. "I’ve seen first-hand the critical role that telehealth plays in serving communities, particularly to protect so many families from COVID-19," said HHS Secretary Xavier Becerra in a statement about the grant availability. "As providers transitioned from providing in-person primary care to offering telehealth services, we were able to test, vaccinate, and act as lifelines to communities disproportionately hit by the pandemic," he said. "Increasing our investment and access to telehealth services remains critical." WHY IT MATTERS The Office of Population Affairs funds 71 Title X family planning service grantees and supports hundreds of subrecipients and thousands of service sites around the country. Family planning includes a broad range of services related to reproductive health, including contraception, sexually transmitted infections and pregnancy testing. Although abortion care can be co-located with family planning services, Title X funds cannot be used to pay for it. Although some services require in-person treatment and exams, others can be carried out via telehealth – as evidenced by grantees' use of virtual care to help their patients during the COVID-19 crisis. Still, facilities may not have adequate technology available. "During the global COVID-19 pandemic, family planning programs have accelerated the use of telehealth," said Dr. Rachel Levine, assistant secretary for health, in a statement. "These ARP funds will facilitate the delivery of quality family planning services and reduce access barriers for people living in America who rely on the health care safety net for services," she added. HHS plans to use the funds to award about 60 one-time grants to active Title X grantees. Organizations must apply by February 3, 2022, and notices of awards will be announced before the project start date of May 1, 2022. THE LARGER TREND Even as the government has moved to shore up telehealth infrastructure via funding, the question of virtual care's future continues to hang over Congress. Despite requests from hundreds of advocacy organizations, legislators have so far failed to take action to permanently safeguard telehealth after the end of the COVID-19 public health emergency – what some activists have referred to as "the telehealth cliff." "We recognize there are many unknowns related to the trajectory of the COVID-19 pandemic over the next 12 to 24 months," said American Telemedicine Association CEO Ann Mond Johnson in October. "However, we implore Secretary Becerra to provide as much predictability and certainty as possible to ensure adequate warning before patients are pushed over this looming cliff." ON THE RECORD "The pandemic has laid bare the important role that telehealth can play in our nation’s healthcare service delivery, and we are profoundly grateful for the opportunity to support continued investments in telehealth for the nation’s family planning safety net," said Jessica Swafford Marcella, HHS deputy assistant secretary for population affairs, in a statement. < Previous News Next News >

Telehealth Industry Expected to Grow from $26.4 Billion in 2020 to $70.19 Billion by 2026, at a CAGR of 17.7% DUBLIN--(BUSINESS WIRE) August 5, 2020 The present situation of COVID-19 has a great impact on the Telehealth market, where home care services are increasing through the modes of telehealth services. Information is passed through telecommunication where a patient can access the treatment from the clinician and can take advice without approaching to the doctor and without going out for the hospital. This situation gives immense opportunity for the telehealth market players. Market Highlights The Telehealth Market is estimated to reach USD 70.19 billion by 2026, from USD 26.4 billion in 2020 and registering a CAGR of ~17.7% during the forecast period. The growing technologies in the telecommunications sector to reach the patients in time play a major role in the telehealth services, which raise the growth in the Telehealth market. Based on the application of Telehealth - Telehealth services market is segmented into three segments, including Teleradiology, Tele-consultation, Tele-ICU, Tele-stroke, Tele-psychiatry, and Tele-dermatology. Teleradiology had achieved a major share in the telehealth market in the last year due to increasing mental health issues among people. The insufficient health services providers give the scope of opportunities in the telehealth industry to fulfill the demand of the end-users. The market components cover the segments of Software & Services and Hardware. The segment of software & services accounted for the larger share of the global telehealth market in 2019. Telehealth market based on the end-user segment classified into Providers, Payers, and Patients. The end-users, such as providers segment accounted for the largest share in 2019. Telehealth segmentation is based on geography includes North America, Europe, APAC, and RoW. North America accounts for the largest share in the telehealth market in the entire world. The Telehealth market is growing enormously in the region of North American countries, which is very advanced in the technological perspective and in the advanced medical facilities. The increase of chronic diseases like cancer, asthma, and other diseases driving the adoption of the home healthcare services to avoid the expensive costs charged by hospitals, these are some aspects which increased the growth in the telehealth market in this region. In the last recent years, Europe is also another region in the telehealth market region where market players experienced tremendous growth due to knowing the awareness of remote monitoring and healthcare from home. The telehealth market is expanding globally during the forecasting period. The factors which give opportunities for this market are lack of physicians, increasing chronic diseases that need immediate attention from the physicians. However, the reimbursement or coverage of the fee, illiteracy of some people who cannot adopt the current advanced telecommunication are the challenges faced by the telehealth market. Key Players in the Telehealth Market The key players in the market are Teladoc, Doctor on Demand, GE Healthcare, SnapMD, Encounter Telehealth, GlobalMed, HelloMD, MDLIVE Inc, InTouch Technologies, Dictum Health, Inc., LLC, and American Well. Globally, advancements in the technologies and growing awareness of remote services increased the demand for telehealth services. In the coming future, emerging countries/regions play an important role in the telehealth services market. This study will help the market players to understand the key market trends, market dynamics, and end-users pain-points. The qualitative and quantitative analysis of the study will enhance the user experience of the study. The competitive analysis of the major players enables users to understand the dynamic strategies such as technology innovation, partnerships, merger & acquisitions and joint ventures of the key players This report also provides the portfolio analysis and capability analysis of the leading players. Quantitative analysis of the market enables users to understand the actual facts of the market across four major regions. Companies Mentioned AMC Health American Well Asahi Kasei Corporation Cerner Corporation Chiron Health Cisco Systems E Healthcare Imediplus Iron Bow Technologies Koninklijke Philips Medtronic Medvivo Group Medweb Siemens Healthineers AG Teladoc Health Telespecialists Vsee Zipnosis For more information about this report visit https://www.researchandmarkets.com/r/kyppo0 Contacts ResearchAndMarkets.com Laura Wood, Senior Press Manager press@researchandmarkets.com For E.S.T Office Hours Call 1-917-300-0470 For U.S./CAN Toll Free Call 1-800-526-8630 For GMT Office Hours Call +353-1-416-8900 < Previous News Next News >

Configuring Virtual Care to Boost Pediatric Healthcare Quality, Access eVisit December 12, 2022 Virtual care can be a boon for pediatric patients and providers alike, but the key to a successful program lies in selecting and implementing the right technology. The rise in virtual care use has spurred greater access to healthcare, enabling providers to meet patients where they are. In the case of healthcare's youngest consumers, virtual care has not only helped mitigate barriers to care but also enhanced care delivery. Pediatric patients, like their adult counterparts, used virtual care in droves during the COVID-19 pandemic. One 2021 survey shows that one in five parents said their child had a virtual visit in the past year. Further, virtual care gained popularity among parents. Another survey showed that more than 60 percent of parents said they would want to continue using virtual modalities for their child's care after the pandemic, including almost 30 percent who hadn't used it previously. As a result, healthcare providers are increasingly implementing virtual care services for their pediatric populations. But selecting the right technology, and streamlining its implementation, are essential to ensuring the success of virtual pediatric care programs. BENEFITS OF PEDIATRIC VIRTUAL CARE PROGRAMS Virtual care offers pediatric patients and their providers a myriad of benefits, including expanded access to care. Many pediatric specialists treat patients across multiple states with facilities managing large patient populations. Children with chronic illnesses often have to take time out of school to see a specialist, while their parents or guardians have to take time off work. In addition, care providers may have trouble traveling to rural communities to provide care, taking unaffordable time away from the office for long periods as they care for individual patients across regions. "Virtual care not only increases efficiency but impacts access to care in ways in-person care cannot. It has helped those who don't have access to transportation, especially in the middle of the night," says Jacquelin Solomon, Implementations Project Manager at eVisit, a telemedicine solutions provider. "A parent with a sick child being able to have increased access to care — that's a huge thing that virtual care services provide now." Telehealth has been especially useful in unlocking access to specialty care for children, such as speech therapy and behavioral health services. Before the COVID-19 pandemic, many specialty care providers didn't consider virtual care a viable option to provide care, according to Jackie Thomas, Enterprise Customer Success Manager at eVisit. But following the widespread use of virtual care during the public health emergency, providers found that it can, in fact, improve care quality, particularly for children with special needs. For instance, a 2022 pre-and post-data analysis showed wrap-around virtual care programs for children and adolescents with medical complexity demonstrated a statistically significant reduction in hospitalizations and ED visits. Virtual care can also be beneficial for providers to virtually observe an autistic child in their home environment where they are most comfortable and can best demonstrate their routine to develop an appropriate treatment plan, she adds. Further, virtual care supports pediatric care providers in several ways, including by boosting operational efficiency and clinician productivity. Care coordination, education, parental support, and care triage, in particular, become easier with virtual care, Solomon and Thomas note. KEY CONSIDERATIONS WHEN SELECTING TELEHEALTH TECHNOLOGY To ensure the success of a pediatric virtual care program, healthcare providers must select the right technology. One key factor to consider is the configurability of the platform. "You do not want your highly compensated providers trying to figure out all the nooks and crannies of a platform that isn't configured and designed to their workflow," says Jason Weinrich, Senior Director of Professional Services at eVisit. Configuring the platform to clinical workflows — rather than adjusting workflows to the platform's capabilities — can support provider adoption and continuity of care. "Having that ability to quickly access the visit from their schedule, see a patient, hand off the patient to another clinician, like a nurse educator, all from one virtual care platform allows for continuity of care," Thomas states. "It also prevents burnout for the provider by allowing an MA to support rooming the patient and the entire clinical team to work at the top of their license." Additionally, customizing virtual care platforms can allow clinicians to address social determinants of health specific to the pediatric populations they serve. For instance, adding translation services to the platform can help providers engage with patients with limited English proficiency. "Providing access to these patient populations and allowing them to have the whole platform translated into Spanish increases patient satisfaction as well as adherence to care plans for non-English speaking pediatric patients and their parents or caregivers," says Solomon. Another critical consideration is whether the virtual care platform integrates into the provider's EHR, which can further streamline workflows, eliminate redundant and duplicative tasks, and increase proper visit documentation, freeing up providers for patient care, she adds. Ultimately, pediatric virtual care programs have the best chance for success when the selected technology meets the health system’s specific needs. The only way to ensure this is through detailed conversations between vendors and clinical leaders. "Clinical leaders need to have a conversation with vendors about what workflows look like with their solution, discussing what their clinical teams are doing every day, and where the pain points are,” says Weinrich. “Vendors should be able to recommend solutions to accommodate clinical workflows across multiple specialties, supporting both scheduled and on-demand visits. Bringing that insight into the conversation as opposed to just giving you their out-of-box product is key. Build that box together." BEST PRACTICES FOR IMPLEMENTATION Implementation of virtual care that supports the digitization of pediatric care requires significant efforts to ensure new care models do not inadvertently exacerbate inequities in care. Deciding on a comprehensive project plan is the first step. Platforms should be configurable to align with established workflows while also offering innovative ways to enhance workflows for greater efficiency. Then, there needs to be discussions around platform education and adoption strategies. Vendors should partner with the health system’s training teams to ensure a successful rollout. Health systems must then walk through the workflows before putting them into action. Having your providers test everything and offer real-time feedback before going live can prevent future issues. In this way, providers can ensure that the technology will power their pediatric virtual care programs and provide the necessary flexibility as virtual care preferences shift. "You want to adjust quickly because the market's adjusting quickly because patients enjoy the access virtual care gives them," Weinrich said. "It's exciting; we see our health system clinical teams getting very excited about jumping on, doing quick testing with us to make sure things work. They are excited too about where virtual care is headed." Though virtual care use has leveled off since its peak in the early months of the pandemic, virtual care has become an integral part of the healthcare delivery model. As pediatric providers optimize their programs, the right technology can go a long way toward widening access and improving the healthcare experience for patients and their families. ___________________________________ About eVisit eVisit is an enterprise virtual care delivery platform built for health systems and hospitals. It delivers innovative virtual experiences in care navigation, care delivery, and care engagement, improving margins at scale without sacrificing quality or patient and provider satisfaction. eVisit works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue. Based in Phoenix, Ariz., eVisit helps healthcare organizations innovate and succeed in today’s changing healthcare market. See original article: https://mhealthintelligence.com/news/configuring-virtual-care-to-boost-pediatric-healthcare-quality-access < Previous News Next News >

Out-of-State Telehealth Aided Rural Residents Amid the Pandemic Mark Melchionna September 22, 2022 New research shows that several Medicare beneficiaries benefited from expanding out-of-state telehealth services, including rural residents and cancer survivors. September 22, 2022 - A study published in JAMA Health Forum found that many Medicare beneficiaries benefitted from the elimination of restrictions on out-of-state telehealth services during the COVID-19 pandemic, primarily those with cancer, rural residents, and those residing nearby state borders. According to the Centers for Disease Control and Prevention, 95 percent of health centers used telehealth during the COVID-19 pandemic. This sharp uptake has prompted researchers to explore the effects of telehealth and the populations that use it the most. This study examined out-of-state telehealth data from January to June 2021. They selected this time period because it followed the abrupt onset of the pandemic and included vaccine distribution efforts. Further, state-based licensing flexibilities were still in effect during the study period, enabling out-of-state telemedicine. Most flexibilities were eliminated by mid-2021, after which pre-pandemic state licensing laws were reinstated. Overall, 8.3 million Medicare beneficiaries participated in a telehealth visit between January and June 2021. Of these, 422,547 (5 percent) had one or more out-of-state telehealth visits. Through geographical analysis, researchers determined that 57.2 percent of all out-of-state telehealth visits involved patients who lived near a state border, defined as within 15 miles of a border. Upon analyzing out-of-state visits, researchers found that 64.3 percent included a primary care or mental health clinician, and 62.6 percent were preceded by an in-person visit between March 2019 and the telehealth visit involving the same patient and provider. Researchers also found that rural residents were more likely to receive telehealth from an out-of-state location, with 33.8 percent of out-of-state visits involving a rural resident versus 21 percent of within-state telemedicine visits. Also, 9.8 percent of out-of-state telehealth visits were for cancer care, the highest rate among all specialties. Based on this data, researchers concluded that Medicare beneficiaries living in rural areas, seeking cancer care, and living nearby state borders were the most likely to obtain telehealth from an out-of-state clinician. The study results also imply that these populations are highly affected by restrictions that limit out-of-state telehealth. Researchers noted a few limitations within their study, including the potential bias associated with data from the traditional Medicare population and the use of home addresses to determine the state in which a patient resides. Various studies have collected data that reveal the difficulties some patients may face when obtaining care. Highlighting the care disparities between urban and rural residents, research from June found that Native American patients often faced difficulties when accessing cancer care. This was largely due to the large geographic distance between the areas in which American Indian and Alaska Native patients reside and the locations of clinics. Due to the high prevalence of access disparities, organizations often push for regulatory expansions related to telehealth. In September, 375 stakeholders signed a letter sent to the US Senate that requested the solidification of telehealth access for two years after the COVID-19 public health emergency has ended. See original article: https://mhealthintelligence.com/news/out-of-state-telehealth-aided-rural-residents-amid-the-pandemic < Previous News Next News >

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2021 National Telemedicine Summit World Conference Forum, LLC Sept. 13, 2021 Key Strategies to Revolutionize & Transform Healthcare Delivery, Optimize Quality Patient Care & Outcomes, Increase Accessibility, Enhance Data Analytics, and Reduce Costs! September 13 – 14, 2021 • The Ritz-Carlton, South Beach • Miami, FL Today, telemedicine is one of the fastest growing sectors in healthcare. Specifically, COVID-19 has enhanced and accelerated the role that telemedicine plays within our healthcare system. It is reshaping the landscape of healthcare delivery in the United States, and is being recognized as the future of global healthcare. Telehealth addresses and achieves the basic tenants of Healthcare Reform: providing the population with access to improved and convenient, high quality patient centric care, enhancing outcomes, while reducing per capita expenditures. Today, more than 70 percent of hospitals throughout the United States are engaged in telehealth programs. Studies have shown that the benefits of telehealth include significantly improved outcomes, efficient care delivery as well as reduction in mortality rates, hospitalizations, length of stay, readmissions and healthcare costs. Telehealth has greatly enhanced access to quality care in rural areas and patient satisfaction has increased due to its convenience and patient centric approach. We have created an exciting, high level forum featuring knowledgeable leaders and executives from the nation's leading Hospitals and Health Systems who will share their perspectives, valuable insights and expertise on how to be best equipped for the rapidly evolving and exciting landscape of telehealth. This exclusive event targets senior level executives in order to maximize educational and networking opportunities. By attending the 2021 National Telemedicine Summit, you will learn what highly regarded Hospitals and Health Systems are doing to be prepared for the challenges that lie ahead in 2021 and beyond! We look forward to greeting you in Miami! Link: https://www.wcforum.com/conferences/telemedicine < Previous News Next News >

Building Lasting Tele-Behavioral Health Programs to Address Patient Needs Kat Jercich, Healthcare IT News. August 2021 In a HIMSS21 Global Conference Digital session, two experts discuss what it's taken for the University of Rochester to spin up a virtual behavioral health program over the past nine years. Telehealth during the COVID-19 pandemic has allowed many patients – especially those in under-resourced areas – unprecedented access to behavioral healthcare. But as Michael Hasselberg, senior director of digital health at the University of Rochester, discussed with Cleveland Clinic Director of Design and Best Practices Julie Rish during a HIMSS21 Global Conference Digital session, such programs have required being nimble and adaptable in the face of changing needs. Hasselberg outlined the results of a tele-behavioral health model in effect at the University of Rochester, explaining that it grew from a pilot program aimed at primary care doctors to a full-scale initiative in nearly a decade. But the pandemic, he says, ramped up demand – and the supply had to change in response. "Like every health system in the entire country, overnight you had to flip the switch on, and essentially totally pivot to telemedicine," he said. Having the infrastructure and years of experience allowed the team to shift within about a week to providing behavioral health services nearly entirely virtually. Even as vaccines have become more readily available, Hasselberg estimates that about 60% of the team's ambulatory services are being provided via telemedicine. Interestingly, considering reports from other parts of the country, Hasselberg said the team has not encountered patient difficulties with broadband access, even in rural areas – thanks in part to state government efforts to ensure connectivity throughout the region. But one challenge, he said, has been gaining community trust and support. "Learning to build those community partnerships, identify how the stakeholders are, doing focus groups … has allowed us to be successful," he said. For other organizations looking to replicate the university's success, he said, start by reaching out to providers already in place. "Build that partnership there. Find out where their struggles may be, where the gaps may be, how you can join forces to fill those gaps and truly partner," he advised. He also suggests approaching the programs as iterative – being agile and flexible, and not allowing perfect to be the enemy of good. "Just get something out there: See what works and what doesn't work, and continue to build off of that," he said. It's also vital to remember that not every service can be done via telehealth, he said. Having a support network to assist patients with technology is enormously helpful. Rish noted that it's not just about access alone. It's also about comfort and about trust. "Having somebody from your team who can get to the community, who can be onsite – that's really important," said Hasselberg. Hasselberg said it's been useful to examine who can most benefit from telehealth because of transportation hurdles or other barriers to in-person care. "Finding parking at an academic medical center is not an easy thing to do!" he laughed. By merging that information with electronic health record data, he said, the team can get specific about how best to target services. As far as care delivery predictions, Hasselberg said he saw telemedicine as the "tip of the iceberg." "I think the future of behavioral health will be an a la carte array of options," he said. < Previous News Next News >