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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 >

Interstate Telehealth Use By Medicare Beneficiaries Before And After COVID-19 Licensure Waivers, 2017–20 Juan J. Andino, Ziwei Zhu, Mihir Surapaneni, Rodney L. Dunn, and Chad Ellimoottil Abstract During the COVID-19 pandemic, all fifty states and Washington, D.C., passed licensure waivers that allowed patients to participate in telehealth visits with out-of-state clinicians (that is, interstate telehealth). Because many of these temporary flexibilities have expired or are set to expire, we analyzed trends in interstate telehealth use by Medicare beneficiaries during 2017–20, which covers the period both directly before and during the first year of the pandemic. Although the volume of interstate telehealth use increased in 2020, out-of-state telehealth made up a small share of all outpatient visits (0.8 percent) and of all telehealth visits (5 percent) overall. For individual states, out-of-state telehealth made up between 0.2 percent and 9.3 percent of all outpatient visits. We found that most out-of-state telehealth use was for established patient care and that a higher percentage of out-of-state telehealth users lived in rural areas compared with beneficiaries who did not receive care outside of their state (28 percent versus 23 percent). Our collective findings suggest that the elimination of pandemic licensure flexibilities will affect different states to varying degrees and will also affect the delivery of care for both established patients and rural patients. View Full Article: https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2021.01825?journalCode=hlthaff < Previous News Next News >

Once a Temporary Convenience, Telehealth is Here to Stay Beth Wood August 2021 Multifaceted networks supporting virtual medical visits hailed as a positive legacy of pandemic Whether you call it telehealth, telemedicine, e-health, virtual or video visits, the electronic delivery of health care services is coming into its own. The coronavirus pandemic spurred federal, state and private insurance programs to offer more coverage of telehealth to encourage people to follow the stay-at-home rules established in mid-March 2020. “After this last year and the benefits we’ve seen, telehealth is definitely here to stay,” said Kiran Savage-Sangwan, speaking from Sacramento. She is the executive director of the California Pan-Ethnic Health Network, a statewide health-advocacy organization. “The way we pay for healthcare has not robustly supported telehealth in the past,” Savage-Sangwan said. “The state has taken some interim steps before making permanent policy changes. The state will be extending the flexibilities for the Medi-Cal program through the end of next year, I believe, to continue to work out some of the policy issues.” According to the Centers for Disease Control and Prevention, the number of telehealth visits increased in the first quarter of 2020 by 50 percent, compared with the same period the year before. A single week in March 2020 showed a 154 percent increase, compared with the same period in 2019. Behind those numbers was a massive effort among health providers to accommodate this change. Even for UC San Diego Health, a pioneer in telehealth, the quick transition required an all-hands-on-deck approach. “We knew the shutdown would happen, but we didn’t know when,” recalled Marlene Millen, M.D., UC San Diego Health’s chief medical information officer for ambulatory care. “But our operational leads were already prepared for increasing video visits. Over the course of one weekend in March, we trained 1,000 doctors and staff. “We converted appointments and sent patients instructions. That very Monday, when everyone was supposed to be locking down, we were able to convert a couple of thousand appointments into video visits. That’s because we had a really good structure in place.” Millen spent the entire weekend at her home desk with multiple screens open, setting up online patient visits. An internal medicine physician, she has played a role in UC San Diego Health’s development of video visits for 10 years. About two or three years ago, she said, an app-based program was launched, which made it more accessible. But it wasn’t until the insurance coverage changed that telehealth’s potential could be tested. Until the shutdown, video visits were used for patients who had extreme obstacles to making in-person appointments. “Patients we targeted for these visits were ones with medical conditions who couldn’t come into the clinic,” Millen said. “They really embraced it. I had a patient in a wheelchair that had to be carried out of the house and another with a condition that made her use the bathroom all the time. Others had immune conditions. Then there were people who had to get on three buses to get to us. “Some of those patients were in danger of getting kicked out of insurance because of their number of no-shows. Video visits improved those situations. But it wasn’t a general-use case at that time.” Support for telehealth Now that pandemic restrictions have eased, the percentage of telehealth appointments versus in-person consultations has decreased in most of California. At UC San Diego Health, Millen noted, video visits rose to 30 percent during the early 2021 surge in COVID-19 cases. Video visits now account for between 15 and 20 percent of all appointments, a figure higher than prepandemic rates. As headlines attested, the pandemic put socioeconomic disparities in access to health care in stark relief. Some believe telehealth could provide a way to distribute health access more equitably. But there are hurdles. Many low-income people live in Wi-Fi deserts. Some have limited minutes on their smartphones, and others are unfamiliar with the technology. For some, finding a quiet private place in a multiperson home can be a challenge. “California has significant disparities — particularly by race, language and region — when it comes to health care access and health care outcomes,” Savage-Sangwan said. “Certainly, telehealth was helpful during the pandemic. “When people go into a medical office, various medical professionals assist them. Someone checks you in, someone takes your weight. People support you through the process. But when you’re accessing virtual care from home, you’re going to need to get that support a different way. “What we’ve seen to be successful is for the providers’ offices to build that into their workflow. Maybe someone calls you about your doctor’s appointment and would say: `'Hey, are you set up? Do you know how to use the platform? Let me walk you through it.’ We need to support people, so they are truly engaged in their health.” What’s telehealth friendly? Colonoscopies, mammograms and MRIs are obviously not possible through telehealth (at least not yet). But a lot can get done through a video visit, including assessing a medical problem and prescribing remedies for it. Millen, of UC San Diego Health, said her telehealth patients usually followed through on her instructions. She also noted that caregivers and family members became more engaged in video visits, particularly when she asked them to help with the exam. From monitoring diabetes and diagnosing a sinus infection to doing preliminary neurological tests and conducting speech therapy sessions, the use of telehealth has been wide ranging. “Before the pandemic, I would have definitely said: `'Yeah, there are some specialties that won’t be able to do video visits at all,’ ” Millen observed. “I was surprised how well our doctors and staff figured out how to get patient history and information.” Both Millen and Savage-Sangwan of the California Pan-Ethnic Health Network think that behavioral health and counseling services are extremely telehealth friendly. Savage-Sangwan pointed out that the network’s community clinics had been experiencing a high rate of no-shows for these services before the pandemic. With telehealth, the number of no-shows dropped to almost zero. In general, telehealth has proved itself worthy of coming out of the prepandemic shadows and becoming a vital component of equitable healthcare. “I’m happy by how many video visits are still going on,” Millen said. “I was thinking it would fall off rather quickly. But there are certain doctors who really love it and certain patients who really love it. “I see it getting a little more mature. What’s happened in the last few months is that we’ve created more of a system for it that makes sense. On both sides, I think we all know when to hold it and when to fold it.” She laughed. “I mean, when to see them and when to video.” Source: https://www.sandiegouniontribune.com/news/health/story/2021-08-03/once-a-temporary-convenience-telehealth-is-here-to-stay < Previous News Next News >

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

Medicare Telehealth: Actions Needed to Strengthen Oversight and Help Providers Educate Patients on Privacy and Security Risks U.S. Government Accountability Office (GAO) September 26, 2022 To help patients access care during the pandemic, Medicare temporarily waived restrictions on telehealth—health care services delivered via phone or video. The use of telehealth services rose tenfold: 53 million telehealth visits in Apr.-Dec. 2020 vs. 5 million during the same period in 2019. But Medicare hasn't comprehensively assessed the quality of care patients received, and lacks data on telehealth services delivered in patients' homes or via phone. Patients may also be unaware that their private health information could be overheard or inappropriately disclosed during their video appointment. Our recommendations address these issues. Highlights What GAO Found In response to the COVID-19 pandemic, the Department of Health and Human Services (HHS) temporarily waived certain Medicare restrictions on telehealth—the delivery of some services via audio-only or video technology. Use of telehealth services increased from about 5 million services pre-waiver (April to December 2019) to more than 53 million services post-waiver (April to December 2020). Total utilization of all Medicare services declined by about 14 percent post-waiver due to a 25 percent drop in in-person service use. GAO also found that, post-waiver, telehealth services increased across all provider specialties, and 5 percent of providers delivered over 40 percent of services. Urban providers delivered a greater percentage of their services via telehealth compared to rural providers; office visits and psychotherapy were the most common services. See full article: https://www.gao.gov/products/gao-22-104454 < Previous News Next News >

Telehealth 2.0: How Providence is taking its platform to the next level Laura Dyrda June 13, 2022 Telehealth became the prevailing mode for medical providers to see patients during the early days of the pandemic, and while use has leveled off in many areas, virtual care has become a permanent part of the healthcare ecosystem. Hospitals and health systems across the U.S. are now building telehealth, remote patient monitoring and hospital-at-home programs as part of their growth strategies. Patients also prefer telehealth as a convenient way to see their clinicians when an in-person visit isn't necessary. Most health systems have built a functioning telehealth program, but what opportunities are there to refine these programs for a better patient and clinician experience? Todd Czartoski, MD, chief medical technology officer at Renton, Wash.-based Providence, joined the Becker's "Digital Health + Health IT" podcast to talk about where the health system's virtual care program is headed. Click here to subscribe to the podcast and keep an eye out for Dr. Czartoski's episode. Note: Response below is edited lightly for clarity. Question: Where do you see telehealth becoming a better tool for clinicians and patients? How is virtual care at Providence evolving? Dr. Todd Czartoski: Over the last two years, our organization has done just over 4 million [telehealth] visits. For perspective, in 2019 we did 67,000 visits, and in one year we were doing 70,000 visits a week in April and May of 2020. That was a huge shift. Now, turning the lights on and being able to walk into the room is one thing, moving furniture around and optimizing the flow is another. A lot of our focus in the last couple years has been improving the experience for the provider, clinic staff and for the patient. We have really gotten it down to where the basic technical components of [telehealth] work pretty darn well, and we don't have a lot of issues with the connectivity piece. We've added interpreter services, and we've added in the ability to talk to more than one person at a time so you can have a family member in a different part of the country join the visit. Those types of things have been important add-ons, in addition to waiting room functionalities where you can add a survey or information tailored to the patient while they're waiting to see their provider in the virtual waiting room. Those are the things you're going to see continuing to evolve and emerge as additional capabilities. The support staff for the physician or provider's clinic also see their function and role evolving. If you think about a traditional clinic, a lot of those roles require putting patients in the room, checking their vitals, ordering labs or getting patients a follow-up appointment. Some of these things still exist, and some are going to be automated or done as part of a telehealth visit. That's where some of the opportunities are arising to continue to optimize the experience for the patients, staff and provider. You're going to see big trends overall here. Telehealth as a video visit, as a functionality, is somewhat limited. What we've learned is that whether you're a behavioral health specialist, a primary care provider or a subspecialty surgeon … all of those specialist visits can be done safely and effectively with telehealth. It's opened the door for looking at what else could we do beyond just a face-to-face visit. Specifically, the door has been opened for home monitoring. We have a remote patient monitoring solution that we built for COVID-19 home monitoring specifically, and because of the success of that, we've monitored over 30,000 patients up to two weeks who either confirmed or were under suspicion of having COVID-19. That opens the door for what we could do in terms of other types of home monitoring for COPD, diabetes, hypertension or whatever the case may be. That's a big area for growth and development. Finally, moving services outside the hospital, hospital-at-home, is a big initiative for us. We've been working on it for a long time and we're seeing some success. We're rapidly deploying that across our ecosystem and a lot of other health systems are as well. It really checks a lot of the boxes for patient experience; our patients absolutely love it. It's bending the cost curve, improving access and helping improve capacity so we don't have to build more super expensive towers and hospitals. Some of the outcomes with hospital-at-home have been shown to be better than traditional hospitalization when it comes to delirium, falls, length of stay and complications. People actually heal better on their own in a comfortable home environment. Those are a few examples of areas that we're going to see growth in our ecosystem. See original article: https://www.beckershospitalreview.com/telehealth/telehealth-2-0-how-providence-is-taking-its-platform-to-the-next-level.html?origin=CIOE&utm_source=CIOE&utm_medium=email&utm_content=newsletter&oly_enc_id=1372I2146745E8F < Previous News Next News >

Controversy about Eliminating Telephone Telehealth Coverage By Dr. Maheu April 7, 2021 Clinicians do not typically know how much they don’t know about using the technology until they start a serious course of telehealth training. Only then do they realize how many basic assumptions are incorrect and many of the strategies that they learned in school now need to be re-considered to meet legal and ethical standards. A study published in the Journal of the American Medical Association focused on telehealth use among the low-income population in California. The study included data from outpatient primary care and behavioral health visits from February 2019 to August 2020 at forty-one federally qualified health centers representing 534 locations in California. The study showed that, with regards to primary care visits, 48.5% of visits occurred via telephone, 48.3% occurred in person, and 3.4% occurred via video. For behavioral health visits, 63.3% via telephone, 22.8% in person, and 13.9% via video. The study’s key finding was that most telehealth appointments during the pandemic period were conducted over the phone. “Eliminating telehealth coverage for audio-only telemedicine visits would disproportionately impact underserved communities,” according to Lori Uscher-Pines, the study’s lead author. “Lower-income patients may face unique barriers to accessing video visits, while federally qualified health centers may lack resources to develop the necessary infrastructure to conduct video telehealth,” she said. “These are important considerations for policymakers if telehealth continues to be widely embraced in the future.” Since the use of telehealth expanded due to COVID, few studies have examined differences in the use of telehealth modalities. However, one federal agency estimated that 30% of telehealth visits had involved phone therapy sessions alone during the pandemic. According to the study, telehealth visits delivered via over-the-phone therapy peaked in April 2020, comprising 65.4% of primary care visits and 71.6% of behavioral health visits. Before the pandemic, many definitions of telehealth excluded phone therapy visits, and private insurers or the government rarely reimbursed them, the study authors noted. Some payers, including the Centers for Medicare and Medicaid Services, have indicated they may stop telehealth coverage reimbursement for phone therapy sessions when the pandemic ends. Read more about previous rulings for COVID-19 Telephone Telehealth Reimbursement. “There are some concerns that telephone visits could result in fraud, abuse, and unnecessary and lower-quality care. Although these concerns are important to assess, eliminating telehealth coverage for telephone visits could disproportionately affect underserved populations and threaten the ability of the clinics to meet patient needs” stated Dr. Uscher-Pines. The Reality of Professionalism and Telephone Therapy It seems a bit dramatic to point out that telephone therapy can be more subject to fraud and abuse when it actually is often the only lifeline for many people in distress during the pandemic, and beyond. Fraud and abuse can potentially exist everywhere. The real question is whether the professional has bothered to learn how to properly use the telephone for clinical interventions – or if they are making it up on the fly. Unfortunately, although a clear evidence base exists for telephone-based interventions, very few professionals have received adequate training, and more likely, no professional training to use only the telephone to deliver services to a patient or client. They may not have yet realized that a good in-person clinician is not the same as a good telephone therapist, regardless of intention or need. This point can be clarified quite readily by looking at the case of the alcoholic therapist-in-recovery who now decides to offer therapy for alcohol use. Assuming of course that the therapist has excellent therapy skills to start, the therapist’s history with alcohol can actually interfere with their functioning as an addictions therapist, narrowing perspective with unchallenged assumptions related to etiology, treatment options, and/or prognosis. This is why the professional standard for qualifying alcohol therapists is not one’s prior experience with alcohol, but rather, a course completion certificate or certification in alcohol interventions. Even a good (or great) in-person therapist approaching telephone telehealth without training is likely to overestimate the quality and/or effectiveness of their communications. If one does read the literature about telehealth in general and telephone therapy in particular, it is very clear that professional training in order. In fact, most published studies directly call for clinicians to get such training for telehealth and telephone therapy as well. The Telephone Telehealth Evidence-Base The research in telehealth, in general, has also been quite clear that therapists who have received training are more likely to use the medium correctly to deliver outcomes that are not only comparable to in-person care but also to minimize frustration in both themselves and their clients/patients and feel more confident about how to protect the privacy of the exchange. In 2018, after conducting a systematic search for articles published over a 25-year period (January 1991–May 2016), Coughtrey & Pistrang published a study of 14 studies that concluded that “telephone-delivered interventions show promise in reducing symptoms of depression and anxiety.” This conclusion is warranted, given that much of the Similarly, in 2020, Castro and colleagues published a meta-analysis looking at 10 studies looking at treatment adherence to telephone therapy for depression. In general, they showed beneficial effects on depression severity when compared to control conditions. However, in these and other published reports showing the effectiveness or adherence rates related to telephone telehealth, treatment models are typically highly manualized. That is, they do not consist of free-form, open discussion common to many psychotherapeutic approaches. Therapists in such studies tend to follow very strict procedural dictates, and often, the recipient of care is given written materials and assignments that coincide with specified topics for each meeting. Conducting a mid-pandemic online qualitative survey of mental health care professionals in Netherlands, Feijt and colleagues (2020) reported, “Regarding the mediated nature of communication, the most frequently reported challenge concerns the lack of nonverbal signals that practitioners normally use in face-to-face communication, such as posture and hand movements, but also general demeanor, including smell. Practitioners find it more difficult to connect with their client or clearly communicate their intended message. This is even stronger when sessions are conducted by telephone when there is only audio to rely on.” Such a conclusion seems warranted, given that in-person training often teaches practitioners to rely on visual stimuli to render a diagnosis, develop and deliver a treatment plan. In evidence-based telehealth professional training, and especially in competency-based certificate programs of professional training, many of these issues can be addressed using protocols that are tailored to the clinician’s specific client for one’s patient population, setting, state, and professional requirements. On the other hand, clinicians who use communication technology without professional training are likely to be as confused by the online delivery of healthcare as someone accustomed to using a handset telephone who now is handed a smartphone to make a simple call. Therapist Vulnerability in Telephone Telehealth? Assessing a client or patient’s emotional state from voice alone can be problematic, particularly if the professional’s prior telephone habits involve multitasking. As discuss by Hilty, Randhawa, Maheu, McKean, Pantera & Mishkin (2020), distractions are the #1 problem with digital interventions. Don’t we all multitask when on the phone? Where then does distractibility leave the busy professional who typically multi-tasks during telephone therapy? Professionals who allow their workspace to be impinged by devices that regularly emit incoming messages, beeps, flashing lights, and other forms of alerts will likely find it difficult to stay focused on the voice input they now are attempting to use to deliver the same standard of care as in-person. Some therapists even so boldly encourage their clients and patients to “take a walk” while they themselves stroll about their neighborhoods or other local public areas while offering telephone therapy. All the while, these professionals profess to be delivering the same standard of care as when the client is seated in front of them, in a closed room. Could these realities be used to discredit an earnest professional who is attempting to deliver quality care via telephone therapy to people in need? Telehealth Service Delivery is Not Intuitive Telehealth service delivery is not intuitive, regardless of one’s experience in person or the need of the client. Faulty assumptions, lack of knowledge, undeveloped skillsets, and naive attitudes can lead to preventable error and potential harm. Pierce, Perrin, & McDonald (2020) stated, “Organizations interested in encouraging telepsychology use should adopt policies supporting the use of telepsychology and provide adequate training to do so.” Such calls for training are common to published reports and mimic those of telehealth in general for more than two decades. In 2000, Maheu and Gordon reported the results of an extensive survey assessing psychologist’s assumptions regarding the legal and ethical requirements for telehealth. Fourteen years later, a similar article was published by Maheu and a larger team of researchers who assessed roughly the same variables. In the 2020 study, two-thirds of clinicians endorsed items suggesting that standard legal and ethical mandates don’t apply to telehealth delivery of psychotherapy (Maheu & Gordon, 2000). In a more extensive survey, Glueckauf, Maheu, Drude, Wells, Wang, Gustafson & Nelson (2018) showed that the number had decreased to one-third. The disturbing fact is, however, that while two-thirds of clinicians endorsed items suggesting an awareness of legal and ethical mandates, it cannot be assumed that those clinicians understood how those mandates apply to their everyday telehealth practices. Where does this leave the average clinician who has no or minimal telehealth training, yet is confident that they are delivering quality care because they “feel good about it” and because it is “needed?” Therapists too are vulnerable to emotional reasoning… Courtroom Realities of Telephone Therapy Knowing how litigating attorneys work, it is quite conceivable that opposing counsel in a lawsuit against a therapist would wield several such recently published telehealth articles in the direction of an unwitting therapist who blithely offers telephone therapy without the proper documentation to prove that they indeed were actually trained in evidence-based telephone telehealth. Perhaps the CIVID emergency would tempter such accusations, depending on the circumstance. Hopefully so. However, the worrisome issue at hand is that most clinicians have never been taught the reality of what actually happens in courtrooms. Such training can be a difficult awakening. To help our readers better understand the issues involved with delivering clinical care in an area where there is a lack of professional training, we will make you privy to a training video that we regularly show in our 2-day certificate training programs. It features Attorney Joe McMenamin demonstrating his litigation skills as a prosecuting attorney for the defense in a “mock deposition.” In this video, he demonstrates exactly how a prosecuting attorney would “prepare” their case against a witness’s testimony for a trial wherein the therapist is being sued by an angry client. The video is painful to watch. Our only solace at TBHI is that Mr. McMenamin has not only worked for decades as a prosecuting attorney for the defense, but he is also a physician. he understands and shares the ethos of many healthcare professionals, and has worked these many years to defend us in court. That’s his motivation for working with TBHI for decades to develop training materials and peer-reviewed books and articles – to help professionals who are poorly informed of what can happen when one is led by the unbridled desire to help rather than a firm grounding in telehealth theory and practice. Caveat While this type of cross-examination wouldn’t happen to professionals who deliver telephone therapy during the pandemic because we are currently in a state of national emergency, but if telephone therapy were to be approved long-term, this is precisely the type of rigor that would be expected of professionals delivering professional services to people in need. As all licensed professionals know, there is a high bar for the delivery of professional services. Practicing licensed healthcare professional in the United States or Canada as well as in many other countries isn’t something one does in the same manner as they would if they were talking to a family member on the phone, multitasking, opening email, glancing at texts, perhaps outside strolling about the park — while the other party probably is also multi-tasking and/or strolling about as well. When we share the video below, please use this information to extrapolate how a skilled professional needs to be able to defend the amount of training they have obtained in any new area of practice including phone therapy sessions alone when a litigating attorney has them on the witness stand. Please note, we at TBHI are not saying this process is fair or right. It simply is reality. Courtroom Realities of Telehealth Malpractice Before watching, please let us explain what is happening in the video. First, this is one of the many training videos that we typically share with our training audiences. You will see how the attorney discredits the psychologist who is named “Dr. Joanne Johnson,” acted by Dr. Marlene Maheu for purposes of this role-play. The cross-examining attorney is Mr. Joe McMenamin, who is indeed a litigating attorney and physician in real life. He, however, defends practitioners in court rather than a prosecuting attorney, which he depicts in this audio lesson. However, having litigated against attorneys who prosecute, he is in a unique position to show you exactly what happens in court, should you ever have the misfortune of experiencing it firsthand. The interactions portrayed in the audio recording are abbreviated because Dr. Johnson provided additional information rather than doing as witnesses are instructed, and that is to give yes/no answers when possible, and offer as little as possible unless directly asked. You will see that Dr. Johnson actually offers a fair amount of information to get to the point of the demonstration. Upon experiencing the agony of witnessing such an exhaustive exchange, but in real life, it would behoove you to obtain the advice of a defense attorney about offering as much information as is depicted. The purpose of the demonstration, in this case, was to show you what a skilled litigator can do to disarm a well-intentioned professional during a deposition. The attorney goes on to explain his rationales, strategies, and how opposing counsel (which he is role-playing) would generally use the information gathered to discredit the plaintiff in court. This first training video is 37 minutes in length. TBHI Position on Telephone Therapy Just to be clear, TBHI is in complete support of phone therapy sessions alone for all clients and patients who need or are interested in such healthcare. However, having been the Chair of the CTiBS Committee on Telebehavioral Health Competencies, the Founder of TBHI is acutely aware of the lack of competence in psychotherapists who deliver such care. Clinicians do not typically know how much they don’t know about using the technology until they start a serious course of telehealth training. Only then do they realize how many basic assumptions are incorrect and many of the strategies that they learned in school now need to be re-considered to meet legal and ethical standards. All untrained professionals then are encouraged to consider serious telehealth training if they wish to be competence and legally and ethically compliant with the evidence base. References Castro, A., Gili, M., Ricci-Cabello, I., Roca, M., Gilbody, S., Perez-Ara, M.A., Seguí, A. & McMillan, D. (2020) Effectiveness and adherence of telephone-administered psychotherapy for depression: A systematic review and meta-analysis. Journal of Affective Disorders, 260, 514-526, ISSN 0165-0327,https://doi.org/10.1016/j.jad.2019.09.023. Coughtrey, A. E., & Pistrang, N. (2018). The effectiveness of telephone-delivered psychological therapies for depression and anxiety: a systematic review. Journal of telemedicine and telecare, 24(2), 65-74. Feijt, M., de Kort, Y., Bongers, I., Bierbooms, J., Westerink, J., & IJsselsteijn, W. (2020). Mental health care goes online: Practitioners’ experiences of providing mental health care during the COVID-19 pandemic. Cyberpsychology, Behavior, and Social Networking, 23(12), 860-864. Glueckauf, R. L., Maheu, M. M., Drude, K. P., Wells, B. A., Wang, Y., Gustafson, D. J., & Nelson, E. L. (2018). Survey of psychologists’ telebehavioral health practices: Technology use, ethical issues, and training needs. Professional Psychology: Research and Practice, 49(3), 205. Hilty, D. M., Randhawa, K., Maheu, M. M., McKean, A. J., Pantera, R., & Mishkind, M. C. (2020). A Review of Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care. Journal of Technology in Behavioral Science, 1-28. https://doi.org/10.1007/s41347-020-00126-x Maheu, M. M., & Gordon, B. L. (2000). Counseling and therapy on the Internet. Professional Psychology: Research and Practice, 31(5), 484. Pierce, B. S., Perrin, P. B., & McDonald, S. D. (2020). Demographic, organizational, and clinical practice predictors of US psychologists’ use of telepsychology. Professional Psychology: Research and Practice, 51(2), 184. Link: https://telehealth.org/telephone-telehealth/?utm_source=ActiveCampaign&utm_medium=email&utm_content=New+COVID-19+FCC+Telehealth+Grant+%7C+TBHI+Telehealth+News+4%2F14%2F21&utm_campaign=April+13th+Newsletter&vgo_ee=L60XUD6gIFzXzaAzbkkf6r35hO7C%2FF3J%2FgQB9Uu3XAY%3D Previous rulings for COVID-19 Telephone Telehealth Reimbursement: https://telehealth.org/reimbursement-covid-19-telephone/ < Previous News Next News >

Legislators Throughout the Southwest are Moving Towards Institutionalizing Telehealth Services Kirin Goff, Southwest Telehealth Resource Center July 2021 Legislatures across the southwest have sprung into action to enact bills that permanently expand telehealth services As the COVID-19 pandemic becomes increasingly under control and more states are ending their public health emergency declarations, legislatures across the southwest have sprung into action to enact bills that permanently expand telehealth services. At the forefront of this new legislation is Arizona’s HB 2454 that Governor Doug Ducey signed into law on March 5, 2021 to provide comprehensive amendments to the state's laws governing telehealth. In Arizona and other southwest states’ new telehealth laws, entities are generally prohibited from denying coverage for telehealth services and are required to cover remotely provided services at the same rate as equivalent in-person services. Exceptions to these requirements may be developed by an advisory committee of government officials, practitioners, and other stakeholders, who will determine, among other things, circumstances in which telehealth services are inappropriate. Even in the absence of a rule prohibiting telehealth services, healthcare providers must use good faith in determining whether telehealth services are appropriate, and if so, which communication modalities are appropriate. Communication Modalities Prior to the public health emergency response to the pandemic, audio-only services were generally permissible only if the healthcare provider had an existing relationship with the patient and audio-visual communication was not reasonably available. Voicemail was specifically excluded. Going forward, telehealth services in Arizona may be provided, when appropriate, through interactive audio/video, asynchronous store-and-forward technology (i.e., digitally stored medical imaging, multimedia files, other information that can be reviewed remotely), and remote patient monitoring technology. Legislation in other states throughout the southwest also includes measures that govern the types of communications by which telehealth services can be provided. In many cases, telehealth can be provided by means other than real-time, audio-visual communication. Nevada SB 5, for example, amends an existing definition of telehealth to include audio-only interactions. Utah's SB 161, which was enacted, allows providers to use HIPAA-compliant asynchronous audiovisual technology for certain treatments. Amendments to New Mexico's Cannabis Regulation Act (HB 2, also enacted) provide a patient to be diagnosed as a qualified patient via telemedicine, which includes store-and-forward and remote patient monitoring technologies as options. Collection and Reporting of Telehealth Data to Form Policy Decisions Legislators in Nevada, like those in Arizona, seek to collect and use data on telehealth services to aid in forming policy. Nevada SB 5 requires the state's Department of Health and Human Services to establish (if funding permits) a data dashboard allowing analysis of access to telehealth by different groups and populations. The bill goes further to include behavioral health boards, the Patient Protection Commission, and the Legislative Committee on Health Care to use the dashboard in formulating policy. Another Nevada bill (ACR 5) establishes a legislative committee to address the shortage of behavioral health professionals in the state. This committee will study the provision of behavioral health services through telehealth and consider ways to expand the use of telehealth to provide such services. Expansion of Services Various bills explicitly expand telehealth services in particular fields such as dentistry (Colorado SB 21-139, New Mexico SB 200), audiology and speech pathology (Colorado SB 21-021, New Mexico HB 210), occupational therapy (Colorado HB 21-1279), and dietetics and nutrition (New Mexico HB 147). Other measures are aimed at expanding broadband access:(Nevada AB 388; Colorado HB 21-1109), including efforts specifically directed at underserved communities (Arizona HB 2885, Nevada AB 388), seniors (Colorado SB 21-210, New Mexico SM 6), and children (New Mexico SM 15). In-Person Medical Examination Requirements In-person requirements have long been a contentious topic in the provision of initial telehealth services in certain contexts. For example, Arizona’s HB 2454 prohibits providers from prescribing Schedule II drugs after an audio-only communication with the patient, but generally allows other drugs to be prescribed after audio-only telehealth communications. In another context, Nevada’s SB 266 provides for in-person medical examinations for workers' compensation claims, but only if initial examinations were performed through telehealth services and only if a party requests an in-person examination. Interestingly, some bills seek to relax restrictions. For example, New Mexico’s HB 12 seeks to eliminate a previous requirement that a practitioner could only certify a patient for medical cannabis use if the practitioner had previously examined the patient in-person. Overall, the surge of bills moves us towards institutionalizing telehealth. Importantly, the latest round of legislation also exposes how much more there is to learn about optimizing telehealth and identifying best practices as uptake continues to increase across the southwest. New Mexico HB 147: https://track.govhawk.com/public/bills/1414538 New Mexico SM 6: https://track.govhawk.com/public/bills/1425880 New Mexico SM 15: https://track.govhawk.com/public/bills/1443803 New Mexico’s HB 12: https://track.govhawk.com/public/bills/1428580 Source: https://southwesttrc.org/blog/2021/legislators-throughout-southwest-are-moving-towards-institutionalizing-telehealth < Previous News Next News >

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 >

Federal Broadband Funding Negotiations Continue Center for Connected Health Policy June 2021 As the administration and Senate Democrats attempt to come to a bipartisan infrastructure deal over the next month, they have since presented a counter offer of $1.7 trillion, $65 billion of which would expand broadband funding. President Biden’s American Jobs Plan originally totaled $2.3 trillion, $100 billion of which was designated to broadband. As noted in recent CNBC articles, as the administration and Senate Democrats attempt to come to a bipartisan infrastructure deal over the next month, they have since presented a counter offer of $1.7 trillion, $65 billion of which would expand broadband funding. While Senate Republicans then put forward a $928 billion counteroffer, there appears to be agreement on both sides with the piece of the proposal designating $65 billion to broadband. Nevertheless, discussions on other issues remain far apart and it is possible to pass the bill without Republican support in the evenly split Senate, therefore Senate Majority Leader Chuck Schumer recently expressed his desire to continue the process with or without Republicans to get comprehensive jobs and infrastructure legislation done this summer. For more information read the American Jobs Plan in its entirety - https://www.whitehouse.gov/american-jobs-plan/. < Previous News Next News >

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

Top of Page 1 2 3 4 5 6 7 8 9 10 11 NMTHA's Telehealth Toolkit NMTHA's Telehealth Toolkit provides: Templates Best practice guidelines Gene ral resources Links to additional toolkits 11 telehealth topic areas, including: Client engagement Provider eng agement Provider self-care Technology Clinical specialities As part of a grant provided by the New Mexico Human Services Department (HSD), the resources below were curated and organized to match themes from interviews and surveys supported through efforts by the NMTHA and Anchorum St. Vincent . How do we address broadband and other telehealth challenges in rural New Mexico? How do we get started with telemedicine? How do we improve client engagement? How do we improve provider engagement? How do we manage our telehealth practice? How can we reduce provider burnout? How do we use/expand telehealth in schools and youth programs? What are the best ways to use telehealth for clinical specialties? What is the future of telehealth? What is the latest data on telehealth? How do we collect data on telehealth use? What telehealth platforms are best (and other technology questions)? 1 HOW DO WE ADDRESS BROADBAN D AND OTHER TELEHEALTH CHALLENGES IN RURAL NEW MEXICO? To o lk i ts Rural Telehealth Toolkit T h is toolkit from the Rural Health Informat ion Hub, compiles evidence-based, promising models and resources to support organizations in identifying and implementing telehealth programs to address common challenges experienced in rural communities across the United States. Audience: Facility leadership and providers in rural areas. G ene ral Resources Active Programs to Improve Telehealth Services in Remote Areas Office of the Advancement of Telehealth (OAT) provides funding to promote and improve telehealth services in rural areas. Audience: Executive leadership for clinics/facilities in rural areas. Virtual Critical Care: A Lifeline for Rural Hospitals and Patients (CASE STUDY) Auburn University Health and Amwell identify methods participating rural hospitals used to reduce their transfers by more than 80%, enabling patients to receive care in their communities with minimal disruption to continuity of care. Comparing Televideo and Telephone Behavioral Health Services for People with Chronic Mental Illness Powerpoint presentation from the UNM Rural Psychiatry Program, Annual Spring Conference: "Adapting Care for 2021 and Beyond." HOW DO WE GET STARTED WITH TELEMEDICINE? Toolkits Setting Up Tele-Be havioral Health Service This step-by-step guide provided by the Indian Health Services is meant to be comprehensive, touching upon everything that may need to be considered in s etting up Telebehavioral health services at your site. Audience: Facility directors and providers serving tribal and Indigenous populations. Telehealth Program Developer Kit From the California Telehealth Resource Center: "The CTRC Program Developer was designed to assist in developing and implementing telehealth services. This Guide provides overview information on the process and the activities and information you will collect during each of the development phases. Each of the steps is designed to allow an organization to consider critical aspects of development and to support decision making.” Telehealth Implementation Playbook Learn more about identifying the need for telehealth, finding a vendor, designing the workflow, implementing, and scaling from the American Medical Association. A Toolkit for Building and Growing a Sustainable Telehealth Program in Your Practice Telehealth services and payment, roles and responsibilities, licensing and legal requirements, technology, workflow, and family medicine scenarios. Toolkit from the American Academy of Family Physicians (AAFP) . Templa tes Telemedicine Multi-S ite Agreement Arizona Telemedicine offers a template for consideration of the mutual covenants and agreements for involved parties. Best Practice Guidelines 15 Key Steps to Creating a Business Proposal to Implement Telemedicine Here you’ll find a concise overview of 15 steps to implement a successful telemedicine program at your facility. Offered by the Northwest Regional Telehealth Resource Center. Audience: Directors and Executive leadership. General Resources Telehealth Start-Up and Resource Guide Covering Telehealth vs. Telemedicine, ATA and AMA guidelines, startup to sustainability, telehealth module and outlook, reimbursement guide, Medicaid, Medicare billing, CNM code information and other resources. This start-up and resource guide was created in partnership between Telligen and gpTRAC, the GreatPlains Telehealth Resource and Assistance Center. It is intended to provide an overview and framework for implementing telehealth in critical access hospitals and rural areas, and to point the reader toward reliable and informative resources for learning about telehealth and the organizations that support the use of telehealth in various ways. General Provider Telehealth and Telemedicine Tool Kit This document contains links to reliable information sources regarding telehealth and telemedicine. Most information is directed toward providers seeking to establish a permanent telemedicine program with specific documents useful for choosing telemedicine vendors, initiating a telemedicine program, monitoring patients remotely, and developing documentation tools. The New Normal: Tips for Making Telemedicine Part of Your Permanent Practice September 2020, 1:02:46 Alaska Native Medical Center and Shoshone Family Medical Center join together via Project ECHO to help participants understand tactics to develop a well-rounded telehealth program, move telemedicine into their standard operations, outline the elements of a telemedicine quality program, understand considerations of health equity in telemedicine, proactively and reactively address patient barriers, and outline infrastructure components needed to support ongoing program success. Audience: Facility directors ready to establish a telemedicine program. Telemedicine: Where Do I Start? July 2020, 1:03:41 Project ECHO, Shepherd’s Clinic, UV Medicine, and CommonSpirit Health offer an expert-guided video on how to start and subsequently navigate telemedicine. Audience: Facility directors ready to establish a telemedicine program. 2 3 HOW DO WE IMPROVE CLIENT ENGAGEMENT? Templates Behavioral Telehealth Session Checklist Mental Health Technology Transfer Center Network provides this checklist put together by Operation PAR, Inc. to provide basic guidance on the before-, during-, and after- of a telehealth session. Audience: Behavioral health providers using telehealth and looking to improve their interactions with clients or behavioral health providers using telehealth for the first time. Telehealth Instructions for Behavioral Health Patients Behavioral Health Partners offers telehealth instructions to behavioral health patients in preparation for a telehealth visit. Patient Consent Form Telemedicine patient consent form provided by the Southwest Telehealth Resource Center. Audience: Facility directors. Telehealth Instructions for Behavioral Health Patients Behavioral Health Partners offers telehealth instructions to behavioral health patients in preparation for the telehealth visit. Audience: Behavioral health providers using telehealth and looking to improve their interactions with clients or behavioral health providers using telehealth for the first time. Telehealth Visit Etiquette Checklist From the American Medical Association: "This checklist is intended for clinicians and care team members who will be hosting the telehealth visit to ensure that the professional standards of in-person care is maintained in a virtual environment.” Audience: Telemedicine and telebehavioral health providers. Patient Information Sheet (English) Overview of telehealth visit for patients from the FQHC Telehealth Consortium. Patient Information Sheet (Spanish) Overview of telehealth visit for patients from the FQHC Telehealth Consortium. Best Practice Guidelines Telehealth Etiquette Video Series In this series of videos, we learn the difference between a Bad, Good, and even Better telehealth consult. While some demonstrations may seem humorous or “over the top,” all are based on actual patient scenarios. As you watch, notice the difference between the Good, the Bad, and the downright Ugly. Provided by the South Central Telehealth Resource Center and produced by Old Dominion University College of Health Sciences, School of Nursing. Audience: Telemedicine and telebehavioral health providers. General Resources Telehealth Best Practice s April 2020, 0:04:06 A short video from the Hawaii State Department of Health Genomics Section highlighting best practices for healthcare providers when using telehealth to provide services. Audience: All providers. 4 HOW DO WE IMPROVE PROVIDER ENGAGEMENT? General Resources Clinical Best Practices and the Art of the Tele-Physical Exam September 2020, 0:59:31 This video aims to help providers understand the process of conducting a telemedicine visit, select the equipment needed to conduct a physical assessment through telemedicine, collec t physical data through a videoconferencing session without peripherals , and utilize creative strategies to obtain clinical data. Provided by the University of New Mexico’s Project ECHO as a joint effort with the Center for Telehealth Innovation, Education, & Research; Old Dominion University; and the Mid-Atlantic Telehealth Resource Center. Audience: Primary care providers. Physicians' Motivations and Requirements to Adopting Digital Clinical Tools February 2020 Study by the American Medical Association on “Physicians’ motivations and requirements for adopting digital health and adoption and attitudinal shifts from 2016 to 2019.” Audience: Executive leadership. Telehealth Driver Diagram Develop a sustainable, patient-centered, and equitable telehealth model and achieve an advanced level of maturity with the FQHC Consortium diagram. Top Five Tips for Managing Expectations and Challenges of Transitioning to Telehealth May, 2020, 0:17:46 Discussion of the "Top 5 tips for Managing Expectations and Coping with the Challenges of Transitioning to Telehealth." Speakers: Nancy Roget, Executive Director of the Center for the Application of Substance Abuse Technologies at the University of Nevada–Reno and Co-Director of the Mountain Plain Addiction Technology Transfer Center (ATTC) Regional Center, and Paul Warren, research project director at the New York State Psychiatric Institute, Division of Substance Use Disorders, in association with Columbia University and Project Manager for the Northeast and Caribbean ATTC. Audience: Executive leadership and facility directors. 5 HOW DO WE MANAGE OUR TELEHEALTH PRACTICE? Toolkits Organizational Assessment Toolkit for Primary and Behavioral Health Care Integration Designed by a team of integration experts and offered by the National Council for Mental Wellbeing, the Organizational Assessment Toolkit for primary and behavioral health care Integration (OATI) provides a compendium of tools that lay out a path for organizations to assess readiness for integration, as well as benchmarking opportunities for those organizations well down the line in integration efforts. Audience: Facility directors and providers looking to integrate primary care and behavioral health. Telehealth Playbook Federally Qualified Health Centers Telehealth Consortium provides a Telehealth Playbook as a how-to guide to support the adoption and sustainability of telehealth at health centers. Templates Job Description RN Coordinator - Telehealth Sample Sample from UW Health. (University of Wisconsin) Audience: Clinic administrators and directors. Job Description: Telehealth Program Coordinator Sample Sample from the FQHC Telehealth Consortium. Audience: Clinic administrators a nd directors. Job Description: The Telemedicine Navigator (TMN) Sample Sample from the FQHC Telehealth Consortium. Audience: clinic administrators and directors. Job Descriptions Multiple Telemedicine Positions Includes several sample telemedicine job descriptions from the California Telehealth Resource Center. Audience: clinic administrators, directors and executive leadership. Appointment Types & Duration Guide From the FQHC Telehealth Consortium. Audience: Clinic administrators. Best Practice Guidelines Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service Prepared by the Center for Connected Health Policy and The National Telehealth Policy Resource Center to provide guidance on billing for telehealth and virtual healthcare and fee-for-service (FFS) Medicare and Medicaid programs. Audience: Facility directors and providers. General Resources 2021 Medicare Coverage and Payment for Audio Only Services (Telephone E/M) The Association of American Medical Colleges provides an overview of current Medicare coverage for audio-only services. Audience: Facility directors and providers. Billing and Coding Medicare Fee-for-Service Claims During the COVID-19 Pandemic More Medicare fee-for-service (FFS) services are billable as telehealth during the COVID-19 public health emergency. Read the latest guida nce on billing and coding FFS telehealth claims. Audience: Facility directors and providers. Coding Scenario: Coding for Telehealth Visits Guide for how to bill for a variety of telehealth visits from the American Academy of Family Physicians. Audience: Facility directors and providers. C overage and Payment for Telemedicine The American Medical Association offers an overview of health plan coverage and payment for telemedicine services. Audience: Facility directors and providers. Interstate Medical Licensure Compact American Medical Association explains pathway to expedite licensing of physicians already licensed in another state. Audience: Facility directors. NCTRC Webinar - Digital Marketing: Best Practices for Direct-to-Consumer Telehealth July 2020, 0:59:09 This South Central Telehealth Resource Center presentation lays the foundation for building a digital strategy for telemedicine practice. Participants will learn how to identify opportunities to reduce friction based on consumer journey, discuss highest value marketing channels based on consumer data, define audience segments, and outline conversion goals. Audience: Executive leadership and facility directors. NCTRC Webinar - Leveraging Telehealth to Address Social Determinants November 2020, 1:00:08 The National Consortium of Telehealth Resources presents on how the healthcare industry's shift from fee-for-service (FFS) to value-based care, planning, implementing, and enhancing telehealth as a service delivery model, makes it crucial to ensure practices are on the leading edge - not the bleeding edge - of reimbursement strategies. Audience: Executive leadership and facility directors. Overview of Telehealth Billing and Reimbursement Policies August 2020, 1:03:35 The Center for Connected Health Policy, via Project ECHO, presented this installment during a 10-week series offered by the National COVID Response peer-to-peer learning. Audience: Executive leadership and facility directors. Policy Telehealth Coding and Payment Quick Guide The American Medical Association’s Advocacy team summarizes the latest updates in Federal policy , including key policy and payment considerations. Audience: Executive leadership and facility directors. Service Provider Directory Telemedicine and Telehealth The directory lists companies providing medical specialty services (e.g., radiology, rheumatology, neurology, psychiatry) and ancillary services (e.g., patient education and language interpretation) through telemedicine to healthcare providers (e.g., hospitals, clinics, nursing homes, private practices, urgent care centers). Audience: Hospital and healthcare administrators and other decision-makers who want to expand or improve their healthcare services to their patients, employees, clients, etc. by connecting them with specialty care. Telehealth and Health Equity: Considerations for Addressing Health Disparities During the COVID-19 Pandemic September 2020, 1:04:50 Centers for Disease Control and Prevention presenters discuss the intersection of telehealth and health equity, and the implications for health services during the COVID-19 pandemic. Presenters will identify long-standing systemic health and social inequities that contribute to COVID-19 health disparities while highlighting the opportunities and limitations of telehealth implementation as an actionable solution. Audience: Executive leadership, facility directors and providers. Telemedicine Policy Guidelines for creating a telemedicine policy from the American Medical Association. Audience: Facility directors. Telemedicine Quick Reference Guide Created by BlueCross/BlueShield of New Mexico to help providers with questions on telemedicine services and billing. Please note: this does not include federal or state exceptions for the Public Health Emergency for COVID. Audience: Directors and providers offering telemedicine in New Mexico. Workflows and Documentation August 2020, 1:02:00 The California Telehealth Resource Center, along with Dartmouth-Hitchcock Medical Center and Mary’s Center, offer a Project ECHO video presentation showing basics of facilitating workflow conversations, creating workflow maps, and how to pull together and lead successful teams. Audience: Executive leadership, facility directors and providers. Podcasts Top Five Clinical Best Practices for Telehealth April 2020, 0:10:08 Mary Ellen Evers, LCSW, CAADC, a registered telebehavioral health clinician for mental health and addiction services and a telebehav ioral health trainer for the Center for the Application of Substance Abuse Technologies, shares her top five clinical best practices for providing services via telehealth platforms. Audience: Providers. Top Five Tips for Group Services via Telehealth April 2020, 0:09:03 Sandes Boulanger, LCSW, MCAP, the Vice President of Clinical Services for Operation Par, Inc., located in Florida, shares her top five tips for running group sessions and support via telehealth during COVID-19. Audience: Providers. Top Five Tips for Telehealth Implementation April 2020, 0:09:22 Kathy Wibberly, the Director of the Mid-Atlantic Telehealth Resource Center located at the University of Virginia Karen S. Rheuban Center for Telehealth, gives her top five tips for successful implementation of telehealth services. Audience: Executive leadership, facility directors and providers. Top Seven Telehealth Privacy Considerations April 2020, 0:09:41 The Center for Excellence for Protected Health Information presents key points around privacy, HIPAA, and confidentiality when providing telehealth behavioral health and addiction services, with Jacqueline Seitz, JD; CoE-PHI, Christine Khaikin, JD; CoE-PHI, and Michael Graziano. Audience: Executive leadership, facility directors and providers serving behavioral health patients. Top Seven Tips for Telehealth Billing April 2020, 0:18:34 A review of best practices for billing for telehealth services to ensure reimbursement during COVID-19, presented by Kathy Wibberly, PhD, the director of the Mid-Atlantic Telehealth Resource Center located at the University of Virginia. Audience: Facility directors and providers. 6 HOW DO WE REDUCE PROVIDER BURNOUT? Toolkit Physician Suicide and Support The American Medical Association discusses how to identify at-risk physicians and facilitate access to appropriate care. Audience: Executive leadership and facility directors. Provider Self-Care Toolkit The National Center for Post Traumatic Stress Disorder discusses how managers can support employees struggling with burnout and stress. Audience: Executive leadership and facility directors. Tips for Supporting Employee Mental Health The National Council for Mental Wellbeing offers a toolkit on Stress, Anxiety, Depression: "What it Looks Like at Work and How to Provide Support." Audience: Executive leadership and facility directors. General Resources Burnout in Healthcare Workers: Prevalence, Impact, and Preventative Strategies Article from the National Center for Biotechnology Information, U.S. National Library of Medicine . Audience: Providers and executive leadership. Equipping Physicians to Manage Burnout Resources from the American Medical Association, including a tip of the week, free learning modules, and podcasts. Audience: healthcare leaders and providers. Gratitude Practice for Nurses The Gratitude Practice for Nurses initiative is a joint effort of the American Nurses Foundation and the Greater Good Science Center at the University of California, Berkeley, aimed at cultivating the practice of gratitude within the nursing profession. Decades of research have shown that practicing gratitude is highly effective in promoting physical and psychological health, both at the individual and organizational levels. Audience: Nurses and healthcare leaders. Mental Health Support for Healthcare Providers Support from the National Alliance on Mental Health includes confidential and professional support, peer support, resources on building resiliency, and more. Audience: All medical and behavioral treatment staff and providers. Provider Burnout: Prioritizing Self-Care to Strengthen Patient Care Ideas for self-care from the American Academy of Physician Assistants. Audience: All medical and behavioral treatment staff and providers. 7 HOW DO WE USE/EXPAND TELEHEALTH IN SCHOOLS AND YOUTH PROGRAMS? Toolkit National Telehealth Toolkit for Educators/Faculty Created in 2019, a group of over 45 nursing faculty from 19 U.S. States, Canada, and 28 universities met to develop a telehealth toolkit with the goal of providing faculty with content needed to integrate telehealth across the curriculum for health professions programs. Roadmap for Action: Advancing the Adoption of Telehealth in Child Care Centers and Schools to Promote Children’s Health and Well-Being School-Based Checklist and Resources Compiled by the Clearinghouse for Military Family Readiness at Pennsylvania State University, this document provides a variety of checklists as well as links to additional resources. Audience: Directors of school and youth programs using telehealth. Best Practice Guidelines Evaluation Considerations for Delivering Virtual School-B ased OT Services via Telehealth Checklist, resources, and recommendations provided by the American Occupational Therapy Association. Audience: Directors of school and youth programs using telehealth. General Resources How to Start and Implement a School-Based Telehealth Program How to Build a School-Based Telemedicine Program in Your Community 0:52:21 The South Central Telehealth Resource Center, University of Arkansas for Medical Sciences, offers a video on building a school-based telemedicine program. Audience: Directors of school and youth programs looking to implement a telemedicine program. R eimbursement of School-Based Telehealth Services-Report The National Academy for State Health Policy report explores how states are increasing their Medicaid coverage of school-based telehealth services during COVID-19, determining which services can be effectively delivered through telehealth, and supporting equitable access to telehealth services for students. Audience: Directors of school and youth programs using telehealth. 8 WHAT ARE THE BEST WAYS TO USE TELEHEALTH FOR CLINICAL SPECIALTIES? Behavioral Health Best Practice Guide Introduction to telehealth for behavioral health care. Audience: Executive leadership and fac ility directors. Telehealth Delivery of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) The Medical University of South Carolina offers a 2-part webinar series: Part 1 (0:59:26) - Provides logistics for delivering trauma-informed, evidence-based mental health services via telehealth (e.g., necessary equipment, procedures, documentation, ethical considerations) Part 2 (1:41:09) - Provides specific tips and resources for delivering Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) via telehealth. Audience: Facility directors and providers. Dentistry ADA Guide to Understanding and Documenting Teledentistry Events The American Dental Association provides Q&A with scenarios providing insight and understanding of how care is delivered and reported wh en teledentistry is a facet of the process. Audience: Dental office directors and providers. Emergency Departments Best Practice Guide: Introduction to Telehealth Practices for Emergency Departments The Health Resources and Services Administration (HRSA) provides information on getting started, billing, tele-triage, tele-emergency care, virtual rounds, e-consults, and telehealt h for follow-up care. Audience: Executive leadership, ED directors, and providers. Hospice and Palliati ve Care Best Practices for Using Telehealth in Hospice and Palliative Care Article from the National Library of Medicine highlights the work of expert clinicians from multiple hospice and palliative care organizations to develop best practices for conducting telehealth visits in inpatient and community settings. Audience: Facility directors and providers. Maternal Health UMTRC Webinar: Ohio Telehealth Billing & Reimbursement Webinar for Maternal Health May 2020, 0:55:22 Ohio State University and the Ohio Department of Health provide a video on how maternal health providers in Ohio can integrate telehealth into their clinical practices, and a deep dive into telehealth reimbursement for maternal health, with an emphasis on Ohio Medicaid. Audience: Facility directors and providers. Pediatrics Pediatric Telemedicine in Ambulatory and Inpatient Settings D uring COVID-19 and Beyond May 2020, 1:0 4:51 The University of Minnesota Pediatrics Grand Rounds offers a video that describes: 1. Evolution of telemedicine practice before and since COVID in pediatric ambulatory and inpatient settings. 2. Three elements of best practice for effective telemedicine visits. 3. Advantages and disadvantages of telemedicine in Pediatrics. 4. Applications for telemedicine after the COVID-19 pandemic in your practice. Audience: Facility directors and providers. Remote Monitoring Remote Patient Monitoring Toolkit The Mid-Atlantic Telehealth Reso urce Center designed a toolkit to help many different audiences quickly understand remote patient monitoring and define the responsibilities of each role. Audience: Facility directors and providers. Substance Use Disorders Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders From the Center for Mental Health Services (CMHS) and Substance Abuse and Mental Health Services Administration (SAMHSA): “This guide reviews ways that telehealth modalities can be used to provide treatment for serious mental illness and substance use disorders among adults, distills the research into recommendations for practice, and provides examples of how these recommendations can be implemented.” Audience: Behavioral health providers and clinical supervisors. Tele-Treatment for Substance Use Disorders Treating substance use disorders via telehealth requires expertise and training in addiction care. Telehealth Health and Human Services provide special considerations to keep in mind for telehealth substance use treatment. Audience: Facility directors and providers. 9 WHAT IS THE FUTURE OF TELEHEALTH? Best Practice Guidelines Current State Laws and Policies for New Mexico Current state laws and policies related to telemedicine in New Mexico curated by the Center for Connected Health Policy. Audience: Ex ecutive leadership, facility directors and providers. Statute on Establishing a Patient-Physician Relationship Via Telehealth The American Medical Association offers a quick reference guide for providing care with medical ethics while maintaining the patient’s well-being via telemedicine. Audience: Executive leadership, facility directors and providers. General Resources A New Decade for Telehealth: A Loo k at the Rapid Rise in Telehealth Adoption and What's Required to Support its Growth White paper from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber te chnology solutions serving America’s largest businesses and communications service providers. Audience: Executive leadership. Covering the Cost of Telehealth White paper from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers: “Healthcare leaders expect patient demand for digital services to continue rising — even after the COVID-19 public health crisis subsides. That in turn has healthcare organizations (HCOs) strategizing on how to cover the costs of the telehealth investments they’ll need to meet rising demands in the months and years ahead.” Audience: Executive leadership. How Telehealth Can Support People Living in the Community The American Telehealth Association provides background education on telehealth, increases awareness of the benefits of telehealth that support community living, and raises policy considerations for States, health plans, and providers. Medicare and Medicaid COVID-19 Program Flexibilities and Considerations for Their Continuation Statements of Jessica Farb, Director of Health Care, and Carolyn L. Yocom, Director of Health Care, were incorporated in the Testimony Before the Committee on Finance, U.S. Senate, in response to the COVID-19 pandemic to discuss flexibilities related to Medicare and Medicaid made available during the public health emergency. Testimony highlights the various flexibilities and waivers implemented during the COVID-19 pandemic and provides preliminary information on how these flexibilities have likely benefited providers and beneficiaries. Audience: Executive leadership, facility directors and providers. Pending Telehealth Legislation and Regulation in New Mexico and the United States A quick reference guide presented by the Center for Connected Health Policy. Audience: Healthcare leadership and all providers. Return on Health: Moving Beyond Dollars and Cents in Realizing the Value of Virtual Care This report, jointly developed by the American Medical Association and Manatt Health Strategies, expands on existing research by articulating a more robust framework for measuring the value of digitally enabled care that accounts for the various ways in which virtual care programs may increase the overall “return on health” by generating positive impact for patients, clinicians, payers and society going forward. Audience: Executive leadership, facility directors and providers. Telehealth Needs & Opportunities: Emerging Findings from Non-Profit Behavioral Health Providers in Northern New Mexico Special Report from the New Mexico Telehealth Alliance and Anchorum St. Vincent, a community health impact organization, resulting from a needs assessment in early 2021. Audience: Executive leadership, facility directors and providers. 10 WHAT IS THE LATEST DATA ON TELEHEALTH USE OR HOW DO WE COLLECT DATA ON TELEHEALTH USE? Te mplates Telehealth Patient Experience Survey Sample survey from the FQHC Telehealth Consortium. Audie nce: Providers and administrators. General Resources Configuring Telehealth Visits Using RPMS and EHR Presentation by the Indian Health Service from Sept. 2020 regarding standardization for national tracking and reporting. Audience: Facility directors and provid ers serving native and Indigenous populations. Measures of S uccess: 5 Key Metrics for Evaluating Telehealth Services White paper from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers. Audience: Executive leadership. Measuring Patient Experience and Satisfaction with Telemedicine: A Quick Guide to Survey Selection The California Health Care Foundation provides a guide to support and inform quality improvement efforts at health centers. Audience: Executive leadership and facility directors. Supporting Today’s Data-Intensive Clinical Environments Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers, offers tep-by-step guidance for planning a network infrastructure that advances digital health initiatives and improves efficiency and patient outcomes. Audience: Executive leadership. Telemedicine and Non-Telemedicine Visit Experience Interview Guides The University of Rochester provides an interview guide designed to be conducted with patients, physicians, nurses, and office staff in an ambulatory setting and includes questions to assess users' satisfaction and perceptions of telehealth. Audience: Executive leadership, facility directors and providers. 11 WHAT TELEHEALTH PLATFORMS ARE BEST AND OTHER TECHNOLOGY QUESTIONS? Toolkits Remote Patient Monitoring Platforms: Vendor Overview Snapshot of various platforms from the FQHC Teleheal th Consortium. Telehealth Platforms: Vendor Overview Snapshot of various platforms from the FQHC Telehealth Consortium. Vendor Selection Toolkit From the Mid-Atlantic Telehealth Resource Center, this provides some quick info on selecting your telehealth vendor. Audience: Directors and executive leadership. General Resources AMA Telehealth Implementation Playbook Includes a vendor evaluation checklist on pages 32-38. Audience: Directors and executive leadership. Comparing 11 Top Telehealth Platforms: Company Execs Tout Quality, Safety, EHR Integrations Article from HealthcareIT News. Audience: Executive leadership and facility directors. Growing Digital Health Innovation Means It’s Time for a Bandwidth Checkup Whitepaper from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers. Audience: Directors and executive leadership. Telehealth Technology Trends October 2020, 0:59:41 National Consortium of Telehealth Resources: The Telehealth Technology Assessment Resource Center (TTAC) has seen a significant shift in choosing telehealth technology for providing patient care, specifically in choosing video conferencing platforms and providing care to the patient in the home, both from the provider and the consumer perspective. TTAC gives a short overview of changing trends observed now and for the future. Audience: Executive leadership and facility directors. The Top 30 Tools for Improving Your Telehealth Implementation Telehealth tools, hardware, software, monitoring and on-demand portals from Cambridge Brain Sciences. Audience: Executive leadership and facility directors.

Top of Page Agenda Kick-off, Welcome, Intros Opening Remarks Equity Gaps AI + Digital Innovation Medicare Telehealth HCA/Turquoise Care Closing Remarks Innovating Remote Access 2 Innovating Remote Access to Care A New Mexico Telehealth Alliance, Southwest Telehealth Resource Center, & HealthInno NM Collaboration 2024 Q4 Education & Networking Special Event: Date: Thursday, October 17th, 2024 Time: 2:00 - 7:30pm MST Place: Indian Pueblo Cultural Center & Zoom Cost: Complimentary! Agenda INNOVATING REMOTE ACCESS TO CARE A special extended event starting with educational presentations from national and regional experts, followed by Table Talks for networking and small-group discussions, and ending with an open mic session for in-person attendees to introduce themselves and their work, and to announce upcoming events, accomplishments, and collaborative opportunities. The recorded educational presentations linked below focus on trends and updates in remote care delivery, telehealth adoption, regulation, and local efforts to expand innovative approaches to remote access to health care. AGENDA Kick-off, Welcome, Event Partner Introductions Opening Remarks Bridging Health Equity Gaps / Disparities AI + Digital Innovation Medicare Telehealth HCA/Turquoise Care Vision & Strategies Closing, State Legislature Remarks PRESENTATION RECORDINGS, SLIDE DECKS, & SUMMARIES: Kick-off with Event Welcome + Introducing Partner Stefany Goradia, MEIE ( LinkedIn ) Head of Impact + Community, HealthTech Rx Stetson Berg, MPH ( LinkedIn ) Board Chair, New Mexico Telehealth Alliance Alex Carter, PA-C ( LinkedIn ) Board Vice Chair, New Mexico Telehealth Alliance Video Key Points & Highlights Stefany Goradia: Overview of HealthTech RX's mission and event goals Networking and Participation: In person attendees encouraged to network and rotate through 4 Table Talks on diverse healthcare topics. No scheduled breaks; food served and cash bar served opens at 5 PM. Focus Areas: Enhancing care delivery for rural and underserved communities. Exploring partnerships and innovation in digital health solutions. Event Structure: First Half: Educational presentations by local/national experts on trends and regulations (2–5 PM). Second Half: Interactive Table Talks focusing on specific topics (5–7:30 PM). HealthTech RX Role: Functions as innovation hub and convenes stakeholders for collaborative problem-solving. Organizes quarterly events, innovation challenges, hackathons, and pilot programs to address unique healthcare challenges. Event Overview: Q4 HealthInno NM event by HealthTech RX, focusing on healthcare innovation in New Mexico. Aims to bring together healthcare leaders, technologists, policymakers, and stakeholders to improve health equity and economic development. Theme: "Rethinking Remote Care," emphasizing telehealth and tech-enabled care models for underserved communities. Stetson Berg: Telemedicine advancements and local/national scale innovation Alex Carter: Personal and professional insights on telehealth Opening Remarks Elizabeth Krupinski, PhD ( LinkedIn ) Professor & Vice-Chair for Research, Dept. of Radiology & Imaging Sciences, Emory University Associate Director of Evaluation, Arizona Telemedicine Program Director, Southwest Telehealth Resource Center Video Key Points & Highlights Southwest Telehealth Resource Center: Focuses on promoting and supporting telehealth in Four Corners region and Nevada. Aims to expand, start, or improve telehealth programs through training, grant support, and resource sharing. Mission and Goals: Enhance patient care and accessibility using telehealth. Overcome challenges and advocate for telehealth adoption as a standard care tool. Historical Collaboration: Participated in Four Corners Telehealth Consortium, connecting states in the region. Involved in telehealth and digital health initiatives since the mid-1990s, including partnerships in New Mexico. Future of Telehealth: Envisions telehealth as a standard tool for quality care rather than a distinct service. Strives for seamless integration of telemedicine and digital health in healthcare practices. Event Contribution: Supporting educational talks and roundtables to share knowledge and resources. Encourages attendees to adopt telemedicine and digital health practices to improve care delivery. Telehealth: Bridging Health Equity Gaps or Widening Disparities? Michael Holcomb, BS-MIS ( LinkedIn ) Associate Director for Information Technology, Arizona Telemedicine Program Interim Director, Southwest Telehealth Resource Center Carrie Foote, BS, BA ( LinkedIn ) Program Administrator, Southwest Telehealth Resource Center Video Key Points & Highlights Modalities: Synchronous care Asynchronous care Mobile health Remote patient monitoring Requirements: Service availability Broadband internet connection Patient/caregiver Literacy Telehealth compatible technology Patient assistance/accommodations Funding Sources Patient consent Privacy and HIPAA Benefits: Promotes equity by addressing barriers to healthcare access Dismantles geographic constraints Eliminates transportation obstacles Promotes ongoing care for chronic conditions/improves chronic disease management Provides access to specialists Increases access for underserved populations Addresses healthcare professional shortages and healthcare deserts Challenges: Digital divide Language/cultural barriers Digital and health literacy Differential adoption rates Technology comfort level Lack of private space Lack of accommodation for disabilities Telehealth as sole access point Economic barriers Policy barriers Lack of continuity of care Rates of use: High: 73% - young adults 18-24 69% - earn $100k/year 66% - private insurance 62% - white Low: 38% - no high school diploma 44% - older adults >65 51% - Latino and Asian 54% - black Disproportionally impacted by digital divide: Elderly Racial/ethnic minorities Disabled Low-income Rural Limited English proficiency Inherent biases in some technologies Solutions for equitable access: Provider education Assessing patient readiness Infrastructure expansion (broadband) Digital health literacy Telehealth access points Telehealth in libraries Partnerships and leadership Evidence-based solutions AI + Digital Innovation in Healthcare Elizabeth Krupinski, PhD (LinkedIn ) Professor & Vice-Chair, Research Dept. of Radiology & Imaging Sciences, Emory University Associate Director of Evaluation, Arizona Telemedicine Program Director, Southwest Telehealth Resource Center Video Key Points & Highlights Background: Expert in medical imaging, AI, and human-computer interaction Leadership roles in telemedicine and imaging societies AI in Healthcare: AI is transforming healthcare through predictive analytics, ambient clinical intelligence, and wearable technology. 64% of U.S. hospital systems already use AI, primarily for sepsis prediction, reducing hospital readmissions, and improving efficiency. Key AI Applications: Predictive Models: Identifying risks like sepsis and patient decompensation. Ambient Clinical Intelligence: Automatically documenting clinical interactions to save time and improve patient-provider communication. Wearables: Devices like sensors in clothing and rings to monitor health metrics and predict adverse events. Embodied AI: Robotics for tasks like patient transport, medication delivery, and remote communication. Challenges in AI Adoption: Bias: AI often reflects biases in training datasets, leading to inaccuracies in diverse populations. Transparency: Many AI tools lack the ability to explain their decisions, hindering clinical trust and utility. Regulation: Limited FDA oversight of AI tools creates potential risks in their clinical use. Data Quality: Poor data and limited external validation can reduce AI effectiveness. Deskilling: Over-reliance on AI could hinder skill development in healthcare professionals. Ethical and Practical Considerations: Addressing privacy concerns in ambient listening technologies. Balancing the use of AI with human judgment to prevent cognitive biases and over-reliance. Developing explainable AI to enhance clinical decision-making. Future Potential: AI-enabled tools for automating repetitive tasks, improving workflows, and enhancing diagnostics. Integration of advanced biometrics to detect conditions like depression, anxiety, or autism using subtle cues like voice or eye movement. Opportunities to improve healthcare equity by addressing systemic biases in healthcare algorithms. Medicare Telehealth: How to Plan Patient Care During Uncertainty Carol Yarbrough, MBA-TM (LinkedIn ) Business Operations Manager, Telehealth Resource Center, UCSF Medical Center Video Key Points & Highlights Background: Specialization in healthcare compliance, reimbursement, and telehealth policy. Offers guidance on billing, coding, and regulatory compliance for telehealth services. Medicare Telehealth Evolution: Telehealth policy began with Social Security Act (2001), limiting originating sites and eligible providers. During the COVID-19 public health emergency, telehealth services were expanded significantly. Policy Changes and Uncertainty: Public health emergency waivers allowing broad telehealth access are set to expire. Congress and CMS are deliberating future policies, with potential extensions being debated. DEA policies on telehealth prescriptions, especially controlled substances, remain unresolved. Current Telehealth Codes: Medicare supports 268 telehealth CPT codes; some are provisional and may be removed. Behavioral health services retain strong telehealth support, including Audio-Only services (with limitations). Indigenous Health Telehealth Initiative: New federal funding supports telehealth access for indigenous communities in pilot states (e.g., California, Oregon, New Mexico). Practice Management Insights: Clinics should prepare for potential policy changes by documenting telehealth utilization and exploring asynchronous care options. Consider workflow optimizations to balance telehealth and in-person care. Legislative Advocacy: Stakeholders are encouraged to engage with legislators to support permanent telehealth policies. Advocacy is particularly crucial for urban areas where telehealth services might be curtailed. Future Outlook: CMS might provide short-term extensions while working on long-term solutions. New opportunities include caregiver training via telehealth and innovative uses for asynchronous care. HCA/Turquoise Care Vision + Strategies for Expanding Remote/Access to Care Alexandria Castillo Smith, MPH, MSW ( LinkedIn ) Deputy Cabinet Secretary, NM Healthcare Authority Video Key Points & Highlights Overview of Turquoise Care (TC) Goals Goal 1 – Build a NM healthcare delivery system that is accessible for both preventive and emergency care that supports the whole person (PH, BH, SDOH). Goal 2 – Strengthen the NM healthcare delivery system through expansions and implementation of innovative payment reforms and VBC initiatives. Goal 3 – Identify groups that have been historically and intentionally disenfranchised and address health disparities through strategic program changes to enable an equitable chance at living healthy lives. TC Health Plans Blue Cross Blue Shield of NM Molina Healthcare Presbyterian Turquoise Care United Healthcare Community Plan New TC Benefits New Home Visiting Program for New Mothers Reimbursement for Community Health Workers Chiropractic Services Continuous coverage for children up to age 6 Changes to Telemedicine During Covid-19 Promoted access to video and phone telehealth services Expanded proportion of members in rural and urban areas that were able to access care HCA Approach to Telemedicine: TC Contract Requirements Quarterly Telemedicine Report to HCA from MCOs Audiovisual asynchronous, remote monitoring Training for providers of appropriate services for telemedicine Targets set to increase telemedicine usage by 20% or be penalized. NM Medicaid Telemedicine Services Telemedicine Must include audio and visual Be delivered real-time a the originating and distant site No restrictions on services that can be offered via telehealth If provider resides outside of NM they must be licensed in NM Telephone Able to reimburse for all telephonic visits covered during the Public Health Emergency After 12/31/2024 will follow the codes that are permitted by Medicare, primarily BH codes. Project ECHO Have hubs of virtual learning opportunities on a wide variety of topics for providers MCOs support Project ECHO and encourage utilization Collaborates with Indian Health Services Have a unique relationship with Medicaid Program MCOs identify members who would benefit from Project ECHO MCO Support for Advancing Telemedicine Providing access to high-speed internet for rural communities Bring in new providers that focus on telehealth services and specialties Scholarships to health professionals Grants to physician practices to keep providers in NM Tribal Communities’ Health Care Priorities Native American Technical Advisory Committee – 13 Tribes represented Goals include: Increase BH services for Native Americans Increase Medicaid reimbursable provider types and services for HIS and Tribal clinics Increase the number of long-term care options Increase NA enrollment in Medicaid Rebuilding Behavioral Health in NM Received CMS federal approval to begin to provide Medicaid coverage to those exiting incarceration up to 90-before release Raising BH Medicaid reimbursement rates up to 150% of Medicare rates 6 Certified Community BH Clinics (CCBHCs) slated to launch in 2025 Support for pregnant members with Substance Use Disorder Added 5 new BH Practices for enhanced rates, encouraging more providers to expand their services Rural Health Care Delivery Fund $80 Million in funding available to rural health care providers Expansion and delivery of new services in rural communities, including telehealth services NM Telehealth Alliance, NM State Telehealth Law, and Closing Remarks Stetson Berg, MHA ( LinkedIn ) Board Chair, New Mexico Telehealth Alliance Video Key Points & Highlights New Mexico Telehealth Alliance (NMTA): Established in late 1990s to advocate for and advance telehealth in New Mexico. Focuses on policy, legislation, and connecting stakeholders to solve telehealth challenges. Telehealth Law in New Mexico: Among the most progressive in the U.S., enabling telehealth billing parity for audio, video, asynchronous, and remote patient monitoring services. State law allows billing for phone visits, as clarified in 2022 "audio only" update. Applies to fully insured health plans under NM Office of Insurance and specific public health plans, but not Medicaid, Medicare, or self-insured plans. Legislation and Advocacy: NMTHA worked with legislators to craft state-friendly telemedicine policies before the pandemic. Advocating for expanded reimbursement models to ensure telemedicine services are financially sustainable for providers and facilities. Resources and Collaboration: Offers webinars, online resources, and direct problem-solving for billing, policy issues, and other telehealth barriers. Collaborates with federally funded organizations like Southwest Telehealth Resource Center for expertise and solutions. Reimbursement Challenges: Payment parity exists but often doesn't cover operational costs for telehealth services, especially in rural settings (e.g., f inancial strain on providers/facilities delivering telemedicine with insufficient reimbursement). Interstate Practice Issues: Licensure laws vary by state, complicating cross-border care for established patients. Efforts to create interstate compacts for streamlined licensure are ongoing but involve significant paperwork and limitations. Call for Feedback and Participation: NMTHA encourages stakeholders to share telehealth challenges and ideas to inform future legislative and operational improvements. Slides: Equity Slides: AI Slides: Medicare Kick-off, Welcome, Intros Equity Gaps Opening Remarks AI + Digital Innovation Medicare Telehealth HCA/Turquoise Care Slides: HCA Closing Remarks Slides: NMTHA

Pandemic broadens NMDOT’s outlook to lay groundwork for a connected future By NMDOT February 8, 2021 “The pandemic forced New Mexico to rely heavily on internet access, making broadband even more essential,” SANTA FE – The New Mexico Department of Transportation is committed to helping build out the information highways in New Mexico to connect rural communities to vital digital resources while enhancing mobility and safety on state highways. “The pandemic forced New Mexico to rely heavily on internet access, making broadband even more essential,” said Transportation Secretary Mike Sandoval. “Digital expansion has been a passion project of the department for a while, but the urgent need for telecommuting, distance learning and telemedicine has fueled the drive to make internet access for every New Mexican a reality.” The DOT is looking ahead at what it would take to piggyback fiber optic infrastructure with current and future road construction projects to achieve dig once practices and help make future broadband expansion projects more welcoming for industry partners. Additional fiber infrastructure would also enhance the department’s Intelligent Transportation Systems (ITS) which allows DOT to install additional digital message boards, cameras, and weather sensors, to provide real-time road condition information through the NMRoads application. “As existing roads are reconstructed, there’s an opportunity to install fiber conduit while the road is torn up, so you’re not digging twice, which minimizes the impact on the environment,” said Sandoval. “Building both literal and digital highways will provide innovative, sustainable infrastructure that serves the entire state.” NMDOT is also partnering with the New Mexico Economic Development Department (NMEDD) to conduct a stratospheric broadband infrastructure assessment which will not only evaluate the connectivity opportunities for rural New Mexico, but also identify the same prospects for the state’s transportation needs. “We have a long way to go, but the department is gathering data and taking the necessary steps to ensure DOT plays a significant role in broadband accessibility,” adds Sandoval. < Previous News Next News >

CMS Releases Final Calendar Year (CY) 2023 Physician Fee Schedule CCHP November 08, 2022 Last week, the Center for Medicare and Medicaid Services (CMS) released the final rule for the CY 2023 Medicare Physician Fee Schedule (PFS). CMS finalized many of their telehealth proposals, which primarily focused on what services will be covered by the program and what will happen immediately following the end of the public health emergency (PHE), including during the 151-day grace period included in the 2022 Budget Act. CMS clarified that the list of services that were temporarily allowed to be delivered via telehealth and reimbursed by Medicare during the PHE, will still be allowed during the 151-day grace period. Additionally, CMS added more of the temporary telehealth PHE list codes to a category of services that would remain through the end of 2023. The rule also reiterates the requirement for an in-person visit in the first 6-months of an initial telehealth mental health visit and every 12 months afterward (with exceptions), and clarifies that won’t be implemented until 152 days after the end of the PHE. They will address the specifics around coding and reporting these types of services through guidance and a sub-regulatory process in the future to ensure a smooth transition after the PHE ends. Stay tuned for an in-depth In Focus write up from CCHP on the 2023 PFS next week, as well as a new factsheet focused on the telehealth elements in the final rule. See original article: https://mailchi.mp/cchpca/its-here-cms-releases-2023-physician-fee-schedule-plus-new-resources-on-telehealth-policy-from-hhs-cchp < Previous News Next News >

ATA: What's ahead for telehealth policy after the pandemic Andrea Fox September 23, 2022 Federal and state advocacy team members discussed the status of telehealth policy as the public health emergency deadline looms and the industry questions, 'Is the pandemic over?' The American Telehealth Association is working with Congress and several federal agencies to shape the fate of policies and payments for telehealth services that experienced a rapid uptake during the COVID-19 pandemic. WHY IT MATTERS Now that President Joe Biden has declared the COVID-19 pandemic over, the ATA's Telehealth Awareness Week policy update webinar explored how federal and state telehealth policies may be affected as Congress decides whether or not to end the public health emergency (PHE). Federal priorities for telehealth have evolved with the pandemic with restrictions lifted by a Congress deciding if the limiting of certain restrictions should be lifted permanently. The PHE must be reviewed every 90 days, so Congress will have to revisit the renewal by mid-October, according to policy experts presenting during Wednesday's online event. "As we know, [President] Biden has said in recent days that the pandemic is over, so it's possible that the technical public health emergency might expire sometime in the very near future," said Megan Herber, director at Faegre Drinker who advises ATA and ATA Action on all things Federal policy. Telehealth payments and provider practices are highly regulated on the Federal level, said Quinn Shean, strategic advisor at Tusk Ventures and the state policy advisor for ATA and ATA Action. But even if providers do not serve Medicare populations, "Medicare policy trickles down," added Herber. For example, before the pandemic, patients had to be in a rural area in a hospital or clinical setting to receive reimbursement for telehealth. "That is the current status quo right now – as long as the COVID-19 public health emergency is in place," Herber explained. But in about five months, "all of those waivers go away automatically unless Congress does something." Approaches to policy can be different in different contexts, noted moderator Alexis Gilroy, co-leader of the healthcare and life sciences practice at Jones Day. "Where do you come at it based on the particular lane it sits in?" In terms of state-level telehealth policy, there are multiple state priorities because states differ in their approaches to telehealth coverage requirements for public and private health plans, reimbursement for services provided via telehealth, and eligibility to deliver reimbursable services. States also differ in how they regulate synchronous and asynchronous telehealth and remote patient monitoring. They vary on which types of providers can deliver telehealth, what establishes a valid patient/provider relationship and if out-of-state practitioners can treat patients in the state remotely without a license, explained Shean. "We have a patchwork of 50 different state requirements here," she said. The ATA has been focused on developing a consistent regulatory framework so telehealth can be deployed across states and fully leveraged. "The ATA is committed to modality-neutral policies," instead of dictating which tools clinicians choose to use to deliver telehealth, she said. ATA is pushing for fair payment for telehealth and home health as well as licensure flexibility across state lines. "It's really aligning our state frameworks with the 21st Century care model," and the states are moving quickly, she said. There have been hundreds of pieces of legislation to update state telehealth policies. The organization is also working with the U.S. Drug Enforcement Agency and Congress to address the future of online prescribing of controlled substances. Many of the barriers to telehealth policy have been based on perceptions that telehealth is somehow substandard and that romanticizes in-patient care, but telehealth has often delivered care where there was no prior access to healthcare, said Shean. "We need to recognize the access gaps that telehealth can fill" and recognize the guardrails that are in place with telehealth as they are with other care settings, said Shean. As more retail providers like CVS, Amazon and others enter the space through mergers and acquisitions, they will also have an impact on the direction of telehealth policy, including how to protect the patient data these companies will have more access to. But with more stakeholders pushing for telehealth on the state level, "having a broader tent now helps show the different patient populations that can be served here and brings more focus," Shean pointed out. THE LARGER TREND Under the CARES Act, Congress granted the Centers for Medicare & Medicaid Services authority to waive certain restrictions for Medicare coverage of telehealth. The agency was able to remove geographic restrictions, expand care at home, increase the amount of Medicare-covered services via telehealth and more. Additional legislative proposals, including the Telehealth Benefit Expnasion for Workers Act, Telehealth Extension Act and others, suggest broadening access to telehealth. "Throughout the pandemic, telehealth has proven to be a vital tool for Americans to receive timely and quality care from their own home," said Tim Walberg, R-Mich, during the bill's introduction at the Capitol in March. "For rural communities in particular, telemedicine has helped remove barriers to care, expand access to specialists and improve health outcomes." ON THE RECORD "There is urgency [for Congress] to act – don't wait until four months and 20 days after the pandemic ends; we need some stability," said Herber. "We'd love to make it permanent, and a lot of these policies we have been asking for since before the pandemic, so it's not really new," she concluded. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS publication. See original article: https://www.healthcareitnews.com/news/ata-whats-ahead-telehealth-policy-after-pandemic < Previous News Next News >

How Does a Telemedicine Pain Program Work in Rural American with Multi-Vulnerable Patient Populations? Dax Trujillo, MD July 20, 2022 In April 2017 Summit Healthcare started a multi-disciplinary program to treat patients with chronic and acute pain in the White Mountains of Arizona. Our patient service area is HRSA-designated as having a shortage of providers and medically underserved. The area is the size of Rhode Island and includes Native American reservations and other vulnerable populations. Many of our patients live in a high poverty area which makes access to care challenging. In order to provide multi-disciplinary services that include interventional procedures, monitored medication management and cognitive behavior therapy, we needed to create a hybrid program. Our program incorporates in-person, video/audio and telephone visits. By using three different modes of care delivery we were able to reach and follow more patients with better outcomes. Since April 1, 2017 we have had over 900 patients participate in our telemedicine pain program. The visits include virtual appointments for medical management, behavioral therapy, and general wellness checks after an in-person visit; virtual check-ins for procedure or testing follow-ups and eVisits via email communication to answer questions and/or review prescription issues or re-ordering. Due to the rurality of the service area we estimate that patients were saved from having to travel 66,144 miles to a physician’s office. This was a significant relief to patients with limited means to transportation, knowing that their weekly, monthly in-patient visits were reduced to quarterly in-patient visits. Patient satisfaction has been high due to the reduction of travel time and costs. Simultaneously, the patient perceived they were being more closely monitored and their pain issues addressed in a timely manner. Another benefit is that more than one professional can join a telemedicine visit with the patient which allows a more holistic and comprehensive visit for better value based care of the patient. By providing virtual visits as part of the entire treatment program, we have saved thousands of dollars in chronic pain treatment costs. Through evidence-based research we know that patients are achieving better healthcare outcomes in this hybrid program by incorporating telemedicine technology. Our program has had overall success with addressing pain but there are some risks involved that must be addressed within your institution to provide a platform that is HIPPA compliant and protects critical sensitive health information. Providing a secure platform must be a top priority when delivering pain treatment virtually due to the sensitive nature of the disease/treatments with this patient population. While most patients do well with the hybrid program we do have patients for whom it is not appropriate. Due to our location, a subset of patients do not have access to broadband internet service so we cannot perform visits via video or sometimes audio. Other patients have expressed a preference for in-person visits while another group prefers all visits to be virtual. Patients needing neuraxial interventions or surgeries will need to be seen in-person. Each patient has their own unique circumstances so having a hybrid pain treatment program with various care delivery options allows us to reach more patients previously not being treated for their chronic pain issues. In the future we will purchase a remote patient monitoring platform/equipment that can be used with our chronic pain patients to better track their vitals, physical and mental health. This will also allow us to manage medications and behavioral issues related to pain and opioid addiction, both of which are prevalent in our service area. Our hospital system is also developing a hospital at home program which will incorporate the telemedicine pain program for patients with co-morbidities. The future of healthcare access is using hybrid delivery of care systems that include telemedicine, to improve accessibility and outcomes for chronic pain patients. For original article: https://southwesttrc.org/blog/2022/how-does-telemedicine-pain-program-work-rural-american-multi-vulnerable-patient < 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 >

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

San Juan Regional Medical Center gets CARES Act funding to expand telehealth services By Hannah Grover, Farmington Daily Times February 15, 2021 AZTEC — Before COVID-19, San Juan Regional Medical Center used telehealth in a limited fashion to support providers and to do provider consultations, according to Chief Information Officer Matt Miliffe. AZTEC — Before COVID-19, San Juan Regional Medical Center used telehealth in a limited fashion to support providers and to do provider consultations, according to Chief Information Officer Matt Miliffe. The pandemic changed things. San Juan Regional Medical Center and San Juan Health Partners worked quickly to expand telehealth offerings. Now the hospital is receiving CARES Act funding to help improve its technology and better provide that service. "Demand (for telehealth) was immediate and has continued to grow," Miliffe said. San Juan Regional Medical Center will receive $1.25 million in CARES Act funding to supply emergency generators as well as to make upgrades in the IT network, according to a press release from the office of Sen. Martin Heinrich, D-NM. IT upgrades, new generators on the way These technology upgrades will support telehealth and field hospital operation projects that have been implemented in an effort to bolster the hospital's response to COVID-19. The grant funding will be matched with $617,000 in local funds. All locations except for San Juan Health Partners Urgent Care began offering a mixture of telephone and video visits in an effort to comply with public health orders, sustain the services offered and prevent the spread of the coronavirus, according to Barbara Charles, administrative director for San Juan Health Partners. The medical center's network infrastructure wasn't designed to service the high demands of video consultations and Miliffe said the IT team has had to push the current capabilities. "However, significant upgrades to the wired and wireless infrastructure is needed to sustain and improve the existing experience, and allow for the continued growth in telehealth demands driven by the pandemic," he said. "This funding will make a fundamental difference in our ability to serve our community’s needs." Your stories live here. Fuel your hometown passion and plug into the stories that define it. Create Account COVID: State health department closes Home Depot over COVID-19 cases One of the barriers that the center has seen is the remote nature of the community. Many patients can only connect through phone due to limited internet connectivity or cell service that can't support video. "The inability to consistently connect by audio and video is an ongoing barrier," Charles said. This funding is part of more than $2.24 million of CARES Act money that will be coming to northwest New Mexico to address healthcare and economic needs. In addition to San Juan Regional Medical Center, the Northwest New Mexico Council of Governments, which is based in Gallup, has been awarded $990,000 to address economic development needs of small businesses and entrepreneurs that have been harmed by the COVID-19 pandemic. The Northwest New Mexico Council of Governments serves Cibola, McKinley and San Juan counties. According to the press release, the council of governments hopes to create 100 jobs and retain 100 jobs through a revolving loan fund that this funding will assist in creating. Legislative session:New Mexico lawmakers work to address economic impact of COVID-19 U.S. Sen. Martin Heinrich Heinrich said in a press release that he has been "moved by the resiliency and grit" of rural New Mexico communities as they have faced a variety of public health and economic challenges related to the pandemic. "That is why I fought so hard to include funding in the CARES Act to help New Mexico’s rural health care systems, small businesses, and entrepreneurs to weather this storm," he said. "This funding is long-overdue and I will continue working for federal resources that New Mexico’s rural communities need to take on the COVID-19 pandemic and rebuild our economy in a way that supports everyone." Heinrich as well as Sen. Ben Ray Luján, D-NM, and Rep. Teresa Leger Fernandez, D-NM, announced $2.24 million of CARES Act funding for northwest New Mexico on Feb. 12. San Juan Regional Medical Center President and CEO Jeff Bourgeois Hospital: Telehealth is here to stay San Juan Regional Medical Center President and CEO Jeff Bourgeois thanked the lawmakers for the funding in the press release and emphasized that the hospital provides essential healthcare services for the Four Corners area. "This funding will ensure that we can meet the diverse needs of our patients and community and improve care for those we are privileged to serve," he said. While the pandemic jump started the demand for telehealth in the community, Miliffe said the San Juan Regional Medical Center does not anticipate it fading away. "Looking ahead to post-pandemic times, we see a long term and stable need for these services in our community as patients look to receive their healthcare in more of a consumer fashion, with services and offerings tailored around them as the individual," Charles, of San Juan Health Partners, said. "It is expected that the need or demand for telemedicine will continue long term. Many patients with health needs that may not require an in-person or face-to-face visit may find this option more flexible and convenient. Additionally, given the unknowns of the pandemic – this remains a safe alternative to in-person visits for patient to seek as needed or routine healthcare needs." Charles said telehealth also plays a key role in the COVID to Home program, which allows COVID-19 patients to receive close monitoring while in self-isolation at their own houses. "Because of this program’s close monitoring through telehealth visits, many patients have been able to stay out of the hospital and manage their care at home through the telephone or video calls. In other cases, caregivers have been able to intervene to coordinate a higher level of care for patients who needed it," she said. "To date, the COVID to Home program has helped more than 1,200 patients manage their care at home, something that would not have been possible without telehealth." Hannah Grover covers government for The Daily Times. She can be reached at 505-564-4652 or via email at hgrover@daily-times.com . This story has been modified to correct the attribution on some quotes. < Previous News Next News >