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A staffing expert shows how telehealth is stepping in to fill the staffing shortage Bill Siwicki December 19, 2022 "As clinicians are passionate about patients receiving quality healthcare delivered in a timely manner, I see telehealth programs being the key to improving patient outcomes and the overall healthcare experience," he says. The staffing shortage is a huge challenge in healthcare today. Another challenge is finding a solution to this vexing problem. But telehealth may be becoming an emerging strategy to help fill in gaps within hospitals and health systems, contended Chris Franklin, president of LocumTenens.com, a self-service job board and a full-service physician and advanced practice recruitment agency working in high-demand medical specialties. Healthcare IT News sat down with Franklin to discuss changes occurring in healthcare staffing, what he calls hybrid staffing strategies, and the results of a new LocumTenens.com survey. Q. Overall, what changes are you seeing occurring in healthcare staffing? A. The changes we've seen in the broader economy regarding contingent employment over the past three years are incredibly impactful on healthcare staffing. There are a few key numbers that tell the story. There currently are 3.5 million fewer workers in the U.S. than there were two years ago. Since February 2020, job openings have gone up by 50%, while total employment in the U.S. has gone slightly down. Because demand is outpacing the available supply, workers are demanding not just increases in pay, but also more choice and control over when, how and where they work. This is incredibly true in healthcare, based on every indicator we watch. New data shows more than 300,000 healthcare workers dropped out of the workforce in the last two years. Physicians report they are choosing early retirement or leaving the full-time practice of medicine for other kinds of work, in and outside of our industry. Nurses on the frontline have made the news due to the difficulties they have experienced, and also because of the freedoms they are newly experiencing due to the uptick in travel nursing. According to a 2021 study from Health Affairs, nearly 100,000 nurses exited the profession last year – most of them under the age of 50. Another 32% of nurses have said they may leave the profession. The Bureau of Labor Statistics estimates we'll need to fill nearly 200,000 nurse vacancies a year until 2030. Patients are sicker than they have ever been. Over the past year, nearly every hospital has seen increases in patient acuity, largely driven by care that was delayed during the [COVID-19] pandemic. And chronic disease and obesity continue to be primary drivers of healthcare consumption in the U.S. Even though it's been on the horizon for years, the impact of a big population of aging baby boomers – the oldest turned 75 this year – is finally here, and demand for healthcare is about to increase dramatically as a result. Burnout also is at an all-time high. A recent survey from MGMA and Jackson Physician Search highlights a sobering pair of statistics: Nearly two-thirds of physicians (65%) report they are experiencing burnout in 2022, up four percentage points from the 2021 study. Of those experiencing burnout, more than one in three physicians (35%) said their levels of burnout significantly increased in 2022. All of this points to a big, industrywide shake-up, and we are seeing first-hand that traditional workforce staffing models are no longer working, especially in healthcare. What's emerging is something very different – hybrid models that anticipate both permanent and contingent workers, an uptick in models that combine site-based care with a robust telehealth presence, an increase in APP staffing overall, and in general, a growing commitment to giving providers access to the kind of work-life balance they are desperately seeking. Q. You say you are seeing a hybrid staffing strategy that includes elements of locum tenens, more advanced practice providers and more telehealth coverage. Please elaborate on this. A. Healthcare leaders are looking for new and creative solutions now more than ever – and all amidst this backdrop of healthcare workforce shortages. We have seen first-hand the impact the gig economy is directly having on the healthcare workforce and know the biggest concerns for healthcare facilities are attracting talent, retaining talent, and avoiding or mitigating burnout. To help clinicians' desire to achieve a more viable work-life balance, healthcare leaders are evolving their hiring models to reflect a new appreciation for the flexibility that hybrid staffing models represent. Solely relying on traditional staffing models and solutions just won't work anymore. Through staffing innovation, hospitals and healthcare organizations are actively seeking options to improve access to care with more sustainable models. Healthcare staffing is complex and there's never a one-size-fits-all solution, but we are seeing an increase in interest in alternative models of staffing, including a growing use of locum tenens staff and improving patient access to care with advanced practice providers (APPs) and telehealth expansion. Awareness of and interest in locum tenens are at an all-time high for both healthcare organizations and clinicians. People are actually taking their own well-being into account in terms of their employment, opting into contingent work as a way to manage their levels of stress and burnout. We had a locum tenens physician tell an audience at a recent conference: "If you have burnout in locums, you are not doing it right." There's no doubt flexibility of locum tenens offers a desirable outcome on what physicians are wanting out of life. According to the recent survey: Nearly 90% of healthcare facilities already use locum tenens staffing. Nearly 57% of facilities that have not used locum tenens staffing in the past are planning to use it in the next year. According to a recent survey we conducted on innovation and flexibility in staffing, when most administrators consider locum tenens, they most commonly think about onsite physician care. Data shows hospitals utilize onsite locum tenens more than three times as often as telehealth, but that is starting to change. Facilities that were previously reliant on onsite are now embracing telehealth. COVID-19 expedited this adoption, as hospitals looked beyond traditional models to meet their patients' needs. In some cases, hospitals are taking a flexible, hybrid approach that integrates telehealth and onsite care, providing the best of both worlds and delivering value to patients. Additionally, the use of APPs in combination with physicians as a strategy is growing, with 73.9% affirmatively responding to the question, "Do you plan to expand APP coverage?" Q. Your company recently did a survey of hospital administrators to get a clearer view of the challenges in today's landscape. What did you learn as it relates to telehealth? A. Our recent survey results – which are detailed in the Innovation & Flexibility: Journey to Sustainable Healthcare Report – revealed that hospital administrators have strong feedback when it comes to managing today's challenging landscape. With regard to how it relates to telehealth, more facilities are using telehealth than ever before. COVID-19 expedited this adoption, but over the coming year, most hospitals expect to expand their use of telehealth even further – there is no turning back. Patients across the board now are more comfortable using telehealth as the COVID-19 pandemic drove a surge in virtual visits, including those who have historically hesitated to use technology. Traditionally, psychiatric services dominated locum tenens telehealth services, with behavioral health accounting for 79% of telehealth services for LocumTenens.com. However, utilization has started to shift as hospitals look at other specialties, including oncology, cardiology and physiatry. By expanding telehealth offerings, facilities can expand access to care and reach more patients in new locations. Over the past year, many facilities have been able to deliver a higher level of specialty care to satellite or remote locations through telehealth. Going forward, better reconciling reimbursements to align with the level of care provided in a telehealth setting will lead to broader adoption. Q. Where do you see the telehealth component of staffing in five years? A. The feedback we have gotten shows that more than half (60%) of those surveyed plan to expand telehealth. Through innovation, healthcare providers will continue to adapt to flexibility and improved access to care. These flexible solutions create a more sustainable model to provide quality care to patients and their communities. As clinicians are passionate about patients receiving quality healthcare delivered in a timely manner, I see telehealth programs being the key to improving patient outcomes and the overall healthcare experience. The beauty of telehealth is that it provides access to a qualified provider at any time. For example, we have a client that provides psychiatric services across the country. During a busy day, a patient presented who was experiencing domestic violence trauma, and she wasn't comfortable talking with a male doctor. The problem was there were only male psychiatrists on call at her presenting hospital. The hospital contacted our team, and we in turn reached out to two privileged and credentialed female providers that weren't on-call that day. Although one was heading out to attend a wedding, she accepted the assignment to immediately provide care for this patient. So, even though this psychiatrist worked five states away from the hospital, she was able to provide care because of the access to telehealth. The result: The patient received the "right care" that she needed at the right time with an experienced provider. Follow Bill's HIT coverage on LinkedIn: Bill Siwicki Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/staffing-expert-shows-how-telehealth-stepping-fill-staffing-shortage < Previous News Next News >

Extended Reality for Telehealth The technologies enabling a more fully immersive telehealth experience of the future Jordan Owens September 20, 2022 There has been a digital transformation in telehealth in the form of remote meetings and video consultations. Just a few years ago, it was considered innovative to meet with a patient over video: now it’s seen as routine. Necessity can be a catalyst for innovation and telehealth is now here to stay. But that doesn’t mean the industry has finished growing, changing — or expanding. Extended reality (XR) is a catch-all term used to describe the many and various ways that technology can enhance what we perceive with our senses: how the real and virtual worlds can combine to extend perception, observation, and — in the case of telehealth — patient care and diagnosis. Using extended reality tools like augmented reality headsets and wearable devices, healthcare workers can diagnose with better accuracy, treat patients faster, and provide an optimal level of care — even when the patient is on the other side of the country (or the world). Some of the innovative ways that people are combining telehealth and extended reality include: Wearable technology to enhance remote patient monitoring You enter a remote telehealth session with a patient. You ask them what seems to be the issue. They respond, “Well, my ring says that my sleep patterns have been disturbed for the past few nights due to elevated heart rate, and then today my temperature has gone up. Here, look at the data for yourself.” Wearable technologies — from smart watches and wristbands to patches, rings, and even headsets — help collect valuable health data. These devices are already shaping the future of telehealth by making remote patient monitoring faster, easier, and more accurate than ever before. There are currently thousands of wearable devices on the market, tracking a variety of conditions. But as sensor technology improves, the accuracy of these devices improves as well. In fact, Gartner predicts that “by 2024, miniaturizing capabilities will advance to the point that 10% of all wearable technologies will become unobtrusive to the user,” leading to rapid market growth over the next three to five years. Virtual reality environments to set remote patients at ease The immersive nature of VR makes it a great way to distract patients from the stress they’re feeling. In fact, virtual reality has already proven effective in helping anxious in-office patients relax in stressful situations — like a child receiving a vaccine. This soothing, calming effect can be replicated in telehealth as well. Virtual environments can help alleviate some of the awkwardness of remote telehealth sessions, and help the patient feel closer — both physically and mentally — to the caregiver, which can improve patient care. According to a recent paper on the use of extended reality in telehealth: “Some patients report reluctance to self-advocate during typical telehealth sessions because of poor eye contact and audio interference if more than one person speaks at a time (….) Technologies that evoke presence—the perception, feeling, and interaction with simulations as if they were real — can meaningfully impact the practice and outcomes of telehealth.” While VR technology might not yet be advanced enough to create a fully immersive telehealth experience, it could be very soon. Imagine the possibilities. Augmented reality to improve patient care and diagnosis Wearables aren’t just for patients. There are many devices on the market that can augment and enhance the skills of medical caregivers as well. Visual overlays can help practitioners improve the accuracy of incisions, find difficult veins, take patient temperatures remotely, and much more. Many of these AR headsets, like those designed by RealWear, are also voice-controlled, leaving the practitioner’s hands free to do the work that needs to be done. They can also use the headsets to contact, and even video chat with, clinical specialists to get advice and guidance — making it easier for first responders in the field to accurately diagnose and treat illnesses and injuries before the patient even arrives at the hospital. Getting started with extended reality in telehealth As with any new technology, it’s important to work with partners who provide not only general support, but also vertical-centric support. Pexip is achieving this through partnering and working closely with headset manufacturers like RealWear and Hippo. We are also working with vertical-centric partners like SimplyVideo, allowing Pexip customers to add a variety of XR functionalities to their existing video telehealth platform. Pexip’s vision for the future is centered around leveraging technology to enhance and improve what people can achieve. We’re excited for the journey ahead and hope you will join us. About the Author Jordan Owens is the VP of Architecture for Pexip. He joined Pexip in 2012 from TANDBERG and Cisco where he led the Americas Technical Support organization, the Americas Product Engineering team, and a Pre-Sales Engineering organization for the previous 10+ years of his career. At Pexip, Jordan is responsible for leading the Americas engineering organization and serving as an extension of the global R&D organization. He can be reached at jordan@pexip.com See original article: https://www.americantelemed.org/blog/extended-reality-for-telehealth/ < Previous News Next News >

Grants & Funding The Federal government has numerous funding sources for telehelath support: USDA Community Connect Grants USDA Distance Learning and Telemedicine Grants Other Telemedicine Grants FCC Rural Health Care - Healthcare Connect Fund USDA COMMUNITY CONNECT GRANTS This federal program funds broadband deployment into rural communities where it is not yet economically viable for private sector provi ders to deliver service. For more information, please visit USDA Community Connect Grants . USDA DISTANCE LEARNING AND TELEMEDICINE GRA NTS Th is federal program helps rural communities use telecommunications' unique connectivity capabilities to overcome effects of remoteness and low population density. Grant funds may be used for a cquisition of eligible capital assets, such as: Technical assistance and instruction for using eligible equipment Inside wiring and similar infrastructu re that further DLT services Acquisition of instructional programming as a capital asset Computer hardware, network components, and software Audio, video, and interactive vid eo equipment Terminal and data terminal equipment For more information , please visit USDA Distance Learning and Telemedicine Grants . OTHER TELEMEDICINE GRANT OPPORTUNITES The Health and Human Services Division for telehealth and broadband related programs posts funding opp ortunities HE RE . HEALTHCARE CONNECT FUND The New Mexico Telehealth Alliance (N MTHA) manages the Southwest Telehealth Access Grid (SWTAG), a Federal Communications Commission (FCC) approved consortium for funding through the Healthcare Connect Fund (HCF). If you manage one or more healthcare provider sites serving clients in New Mexico, contact NMTHA to discuss joining SWTAG. Advantages to applying to SWTAG via NMTHA include: Lower application and administrative costs. Access to expert funding advice for a mix of rural and urban sites. Professional assistance with proven track record of funding success. Additional information on eligibility and application procedures can be found HERE . Community Connect Distance Learning Other Healthcare Connect

Audio-Only Telemedicine Services Special Announcement NMTHA's communication with the New Mexico Office of the Superintendent of Insurance about billing for AUDIO-ONLY telemedicine services February 2022 Update: New Mexico Audio-Only Telemedicine Services The New Mexico Telehealth Alliance (NMTHA) works hard to ensure telehealth is sustainable and meets healthcare needs in our State. The NMTHA has been instrumental in ensuring New Mexico has one of the leading telehealth laws in the country. Looking at the NM Telehealth Act, last amended in 2019, the New Mexico Office of Superintendent of Insurance (OSI) has put out the following information around the continued ability to bill for telephonic services. What you need to know: The telemedicine definition allows the use of audio-only telemedicine services. The NM Telehealth Act: The New Mexico Telehealth Act, which was last amended in 2007, defines telehealth as “the use of electronic information, imaging and communication technologies, including interactive audio, video, data communications as well as store-and-forward technologies, to provide and support health care delivery, diagnosis, consultation, treatment, transfer of medical data and education.” § 24-25-3(C) NMSA. This definition clearly incorporates audio-only services, particularly as “the purpose of the New Mexico Telehealth Act is to provide a framework for health care providers to follow in providing telehealth services to New Mexico citizens in a manner that provides efficient and effective access to quality health services.” § 24-25-2(B) NMSA. What insurance this affects: This is only for fully-insured health plans regulated by the NM OSI, and for NM State employee, public school, and retiree health plans. It does not apply to Medicaid, Medicare, other federal health plans, or self-insured health plans. Access the final text of S.B.354 (2019) and chaptered statutes HERE . See the email communication from the NM OSI HERE . Sincerely, New Mexico Telehealth Alliance

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

Telehealth Remains Key Modality for Behavioral Healthcare Delivery eVista December 19, 2022 A Michigan-based provider leveraged a telehealth solution to expand critical access to behavioral healthcare as demand for these services skyrocketed during the COVID-19 pandemic. After reaching new heights during the first year of the COVID-19 pandemic, telehealth use is leveling off in several clinical care areas. But there is one prominent exception: behavioral healthcare. Healthcare stakeholders are continuing to flock to telehealth for behavioral health services. An analysis of data from January 2020 to March 2022 shows that mental health conditions were the most common telehealth diagnoses at the national level. In addition, data shows that amid a drop in overall telehealth use since 2020, telemental healthcare has grown. In the first quarter of 2019, 32.4 percent of all telehealth visits were related to behavioral healthcare, according to a market research report. That figure jumped to 59.9 percent by Q1 2022. This data, along with the ongoing mental health crisis in America, signifies the importance of providing virtual care options for behavioral healthcare. At Michigan-based Easterseals MORC, telehealth has been integral to behavioral healthcare delivery since 2019. Then, amid the pandemic, the organization saw its virtual visit volumes skyrocket, and they continue to show no signs of slowing down. "We went from 25 telehealth users before the pandemic to 300," says Clarissa Hulleza, Chief Information Officer of Easterseals MORC. "Those numbers are still going up. We're not seeing any decrease." WHY THE ORGANIZATION IMPLEMENTED TELEHEALTH Easterseals MORC, an affiliate of the national Easterseals organization, serves over 21,000 individuals annually. It provides a wide array of behavioral health services, including therapy, psychiatric care, and substance abuse treatment, as well as long-term care for those with intellectual and developmental disabilities. In 2019, the organization decided to implement a telehealth solution. One of the key goals of the move was to expand access to behavioral healthcare across the state. “The reason we pursued a telehealth solution was so that people who couldn't get to us regularly or at all, could be provided the opportunity to still receive care," says Hulleza. "We serve all of Michigan, and not all of Michigan has access to transportation, or maybe their closest local provider is 20 miles away. So, it was really creating more opportunities for access." Additionally, telemedicine was already becoming popular as a mode of physical healthcare delivery, prompting behavioral healthcare providers to catch up. "It was one of those, 'well, why aren't we doing the same?'" Hulleza says. Easterseals MORC partnered with eVisit to launch a telehealth pilot program in May 2019. A little under a year later, the COVID-19 pandemic hit, compelling providers across the country to rapidly scale up their telehealth programs. According to Hulleza, already having a telehealth solution and vendor partnership in place enabled Easterseals MORC to expand virtual care use seamlessly. "I would say that the absolute benefit was that we never had to close our doors," she adds. "In a time that people needed behavioral healthcare the most, we were able to provide it." IMPLEMENTATION CHALLENGES AND KEY LESSONS LEARNED Easterseals MORC leverages telehealth for nearly all of its services, including case management, one-on-one and group therapy. The organization even provided Applied Behavior Analysis (ABA) therapy virtually, which aims to improve social behaviors using interventions. But implementing a telehealth solution for behavioral healthcare has its challenges. For Easterseals MORC, those challenges ranged from clinician training to technology issues among those receiving services. Clinicians were not only providing care in a new way, they also had to become tech support in helping those they served navigate the new technology. Training is a critical aspect of telehealth technology implementation. If training is not provided proactively, it can result in clinicians avoiding virtual care use as they might find it difficult and overwhelming. “Pilot testing the solution before a full rollout was critical to ensuring that clinicians had adequate training to use the technology and that workflows were not negatively impacted,” Hulleza says. Partnering with the right vendor was a vital aspect of this effort, as the vendor was able to provide clinician training resources as well as suggest new policies and processes required to promote and support the telehealth program. “Ultimately, we selected our vendor because we were looking for a partnership that would improve the overall behavioral healthcare delivery experience. This meant that we needed a tool that offered more than a two-way video solution — one that integrated with, and empowered, the clinical workflow with value-added technology,” Hulleza shares. “There were multiple tools in the marketplace that solved the video connection challenge, but Easterseals MORC was looking to do more than simply move the clinical interaction to a video screen.” Further, choosing the right partner and then piloting the telehealth solution allowed the organization to test the supporting technology infrastructure before a full rollout. Easterseals MORC tested laptop specifications and made sure the solution worked equally well on different devices, including mobile phones and tablets. "We even went as far as making sure our bandwidth at all of our locations was increased so that if we had 20 people doing telehealth at the same time, there wouldn't be any degradation in services," Hulleza says. On the side of those receiving services, Easterseals MORC had to consider the digital divide facing its population. "[The people we serve] don't always have the newest phones, the best bandwidth," she says. "They don't have the luxury of going to a bedroom and closing the door. They might have shared living arrangements. We had to make sure we were accommodating all of those things." To address individuals' technology access needs, the organization applied for various grants and used those to provide iPads and iPhones with built-in data plans. Another essential aspect of closing the digital divide is identifying the viability of an individual to receive services via telehealth. Easterseals MORC uses a checklist tool provided by the telehealth vendor to identify these individuals and the barriers they face. "Do you have a private place? Do you have a microphone? What model phone do you have or mobile device?" Hulleza adds. "The tool goes through all of these questions and allows providers to evaluate if telehealth is an option." Easterseals MORC plans to solidify telehealth as a key behavioral health delivery mechanism within its business. It is unclear if Congress will make the temporary telehealth flexibilities enacted during the pandemic permanent — but for Hulleza, there is no going back. "I absolutely want to grow telehealth here," she says. "The need amplified because of the pandemic, but telehealth was going to exist for our organization even if the pandemic didn’t happen." ____________________________ About eVisit eVisit is an enterprise virtual care delivery platform built for health systems and hospitals. It delivers innovative virtual experiences in care navigation, care delivery, and care engagement, improving margins at scale without sacrificing quality or patient and provider satisfaction. eVisit works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue. Based in Phoenix, Ariz., eVisit helps healthcare organizations innovate and succeed in today’s changing healthcare market. See original article: https://mhealthintelligence.com/news/telehealth-remains-key-modality-for-behavioral-healthcare-delivery < Previous News Next News >

Congress' last-minute $1.7 trillion omnibus package: 8 healthcare takeaways Molly Gamble December 20, 2022 Lawmakers rolled out a roughly $1.7 trillion year-end spending bill Dec. 20 to fund the U.S. government through most of 2023, tacking on proposals to extend telehealth and hospital-at-home flexibilities while leaving out other healthcare asks. Lawmakers have until the end of Dec. 23 to clear the 2023 Omnibus Appropriations bill or federal funds are set to run out, bringing key agencies and programs to a halt. The package consists of all 12 annual appropriations bills Congress must pass and would fund the government through the remainder of fiscal 2023, which runs through September. Eight healthcare- and hospital-specific notes out of the 4,155-page bill: 1. The legislation curbs a scheduled cut of nearly 4.5 percent to the Medicare physician fee schedule that was set to take effect in 2023, narrowing the cut to 2 percentage points in the year ahead with a scheduled cut of 3.25 percentage points in 2024. The American Medical Association, which lobbied against the cuts, said it is "extremely disappointed and dismayed" with the cuts that made it to the bill. 2. While physicians did not get the relief they sought with complete aversion of fee schedule payment cuts, the spending bill would avert the 4 percent Statutory Pay-As-You-Go reduction, which would have amounted to cuts of approximately $36 billion, from taking effect in 2023. 3. The legislation extends incentives under the alternative payment model, which were set to expire this year, but reduces the amount from 5 percent to 3.5 percent. The incentive is designed to offset losses in revenue physicians may incur as they move from fee-for-service to participation in value-based care models. 4. The package extends Medicare telehealth flexibilities through 2024. The deadline for these flexibilities has been tied to 151 days after the end of the COVID-19 public health emergency, meaning the precise date was unclear as HHS has continued to renew the PHE in 90-day increments. Under the legislation, providers would be able to lean on flexibilities guaranteed throughout 2024. 5. The package extends acute hospital care at home waivers and flexibilities for two years through 2024. Similar to telehealth flexibilities, the deadline for hospital care at home waivers was tied to the status of the PHE. CMS has approved more than 250 hospitals to participate in the acute hospital care at home program. 6. The legislation extends the low-volume hospital payment adjustment and Medicare-dependent hospital programs through fiscal year 2024, or Sept. 30, 2024. 7. The legislation includes $118.7 billion — a 22 percent increase — for VA medical care. Other healthcare end medical allotments include $47.5 billion for the National Institutes of Health (a 5.6 percent increase); $9.2 billion for the CDC; $1.5 billion for NIH's second-year Advanced Research Projects Agency for Health and $950 million for the Biomedical Advanced Research and Development Authority, according to Senate Appropriations Committee Chairman Patrick Leahy. 8. The American Hospital Association expressed satisfaction with a number of measures in the legislation, including the extension of telehealth, hospital-at-home and programs to help rural hospitals, but signaled toward the work that remains to garner funding for hospitals. "In the new year, we will continue to advocate for Congress and the administration to take action to address patient discharge backlogs, support our current workforce and increase the pipeline into the future, hold commercial health insurers accountable for policies that compromise patient safety and add burden to care providers, and strengthen hospitals that care for a disproportionate number of patients covered by government programs or are uninsured, to name a few of our priorities," association President and CEO Rick Pollack said in a statement shared with Becker's. See original article: https://www.beckershospitalreview.com/finance/congress-last-minute-1-7-trillion-omnibus-package-8-healthcare-takeaways.html < Previous News Next News >

Rural Providers Weigh Telehealth Investment Against Regulatory Uncertainty Holly Vossel June 8, 2022 Hospices are leveraging expanded telehealth options to maximize access for hard-to-reach rural patients despite lingering regulatory uncertainties. Case in point, the Providence Institute for Human Caring last year launched a tele-palliative care program aimed at addressing rural patients’ unmet needs. Thus far, the initiative has yielded positive results, but the process hasn’t always been easy, according to Dr. Gregg VandeKieft, executive medical director of the institute’s Palliative Practice Group. Snags along the way included dairy cows blocking staff from reaching patients. “For the first time we’re able to offer equitable access to specialty palliative care services for patients who need and want them in this rural setting,” VandeKieft told local news. “But we often have to balance providing health care with the time schedules and welfare of livestock, crops and other realities of rural living.” Washington-based Providence Health System provides a range of facility- and home-based care, including senior services and hospice. The company has more than 119,000 employees serving communities in six states. The TelePC program has increased care collaboration between Providence and the patients’ other providers, including family caregivers. It has also reduced travel time for the palliative care team and curbed unnecessary patient transfers and recurring hospitalizations. Hospice and palliative care providers have wrangled for decades with obstacles that complicate access to rural patients and make their care more expensive. For starters, rural regions are less likely to have a Medicare-certified hospice than urban counties. The service areas of the nearest hospices may not extend far enough to reach some of the people in those zones. When rural patients do have a provider in range, those hospices do their best to deliver care while contending with lower patient volumes, a smaller labor pool, long-travel times between home visits and the resulting travel costs. Some of the challenges are very unique to rural areas, like livestock schedules, lack of nearby caregiver support and limited internet bandwidth capacity. Telehealth has been an important part of improving providers’ ability to reach rural patient populations, according to Dr. Michael Fratkin, chief medical officer for ResolutionCare, a Vynca company. Fratkin founded palliative care provider ResolutionCare in 2015. Advanced care planning technology company Vynca acquired the company last year in its first move into the clinical care space. The pressures on rural providers go beyond the logistical. A successful tele-palliative care program requires not only greater access to high-speed internet in those areas, but also the confidence of the people they serve. Many rural residents place a lower value on telehealth services compared to the in-person care they are used to, said Fratkin. “The advantages of telehealth are the gain of seeing people at home and instantaneously sharing space with them,” Fratkin told Hospice News. “We are not physically entering their private space, not requiring them or staff to drive. What’s most important is creating that safe space to share. There are biases that virtual care is second rate. We have to blast through these biases. They are a bigger barrier to palliative and hospice care than dairy cows.” Then came the pandemic, and with it broad expansion of how providers can use telehealth — at least for the time being. Rapid deployment of telemedicine during the COVID-19 public health emergency (PHE) has created “a new pathway” for bringing palliative and hospice care specialists to rural areas, according to authors of a recent report published in the JAMA Health Forum. Additional studies further support the claim that changes to telehealth policy improved access. But without further regulatory or legislative action, those pathways will close when the federally declared emergency ends. The U.S. Department of Health & Human Services (HHS) most recently extended the PHE period to expire in July. The agency has not indicated whether or not they will renew it. As hospices navigate how they will use telehealth in the long-term, these uncertainties put them in a bind. Many are trying to weigh the benefits of telehealth investments against the possibility that they may soon have to shut down or cut back those programs. One factor policymakers might need to consider is that people may now expect that these services will remain available to them. The events of the past two years have opened the eyes of many patients to telehealth’s potential , according to Fratkin. “The pandemic telehealth experiment is unmeasured, but what we’ve discovered by being thrust into this experiment is that I don’t think patients want to give it up,” Fratkin told Hospice News. “They discovered the value of communications technology allowing them to stay in their lives and not interrupt care. Some of these providers are running back to the status quo as if it was working, but we’re going forward, not backward in this.” < Previous News Next News >

Opportunity Knocking — Empanelment, COVID-19 and Telehealth By Trudy Bearden, PA-C, MPAS February 17, 2021 Do you know what it is? Probably not if you’re not “in” primary care. You may know the patient side of empanelment, though. If you have a primary care provider (PCP), it usually means you have been empaneled to that provider. Empanelment. Do you know what it is? Probably not if you’re not “in” primary care. You may know the patient side of empanelment, though. If you have a primary care provider (PCP), it usually means you have been empaneled to that provider. Empanelment is a foundational component of primary care and is essential in population health management. In 2019, the People-Centered Integrated Care collaborative, participants from 10 countries developed an overview of empanelment and a comprehensive definition: Empanelment is a continuous, iterative set of processes that identify and assign populations to facilities, care teams, or providers who have a responsibility to know their assigned population and to proactively deliver coordinated primary health care. That definition is accurate and comprehensive, but we must appreciate the recent, succinct statement by my Empanelment Learning Exchange colleague Elizabeth Wala, Global Advisor, Health and Nutrition at Aga Khan Foundation: “Empanelment is grouping patients under providers.” Opportunity. As a primary care clinician and health care consultant, I have been thinking hard since April 2020 about the importance of empanelment, telehealth and the COVID-19 pandemic. Just to be clear, I’m using the term telehealth as defined by the discrete set of services described by the Centers for Medicare & Medicaid Services (CMS) List of Telehealth Services. Similarly, there are amazing opportunities for other remote services, including chronic and principal care management, remote patient monitoring, virtual check-ins and more that lend themselves to applying empanelment to improve health and well-being. Maybe for another blog … Most clinicians use electronic health records (EHRs) these days and can run or request reports on their patient panels to identify which patients may need health care services. Empanelment provides each clinician with a list of names of their patients along with additional information such as age, date last seen, diagnoses, preventive and chronic care that is due and more. Here are some of the ways we can leverage empanelment and telehealth to keep people safe, expand access and capture revenue. Check in on the unseen and unknown. Empanelment is not just about those who seek health care services from us, although that’s often how it starts. The beauty of empanelment is that there should be no people on a clinician’s panel who are “unseen and unknown.” However, the Centers for Disease Control and Prevention (CDC) estimates that 41% of U.S. adults have delayed or avoided medical care during the pandemic because of concerns about COVID-19, which presents us with an opportunity. Identify who hasn’t been seen in the past 6-12 months for each clinician’s panel. Have clinicians go through the list and identify who should receive a check-in call and who should be scheduled for a telehealth visit. There may not be reimbursement for those check-in calls; although there are service codes and reimbursement for virtual check-ins, those check-ins are technically supposed to be initiated by the patient. Conduct advance care planning. If ever there was a time! And it can be accomplished by telehealth — using codes 99497 (~$85) and 99498 (~$74) — with decent reimbursement. Start with all individuals 65 and older in your panel. Ensure high-risk patients know about telehealth. Now more than ever, know who your top 5-10% highest risk patients are, including those at highest risk for adverse COVID-19 outcomes. These patients will benefit from having telehealth as an option perhaps more than any other population in your practice. Conduct targeted outreach to the top 5-10% high-risk patients to schedule a telehealth visit, if needed or to let them know about telehealth as an option. Address chronic and preventive gaps in care. As people delay care and as team-based care and pre-visit planning workflows seem to fall by the wayside, I am concerned that missed and delayed diagnoses will soar, which is both terrible for individuals and families, but is also one of the most common reasons for malpractice claims. Use panel data to identify who’s due for what: Chronic conditions, e.g., office visits, tests, vaccines, prescription renewals Preventive services, e.g., well-child visits, colorectal cancer screening (CRC), vaccinations Advise patients about the services that are due by phone, text or letter and schedule those for telehealth visits, if needed. Consider this a call to action for primary care practices! If you’re not already leveraging empanelment to optimize telehealth, expand access, make sure people are doing okay and keep people safe, what can you do by next Tuesday to up your game? < Previous News Next News >

CDC: Increased Use of Telehealth Reduces Risk of Overdose Brendan Rodenberg August 31, 2022 BISMARCK, ND (KXNET) — A new study done by the Centers for Disease Control (CDC) suggests the expansion of ‘telehealth’ programs plays an important part in reducing the risk of drug overdoses and keeping people in treatment. The term ‘telehealth’ often refers to the distribution of health services and health-related information — including long-distance consultation with medical professionals, medical education, counseling, and intervention — via social technology such as phones and computers. A study published in the journal JAMA Psychiatry noted that during the pandemic, individuals with opioid use disorders (OUDs) who took part in telehealth services not only remained in treatment longer than usual but were also less likely to suffer drug-related overdoses. An increase in individuals taking MOUD (medications for opioid use disorder) was also reported. The key takeaways from the study include the following information: When two groups of Medicare beneficiaries (one that received OUD care before the COVID-19 pandemic and one that received OUD during the pandemic) were compared, people in the pandemic group were much more likely to receive OUD-related telehealth services compared to the pre-pandemic group (19.6% compared to the pre-pandemic’s 0.6%). They were also more likely to receive MOUD services (12.6% compared to pre-pandemic’s 10.8%) Among the COVID-19 pandemic group, receipt of OUD-related telehealth services was associated with significantly better MOUD treatment retention and lower risk of medically-treated overdoses. “Strategies to increase access to care and MOUD receipt and retention are urgently needed, and the results of this study add to the growing research documenting the benefits of expanding the use of telehealth services for people with OUD,” said the acting director of the National Center for Injury Prevention and Control at the CDC and study’s lead author Dr. Christopher M. Jones in a press release. “The findings from this collaborative study also highlight the importance of working across agencies to identify successful approaches to address the escalating overdose crisis.” Mass-overdose events happening across US, DEA warns While successful health services were reported in the study, and telehealth programs have been associated with reduced overdoses and increased treatment, it was also noted that some groups — particularly non-Hispanic black persons and individuals living in the southern United States — were less likely to receive these services. The study and CDC state that this information further highlights the need for more efforts to eliminate the ‘digital divide’ and reduce inequalities in access to care and services. “The expansion of telehealth services for people with substance use disorders during the pandemic has helped to address barriers to accessing medical care for addiction throughout the country that have long existed,” said deputy director of the National Institute on Drug Abuse and senior author of the study Wilson Compton, M.D., in the release. “Telehealth is a valuable service and when coupled with medications for opioid use disorder can be lifesaving. This study adds to the evidence showing that expanded access to these services could have a longer-term positive impact if continued.” If you or someone close to you needs help for a substance use disorder, talk to your doctor or call SAMHSA’s National Helpline at 1-800-662-HELP or go to SAMHSA’s Behavioral Health Treatment Services  website. See original article: https://www.kxnet.com/news/national-news/cdc-increased-use-of-telehealth-reduces-risk-of-overdose/ < Previous News Next News >

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

Access and Equity in Medicaid Telehealth Policy Webinar Center for Connected Health Policy April 30, 2021 Access and Equity in Medicaid Telehealth Policy Webinar April 30 Telehealth has demonstrated that it has the potential to make healthcare more accessible for hard-to-reach patient populations in medically underserved communities. However, some lessons from telehealth utilization during the COVID-19 pandemic have raised concerns about access gaps for these patients. Join the Center for Connected Health Policy (CCHP) and leading Medicaid experts on Friday, April 30, 2021 for the first webinar in our Spring webinar series, Access and Equity in Medicaid Telehealth Policy. This webinar will feature presentations from Medicaid administrators and policy staff on trends in telehealth access and equity and strategies to address these gaps. Stay tuned for more information on confirmed speakers for this webinar. This event is free and open to the public. Register: https://us02web.zoom.us/webinar/register/WN_B-EIOkBkQW-QvcxUcqHxKA < Previous News Next News >

Emergency Broadband Benefit Resources Center for Connected Health Policy April 2021 FCC recently posted a new consumer FAQ on the Emergency Broadband Benefit Program, which the FCC is still working to make available but hopes to have in place for signup by the end of April 2021. The Federal Communications Commission (FCC) recently posted a new consumer FAQ on the Emergency Broadband Benefit Program, which the FCC is still working to make available but hopes to have in place for signup by the end of April 2021. The program will help households struggling to pay for internet service during the pandemic. The FAQ provides answers to common consumer questions on benefit eligibility, how the discount will be applied to broadband service costs, and program length. It also includes information on the enhanced Tribal benefit and the connected device benefit. Additional questions can be sent to broadbandbenefit@fcc.gov and webinars, informational materials, and upcoming trainings can be found here: https://www.usac.org/about/emergency-broadband-benefit-program/webinars-and-trainings/ FCC Consumer FAQs: https://www.fcc.gov/consumer-faq-emergency-broadband-benefit < Previous News Next News >

NMTHA Sponsors NMTHA Sponsors support our efforts in exchange for promotional benefits: Sponsorship Available to members and non-members All Sponsor benefits included Does not include member benefits Membership is not required for sponsorship Better Access. Better Outcomes. More about AmplifyMD AmplifyMD is a multi-specialty physician practice providing virtual consults via telehealth. Our doctors cover all E & M specialties, including; Psychiatry, Cardiology, Neurology, Infectious Disease, Orthopedics, Hematology, Oncology, etc. At AmplifyMD, we’ve streamlined workflows so you can manage everything from one screen. By centralizing all your virtual care delivery onto a single turnkey platform, we’ve alleviated the cost, time, and frustration burden of setting up and managing multiple hospitals and telehealth systems. More about ENVIVE ENVIVE Solutions, LLC is a nationally certified women-owned business located in the enchanted southwest. We provide quality remote and onsite strategic management, project planning, coaching and consultation, and implementation support services to organizations across the United States - with expertise in large-scale collaborations and human-centered initiatives (e.g., behavioral health, human services). We lead and support teams and projects through all phases of strategic management - from conceptualization to successful implementation. For Members and Non-Members NMTHA Sponsors (Membership not required) $2,500 $ 2,500 (Member benefits not included. Membership is available separately.) Valid for one year Select Tax-deductible sponsorship is donation to 501c3 organization Organization featured on NMTHA's dedicated Sponsor webpage Webinar presentation to NMTHA Board of Directors Poster presentation at NMTHA's Annual Town Hall 1-page contract with defined mutual expectations

Using Telemedicine When it Makes Sense Adam Ang October 11, 2022 Patients worldwide prefer a mix of in-person and virtual care moving forward from the pandemic. During the pandemic, organisations across private and public healthcare systems have been rethinking their care delivery models. This is one of the major trends Ronald L. Emerson, Global Healthcare Lead at Zoom, shared virtually in the keynote session, "The Rise of Digital First and Decentralized Healthcare," at the HIMSS22 APAC conference. He was joined by Benjamin Lim, Zoom's APAC Leader for ISV Platform Business, who moderated the discussion in person. Recently commissioned research by Zoom found that patients who have used telehealth once prefer a hybrid mode of care post-COVID-19. This has given rise to digital-first healthcare, which does not mean "digital only." "What it does mean is that many healthcare systems, public and private, are developing virtual care models or hybrid models of care," Emerson said. "They thought to let the interaction or the clinical situation dictate the level of care that is needed… If they can handle [visits] over telemedicine and take care of the patient, the patient doesn't need more expensive care. They don't have to come to the emergency room or the hospital or the physician's office. And so we're seeing a large shift in that area and it's decreasing the entry point into the healthcare system," he noted. Rather than an all-digital model of care, a care model that makes sense to a patient's situation is ideal to bridge the gap in healthcare access. "I think our goal with telemedicine is how we utilise it when it makes sense. I am not for an all-digital care model, an all-video model, an all-virtual care model; I'm all for a model that makes sense based on the actual clinical application that can lower the threshold and increase access when people need the care [so] then we can make a better decision on the clinical disposition of the patient," Emerson shared. Telemedicine adoption Another key trend is the rise of video-assisted virtual visits during the pandemic. Care providers are now getting their money's worth in using cost-efficient virtual care technologies. In taking on a vendor's telemedicine platform, care providers usually consider the following: patient acceptability, clinical efficacy, and cost and sustainability. "We're actually seeing the return on investment and sustainability of the project. Vendors and organizations like Zoom have really lowered the price point where these projects are sustainable," Emerson said. Zoom has found its success in integrating as few workflows as possible in an organisation's existing centralised platform. "Healthcare professionals do not want any more platforms to manage. They wanna use their sort of centralized platform if they have electronic medical records," he mentioned. Decentralised healthcare Finally, Emerson noted how organisations are making efforts to reach out to patients across the continuum of care and work to provide the same levels of care they would receive in an in-hospital setting. This trend of decentralised healthcare is happening, he claimed, because health systems now are not just focusing on sickness but also on the ability to keep people healthy through wellness and prevention, education, and better discharge planning – all of which require virtual technology and communication. "We expect to see more and more of this [in] other places," he quipped. Virtual health as a strategic goal For organisations looking to develop their own digitally-enabled care delivery models, Emerson shared that the way to success is by making virtual health a strategic goal in their care provision. "That means the doctors are on board, it's written in their job descriptions. [It's going to be a] part of the delivery system of how we take care of people," he said. See original article: https://www.healthcareitnews.com/news/asia/using-telemedicine-when-it-makes-sense < Previous News Next News >

CMS-Supported Telehealth Will Continue To Be A Driving Force – But Watch for Greater OIG Enforcement The National Law Review March 3, 2022 As mindsets pivoted to a post-pandemic life, telehealth advocates petitioned CMS to embrace telehealth as a permanent care option, and CMS responded with regulatory action at the end of 2021. During the Covid-19 Pandemic, telehealth usage surged as patients and providers turned to it as a safer care alternative. McKinsey estimated telehealth claim volumes reached 80 times pre-pandemic levels at its peak, ultimately stabilizing at 38 times pre-pandemic levels by early 2021.1 This increase was mostly driven by CMS’ waivers and relaxation of regulatory constraints for telehealth reimbursement. But, the temporary nature of both left questions regarding telehealth’s future. In December 2021, CMS issued new regulations which, collectively, steer telehealth toward becoming a part of the telebehavioral health toolkit accepted by Medicare post-pandemic. In the CY2021 Physician Fee Schedule Final Rule2 , further discussed here, CMS broadly expanded access to telebehavioral health services. Specifically, Medicare permanently authorized payment for telehealth services furnished “for purposes of diagnosis, evaluation or treatment of a mental health disorder” under the following relaxed criteria:3. Read full article here: https://www.natlawreview.com/article/cms-supported-telehealth-will-continue-to-be-driving-force-watch-greater-oig < Previous News Next News >

Senate panel seeks to expand telehealth for Medicare mental health services Jeff Lagasse, Editor May 27, 2022 The draft suggests removing Medicare's in-person visit requirement, protecting audio-only telehealth and supporting provider use. Senate panel seeks to expand telehealth for Medicare mental health servicesThe draft suggests removing Medicare's in-person visit requirement, protecting audio-only telehealth and supporting provider use. Jeff Lagasse, Editor Photo: Kilito Chan/Getty Images The Senate Finance Committee, led by Chair Ron Wyden (D.Ore.), is seeking to make permanent some of the telehealth flexibilities enacted during the COVID-19 pandemic that pertain to mental health services. In what the committee calls a mental health "bill of rights," Wyden and ranking committee member Mike Crapo (R-Idaho), along with Senator John Thune (R-S.D.) and Senator Ben Cardin (D-Md.), released a discussion draft for telehealth policies that suggests, among other things, removing Medicare's in-person visit requirement and codifying audio-only mental health coverage. Wyden said via statement that the policies outlined in the draft "will help strengthen access, awareness and support for telehealth." Aside from nixing Medicare's in-person visit requirement, the committee's proposed policies include establishing benefit transparency for mental health services delivered via telehealth, to inform Americans with Medicare how and when they can access such services. The committee also recommended directing Medicare and Medicaid to promote and support provider use of telehealth; and incentivizing states to use their CHIP programs to establish local solutions to serve behavioral health needs in schools, including through telehealth. The telehealth discussion draft is the first legislative draft released by the committee since it began its larger mental healthcare initiative. Other discussion drafts may be released prior to a committee markup. The committee said it's committed to fully paying for any mental health package with bipartisan, consensus-driven offsets. Earlier this year, the committee announced five areas of focus for addressing shortfalls in mental healthcare: workforce, care integration, mental health parity, telehealth and youth. WHAT'S THE IMPACT? When the pandemic first began, the Centers for Medicare and Medicaid Services waived barriers to telehealth reimbursement, but those flexibilities only last for 151 days after the end of the COVID-19 public health emergency. The current PHE expires in mid-July. If again extended as expected and for another 90 days, the PHE would end in mid-October, just prior to the midterm elections. Most experts have said they expect the PHE to be extended through the end of the year. To make telehealth flexibilities permanent, CMS needs authority from Congress. Wyden says that the committee's goal is ultimately to craft a behavioral telehealth bill by this summer. Other proposed policies in the draft include requiring fee-for-service and Medicare Advantage plans to publicly post information on Medicare beneficiaries' rights to receive telehealth services for mental healthcare, plus information on approximate cost-sharing obligations for virtual mental health services. The committee also recommended: mandating that the federal government collect information on trends and care quality and give regular reports to lawmakers. requiring that Medicare give providers guidance on improving access to virtual mental healthcare for those with language barriers and hearing or vision impairments. "Telehealth, particularly for behavioral health services, has become an essential component of care, and I am pleased that we have this opportunity to improve access to telemental health care, particularly for underserved communities," said Cardin. THE LARGER TREND The draft comes at a time when mental health concerns are rising for many Americans. Earlier this month a CVS Health/Morning Consult poll showed Americans of all backgrounds, but especially those who are Black, young adults, older than 65 or who identify as LGBTQIA+, are increasingly concerned about mental health and how to access care. Results show that a majority of respondents, 59%, have experienced concerns about either their own mental health or that of family and friends. That's a 9% increase since April 2020. Another majority, 53%, agree that hearing about other people's challenges makes them more comfortable seeking out resources and care for themselves. A 2021 study showed that mental health services accounted for the most common use of telehealth during the early days of the pandemic. In the midst of skyrocketing depression rates, the findings show that more patients used telehealth for behavioral, rather than physical conditions. A report from health insurer Cigna, also released last year, made it clear that businesses have taken notice of this shift to behavioral telehealth: Some 44% of human resources decision-makers and 27% of health plan leaders said that increased access to mental health services will become a long-term solution for their organization. Some 57% of health plan leaders said they had seen the value of mental health services increase more than for most other services and benefits as a result of the coronavirus. For more information: https://www.healthcarefinancenews.com/news/senate-panel-seeks-expand-telehealth-medicare-mental-health-services < Previous News Next News >

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

Telehealth May Help Reduce Medicine's Carbon Footprint Kat Jercich, Healthcare IT News July 2021 A wide-ranging study recently found that an increase in telehealth over the past six years corresponded with a decrease in greenhouse gas emissions due to transportation. A large-scale study recently published in The Journal of Climate Change and Health found that an increase in telehealth use in the Pacific Northwest corresponded to a dramatic decrease in transportation-related greenhouse gas emissions. The study – a collaboration among researchers from Northwest Permanente, Brigham and Women's Hospital and Harvard Medical School – examined six years of outpatient care at Kaiser Permanente Northwest, which serves more than 600,000 people in Oregon and Washington. "Prior to the pandemic, despite rising total visit volume, transportation-associated emissions were already declining due to a greater proportion of telehealth visits," observed the researchers. WHY IT MATTERS As the study notes, the healthcare sector is a "significant source" of greenhouse gas emissions. From 2010 to 2018, emissions from the U.S. healthcare industry increased by 6 percent. Although many of those emissions arise directly from facilities or indirectly from the supply chain, researchers note that patient transportation to clinics also plays a role in healthcare's carbon footprint. "To date, there are no large-scale studies of emissions reductions due to telehealth across an entire ambulatory system of a regional healthcare system in the United States, nor any studies showing the impact of COVID-19 on healthcare-associated [greenhouse gas] emissions as a result of rapid telehealth adoption," they explained. Team members looked back at the total number of in-person and telehealth visits from 2015 through 2020. They calculated the average distance between patients' home addresses and their assigned primary care clinics, and used Oregon Department of Transportation data about how individuals run errands to estimate what percentage of in-person trips were taken by car. They also assumed that telehealth visits replaced in-person visits on a 1:1 ratio (which may not be true, as other studies about downstream care have shown). Overall, in-person outpatient visits had increased at 1.5% per year through 2019 – but declined by 46.2% in 2020. Meanwhile, telehealth visits – which had already been increasing – jumped in 2020 by 108.5%. Researchers calculated that greenhouse gas emissions from patient travel due to transportation for primary care, specialty care and mental health visits fell from 19,659 tons CO2-eq in 2019 to 10,537 tons CO2-eq in 2020. "This reduction is primarily due to increased use of telehealth services as opposed to a decline in total annual visits during the pandemic and is evidenced by the total number of visits in 2020 being greater than prior years that had much larger total emissions," said researchers. "Nor is this reduction attributable to changes in fuel efficiency or transportation mode share over time, which are likely minimal on this time scale and were not modeled in this analysis," they added. The researchers argue that reductions in transportation-related greenhouse gas emissions "greatly eclipse" smaller increases associated with the use of computer equipment. The study has limitations: In addition to the 1:1 assumption mentioned above, researchers also pointed out that some visits would not have been conducted at a primary care clinic. In addition, they acknowledge that the Oregon DOT estimates may not represent medical appointment visits accurately. Still, "our study likely underestimates emissions reductions as we did not account for decreased commuting by healthcare providers conducting telehealth visits from home," the researchers wrote. "Furthermore, the environmental benefit of telehealth may not be limited to reductions in transportation-associated emissions if increased virtual care permits healthcare systems to care for more patients without increasing outpatient clinic space," they added. THE LARGER TREND Given the effect of climate change on the environment – and, in turn, on wellness, particularly for already vulnerable communities – many healthcare experts have called for action, with some noting the role that digital tools can play. In addition to preventative measures such as those outlined in the study, digital health tools may also help in the shorter term with regard to the consequences of climate change. When a winter storm tore through the southern United States earlier this year, for example, clinicians were able to keep seeing patients from their own homes. "If there are natural disasters, which we're seeing more and more of, because of global warming, we're hoping we'll be able to continue to provide care [via telehealth] through more weather events – like the freeze, like the hurricanes, and things of that nature," said William Kiefer, CEO of Chambers Health, a community-based system in Texas, in March. ON THE RECORD "If the U.S. healthcare system were to maintain or expand upon current levels of telehealth utilization, additional reductions in [greenhouse gas] emissions would potentially be achieved through impacts on practice design," said researchers in the new study. "Ambulatory visit carbon intensity would be an effective way to measure these changes." < Previous News Next News >

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