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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

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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 >

Update on Risks of Payments in Arrangements With Telemedicine Companies: OIG Warns of Prosecution Risks and Identifies Seven Criteria for Caution When Entering Into Telemedicine Payment Arrangements, and the Advancing Telehealth Beyond COVID-19 Act Passes Andrea M. Ferrari, Nadia de la Houssaye August 26, 2022 On July 20, 2022, the Office of Inspector General of the US Department of Health & Human Services (OIG) issued a Special Fraud Alert urging healthcare practitioners to exercise caution when entering into arrangements with telemedicine companies. OIG issued this Special Fraud Alert the same day the US Department of Justice (DOJ) announced criminal charges against 36 defendants in 13 federal districts as part of the DOJ’s Nationwide Coordinated Law Enforcement Effort to Combat Telemedicine, Clinical Laboratory, and Durable Medical Equipment Fraud.[1] The Special Fraud Alert notes that OIG has recently conducted dozens of investigations of alleged fraud schemes involving companies that provide telehealth, telemedicine, or telemarketing services (collectively, Telemedicine Companies). It also notes that in many of these investigations, OIG found evidence that the Telemedicine Companies intentionally paid physicians and non-physician practitioners (collectively, Practitioners) kickbacks to generate orders or prescriptions for medically unnecessary durable medical equipment, genetic testing, wound care items, or prescription medications. The Special Fraud Alert warns that such kickback schemes implicate the federal Anti-Kickback Statute and can lead to Practitioners, Telemedicine Companies, and others that participate in the schemes being held liable criminally, civilly, and administratively. Liability may arise from (1) paying or receiving payment in violation of the federal Anti-Kickback Statute; and (2) causing submission of fraudulent claims to federal healthcare programs such as Medicare, Medicaid, and Tricare, which may constitute a violation of the federal False Claims Act and other federal laws. As a cautionary guide, the Special Fraud Alert identifies seven arrangement characteristics that may raise OIG scrutiny: 1. The patients for whom a Practitioner orders or prescribes items or services are identified or recruited by a Telemedicine Company, sales agent, recruiter, call center, or health fair, and/or through internet, television, or social media advertising for free or low-cost out-of-pocket items or services. 2. A Practitioner does not have sufficient contact with or information from the purported patient to meaningfully assess the medical necessity of the items or services ordered or prescribed. 3. A Telemedicine Company compensates a Practitioner based on the volume of items or services ordered or prescribed, which may be characterized to the Practitioner as compensation based on the number of medical records that the Practitioner reviewed. 4. A Telemedicine Company furnishes items and services only to federal healthcare program beneficiaries and does not accept insurance from any other payor. 5. A Telemedicine Company claims to furnish items and services only to individuals who are not federal healthcare program beneficiaries but may, in fact, bill federal healthcare programs. 6. A Telemedicine Company only furnishes one product or a single class of products (e.g., durable medical equipment, genetic testing, diabetic supplies, or various prescription creams), potentially restricting a Practitioner’s treatment options to a predetermined course of treatment. 7. A Telemedicine Company does not expect Practitioners to follow up with patients, nor does it provide Practitioners with the information required to follow up with patients (e.g., the Telemedicine Company does not require Practitioners to discuss genetic testing results with each purported patient). OIG advises in the Special Fraud Alert that this list of suspect criteria is illustrative and not exhaustive. Therefore, even arrangements that do not specifically fit one or more of these suspect criteria may still be suspect. However, OIG also indicates that it recognizes there are many legitimate telemedicine and telehealth arrangements, and explicitly states that the Special Fraud Alert is not intended to discourage those legitimate arrangements. Rather, OIG is using the Special Fraud Alert to encourage Practitioners (and, by extension, their advisors) to use heightened scrutiny, exercise caution, and consider the above list of suspect criteria before entering into arrangements with Telemedicine Companies. Telehealth Expansion Legislation Significantly, a week after OIG issued the Special Fraud Alert, the US House of Representatives overwhelmingly (416-12) passed the Advancing Telehealth Beyond COVID-19 Act of 2022 (HR 4040), which encourages broad use of telehealth by expanding and extending for at least an additional two years — through December 2024 — the Medicare telemedicine payment policies that were introduced for the COVID-19 public health emergency. The House bill removes geographic restrictions and expands originating sites for telehealth services, continues expansion of the practitioners eligible to provide telehealth services, allows mental health services to be provided via telehealth and telecommunications, and continues certain COVID-19 allowances for audio-only telehealth services. The bill is now pending in the Senate. [1] Press Release, US Department of Justice, Justice Department Charges Dozens for $1.2 Billion in Health Care Fraud (July 20, 2020), https://www.justice.gov/opa/pr/justice-department-charges-dozens-12-billion-health-care-fraud. © 2022 Jones Walker LLP National Law Review, Volume XII, Number 238 See Original article: https://www.natlawreview.com/article/update-risks-payments-arrangements-telemedicine-companies-oig-warns-prosecution < Previous News Next News >

House reps advocate for audio-only telehealth extensions for opioid treatments Jeff Lagasse October 21, 2022 The lawmakers describe the future of audio-only telehealth coverage as "unpredictable" and say a consistent policy should be established. Two Democratic members of the U.S. House of Representatives have penned a letter to the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Agency, imploring the agencies to extend flexibilities for audio-based telehealth so physicians may continue prescribing medication-assisted treatments to address opioid use disorder. Representatives Ann McLane Kuster, D-N.H., and Lori Trahan, D-Mass., said they're advocates for the development of a long-term policy regarding telehealth flexibilities, particularly, when it comes to administering buprenorphine to patients, a medication that helps prevent overdose death. They cited research from the National Library of Medicine suggesting that the COVID-19 pandemic introduced increased barriers to accessing treatment for those with opioid use disorder. Drug overdoses are increasing and disparities have been worsening over the last several years, with opioid-related overdose deaths reaching an all-time high in 2021. Kuster and Trahan noted that the Physician Fee Schedule proposed rule regarding coverage of audio-only telehealth for buprenorphine initiation depends on if "buprenorphine is authorized by the DEA and SAMHSA at the time the service is furnished." Since payment for services is dependent on Drug Enforcement Agency and Substance Abuse and Mental Health Services Administration guidance, the House members encouraged the agencies to release the public guidance quickly, and to include policies, such as telehealth, that increase access to OUD treatment. WHAT'S THE IMPACT? Audio-only telehealth is an important tool for clinicians in responding to the addiction crisis, the lawmakers said. A 2021 study from the National Library of Medicine backs this up, finding that audio-only telehealth, as a "low-threshold" approach to medication-assisted treatment, was associated with better retention in care. Previous studies also show that providers treating patients with OUD think that telemedicine, including audio-only options, should be offered in some form beyond the COVID-19 pandemic, regulations permitting. The American Society for Addiction Medicine recently released their policy statement on telehealth, saying it's a viable tool to increase access to buprenorphine as part of OUD treatment "and that there is ample opportunity moving forward to study the role that audio-only care can play in responding to the opioid crisis," the lawmakers wrote. Calling the future of audio-only telehealth coverage "unpredictable," the representatives requested that SAMHSA and the DEA grant telehealth flexibilities along with the declaration of a public health emergency for the opioid crisis; evaluate long-term policy for flexibilities based on the utilization and effectiveness of audio-only telehealth in relation to medication-assisted treatment; and detail a projected timeline regarding rulemaking for audio-only telecommunications for the initiation of buprenorphine for treatment of OUD. THE LARGER TREND Overdose deaths were rising prior to the COVID-19 pandemic, but in 2020, there was a significant increase in overdose deaths. According to provisional CDC data, overdose deaths increased more than 30% in 2020, leading to more than 93,000 deaths. This increase was driven by the use of synthetic opioids, such as fentanyl and stimulants, such as methamphetamine and cocaine, or combinations of substances. Pandemic restrictions intended to prevent the spread of COVID-19 have unfortunately also made it harder for individuals with substance use disorders (SUDs) to receive treatment and support services. Providing funding for harm-reduction services is one pillar of a four-pillar approach being implemented at the federal level. Evidence-based harm-reduction strategies minimize the negative consequences of drug use, according to the Department of Health and Human Services. The other three pillars of the administration's opioid mitigation strategy are primary prevention, focusing on the root causes and predictors of SUDs, evidence-based treatment and recovery support. A December 2021 report from the Office of the Inspector General found that while more than 1 million Medicare beneficiaries had a diagnosis of OUD in 2020, less than 16% of those beneficiaries received medication to treat their conditions. They accounted for fewer than 1 in 6 of all Medicare beneficiaries with OUD. Twitter: @JELagasse Email the writer: jeff.lagasse@himssmedia.com See original article: https://www.healthcarefinancenews.com/news/house-reps-advocate-audio-only-telehealth-extensions-opioid-treatments < Previous News Next News >

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

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 >