Why is an Alliance needed? NMTHA assists with ensuring telehealth program dollars are applied effectively and efficiently through : Clinical coordination Technical coordination Health information technology Administrative Services Federal, State, and private funds are spent on telehealth programs with little or no attention to coordination with other programs, efficient reuse of existing resources, and delivering the best level of cost-effective services. Existing and proposed programs create a patchwork of telehealth solutions with overlaps, gaps, and little long-term accountability. No entity coordinates telehealth statewide and ensures that telehealth programs and dollars generate the best possible health benefits for New Mexicans. How can New Mexico ensure dollars spent on telehealth programs are applied effectively and efficiently? New Mexico needs an organization to provide the following telehealth-related services: Clinical Coordination: Identifying healthcare delivery needs, finding organizations to deliver healthcare services, monitoring the delivery, and ensuring improved health outcomes. Technical Coordination: Identifying the proper technical solution for healthcare service delivery including equipment evaluation, telecommunications connectivity, reuse of existing resources, scheduling, network management, support, and maintenance. Health Information Technology: Managing information exchange among healthcare providers and ensuring compliance with federal, state, and other standards. Administrative Services: Reimbursement issues, administrative policy and procedures, legislative issues, and general management of the telehealth process. Every dollar spent on coordination ensures that dollars spent on specific telehealth programs generate the greatest improvement in health across all programs and regions of the State. Be part of the solution! Join the New Mexico Telehealth Alliance JOIN NOW

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

Southwest Telehealth News

Billing & Reimbursement Guides Southwest Telehealth Resource Center & ruralMED Revenue Cycle Resources Medicare, Medicaid and private payor: Payor Matrix Allowable, Conditional, Not Allowable 4 virtual visit types E-Visit, Telehealth, Virtual Check-In, T elephone NEW MEXICO RESOURCES 2024 Virtual Visit & Reimbursement Guide for New Mexico (Find a ll SWTRC /ruralMED Regional 2024 Billing Guides a nd Resources: HERE ) NATIONAL RESOURCES American College of Emergen cy Physi cians (ACEP) ED Facility Level Coding Guidelines Center for Connected Health Pol icy (CCHP) 2023 Billing for Telehealth Encounters: An Introductory Guide on [Medicare] Fee-For-Service Final Rule for CY 2024 Physician Fee Schedule Centers for Medicare and Medicaid Services (CMS.gov) 2024 List of Telehealth Services: Medicare Physician Fee Schedule 2024 Medicare Learning Network Telehealth Services Fact Sheet “What’s Changed?” Health and Human Services (Telehealth.HHS.gov) Billing for Telehealth

Healthcare Connect Fund The FCC's newest component of the Rural Health Care (RHC) program: Funding may significantly improve access for patients and service providers. Participants may receive a subsidy of up to 65%. Funding recipients must provide 35% cash match. The New Mexico Telehealth Alliance (NMTHA) manages the Southwest Telehealth Access Grid (SWTAG), a Federal Communications Commission (FCC) approved consortium for funding through the Healthcare Connect Fund (HCF). If you manage one or more healthcare provider sites serving clients in New Mexico, contact NMTHA to discuss joining SWTAG. Advantages to applying to SWTAG via NMTHA include: Lower application and administrative costs .* Access to expert funding advice for a mix of rural and urban sites. Professional assistance with proven track record of funding success . ELIGIBILITY Eligible healthcare sites must meet all three following criteria: Non-profit or public entity In a rural area (as defined by the FCC: Eligible Rural Areas Search Tool Designated type of facility: Post-secondary educational institution offering health care instruction (e.g., teaching hospital, medical school) Community health center or health center providing services to migrants Dedicated emergency department of a rural for-profit hospital Local health department or agency Community mental health center Not-for-profit hospital Skilled nursing facility Rural health clinic Part-time eligible entity located in an ineligible facility *NMTHA contracts with Prairie Health Ventures to manage the application process and other bureaucratic aspects of the HCF. SWTAG members span over 200 sites in several States including many rural and urban facilities in New Mexico. SWTAG members have secured millions of HCF funding dollars to date. Current funding requests are under development. Universal Service Administrative Company ( USAC) Funding "Lingo" Form 460: Confirms Eligibility Step 1: Determine Eligibility of Your Site Form 461: Request for Services Step 2: Develop Bid Evaluation Criteria & Select Services Form 462: Funding Request Step 4: Submit Funding Requests Form 463: Invoice USAC for Release of Funds Step 6: Invoice USAC Evergreen Contract: Evergreen Contracts Funding Request Number (FRN) Funding Commitment Letter (FCL) Health Care Provider (HCP) Network Cost Worksheet (NCW) F or additional information about the Healthcare Connect Fund, please consult the following resources: HCF web page Related FAQs FCC orders

Events Networking, Education, Advocacy: Happy hours Meetings Webinars Conferences Legislative hearings And more... Let us know about events... and keep checking back for updates! Featured Upcoming & Past Events Let us know about your event HERE! EMBASSY SUITES BY HILTON Albuquerque, New Mexico THURSDAY, MAY 16 – FRIDAY, MAY 17, 2024

Can we provide care across state lines? By Jan Ground PT, MBA, SWTRC Colorado Ambassador March 3, 2021 Snow birds. Not the kind that fly (certainly not now with COVID) but the human kind. For those of you who never heard the term before, snow birds are typically retirees who travel south in the winter to states like Arizona, New Mexico and Florida to get away from the snow and cold up north than go back up north in the summer when the heat hits the south. What does this have to do with telemedicine? A lot actually and not just with snow birds. We are a mobile population. People don’t stay in one place their entire lives anymore – we move around, we travel but when we move from one place to another we don’t get to leave our health conditions behind us. They stay with us and sometimes we just get sick when we travel. Being creatures of habit, however, most people like to have consistency in their health providers. We like to think that our PCP and specialists that we see know us and our problems, that we have a relationship. Back to the snow birds – if my cardiologist lives in Chicago and I see her during the summer I want to see her during the winter as well when I’m relaxing by the pool in Tucson staying warm. Problem is she’s back in Chicago shoveling snow so how can I see her? Telemedicine of course but it’s not that easy. An interstate compact is a contract between two or more states creating an agreement on a particular policy issue, including, but not limited to, the facilitation of licensure of clinicians in states other than that in which the clinician holds his/her home state of licensure. Currently, licensure compacts exist for physicians, nurses, physical therapists, psychologists, emergency management personnel, and speech-language pathologists/audiologists. Licensure compacts for physician assistants, counselors, advanced practice nurses, and occupational therapists are under development. Interstate Compact Models Mutual Recognition (Reciprocity) allows a clinician in a compact state ("home state") to practice in any of the other compact states without obtaining additional licensure in the remote states. The clinician’s home state license is “mutually recognized” by other compact member states. This model allows a practitioner to practice in the compact member states either using a multistate license or by obtaining a “compact privilege”. Expedited Licensure Participating U.S. states work together to significantly streamline the licensing process for physicians who want to practice in multiple states. It offers a voluntary, expedited pathway to licensure for physicians who qualify. These licenses are still issued by the individual states – just as they would be using the standard licensing process – but because the application for licensure in these states is routed through the Compact, the overall process of gaining a license is significantly streamlined. Physicians receive their licenses much faster and with fewer burdens. The Interstate Medical Licensure Compact is the only expedited licensure compact. With the national and state emergency orders related to COVID-19, the regulations requiring that licensed clinicians provide care only to patients who are physically located in the state(s) in which the clinician is licensed to practice have been relaxed. It is not known if, when, and how these regulations will change when the COVID-19 emergency orders have expired. This table summarizes what is going on in each state for a variety of providers with respect to pending (P) versus enacted (E) legislation as of January 2021. These are of course subject to change as each state makes progress in deciding what to do. FOR FULL ARTICLE SEE: https://southwesttrc.org/blog/2021/can-we-provide-care-across-state-lines Physicians www.lmlcc.org Nurses www.ncsbn.org/nurse-licensure-compact.htm Physical Therapists www.PTcompact.org Psychologists www.psypact.org Emergency Management Personnel ww.EMScompact.gov Speech-Language Pathologists Audiologists www.aslpcompact.com Occupational Therapists www.OTcompact.org Advanced Practice Nurses www.nscbn.org/aprn-compact.htm < Previous News Next News >

How Telehealth Enabled Critical Care for Newborns During COVID-19 Kat Jercich, Healthcare IT News July 2021 When the United Kingdom went into lockdown, babies kept being born and kept needing care. That's where teleneonatology came in. When the COVID-19 pandemic began to sweep across the United Kingdom in March 2020, the government quickly moved to impose a stay-at-home order. But even as society ground to a halt, one thing stayed constant: Babies were being born, and they needed care. In Liverpool, England, the restrictions meant a sudden drop in availability for neonatologists. "There were beginning to be discussions about transferring neonatal surgical services to other centers," explained Dr. Christopher Dewhurst, the clinical director for the Family Health Division at Liverpool Women's Hospital and the Liverpool Neonatal Partnership. "Our neonatal service would not have survived in its current state without telemedicine," Dewhurst continued. Dewhurst, who will be presenting at HIMSS21 with Beth Kreofsky, operations manager of the Teleneonatology Program at the Mayo Clinic, explained how moving to telemedicine allowed his team to maintain clinical service at Liverpool Women’s Hospital and Alder Hey Children’s Hospital. Between those two locations, Liverpool has one of the largest neonatal intensive care units in the United Kingdom. "The teleneonatology solution for our city ensured that we could continue to provide safe, quality care to our babies and families across two sites," said Dewhurst. Dewhurst's team turned to InTouch Health (now part of Teladoc) to continue care. The system, he said, was "simple to use, which led to the early uptake by clinicians." And change took place quickly: The program was designed, coordinated, implemented and embraced within two weeks. Dewhurst said he hopes HIMSS21 session attendees learn that "you can make setting up a system as difficult or as easy as you want." "Time is no barrier to setting up a telemedicine service," he added. When it comes to measures of success, Dewhurst said that the team has registered a wide range of good signs. "We have financial benefits, patient satisfaction and clinicians' user feedback, which is positive," he said. In particular, caregivers mention "the speed of reviews and ability to communicate quickly and effectively with specialists from other hospitals," said Dewhurst. Overall, he said, "We showed that with passion, commitment, and [willingness] – you can set up a whole teleneonatology program quickly and safely," he said. < Previous News Next News >

Commentary: Rethinking the Impact of Audio-Only Visits on Health Equity by Lori Uscher-Pines and Lucy Schulson December 17, 2021 New pandemic-era flexibility that allowed audio-only health visits to be routinely reimbursed as telehealth may be leading to substandard care for those it was meant to serve. Prior to the outbreak of the COVID-19 pandemic in 2020, audio-only visits were rarely included in definitions of telehealth and seldom reimbursed. As clinicians were granted numerous flexibilities to deliver various care modalities at the onset of the pandemic, telephone calls were elevated to the status of reimbursable audio-only visits. Although audio-only visits were used across the health care system, federally qualified health centers (FQHCs) that provide primary care and behavioral health services to millions of Medicaid and uninsured patients were particularly likely to deliver audio-only visits in the spring of 2020. They were also more likely to rely on them as the pandemic progressed (PDF) because of patient and clinic barriers to video telehealth and a supportive policy environment. Almost two years into the pandemic, FQHCs in multiple states are reimbursed at the same Prospective Payment System (PPS) (PDF) rate for in-person, video, and audio-only visits. The new flexibility to deliver audio-only visits was a welcome change. It was widely recognized that, due to the digital divide, audio-only visits would play an essential role in maintaining access to care for many populations. An audio-only visit was far better than the alternative at the time: no visit at all. Currently, experts who call for the permanent reimbursement of audio-only visits cite concerns for the underserved. They argue that given the widespread lack of broadband, limited digital literacy, and reduced access to devices, requiring video visits may leave certain patients behind and exacerbate inequities in health care. While this argument had merit in the first year of the pandemic, the risk benefit calculation of audio-only visits has changed, and it is increasingly important to protect patients from potentially lower-quality audio-only visits. We discuss how ongoing delivery of audio-only visits can reduce the quality of care among low-income populations and contribute to health disparities. At the same time, the reliance on audio-only visits may be preventing innovation that could improve video and in-person health care visits for all populations. Ongoing delivery of audio-only visits can reduce the quality of care among low-income populations and contribute to health disparities. Share on Twitter In the spring of 2020, audio-only visits were a lifeline at a time of uncertainty and helped address a critical need when the delivery system was desperate for quick solutions. Numerous data sources showed high use of audio-only visits in this period (11–48 percent of visits), particularly among low-income and older adults. Even though estimates of audio-only use from claims data were high, they were likely underestimates of the total number of visits being delivered. This is the case because of challenges and inconsistencies with coding telehealth visits and the tendency for scheduled video visits to become audio-only visits when technical difficulties arise. For example, using claims data, Medicare estimated that one in three telehealth visits in the spring of 2020 were audio-only visits. However, data from the Medicare Current Beneficiary Survey showed that the majority of beneficiaries (56 percent) who had telehealth visits reported that they were exclusively audio-only. The Variation in Use Across Settings As the COVID-19 pandemic continued, audio-only visits retreated in some settings but remained dominant in others. Studies of the commercially insured demonstrated that as in-person visits rebounded in 2021, telehealth visits in general, and audio-only visits in particular, declined and play an increasingly minor role. In contrast, in the summer of 2021, 32 percent of FQHCs (PDF) across the United States reported that the majority of their total visits continued to be audio-only. A study of 43 large FQHC networks in California demonstrated ongoing, high-volume delivery (PDF) of audio-only visits in primary care despite receiving technical assistance and funding to grow their telehealth programs. Quality Concerns with Audio-Only Visits Audio-only visits can increase access to care, but this key advantage may come at the expense of quality. Evidence of the quality of audio-only visits in primary care is scant but concerning. First, clinicians report that audio-only visits are not as effective. Challenges range from the relatively minor (for example, not being able to assess facial expressions) to major issues (for example, not being able to verify the patient's identity). Studies have shown that clinicians can miss visual cues and struggle with establishing rapport with patients, and visits are shorter. Additionally, patients report lower satisfaction and comprehension rates. Even as new data emerge about the quality of audio-only visits, it is clear that some patients, including many commercially insured patients, are largely getting more evidence-based, tested services (in-person and video visits) while low-income patients are getting an untested service. Furthermore, cervical cancer screening rates, child weight assessment and counseling, and depression screening and follow-up at FQHCs declined with telehealth (predominantly audio-only) use. Drivers of Audio-Only Visits The variation in audio-only use across different populations is likely not fully explained by differences in which conditions are clinically appropriate for audio-only visits or by patient readiness for video visits. Rather, reimbursement, provider preferences, and organizational priorities are playing a significant role in determining how many in-person visit slots there are, and by extension, which patients get audio-only, video, or in-person visits. In October 2021, 33 percent of FQHC visits in California and 24 percent in Arizona, two states that reimburse FQHCs the full PPS for audio-only visits, were conducted virtually. Contrast that with South Dakota (a state that stopped reimbursing for audio-only visits in its Medicaid program as of July 2021 (PDF)), which only saw 5 percent of visits conducted virtually in the same time period. Although the digital divide is a significant problem in the United States that requires focused attention, it cannot fully explain the variation. A recent paper in Medical Care showed that provider behavior and organizational factors, as opposed to patient digital barriers, are playing the largest role in audio-only visits. Sixty-six percent of Medicare beneficiaries who were exclusively offered audio-only visits during the pandemic had access to telehealth-compatible devices and to the internet. Creating Conditions for High-Quality Telehealth Care At present, 22 state Medicaid programs allow for reimbursement for audio-only visits, with nine states adding reimbursement to permanent policy since the spring of 2021. The trend is to increase access to audio-only visits in the interest of health equity. However, telehealth experts have pointed out that failing to rein in audio-only visits risks escalating costs and creating a two-tiered system (PDF) in which affluent patients get video and in-person visits and low-income patients get telephone calls. It may be that this two-tiered system is already coming to fruition and is now harder to justify in the name of emergency response than it was in the spring of 2020. In March 2021, we argued that reimbursement of audio-only visits should continue for several years beyond the public health emergency to avoid exacerbating disparities in access. However, given emerging data about the prominence of audio-only visits in low-income communities, we now have concerns about this approach. Generous parity reimbursement for audio-only visits may be creating perverse incentives to deliver substandard care to the most underserved. It also may be stifling innovation that could be occurring in the delivery of video and in-person visits. Generous parity reimbursement for audio-only visits may be creating perverse incentives to deliver substandard care to the most underserved. Share on Twitter The patients who have challenges accessing video visits are the same patients who face barriers accessing in-person care. Instead of offering scheduled audio-only visits, health systems could be incentivized to address the social determinants of health that create barriers to higher-quality visits. For example, they could partner with community groups to provide transportation to appointments, provide access to low-cost electronic devices, invest in accessible telehealth platforms, create telehealth access points in the community, and train telehealth navigators. Audio-only visits are a powerful tool for emergency response, and over time researchers and clinicians will identify situations in which audio-only visits alone, or as a component of hybrid care models, can support comparable care. But in the coming months, it may be time to consider limiting audio-only visits in the pursuit of health equity. Lori Uscher-Pines is a senior policy researcher and Lucy Schulson is an associate physician policy researcher at the nonprofit, nonpartisan RAND Corporation. This commentary was first published on December 17, 2012 on Health Affairs Blog. Copyright ©2021 Health Affairs by Project HOPE—The People-to-People Health Foundation, Inc. Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis. < Previous News Next News >

For next steps on telehealth, look to the states By Kat Jercich January 26, 2021 Lawmakers in legislatures nationwide have introduced about 300 bills aimed at expanding access to telemedicine – but not every bill is equally helpful. As the United States approaches its one-year anniversary of the COVID-19 pandemic beginning to disrupt normal healthcare operations, a question continues to endure: What's next for telehealth? The answer remains unclear on a federal level, with U.S. lawmakers recently reintroducing legislation that would take at least a few steps toward safeguarding virtual care. In the meantime, though, state legislatures have taken action – and experts say their movement in this regard is unprecedented. "I've been doing this a long time, and I've never seen anything like this," said Claudia Tucker, senior vice president of government affairs at Teladoc, during the third installment of the American Telemedicine Association's EDGE policy conference on Tuesday. HIMSS20 Digital Learn on-demand, earn credit, find products and solutions. Get Started >> As Tucker described it, lawmakers in nearly every state have introduced about 300 bills in the last few months aimed at expanding access to telemedicine. But, she said, not every one of those bills has equal merit. Some, for instance, require providers to see a patient in-person before allowing audio-only appointments – a move that legislators may not realize will have a chilling effect on care. "State policy matters. When you put clinically unnecessary barriers to care [into place] through state policy … they can be a big deal," noted Quinn Shean, managing director at Tusk Ventures/Tusk Strategies. Shean also noted that many of the hundreds of bills being introduced engage with the "who, what, where and when" of telehealth: what types of providers can provide it, and which modality they can use. "We're seeing states catch up based on their experience in the pandemic," she said. Panelists throughout the day pointed to the double-edged sword of telehealth: It can enable patient access, but it can also deepen the digital divide. "The idea that someone living in Appalachia can have access to one of the best oncologists in the country through telehealth is life changing," said Tucker. As Evan Hoffman, director of state and local government relations, pointed out, virtual care can be instrumental in helping keep struggling rural hospitals open. Telehealth tools, he said, "can beam [provider input] in to support rural hospitals and their efforts to engage patients. The flurry of bill volume cannot be understated in telehealth." At the same time, said Shean, "It's going to be on industry and stakeholders to make sure we do use telehealth as a great equalizer." One potential make-or-break issue when it comes to equity is broadband access – whether patients are able to connect with providers at all. "We have seen, especially in our lower-income areas … the disparity in accessibility widen," said New York State Assembly member Pamela Hunter, D-Syracuse. "We need to make sure that those who need accessibility in care – the most vulnerable – are able to utilize this up-and-coming ... technological health-delivery system," continued Hunter. At this point, she said, "it really is not for everyone." Experts also pointed to coverage and reimbursement as pivotal issues for broader access after the COVID-19 pandemic. "We're going to have to talk about parity," said Minnesota Senator Michelle Benson, R-Anoka. "There is some concern that providers are going to have to be held accountable" for potentially inappropriately charging for services. "I don't know how that looks in statute," Benson admitted. "I hate it when legislators are overly prescriptive," she continued, but maintained that some regulation would undoubtedly be necessary. When it comes to policy progress over the next 100 days, Tucker advised, "follow the money." "There's a huge focus on money, reimbursement, health plans," she said. "It's all about: 'Where does the money go?'" Telehealth, she argued, begets access, quality of care, and savings. "Let's not forget that third one," she emphasized. "The flurry of bill volume cannot be understated in telehealth," noted Hoffman. "It speaks to the tremendous opportunity before us." Shean added that the industry is, for the most part, past the need to simply prove the merits of telehealth. Instead, she said, "We should be using this time of telehealth advancement to be rethinking … to really think bigger." Kat Jercich is senior editor of Healthcare IT News. Twitter: @kjercich Email: kjercich@himss.org Healthcare IT News is a HIMSS Media publication. < Previous News Next News >

A New Model For Healthcare: Adding Telehealth To Unclog Patient Flow ‘Hot Spots’ Dr. Corey Scurlock MD, MBA June 8, 2022 It may not match the scale of the exodus of nurses from the healthcare workforce, but a growing shortage of physicians is no less of a threat to patient care. A recent survey found that one in five doctors plan on leaving the profession in the next two years, hastening a projected shortfall of as many as 124,000 doctors by 2034. This has reached such a concerning level that the U.S. Department of Health and Human Services and U.S. Surgeon General Dr. Vivek Murthy have launched a strategic advisory to mitigate clinical burnout. More Information: https://www.forbes.com/sites/forbesbusinesscouncil/2022/06/08/a-new-model-for-healthcare-adding-telehealth-to-unclog-patient-flow-hot-spots/?sh=248c6d415725 Covid-19 and longstanding concerns about changes in the business of healthcare have left many physicians burned out. Older doctors are seeking early retirement, and younger doctors seek a more balanced work/life ratio. Many aren’t interested in some of the all-consuming specialties such as critical care, neurology, oncology and psychiatry. As with everything else in our world right now, supply is not meeting demand. Action is required, but it can’t just rely on yesterday’s solutions. Opening up more slots in medical schools won’t fill the immediate need for experienced, board-certified physicians. Buying up physician practices is largely played out, as most doctors are already employed. I would argue that we can’t wait for a new MD pipeline to open up. Instead, we need to fix the broken practice of medicine. Doctors are burned out because they are locked into 15-minute appointment cycles wrapped around the exigencies of electronic health records systems that demand complete documentation of each step, leaving little time for the “How are you, Ms. Jones?” moments. Patients are unhappy with eight-month waits for new patient appointments to confirm diagnoses of serious diseases. Within the hospital, a lack of staff and available expertise meets up with broken processes to choke off patient flow from the emergency department to laboratories to medical floors. Staff personnel stand around waiting for paperwork. Patients wait on gurneys for everything. By the time things are straightened out, the original order might no longer be appropriate for a patient. Discharge alone has become a major headache. One antidote to this is to create a hybrid model of care as I have done with my company and as my business helps other companies do. It relies on points in the care process being actively managed remotely by specialist physicians who also have a background in telehealth. These veterans should understand where timely intervention can unblock patient flow at “hot spots” in a patient’s journey caused by delays in care, inappropriate care transitions or potential patient harm. Telehealth-enabled monitoring can reduce transfers by accurately assessing patient acuity and overseeing the work of less-experienced hospital staff. Through these interactions, the goal is to see reduced patient readmissions and ED visits, shorter hospital stays and better utilization of resources. Of course, all of this begs the question: If the hospital can’t find enough specialists, how can virtual care physicians fill these roles? The answer is pretty simple, in my opinion. You bring back the joy of being a doctor. These telehealth doctors work from home, linked to pods of multi-specialists who work with the same hospitals, getting to know the staff. They can work when they like and as much as they like. They access the medical record but are called upon to solve problems, full stop. You can also make sure their work is always varied. Doctors want to heal, not master the intricacies of Epic’s latest software. With the tailwind of favorable policy and reimbursement the telehealth industry is experiencing right now, it might be an opportune time to consider this type of strategy. But as one explores telehealth as a business venture, it's important to recognize that all such business is still highly regulated, as it is in the field of care delivery. The core components of an end-to-end telehealth solution include people, process and technology. Here are some thoughts on each. • Technology: Audio-video providers have matured significantly, and increasing interoperability has enabled new entrants. Health systems have sought to standardize enterprise platforms versus best-of-breed applications. Clinical analytics tools can be overlaid on the EMR leading to simpler clinical insight gathering. While not mandatory, such systems target quality or performance metrics to support ROI. • Process: Efforts to virtualize care can be disruptive to care delivery. Consider what technology platforms to purchase, KPIs to measure and clinical workflow to create. • People: Delivering telehealth-enabled care will place the highest regulatory burden on an organization. Malpractice, state licensing and credentialing, and HIPAA, to name a few, are considerations that need to be tackled first. Secondly, your attention to provider experience is paramount to ensure a healthy and sustainable workforce to attract talent. As Covid-19 wanes, we are facing unprecedented change in the provisioning of care. New care models will emerge. Telehealth is not the only solution, but it is clear that it will be a primary one. A recent survey (registration required) of health system CEOs by the University of Colorado’s Health Administration Research Consortium put virtual care as the No. 1 strategy for future growth. For those looking for solutions to today’s healthcare challenges, here are three points to remember: • Telehealth is here to stay: It could be the great equalizer for care access and equity. • Patient flow is key: By focusing on the patient journey across the continuum, hot spots can be identified and targeted. • Clinical and operational alignment are needed: People, processes and technology can combine as a force multiplier to return greater value, but only if everyone has agreed on a care road map. As telehealth goes, we are not battling efficacy anymore; we are battling inaction and the cost such inaction creates. I believe unlocking the potential of all our nation's providers can deliver better care everywhere. It's time to imagine what the design of the next-generation, digitally-enabled clinical workforce looks like, and it's all about access and equity in care delivery. < Previous News Next News >

Contact SBRL Community Contacts Get answers to your Federal and State broadband questions: New Mexico broadband contacts Federal broadband contacts Contacts for New Mexico broadband questions: Rand Tilton, NM Department of Informatio n Technology (NM DoIT)/Broadband Rand.Tilton@state.nm.us Gar Clarke, NM DoIT Geospatial Program Manager Presented October 2021 webinar: "NM Broadband and What’s Next." Recording: HERE Sli des: HERE NM Broadband Program (NMBBP ): Online Interactive Broadband Map Statewide Broadband Strategic Plan (June 2020) NM Speed Tester New Mexico Contacts for Federal broadband questions: U.S. Senator Ben Ray Lujan: Sen. Lujan wants to know about telehealth or broadband barriers and successes you have experienced. Telehealth barriers and successes: M e lanie_Goodman@lujan.senate.gov Health polic y matters: Calli_Shapiro@lujan.senate.gov Broadband and telecommunications matters: Jeffrey_Lopez@lujan.senate.gov. Senator Ben Ray Lujan's recording about New Mexico telehealth: HERE Federal

Membership Benefits COMING SOON: NEW MEMBERSHIP BENEFITS Thank you for your interest in joining the New Mexico Telehealth Alliance. The newly formed Membership Co mmittee and the NMTHA Board of Directors are revising the Membership section of this website. If you have any questions please contact us HERE .

OCR Clarifies Post-PHE HIPAA Compliance for Audio-Only Telehealth Center for Connected Health Policy June 21, 2022image The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently released guidance on the use of remote communication technologies for audio-only telehealth to assist health care providers and health plans, or covered entities, bound by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules (HIPAA Rules). The goal of the guidance as stated by OCR is to support continued access to audio-only telehealth post-public health emergency (PHE) and make clear that audio-only telehealth is permissible under HIPAA Rules. One of the main federal public health emergency (PHE) flexibilities instituted at the beginning of the pandemic included relaxed enforcement of certain federal privacy laws related to the use of various telehealth technologies (see OCR’s Notification of Enforcement Discretion for Telehealth Remote Communications (Telehealth Notification)). The Telehealth Notification states that OCR will not penalize providers under HIPAA related to their good faith use of audio or video remote communication technologies during the PHE. While it appears likely that the PHE will be further extended one more time until mid-October, this guidance seeks to prepare providers for a return to compliance once the PHE and enforcement relaxations are no longer in effect. HIPAA Allows Audio-Only OCR first and foremost confirms the ability to comply with HIPAA when using remote communications to provide audio-only telehealth services. The guidance states the expectation of privacy of protected health information (PHI) from impermissible uses or disclosures and the importance of providing telehealth services in private settings. If the setting is not fully private, however, it is stressed that other safeguards must be put in place, such as speaking in low voices and not using speakerphone functions. In addition, entities must verify the individual’s identity if they are unknown. While verification can be completed orally or in writing, the HIPAA Rules do not require any specific method of identity verification. The guidance also highlights that this requirement may entail the use of language assistance services with individuals with limited English proficiency. HIPAA Only Applies to Electronic Information via Electronic Media In addressing the need to meet HIPAA Security Rule requirements to use remote communication technologies, OCR clarifies that the Rule only applies to electronic PHI (ePHI) transmitted over electronic media. Therefore, the Rule does not apply to audio-only telehealth services provided over a traditional landline, however it does apply to landlines being replaced with Voice over Internet Protocol (VoIP) and other electronic technologies that involve the internet, cellular, and Wi-Fi, as well as smartphone apps and messaging services that electronically store audio messages. These requirements again only apply to covered entities, noting that patients receiving telehealth services via remote technologies are not obligated by HIPAA and therefore covered entities aren’t responsible for the privacy of information once it has been received by the patient’s device. To ensure compliance with the HIPAA Security Rule the guidance states that all potential risks should be identified and addressed as part of risk analysis and risk management processes required under HIPAA, including the risk for interception of information during transmission, the ability for devices to encrypt transmitted information, and other device security and authentication processes. Business Associate Agreements & Payer Rules A business associate agreement (BAA) with a telecommunication service provider (TSP) is not always necessary to utilize audio-only technologies, as long as the TSP is just a conduit for the PHI being transmitted and does not have the ability to access the information being shared. If, however, the provider wants to use an app that does store information, then a BAA is required with the app developer, including apps that may provide translation services. The guidance states that whether or not audio-only services are covered by the patient’s health insurer does not impact a provider’s ability to provide those services in compliance with HIPAA, as payer rules and requirements are separate from HIPAA Rules. While continuation of PHE telehealth flexibilities remains a policy focus in Congress, it is likely that the flexibilities related to privacy enforcement will not be continued post-PHE making the technologies used to provide telehealth services an area of focus for providers looking to continue providing telehealth access moving forward. Continuing use of audio-only telehealth is also an area of policy focus post-PHE, therefore this guidance is very timely. While the guidance is technically specific to just one telehealth modality, it does speak to audio-only through electronic technologies, generally encapsulating other remote communications using electronic means, such as video and store-and-forward telehealth. For more information on OCR’s guidance related to audio-only communications post-PHE, as well as general telehealth guidance, please view the OCR FAQs and other resources listed in their entirety. For more information: https://mailchi.mp/cchpca/ocr-clarifies-post-phe-hipaa-compliance-for-audio-only-telehealth < Previous News Next News >

Telemental Health Collaborative Care Medication Management: Implementation and Outcomes Smita Das, Jane Wang, Shih-Yin Chen, and Connie E. Chen Dec. 22, 2021 Introduction: Access to quality mental health medication management (MM) in the United States is limited, even among those with employment-based health insurance. This implementation, feasibility, and outcome study sought to design and evaluate an evidence-based telemental health MM service using a collaborative care model (CoCM). Abstract Introduction: Access to quality mental health medication management (MM) in the United States is limited, even among those with employment-based health insurance. This implementation, feasibility, and outcome study sought to design and evaluate an evidence-based telemental health MM service using a collaborative care model (CoCM). Materials and Methods: CoCM MM was available to adult employees/dependents through their employer benefits, in addition to therapy. Outcomes included Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) collected at baseline and throughout participation. This analysis was not deemed to be human subjects research by the Western Institutional Review Board. Results: Over 17 months, 212 people enrolled and completed >2 assessments; the enrollees were 58.96% female with average age of 32.00 years (standard deviation [SD] = 7.38). In people with moderate to severe depression or anxiety, PHQ-9 and GAD-7 scores reduced by an average of 7.27 (SD = 4.80) and 6.71 (SD = 5.18) points after at least 12 ± 4 weeks in the program. At 24 ± 4 weeks, the PHQ-9 and GAD-7 reductions were on average 7.17 (SD = 5.00) and 6.03 (SD = 5.37), respectively. Approximately 65.88% of participants with either baseline depression or anxiety had a response on either the PHQ-9 or GAD-7 at 12 ± 4 weeks and 44.71% of participants experienced remission; at 24 ± 4 weeks, 56.41% had response and 41.03% experienced remission. Conclusions: An evidence-based CoCM telemedicine service within an employee behavioral health benefit is feasible and effective in reducing anxiety and depression symptoms when using measurement-based care. Widespread implementation of a benefit like this could expand access to evidence-based mental health MM. Read more here: https://www.liebertpub.com/doi/full/10.1089/tmj.2021.0401 < Previous News Next News >

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

CB Insights Report: Global Telehealth Investment is Still on The Rise Kat Jercich, Healthcare IT News August 2021 Researchers found a 169% year-over-year increase in global telehealth investment, with the top five deals alone worth $1.5 billion. A new report from CB Insights found that global telehealth investment rose for the fourth consecutive quarter in Q2 of 2021 – with teletherapy deals representing a substantial share. The State Of Telehealth report found that much of the growth was pushed by accelerating digital transformation initiatives, as well as patient experience prioritization. At the same time, stakeholders and thought leaders voiced concerns about health inequity, and lobbyists mounted the pressure for long-term regulatory reform. WHY IT MATTERS The telehealth train has continued to chug along, despite dire warnings from health advocates about what might happen if the public health emergency expires without any action from Congress. Indeed, the CB Insights report was optimistic from a financial perspective: It found that global telehealth investment grew 17% quarter-over-quarter compared to Q1 of 2021, and 169% year-over-year, to reach a record high of $5 billion across 163 deals. As far as segments go, telemedicine providers, platforms and marketplaces saw their first decline in six quarters, with mergers and acquisitions at a record high. Meanwhile, teletherapy – especially with regard to mental health and chronic diseases – was an investor hotspot, and virtual care enablement companies saw a funding high. Remote monitoring and diagnostics companies raised $841 million across 33 deals, with decentralized lab tests and vital sign monitors flagged as notable business development areas. And telepharmacy had a strong funding quarter, particularly when it came to direct-to-consumer brands. The report also found that telehealth visits appear to be stabilizing at levels above those pre-pandemic, although they are still below the rates seen in March and April 2020. THE LARGER TREND Retail giants in the United States appear to be betting big on telehealth, even amidst looming uncertainty about its regulatory future. Walmart Health and Amazon Care have both signaled their plans to expand virtual care throughout the country, while established telemedicine vendor Amwell announced two acquisitions this week. But it's not all rosy: Amwell competitor Teladoc reported a $133 million net loss this past quarter. ON THE RECORD "While all telehealth segments saw acquisitions during the quarter, the two biggest hot spots were virtual/digital care enablement and telemedicine providers, platforms and marketplaces," observed CB Insights researchers. < Previous News Next News >

Maximizing Telemedicine Benefits Elizabeth A. Krupinski, Southwest Telehealth Resource Center August 2021 First and foremost, the key to a successful telemedicine program is planning and figuring out exactly what role you expect telemedicine to play and how it fits in the mission and goals of your practice or institution. The United States and the world have seen a dramatic increase in the use of telemedicine since the inception of the COVID-19 public health emergency due in most part to stay at home restrictions for both providers and patients. Prior to this, telemedicine was used in a wide variety of clinical and related patient care applications for at least 30 years, and had been seeing steady but not exponential growth. In many cases programs were initiated quite rapidly using readily available and often low-cost equipment and tools, unless there was already an existing program and platform in place. Further, the use of telemedicine was facilitated at the state and federal levels but widespread waivers and measures being put into place to reduce barriers that were previously in place such as changes in reimbursements, requirements regarding patient and provider locations, cross-state licensure and privacy/security requirements. Those of us in the field for a long time are hopeful that many of these measures will stay in place, but there are clearly some that will or already have expired. We are additionally hopeful that even though in-person practices are clearly coming back full-tilt, that everyone has seen and/or experienced the benefits of telemedicine and will continue to use it to some degree as feasible and appropriate with their patients. As this occurs, however, providers will be faced with new challenges as they take their initial telemedicine set-ups and transition to this new hybrid world of services. As noted, some things will still be allowed (e.g., certain billing codes) but others will likely return to pre-COVID status (e.g., not being able to use non-HIPAA-compliant devices and software platforms). In addition to finding the best software for future telemedicine applications, there are other things to consider when trying to maximize telemedicine benefits. From my perspective, although the technology is critical, telemedicine success has very little to do with the technology and everything to do with the people and the environment within which they practice. Thus, in order to maximize telemedicine these are the elements one should consider and focus on in addition to carefully selecting the most appropriate technology for your practice and providers. First and foremost, the key to a successful telemedicine program is planning and figuring out exactly what role you expect telemedicine to play and how it fits in the mission and goals of your practice or institution. The use cases need to be clearly defined and must match an identified need. Then the who, what, where, why and when must be carefully delineated. Who needs to be involved (e.g., providers, billing, scheduling, IT, legal, administration), what clinical tasks can be accomplished via telemedicine, where will the technology and/or providers be located (e.g., clinic, home) and where will the patients be (e.g., primary care provider office, home, work, school), why will telemedicine be offered as an option (e.g., lack of sub-specialty providers, patients need to travel long distances, no show rates are too high) and when will telemedicine be offered (e.g., certain days/times, any opening in the schedule)? All of this can be accomplished by plotting out in a workflow diagram what the current practice is and how it needs to be adjusted in order to integrate telemedicine into that workflow. Again, the expectation is that although some practices might remain essentially virtual, the majority are going to evolve into a hybrid practice – but such a hybrid will not happen overnight or automatically. Workflow integration is going to be just as critical as integrating telemedicine technologies into a practice – it really is all about the people, setting expectations and establishing standard operating procedures and protocols for everyone that is going to be involved. Another thing that can be done to maximize a telemedicine practice is to properly train everyone on standard operating procedures and protocols, especially the providers who will be interacting with the patients. To date there are very few training programs that incorporate formally telemedicine as part of the curriculum. A number of programs are increasingly exposing trainees to telemedicine if offered at their institution, but typically as an elective or chance encounter in the clinic. There are however a number of organizations that are working on developing and promoting telemedicine competencies and the Association of American Medical Colleges (AAMC) recently developed a set of Core Competencies. Although specific to medical college trainees, they are comprehensive enough to cover nearly every other specialty/profession in many respects. Very briefly, the AAMC Telehealth Competencies consist of three domains, each with a set of explicit skills that increase in complexity and responsibility across three stages of practice: entering residency, entering practice and experienced faculty physician. The skills from each prior stage of training should carry over to the next phase as the provider becomes more expert and acquires additional skill sets. The six domains are: patient safety and appropriate use of telehealth; access and equity in telehealth; communication via telehealth; data collection and assessment via telehealth; technology for telehealth; and ethical practices and legal requirements for telehealth. Patient safety and appropriate use of telehealth includes 4 skill sets ranging from being able to explain to patients are caregivers the benefits and limitations of telemedicine to knowing when a patient is at risk and how/when to escalate care (e.g., convert to in-person) during an encounter. Access and equity in telehealth has 3 skill sets including knowing your biases and implications when considering healthcare, how telehealth can mitigate or amplify access to care gaps, and taking into account all potential cultural, social, physical and other factors when considering telemedicine. Communication via telehealth has 3 skills covering establishing rapport with patients, creating the right environment (e.g., lighting, sound) and knowing how to incorporate a patient’s social support into an encounter. Data collection and assessment via telehealth covers how to obtain a patient history, how to conduct an appropriate remote exam, and how to deal with patient-generated data. Technology for telehealth does not expect everyone to be an engineer or IT expert, but they should be able to explain equipment requirements for a visit, explain limitations and minimum requirements, and explain risks of technology failure and how to respond to them. Similarly, ethical practices and legal requirements for telehealth does not expect everyone to be a lawyer but should be able to describe local legal and privacy regulations, define components of informed consent, understand ethical challenges and professional requirements, and assess potential conflicts of interest (e.g., interest in commercial products/services). Many of these skills can be acquired by those already in practice by attending the wide variety of courses and webinars available for telemedicine skill building. It is also highly recommended that before engaging with patients for the first time via telemedicine to engage in some simulated practice sessions – from start to finish practicing each skill and developing your “style” for interacting with patients via this virtual medium. Finally, in order to maximize benefits you need to assess your program. This does not require a degree in statistics or setting up a complex experimental study. It really requires just two things – a set of metrics and a process. There are lots of metrics available and most have been studied in a wide variety of clinical applications so a good lit review will always help get you started. It is important to keep in mind that the things you measure need to reflect your goals/mission for using telemedicine and the bottom line of making a profit is not always the most appropriate metric to use. There are lots of relevant metrics and as a good starting place the article by Shore et al. “A lexicon of assessment and outcome measures for telemental health” is a great place to get some ideas. Although developed for the telemental health community the metrics provided apply quite well to nearly any specialty or practice. The metrics include such things as patient/provider satisfaction, no shows, symptom outcomes, completion of treatment, wait times, number of services, cultural access, cost avoidance and patient safety. Once you decide on metrics that are appropriate for your practice (recommend starting with 2-3 then add more as your practice grows) there is a very easy, straight-forward process for getting to outcomes. First, consider a given measure an indicator – these are concrete activities, products etc. that can be measured readily (e.g., from the patient record). For example, you could measure A1C levels in patients as a function of being enrolled in a telenutrition program. The next step is to set performance targets – these are concrete goals that are time limited and based on the indicator metrics. For example, you would like to see a 25% reduction in A1C levels in at least 50% of patients enrolled in the telenutrition course at 6 months post-baseline. Finally, you will have quantifiable outcomes (without fancy statistics) at the end of your set time period – if you meet your 25% reduction goal in 50% of patients great. If not, then maybe reassess the program or whether your goals were realistic. In any case, you now have concrete outcomes of your program demonstrating its benefits that you can provide to funders, administration, your care team and even patients and the community. In order to maximize telemedicine benefits you need to get the word out about its availability and its effectiveness! < Previous News Next News >

Trends in Telehealth: CCHP's 50 State Telehealth Policy Summary Report, Fall 2022 Center for Connected Health Policy October 18, 2022 Today the Center for Connected Health Policy (CCHP) is releasing its bi-annual summary of state telehealth policy changes for Fall 2022. Additionally, we are also making available a summary chart showing where states stand on many key telehealth policies, as well as an infographic highlighting our key findings. The most current information in CCHP’s online policy finder tool may be exported for each state into a PDF document. The Fall 2022 summary report adds in two new jurisdictions, Puerto Rico and Virgin Islands, and covers updates in state telehealth policy made between July and early September 2022. Note that in some cases, after a state was reviewed by CCHP, it is possible that the state may have passed a significant piece of legislation or implemented an administrative policy change that CCHP may not have captured. In those instances, the changes will be reviewed and catalogued in the upcoming Spring 2023 edition of CCHP’s Summary Report. As in previous editions, information in the policy finder remains organized into three categories: Medicaid reimbursement, private payer laws and professional requirements. Additionally, for this edition, CCHP received support from the National Association of Community Health Centers (NACHC) through funding from the Health Resources and Services Administration (HRSA) to create a specific category on federally qualified health center (FQHC) Medicaid fee-for-service policies. FQHCs have many unique rules that apply to them that sometimes effect their ability to utilize telehealth, such as the definition of a visit/encounter in the Medicaid program. The new FQHC category takes these considerations into account and will help FQHCs be able to more easily navigate to the policies that specifically affect them. See full article: https://mailchi.mp/cchpca/just-released-cchps-50-state-telehealth-policy-summary-report-fall-2022trends-in-telehealth-policy < Previous News Next News >

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