Libraries Add Telehealth to the Rural Communities They Serve Mari Herreras October 20, 2022 In the early days of the Covid pandemic, Dianne Connery realized something needed to be done for people in her rural Texas community to help connect folks to their medical appointments. Connery, director of the Pottsboro Area Library in Pottsboro, Texas, said it started when one woman with pulmonary disease came to the library for help, desperate to meet with her doctor but too high risk to come to his office—a two-hour drive south to Dallas. “Libraries are such perfect places for this because often we have the fastest internet in town, and we are used to helping people with technology,” Connery said. Connery and her fellow librarians sprang into action—creating a private space in Connery’s office with her laptop that had a camera. That gesture allowed the woman to meet with her doctor and go over recent MRI results. “I had never lived in a rural town until 2010 and didn’t realize how hard it is to access digital technology. You need a solid infrastructure for robust internet. Rural communities like ours don’t have that,” she said. From that first telehealth appointment in Connery’s office grew the library’s telehealth program that’s received national recognition. However, it never would have happened without Connery, with support from the town council, having fiber installed to support a teen eSports program long before the start of the pandemic. More community members used Connery’s office those early telehealth appointments, but through a National Library of Medicine grant and a community appeal, she was able to create a private appointment space from an old junk room and purchase the needed hardware and equipment. The next step was a unique partnership she developed with the University of North Texas Health Sciences Center to pair patients with the medical providers they needed. People can be seen two days a week for those using Medicare and Medicaid. Another day of the week is reserved for behavioral health appointments and another day is reserved for folks seeing their regular health providers. Connery’s work on the telehealth program doesn’t end there. The American Heart Association recently provided her library with blood pressure kits members of the community can check out. They also received a grant to hire a community health care worker to do outreach and education at the library and community spaces like the American Legion and the VFW. Now she’s focused on developing a digital literacy curriculum with the help of a three-year grant that helped her hire a digital navigator. Connery said she’s excited to see other rural libraries in Texas start telehealth programs but hopes more funding loops back to libraries desperate for increases in their own budgets. Connery is part of a national consortium of libraries who meet monthly to discuss telehealth programming—a growing interest in other rural communities beyond her Texas borders. Last month, a new telehealth program recently launched at two rural Pima County Library branches in Ajo and Arivaca—the first of its kind in Arizona—allowing folks with transportation or internet issues access to their doctors without having to drive several hours across the desert to nearby Tucson. “A huge sense of relief,” is how one Ajo resident recently described her experience that helped her connect with her primary care doctor in Tucson about worrisome symptoms she experienced after recovering from Covid. At the Salazar-Ajo Library she was able to collect the vitals her doctor needed using equipment provided by the library. And in the privacy of the library’s meeting room, she met with her doctor via a laptop and the internet provided by the library to go over her symptoms and vitals. “Being able to take my vitals and provide those to my doctor seems really important,” the Ajo resident said. “… while I was on my call with her, she had me do my vitals. We started with the blood pressure cuff, and how to apply it. Then my oxygen with the pulse rate oximeter.” The end of the appointment her doctor determined that the symptoms were not uncommon for someone who has had Covid, allowing the Ajo resident some relief and a better understanding of her recovery. Daniela Buchberger, Pima County Library’s Ajo branch managing librarian, said the new program, Health Connect, provides a private room for telehealth medical appointments. Inside is a laptop with a camera and equipment needed for a patient to take their own vitals: a digital scale, a thermometer, a blood pressure cuff, and a pulse rate oximeter. A patient will need to have the link provided by their doctor, usually via email. Library staff, due to privacy restrictions, aren’t going to be able to help someone log-on or use the equipment although the patient can bring someone with them to their appointment in the study room. Each library has written instructions on laminated cards as well as easy-to-follow visuals to help guide their experience. According to the Pima County Library, Health Connect is made possible by the Arizona State Library, Archives, and Public Records, a division of the Secretary of State, with federal funds from the Institute of Museum and Library Services. It is a joint effort between the Library, Pima County Health Department, University of Arizona’s College of Nursing, the Arizona Telemedicine Program, and United Community Health Care. "Access to telehealth is essential for people to get the care they need when traveling to an in-person visit isn't possible,” said Ken Zambos, program manager for Workforce and Economic Development in Pima County. “By providing this service, the library is providing access to equipment that transforms healthcare delivery and positively affects healthcare outcomes." Buchberger said a library card isn’t needed to use the room. However, reservations are needed and available in hour and half increments. Each person using a room is expected to clean all equipment after use with alcohol wipes provided. A fan in the room will be used to provide white noise to help with privacy as much as possible. “We may not have as much traffic as other libraries, but we are an important part of the community. The library is free, so is the internet,” Buchberger said. “Not everyone here has a car or a computer, but they have us.” About the Author Mari Herreras is the newest member of the Arizona Telemedicine Program and Southwest Telehealth Resource Center teams, serving as Communications Manager. She has worked in marketing and communications in publishing and nonprofits, as well as an award-winning journalism career for community and alternative newsweeklies in Tucson, Los Angeles, Seattle, and Wenatchee, Washington. See original article: https://southwesttrc.org/blog/2022/libraries-add-telehealth-rural-communities-they-serve < 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 >

New Study Pitches Telehealth as Safer Than the Doctor’s Office Eric Wicklund, mhealthintelligence August 2021 In a nod to the value of telehealth in primary care, researchers have found that a person visiting the doctor's office shortly after a visit from someone with the flu has a much higher chance of getting the flu as well. A new study makes a strong case for telehealth as an alternative to the doctor’s office, particularly during flu season. Researchers from the University of Minnesota School of Public Health, Harvard Medical School and the university’s T.H. Chan School of Public Health and athenahealth have found that people who visit their doctor’s office after someone infected with the flu has visited that office are much more likely to come down with the flu themselves. That same increase wasn’t seen in people seeking treatment for issues like urinary tract infections. The study, published this month in Health Affairs, suggests that primary care providers embrace virtual visits as a means of reducing that chance of infection. “It’s a widely accepted fact that patients can acquire infections in hospital settings, but we show that infection transmission can happen when you visit your doctor’s office, too,” Hannah Neprash, an assistant professor at UM’s School of Public Health and one of the study’s authors, said in a news release issued by the university. “Our findings highlight the importance of infection control practices and continued access to telemedicine services, as health care begins to return to pre-pandemic patterns,” she added. "In-person outpatient care for influenza may promote nontrivial transmission of these viruses. This may be true for other endemic respiratory illnesses too, including COVID-19, but more research is needed." The study, which tracked office visits from a national sample of insurance claims and EHR data compiled by athenahealth, is reportedly the first to connect the dots between office visits and the progression of a flu outbreak. According to that data, patients visits their primary care provider were almost 32 percent more likely to contract the flu within two weeks if that PCP had seen someone with the flu within the previous two weeks. In addition, that office would then serve as an incubator for the flu, infecting more patients over time. Neprash and her fellow researchers say their study supports the need for “triage to telemedicine” policies in clinics and medical offices when a patient shows signs of a contagious viral infection like the flu. “Given that upper respiratory symptoms are among the most common reasons for any patient to see a physician, these results highlight the importance of protocols to mitigate the risk for transmission,” the study notes. “Clinically, many of these patients will be at low risk for complications with telemedicine evaluation.” It also suggests that care providers develop “strict infection control practices” whenever a patient showing signs of the flu or a similar virus need to be seen in person. This would include mask-wearing, hand hygiene and putting patients in separate exam rooms that can be decontaminated after a visit. Finally, the study makes a case for continued support for telehealth coverage at a rate equal to in-person care. “Lawmakers in Congress are actively debating the future of telemedicine policy and how it should be reimbursed after the worst of the COVID-19 pandemic recedes,” the study notes. “It is possible that telemedicine reimbursement after the pandemic will be restricted to certain specialties or diagnoses or reimbursed at a rate low enough that many clinicians decide to forgo telemedicine as a mechanism for care delivery. Our results argue that clinically, for infection control, telemedicine should remain a financially viable option for clinicians to provide care for viral respiratory symptoms. < Previous News Next News >

NCQA Report: 3 Strategies to Close Telehealth Access Gaps Mark Melchionna May 16, 2022 The National Committee for Quality Assurance released a telehealth report that highlighted care disparities and strategies for improvement. May 16, 2022 - Prioritizing individual preferences and patient needs, breaking down regulatory barriers, and leveraging technology in an equitable manner can go a long way toward addressing the growing disparities in telehealth use, according to a white paper released by the National Committee for Quality Assurance (NCQA). The white paper, titled The Future of Telehealth Roundtable, discusses ways to close gaps in telehealth use and access. The NCQA is a nonprofit organization that focuses on improving the quality of care and certifying various healthcare groups. Dig Deeper Pressure on Congress to Solidify Telehealth Access Builds GOP, Independent Senators Co-Sponsor Medicare Telehealth Access Bill Lawmakers Ask Congress to Create a Rural Telehealth Access Task Force As virtual care grows amid the COVID-19 pandemic, The Future of Telehealth Roundtable highlighted various areas that could be enhanced. The white paper derives from an October 2021 conference consisting of telehealth and technology experts from several prominent healthcare organizations, including MedStar Health. The experts noted that despite the expected benefits associated with telehealth, such as convenience and lower costs, disparities still exist within specific communities. According to the white paper, three strategies could help close care gaps as telehealth is further implemented. The first is creating telehealth services that cater to personal patient preferences and needs, as some individuals may face struggles due to their primary language and socioeconomic status. The second is addressing regulatory barriers to access and changing regulations to allow expanded clinician eligibility for licensure. The final strategy is ensuring that digital technology can be leveraged efficiently. For example, considering patient access levels to technology is critical because it determines how patients can be reached and how to best care for them. “Even prior to the pandemic, a change in healthcare delivery was on the horizon with ever-evolving advancements in technology,” said NCQA President Margaret E. O’Kane, in an accompanying press release. “As virtually based care expands, unique patient needs and preferences must be identified and prioritized so that telehealth can help us close the gaps in healthcare and not widen existing disparities.” The Future of Telehealth Roundtable also emphasized the continuing popularity of telehealth and that it will hold a place in the new normal. But as the implementation process continues with new technology, avoiding the digital divide is necessary to eliminate disparities. Throughout the COVID-19 pandemic, various studies have emphasized pinpointing the potential barriers to telehealth access. One study published in February revealed that Black patients with cardiovascular disease (CVD) prefer recording and sharing blood pressure (BP) via a text-based program rather than an online patient portal. This is likely because the patient portal has higher technical requirements than text-based communication. Further, research published last November shows that patients with limited English proficiency were less likely to use video when accessing virtual services during the pandemic than adults who could speak English comfortably. For full article: https://mhealthintelligence.com/news/ncqa-report-3-strategies-to-close-telehealth-access-gaps < Previous News Next News >

TELEHEALTH: THE JOURNEY FROM VIDEO VISITS TO STRATEGIC BUSINESS TOOL By Mandy Roth at HealthLeaders April 6, 2021 New approaches to telehealth can help organizations meet their key objectives. KEY TAKEAWAYS: *Asynchronous communication increases provider efficiency and provides a way to address physician shortages. *Virtual hospitals reduce healthcare costs and support the transition to value-based care. *A cloud-based platform enables 24/7 personalized care, moving care upstream to improve outcomes and reduce the cost of care. 2020 was a remarkable year for healthcare innovation, and telehealth finally achieved scale across the industry. Driven by a need to deliver healthcare at a distance, hospitals and health systems stood up new services seemingly overnight, fanned the flames under languishing programs, or found new uses for thriving virtual care initiatives. Now that telehealth has become a fixture in the healthcare delivery firmament, it's time to examine what comes next. While current use predominantly focuses on televisits between providers and patients, and mysteries remain about reimbursement and licensure issues after COVID-19, forward-thinking healthcare executives are using the technology to enable new models of care. Health systems are employing telehealth to transform healthcare delivery in ways that address strategic business objectives: improve outcomes, reduce provider burden, enhance patient experience, improve access, and ameliorate workforce labor issues. HealthLeaders spoke to visionary leaders and digital healthcare experts who shared their insights and perspectives about what organizations should focus on now, next, and in the future to unlock the potential of telehealth. Coverage includes case studies about asynchronous care, remote monitoring, and a futuristic cloud-based platform fueled by artificial intelligence. Health systems shared details about how these initiatives work and how they evaluated the return on investment. These new approaches to telehealth can help organizations meet their strategic objectives and provide information to inspire other organizations on their own telehealth journeys. WHAT'S NOW: PRESBYTERIAN HEALTHCARE SERVICES ENHANCES EFFICIENCY WITH ASYNCHRONOUS COMMUNICATION Strategic Objectives: *Increase provider efficiency and address physician shortages *Reduce costs per patient encounter *Reduce ER and urgent care utilization At the beginning of 2020, physicians and consumers had not yet fully embraced the concept of virtual video visits; many were skeptical about the ability to deliver care effectively in this manner. Yet after the pandemic forced the adoption of virtual visits, their reputation and usage forever changed. Today, asynchronous communication faces the same hurdles. Providers and patients don't understand how it works and question its value. "It's a technology whose time has not yet come," says Oliver Lignell, vice president of virtual health at health system consultancy AVIA, which helps members accelerate their digital transformation initiatives. "It's not yet mainstream, but it should be." Presbyterian Healthcare Services, an Albuquerque, New Mexico–based nonprofit integrated healthcare delivery system, began investigating this approach to healthcare four years ago. "It's been incredibly effective," says Ries Robinson, MD, senior vice president and chief innovation officer. Between the system's nine hospitals and a health plan it offers, the organization serves a third of the state's residents. With a shortage of practitioners in New Mexico, and 70% of the care it provides covered by capitated contracts, Presbyterian needed to find a way to operate more efficiently. Asynchronous communication worked. Last year, a designated group of employed urgent care physicians handled 50,000 asynchronous visits for low-acuity care, and spent an average of two minutes on each encounter—far less than the 15–18 minutes it takes to conduct a typical video call. This form of care does not occur in real time. Depending on the platform used, a patient completes and submits an online form via secure email, text, or an app, detailing his or her complaint and relevant history. A physician receives the information, processes it, and sends a response back to the patient with instructions and prescriptions, if necessary. Presbyterian physicians usually respond within 15 minutes; some health systems using asynchronous communication allow up to 24 hours. There is no direct audio or video exchange with the patient unless the physician thinks it is warranted and escalates the encounter. Asynchronous communication offers some distinct advantages to health systems, say the experts. Synchronous care, which includes video, audio, and in-person visits, comes with an Achilles' heel: Regardless of venue, the physician spends about the same amount of one-to-one time with the patient, says digital medicine expert Ashish Atreja, MD, MPH, chief information and digital health officer at UC Davis Health in Sacramento, California. "The real growth you're going to see in value," he says, "is the ability to deliver one-to-many care." Asynchronous communication is a step in that direction. "One of the most important things asynchronous communication does is help scale response," says Ann Mond Johnson, MBA, MHA, CEO of the American Telemedicine Association. In addition, because patients can use it with a phone or the internet, it can address issues of access, she says. Robinson says the SmartExam™ platform Presbyterian is using, made by Bright.md, includes features that appeal to its physicians. It automatically enters chart-ready SOAP (Subjective, Objective, Assessment, and Plan) notes into the electronic medical record (EMR), creates billing files, and manages patient follow-up communications. "It's extremely elegant," says Robinson. SmartExam's design, which asks patients questions in an interview-style exchange, and advanced logic has earned the trust of the physicians who use it, he says. "I remember the first time [physicians] said, 'I trust it'; I thought that was kind of a funny term to use," Robinson recalls. When he asked the doctors what they meant, they explained that the tool is thorough and consistent in a way humans cannot replicate. "That's what the providers really like." Even the best medical assistant, he says, may vary in how they ask questions of patients, forget to include certain details, or package assessments differently. While Robinson says the health system has detailed financial models that justify the cost of the platform, he declines to disclose the figures, but notes, "It hasn't been an astronomical investment by any stretch of the imagination." Expenses include a one-time cost for EMR integration, ongoing charges for using the platform on a per-patient per-use basis, and marketing and promotion. He also provides formulas to calculate estimated cost savings. They include: *Better utilization of providers' time and related staffing expenses, by reducing each of 50,000 encounters from 15–18 minutes for a video encounter to two minutes for an asynchronous visit. *More appropriate ER usage. Out of 50,000 patients, 8% were redirected away from the ER. This figure is based on patient survey responses indicating they would have visited the ER had the platform not been available. With an average ER visit costing more than $500, says Robinson, "there's a significant savings." *Reduced workload at urgent care facilities. "Just assume 20,000 [of these patients] would have gone to an urgent care that we own," he says. The time and expense of urgent care staffing is used to calculate the savings. Patients also save money, says AVIA's Lignell. Nationally, he says the typical cost for an asynchronous visit is about $20, and many health systems offer these visits for free. This compares to a national average cost of $50 for a video visit and $125 for an in-person visit. There is one additional element that has contributed to the success of asynchronous visits for Presbyterian: a digital front door. Patients visit the pres.today webpage, enter their condition and insurance information, and are automatically directed to the appropriate level of care, one of which includes the option for online visits (using asynchronous care). Because of the asynchronous initiative's success, the health system is expanding its use beyond low-acuity care. Future plans involve developing new uses for the platform, capturing symptoms and history to create greater efficiencies for video visits and even in-person care. "We have gotten religion around the idea of capturing as much information as you can in a sophisticated manner before the visit," says Robinson. "You maximize the quality of care and the efficiency of the visit. We're taking that idea and pushing it forward in multiple avenues of care here at Presbyterian." Value-based care will drive further adoption of these models, says Lignell. "The advantages from a total cost of care standpoint are huge," he says. "It's much less expensive to deliver care this way." While the bulk of growth has been in low-acuity primary care, he says asynchronous care is now being explored in specialty and higher-acuity care, as well as in e-consults between providers. "The asynchronous model is proving to be incredibly efficient for health systems," says Lignell. "That's one of the reasons why it has so much promise." WHAT'S NEXT: ATRIUM HEALTH LAUNCHES A VIRTUAL HOSPITAL Strategic Objectives: *Increase bed capacity, limit staff and patient exposure to COVID-19, and conserve PPE *Reduce costs and support the transition to value-based care *Improve patient satisfaction and experience "Remote patient management is widening the aperture from the episodic-based healthcare reality that we've known for decades towards a 24/7, always-on ubiquitous reality," says Rasu Shrestha, MD, MBA, executive vice president and chief strategy and transformation officer at Atrium Health. Long before COVID-19 hit American shores, health systems began launching remote monitoring programs, particularly to manage chronic diseases. Hospital at home initiatives, or virtual hospitals, are a robust manifestation of this endeavor. While these models have demonstrated cost savings, adoption has been slow due to reimbursement issues. The pandemic offered a trifecta of motivating factors to accelerate adoption of the virtual hospital model: bed capacity issues, a need to limit staff and patient exposure, and dwindling supplies of personal protective equipment (PPE). With these issues in mind, during March 2020 a handful of clinicians approached Atrium Health administrators, suggesting that the 42-hospital Charlotte, North Carolina–based nonprofit health system consider launching a hospital at home initiative. Two weeks later it was operational, says Scott Rissmiller, MD, executive vice president and chief physician executive. In the first 10 months, the virtual hospital admitted 51,000 patients. "We are able to keep patients in their homes, protect our teammates from infection, and also protect patients," Rissmiller says. "It freed up a good bit of capacity in our acute facility," enabling the health system to reserve that space for its more acute COVID-19 patients. The virtual hospital maintains two "floors." The first floor functions as an observation unit; the second floor is reserved for patients requiring more intensive care, says Rissmiller. Any COVID-19-positive patient is admitted to the first floor of the virtual hospital and receives digital tools to monitor temperature, blood pressure, pulse, and oxygen levels. These devices deliver data via Bluetooth® to a smartphone app developed by the health system's IT department. That data feeds into the patient's EMR, fully integrating into the patient's continuum of care, Rissmiller explains. In a bunker back at Atrium Health's call center, a team of clinicians monitors data and checks in with first-floor patients daily. Second-floor virtual patients have the same home monitoring tools, but receive "much more intensive management" and frequent check-ins, he says. In addition, community-based paramedics visit homes to administer IV fluids, IV antibiotics, breathing treatments, EKGs, and other interventions. This arrangement created additional opportunities to reduce hospital bed capacity. "We were one of the first in the nation to get in-home remdesivir, one of the COVID treatments," says Rissmiller. "To receive remdesivir, you have to be on oxygen therapy, so these patients are sick." In a 10-month period, Atrium Health administered about 150 therapeutic rounds of the drug, he says, which saved about 500 hospital days that would have been required if those patients had been hospitalized. "From a quality standpoint, we do not view this any differently than if these patients were within the walls of our hospital," says Rissmiller. All measures, including length of stay as well as readmission, transfer, and mortality rates, have been almost identical to inpatient stats, and patient satisfaction has been "extremely high," he says. "Patients really would rather be in their home surrounded by their loved ones and support system." The hospital at home initiative has been a "costly endeavor," says Rissmiller. "When we realized this pandemic was going to be significant, our CEO [and President Eugene Woods, MBA, MHA, FACHE] called me and said, 'Scott, whatever you need to care for our patients and communities—do it. We'll figure out the costs later.' It freed us up to be able to do things like this." As it turned out, costs have been offset by funds from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which enable Atrium Health to bill for many of the services provided. The organization also is one of a handful of healthcare systems that are doing a pilot with the Centers for Medicare & Medicaid Services, which views virtual beds as real hospital beds. "The reimbursement is similar because of the level of service we're providing," says Rissmiller. Initially, though, "it was all upfront costs for us, but the return was in bed days." A focus on reimbursement continues "as we are now maturing the program," he says. "Our concern is that the reimbursement will go away once those [pandemic] emergency orders expire. We're working with the state, our payers, Medicare, and others to make sure that this continues to be reimbursed at a level that allows us to continue to grow it and cover our costs." "Out of necessity, COVID ultimately accelerated health systems' desire to think through their digital strategies and determine how digital fits into their overall care and business models," says Brian Kalis, MBA, managing director of digital health and innovation in consulting firm Accenture's health practice. "New models are starting to pop up, and care is shifting to the home." Strategic goals include producing outcomes that equal or exceed inpatient care, while also improving labor productivity, Kalis says. "A majority of health systems coming out of COVID are putting care at home as a key strategic focus. That requires a collection of new models to deliver care, putting different care team compositions in place, and [utilizing] technology to help a broad range of conditions for pre-acute, acute, and post-acute care." Atrium's virtual hospital has already expanded beyond COVID-19 patients. Once the surge diminished in July, Rissmiller "challenged the team to look at [the initiative] through the lens of a non-COVID world. Can this become a new way of caring for patients that makes sense to the patient and to us as a healthcare system?" There is now a list of 10 diagnoses to be considered for hospital at home care, and congestive heart failure patients have already been admitted into the virtual facility. "We're starting to branch out," he says. "We're also starting to focus on different communities to make sure that we're doing this in a way that helps with our underserved populations and gives them the resources they need to manage care at home rather than coming through the emergency department." While Atrium Health rolled out its program in two weeks, Rissmiller says, "this is something that would be incredibly hard to start up on your own if you hadn't had the 10 years of virtual experience that we've had building these capabilities, but also the confidence to be able to deliver these kinds of services at home. It takes a while for clinicians to understand that care can be delivered safely virtually. We also have a culture at Atrium Health that really enables our clinical leaders to lead and their voices to be heard. That, more than anything, is the secret sauce that's allowed for innovations like hospital at home." WHAT'S IN THE FUTURE: HIGHMARK HEALTH DEVELOPS PLATFORM TO DRIVE 24/7 CARE Strategic Objectives: *Move care upstream to improve outcomes *Reduce cost of care, patient traffic, and volume *Enable 24/7 personalized care Unleashing the potential of virtual care requires strategic innovation fueled by imagination. Highmark Health is one organization traveling along this path. To understand the power of an initiative now underway at the Pittsburgh-based payer-provider system, one must imagine the potential to do something that is currently not possible. For example, take the hypothetical case of an individual living independently at home with six medical conditions. What if real-time data alerts her care team that her health status has subtly changed? What if this alert takes the complexity of her medical history into account and offers decision-support tools to accelerate clinical action before her health deteriorates? The Living Health Model, fueled by the Living Health Dynamic Platform—a Google Cloud–based technology infused with artificial intelligence and advanced analytics—could be the missing link that will enable care to move upstream. The concept revolutionizes the current perception of telehealth and enables 24/7 care. It aims to connect the provider, patient, and payer in novel ways to improve health outcomes, reduce clinician administrative burdens, enhance patient engagement, and reduce costs, says Karen Hanlon, executive vice president and chief operating officer at Highmark Health. "We believe that we have the capabilities and resources to pull it together," says Tony Farah, MD, FACC, FSCAI, Highmark Health's executive vice president and chief medical and clinical transformation officer, who is also a practicing cardiologist. The platform will amplify the impact of remote monitoring tools, which many health systems already use for chronic disease management. By adding sophisticated data analytics, machine learning, decision support, and patient education tools, the system will support comprehensive care rather than managing diseases in silos, Farah says. "Our partnership with Google Cloud is going to not only accelerate our strategy, but also help us scale it." Data will be constantly mined to determine the "next best action" required to proactively care for a patient and formulate a personalized care plan that delivers a "curated" experience based on the patient's personal needs, says Hanlon. For patients with no apparent health conditions, the system may focus on wellness. While full realization of this concept may be years down the road, Hanlon says the first iteration of the platform will be functional at the end of 2021. Accenture cloud expert Geoff Schmidt, managing director, global lead—life sciences technology, says Highmark Health's plans align with what he's seeing in the life sciences sector. Health leaders should not think of the cloud as a capability or an IT initiative, he says; "think of it as a business transformation enabler." Cloud technology is accelerating companies' three- to five-year strategic plans, compressing those timelines down to 12 to 18 months. "We're seeing dramatic transformations and acceleration of CEO agendas because of the capability that the cloud can provide." Partnering with an outside player is a smart move for health systems that want to expedite their transformation initiatives, says Schmidt. "Major technology partners are innovating at a scale that is, just frankly, hard for payers or providers to keep up with." Prior to its partnership with Google Cloud, Highmark Health piloted "analog" proofs of concept, according to Farah. These pilots involved addressing healthcare for several patient populations, including high-risk patients with multiple comorbidities as well as individual chronic conditions like COPD, heart failure, diabetes, and hypertension. Physicians were asked to improve health outcomes in 12 months. "The patient experience went through the roof, and in almost every case—with the exception of diabetes—the total cost of care came down," says Farah. "I would say physician engagement was our secret sauce." "Consumer engagement is also a key component," says Hanlon. "There are a lot of solutions out there. They're very siloed and they're not integrated. We can have the best solutions in the world, but if the consumer and the clinician are not using them, they will have no impact." While Highmark Health does not disclose the company's investment in this platform, "you can guess that it is a fair amount," says Hanlon. In addition to activating the initiative at Allegheny Health Network, a nonprofit health system that Highmark owns and operates, "at the same time we're a health plan serving 5.6 million members," she says. "The ability to interact with all of those members is incredibly important to us. When you look across our book of business, we're probably managing somewhere in the neighborhood of $26 billion in healthcare costs a year. When we look at the investments that are needed to support that base of membership and that level of healthcare spend, we feel it's appropriate and we can justify the investment." Being both a payer and a provider imbues Highmark Health with the motivation and influence to transform healthcare delivery in this way, Hanlon says. The company is a Blue Cross Blue Shield–affiliated payer operating in three states, and also functions as a provider through the Allegheny Health Network. "By having both of those assets in the portfolio," says Hanlon, "it's easier for us to align on the path forward and the economic model." But to characterize this venture merely as a mechanism to save money misses the point, she says. The model is designed to improve patient outcomes by moving care upstream, explains Farah. "Conditions that exist today will be prevented from deteriorating, and conditions that haven't developed will be prevented—or, at a minimum, be delayed in development. That's the primary goal, and it results in a reduction in total cost of care. It flips the equation from focusing on finances to focusing on health." In addition, for the Living Health Model to be effective, it must work with entities outside of the facilities owned by the Highmark Health system, which provides health plans in Pennsylvania, Delaware, and West Virginia. Allegheny Health Network operates facilities in 29 Pennsylvania counties and portions of New York, Ohio, and West Virginia. "We're looking to have impact across all of the markets that we serve as our insurance company, not just where we own a provider asset," says Hanlon. "The progression of value-based care has been a slow march. I think this platform will be a tool to enable providers to continue down that path. Part of our focus is developing other tools we believe will be necessary for the providers to succeed in a value-based environment. We recognize that we're going to have to be a leader in helping others to move down that path." A FRAMEWORK FOR MOVING FORWARD Planning for the future of telehealth requires rethinking the present. "If the only way that you look at telehealth is as a way to replace one-to-one physical visits with a telehealth visit, you're not changing the world; you're just creating a little bit more convenience," says Roy Schoenberg, MD, MPH, president and CEO of Amwell, a Boston-based technology company that provides telehealth technology to health systems. "If you look at telehealth as a product, you're going to end up behind the competitive landscape curve. If you look at telehealth as an operating system, [it becomes a] mechanism for the digital distribution of care." Transforming the way healthcare is delivered requires changing, from the ground up, the way health systems think about their relationships with patients, Schoenberg says. Telehealth can alter dynamics related to patient traffic and volume, patient flow, transitions of care, and assumption of risk. "When you equip yourself with telehealth capabilities," Schoenberg says, "you should ask yourself, 'Does the system that I buy allow me to create new applications for telehealth that the vendor didn't think about?' [You] should imagine plans for patients that incorporate and take advantage of telehealth. The result of that is a completely different beast." This article appears in the March/April 2021 edition of HealthLeaders magazine. - https://www.healthleadersmedia.com/telehealth/telehealth-journey-video-visits-strategic-business-tool < Previous News Next News >

UCHealth slashes code blues up to 70% with telehealth technologies Bill Siwicki December 20, 2022 The academic medical center uses tele-sitter and virtual ICU platforms for a program it calls Virtual Deterioration. UCHealth is a non-profit healthcare organization based in Colorado made up of 12 hospitals across the state. THE PROBLEM The organization had a new use case for virtual care, a program called Virtual Deterioration. Essentially, it was trying to find patients who were deteriorating in the hospital sooner in order to provide rescue and treatment faster to give them the best outcome. "What we were seeing prior to this program was a lot of variability as we tried to detect deterioration, and then once we were detecting it, reaching out to the bedside caregivers as to what happened next," said Dr. Diana Breyer, chief medical officer of the Northern Region at UCHealth. "And so, this was very much a part of our plan to decrease that variability for patients that were staying in place for us to be able to monitor them consistently with more frequent vital signs to make sure we really had rescued them and utilized technology to keep an extra set of eyes on them," she added. PROPOSAL UCHealth already had implemented vendor AvaSure's TeleSitter platform for patient safety and the vendor's Verify for virtual ICU. It expanded use of these technologies to Virtual Deterioration. Prior to implementing the technology, the process for virtual deterioration involved staff in a remote clinical command center working in tandem with frontline staff. "And we did try a process before we employed the technology, where it was a lot of secure chat through our EHR, similar to texting, in addition to a lot of phone calls and not really being able to visualize our patients," said Amy Hassell, RN, senior director for the Virtual Health Center at UCHealth. "This approach created a lot of friction and interruption to the bedside staff who were trying to do hands-on tasks with the patient," she continued. "So we decided to bring in an audio-visual connection. We have mobile carts, and some of our hospitals have cameras in the ceiling so we can just turn on that camera when a deterioration event is occurring." With the camera in the room, physicians and nurses in the command center now can see and interact with the patient as well as the care team. "They're able to see what's occurring so that it's just like we're in the room with that care team member," Hassell explained. "When we do this, it helps us cut down on phone calls and interruptions at the bedside, allowing us to still participate and do our part of the program. "The program provides support and makes sure milestones of care are being met throughout that deterioration event, and help triage if needed," she continued. Because it's a clinical command center that operates a lot of equipment and different platforms, staff have a weekly operational meeting with the IT team that supports the area. "They were part of our planning phases; further, we did our own IT technical dress rehearsals ahead of implementation with the clinical folks each time we went live," Hassell explained. "IT is in lockstep with us and have been very helpful to getting this deployed by helping support us, navigate us through the bumps, as we push the envelope. They're great partners to us and have been since the very beginning." MARKETPLACE There are many vendors of telemedicine technology and services on the health IT market today. Healthcare IT News published a special report highlighting many of these vendors with detailed descriptions of their products. Click here to read the special report. MEETING THE CHALLENGE Today, the Virtual Deterioration technology is a separate platform. There's going to be context-aware linking soon, and that will help because then staff can go right in from the patient's chart through that portal. Clinicians at the bedside use this technology. Nursing staff and physician staff are the ones pulling the monitoring equipment into the room and using it at the bedside. On the reciprocal end, it's the remote clinical command staff who are accessing that camera to participate with the team and interact with them. UCHealth is in the midst of developing a new role called the "patient technology technician." "The patient technology technician is a staff member who brings the mobile device into the room so that nurses and physicians don't have to be responsible for setting it up, and they can remain focused on the patient," Hassell said. "That's been successful. We're really trying to get all of our folks operating at the top of their license. "This role will be very helpful as we continue to scale it, so the nursing staff aren't the ones having to bring monitoring equipment to that rapid response," she added. RESULTS When UCHealth started looking at this project, it looked for deterioration in particular, such as what are the metrics being sought. One of them that is well-established in the literature is around decreasing code events in the acute care setting, Breyer noted. "Those patients ideally are brought to the ICU and if they're going to code, code there, or if they're rescued," she said. "So we have seen improvement throughout the work that we've been doing around deterioration in this space both in the northern and southern region of UCHealth where we've implemented the solution. "And that's probably our biggest metric that we're able to measure," she continued. "I'll add that in the space of deterioration, it is sometimes difficult to measure what you're doing because you're trying to show that you're now doing something that you were previously not doing. And measuring that omission can be a challenge." The other thing staff are measuring as a process metric is for those patients who stay in place and are not being moved to a higher level of care at the time of their rapid response event. "We are measuring a consistent post-RRT intervention that we previously did not have," Breyer said. "That's another area that we're monitoring. Ultimately, we would like to see this improve mortality, but that's more of a lagging indicator, and that one is a little more variable in the literature as to how much they affect these deterioration events." Hassell stresses the organization is going to have to continue to trend this and the lagging indicator of mortality within the patient population being touched. "But we have early data where we've seen our rapid response rates increase anywhere from 26% up to about an 86% increase, depending on what location you're looking at as we've done this across our system," she reported. "And then, in early data again, we've seen our code blue events in our acute care areas go down by 25% to 70%. "We've seen our code blue events drop, which helps us know we're going in the right direction, we're detecting deterioration earlier, thus reducing a bad outcome from a code blue," she continued. To Breyer's point, UCHealth has seen the post-monitoring period, because it's leaving that camera in place for six hours and virtual staff are helping oversee and watch that patient in conjunction with the frontline staff who are very busy. "And so we've seen an increase in post-rapid response vitals anywhere from a 39% increase up to 152% increase of vitals being ordered, and then working on getting them completed," Hassell explained. "It's been a large range that we've seen, but a lot of intentionality because resources are tied up in that rapid response call. "Once the patient is stabilized, and they're staying on the floor, the nurses then go see other patients that they've not seen for a while," she continued. "And so we've got to make sure that we're taking time to watch over the patient in that kind of fragile window when they still could continue to deteriorate and need a higher level of care. That's where we put a lot of focus and energy, and those are some of our early metrics." ADVICE FOR OTHERS The piece Hassell likes about the technology currently in use is that staff have been able to flex it for a different use case that's been highly valuable. "We're still working on making it an improved platform with the company, but I also think that it's been instrumental and opened up pathways for us that we wouldn't have previously had," she noted. "We weren't seeing the success that we're seeing now until we introduced the camera piece because it solved those issues we mentioned. "And so if you are considering any sort of hybrid approach from, for example, a clinical command center or nursing workflows, you want to have a great platform that you feel your staff can use and interact with seamlessly and with ease," she advised. From a technology standpoint, having it be easy and seamless for the bedside team is key, Breyer said. "While there are now great technology solutions to some of these problems, the heavy lift is the change management with your bedside team, the non-technology piece," she concluded. "And so that's where a lot of the energy for a successful project must be." Follow Bill's HIT coverage on LinkedIn: Bill Siwicki Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/uchealth-slashes-code-blues-70-telehealth-technologies?utm_source=twitter&utm_medium=social&utm_campaign=womeninhit < Previous News Next News >

The challenges of telemental health, and how they can be overcome Bill Siwicki June 14, 2022 Mental healthcare may be among the more intuitive specialties to deliver via telemedicine – but privacy demands, technology difficulties and the need for safe places deter some from taking advantage. Of all the medical specialties impacted by telemedicine during the course of the pandemic, perhaps the one with the most wholesale and lasting effects is behavioral and mental health. Mental health appointments do not typically involve any collection of vitals or specimens, nor do they absolutely require a face-to-face meeting, although therapists can observe physical cues from the whole body in person. Just talking via video, or even just audio, is enough. We talked with Dr. Janice Johnston, chief medical officer and cofounder of Redirect Health, a telehealth technology and services company, to get her expert observations regarding: The biggest ways telehealth is changing America's treatment of mental health. What impact increased telehealth accessibility has had on mental health treatment. The challenges telehealth presents in treating mental health. The improvements that can be made to telehealth for the treatment of mental health. Q. What are the biggest ways telehealth is changing the U.S.'s treatment of mental health issues? A. Before COVID-19 and historically in the U.S., there has been a negative stigma around receiving mental healthcare. While there have been a lot of movements and campaigns attempting to try and stamp out the stigma, many people have been deterred from seeking professional help due to a lack of coverage in healthcare plans, high copays and fear. As telehealth widens, the availability of mental health services continues to grow and is more accessible than ever. Gone are the days of driving to appointments and sitting in a waiting room, with the feeling that all eyes are on you. Social networks also have created a platform for mental health activists and we are seeing, in real time, an increase in people looking for treatment or routine mental care. COVID-19 accelerated the need for more access and new ways of treating mental health, such as telehealth. As a result of the COVID-19 pandemic, we also have seen many major insurance companies offer permanent or temporary plan benefits that include mental health services. Telehealth has made it easier for insurers to include these benefits in their plans with less out-of-pocket costs for patients. In many cases, insurance providers even waived the entire cost for visits when using telehealth. While most people don't want to be thought of or treated differently because they choose to seek mental health treatment, the stigma around it can make them feel judged, and they avoid choosing care. Telehealth has made it possible for people to now access care from the privacy of their homes, making the decision to seek care much easier and more comfortable. Being able to speak with a mental health professional from home has provided patients the ability to choose a setting that provides the most comfort, making the process of opening up and sharing concerns with a new person much easier. Q. What impact has increased telehealth accessibility had on mental health treatment in the U.S.? A. The COVID-19 pandemic forced changes for Americans across the country that have affected mental wellbeing, such as working from home, quarantine enforcements, lack of spending time with friends and family, and feeling isolated. This led to a surge in mental health issues with most non-emergency medical treatments shut down due to safety concerns and quarantine enforcements. Telehealth was a necessity we didn't see coming, and the pandemic accelerated this service due to the timely needs that were arising. With the higher demand for mental healthcare, telehealth has been the answer for many. People living in rural communities or underserved areas, specifically, experience limited access to specialty healthcare services, especially mental health. One of the key impacts of increased telehealth accessibility is that these communities have been able to turn to telehealth as an option when they may not have had an alternative. Different from rural or underserved communities, many urban populations see that finding in-person care isn't the difficult part, but affording it and getting to their appointment can be. Another key impact of increased accessibility is that telehealth tends to be a much more cost-effective option, as in-person care can regularly be more than double the cost. Think of all the money and time wasted having to take off work, which can result in lost wages, needing to hire a babysitter, or paying for gas when commuting to and from appointments. With telehealth, patients are able to afford their scheduled appointment at a time that is convenient and works for them. Additionally, while most offices provide services in standard office hours, many telemental health services provide care before and after work hours as well, so patients have more scheduling flexibility. There also are a lot of cultural barriers and health inequities that many minority communities experience that may deter them from seeking mental healthcare. During the pandemic, these communities experienced a rise in telemental health usage. While there are several reasons why this rise has occurred, we have seen that telehealth has been able to combat some of the barriers these groups have had to overcome. For one, telehealth affordability has made services much more accessible to minority groups or lower income individuals, enabling them to include mental healthcare into their budgets. Additionally, minority groups have experienced higher rates of depression and anxiety, only exacerbated by the pandemic, so the demand from these communities, along with the decrease in negative stigma around mental care through telehealth, has driven them to these options. Lastly, telehealth allows those with language barriers in the U.S. to have access to a broader group of mental health professionals who can provide a better understanding of their cultural backgrounds, partnered with the ability to speak in their preferred language. Q. What are some of the challenges telehealth presents in treating mental health issues, and instances when in-person care must be sought? A. While telehealth has expanded access to mental healthcare for so many across the country, there are still limitations that may lead some to favor in-person care. First, privacy. While many patients prefer telehealth so they can have their appointment in the privacy of their homes, there are situations where people may not have that same privacy in their home. Some people may live in multi-generational homes where others are home and in earshot, or they could share a room with others with privacy not immediately available. This may leave patients taking their calls from their car, which is not always comfortable or preferred. As a result, people in these settings may prefer care in person. Second, safe places. While some people prefer their care virtual for a variety of reasons, others feel that virtual mental healthcare is cold and distant, and favor in-person care in order to feel more engaged with their mental health provider. Sometimes being removed from their normal home setting can help create a safe place for the patient to discuss their mental health concerns. This is especially a factor with live support groups, which can be more engaging and easier in person than virtually. Many times, live support groups are used for people looking to overcoming addictions, and being able to separate them from their traditional setting can be helpful for pulling them out of their environment, even momentarily. And third, technology. Some individuals may not understand the technology behind apps or websites that provide mental health services. They may not know how to access video links or use their phone to connect to a provider, which could result in a sub-par session, where they do not feel comfortable or at ease. Patients also do not want to see time consumed or wasted during their appointment because of technical struggles and may prefer to see their providers in person to avoid the hassle of these situations. Q. What improvements can be made to telehealth specifically for the treatment of mental health issues? A. We can look to the current challenges of the telehealth space to find where to start with improving the telehealth experience for everyone. For starters, creating wider access to the internet allows telehealth to reach more people who may not have any options available to them today. In fact, the Biden administration recently secured commitments from 20 leading internet service providers to either reduce prices or increase speeds to serve low-income households. This is a great step in the right direction. Better cellular and internet speeds allow for more telemental health experiences to be held over video, and not telephonically, where mental health professionals can better assess their patient through both verbal and nonverbal cues. With all the advancements and changes we have seen in technology in just the last few decades, there is a lot for patients and providers to keep up with. Education is key to making sure telehealth sticks around and continues to rise in its availability. Many providers are willing to learn new technology, but need to be trained by the people that thoroughly understand the ins and outs of these systems. As new standards of care are set by technological advancements, providers and patients alike need to be provided the education to keep up with these evolving standards. It is important for those implementing new systems to deliver the proper education providers need to learn the technology, as well as assist their patients. Another thing to consider is how to assist patients with disabilities through telehealth. There are laws in place in the U.S. to ensure equality in care for those with and without disabilities, and therefore considerations need to be made in telehealth situations as well, such as providing additional instructions or scheduling longer appointment times. Sometimes added support or modifications need to be made to technology systems in order to support these patients as well. Telehealth systems should meet accessibility requirements and should provide resources that are available in multiple formats, like audio recordings or large text sizes. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. For more information: https://www.healthcareitnews.com/news/challenges-telemental-health-and-how-they-can-be-improved < Previous News Next News >

Suicide Prevention and Stigma Reduction with Dr. Alison Arnold Dr. Alison Arnold November 18, 2022 Danielle speaks with Dr. Alison Arnold, the Director Interdisciplinary Center for Community Health & Wellness at Central Michigan University (CMU). In this episode we discuss CMU's Preventing Suicide in Michigan Men (PRiSMM) program and how we utilize telehealth to address mental health disparities and increase access to care. See original article with audio: https://www.umtrc.org/podcasts/season-2-episode-19/ < Previous News Next News >

The Centers for Medicare and Medicaid Services (CMS) released its final CY 2022 Physician Fee Schedule (PFS) policies for Medicare last week. Centers for Medicare and Medicaid Services Nov. 10, 2021 CY 2022 Physician Fee Schedule (PFS) policies for Medicare The Centers for Medicare and Medicaid Services (CMS) released its final CY 2022 Physician Fee Schedule (PFS) policies for Medicare last week. Unless otherwise noted, the policies will take effect on January 1, 2022. Much of the proposals published in July 2021 for public commentary remain intact, but CMS did make several modifications and clarifications. https://public-inspection.federalregister.gov/2021-23972.pdf < Previous News Next News >

Patients prefer telehealth for common illnesses, study shows Bill Siwicki November 23, 2022 But more than half are concerned about the quality of care they're receiving, according to the Software Advice survey. One of the firm's analysts dives into the results. Telemedicine has, at long last, become very popular. But lingering concerns remain on its effectiveness for certain diagnoses and treatments. Software Advice's 2022 State of Telemedicine Survey finds that while a majority of people prefer virtual appointments for common illnesses, more than half of patients still are concerned about the quality of care they're receiving. Software Advice, a Gartner company, polled more than 1,000 patients on telemedicine usage after the worst of the pandemic – regarding whether they intend to keep using it and improvements that can be made. We interviewed Lisa Hedges, associate principal analyst at Software Advice, to discuss the findings of the study and talk about the future of telemedicine. Q. What is the overarching message healthcare CIOs and other health IT leaders should take from your study? A. That failure to invest in telemedicine is downright foolish at this point. It's been around for a long time and fully took off during the pandemic. It isn't going anywhere now that so many patients have experienced the convenience it offers. This also means if you are one of the healthcare organizations that adopted telehealth during the pandemic and plan to eliminate those tools in the near future, you're making a mistake. The bottom line here is that telemedicine is a valuable tool for patients, and providers who offer remote care services for certain conditions and symptoms are going to have the edge over providers who don't. Q. About 86% of patients rate their telemedicine experience as positive; 91% are more likely to choose a provider that offers telemedicine. Why do you think this is, and what does it mean for healthcare provider organizations? A. Convenience and ease of use are top reasons patients like telemedicine, and that certainly makes sense when you consider the time it saves. Patients don't have to drive to a physical office, find parking, spend time in a waiting room (where they may be exposed to other contagions), and then drive back home once the appointment is over. All of that is hassle enough even without considering the fact that most people going to see doctors don't feel great, so their baseline before doing any of that is discomfort. What this means for providers is they're looking at a great opportunity. We're all well aware of the current shortage of qualified healthcare workers, and we know that the working conditions for healthcare staff have been particularly brutal during the pandemic. With so many employees quitting, it's left a lot of extra work behind for those who have stayed on, which leads to more burnout and even more turnover. If practices can find a way to alleviate that burden, though, they're going to make life better for their employees. Telemedicine can do this by shortening the average exam time, nearly eliminating patient wait times, reducing the average number of no-shows, and saving money by cutting down on operational costs. All of these things can directly or indirectly impact the quality of life for healthcare workers and for patients. Q. Only 49% prefer telemedicine visits for mental health treatment, despite it being one of the more remote-ready specialties. What does this finding say for the future of telepsychiatry? A. This is a great question that a lot of people are puzzling over. Mental healthcare does seem to be an ideal match for telemedicine, specifically the use of video conferencing to conduct therapy sessions. So, I was a little surprised that more patients in our survey didn't indicate a preference for telemedicine. But there are a couple of things to consider here. First, we didn't collect data on patient history, so not every participant in our survey has experience seeking mental health treatment. That could be a factor in this dataset. Second, 19% indicated no preference between telehealth and in-person appointments for mental health treatment when we asked this question, which means only 32% prefer in-person mental health appointments. So, it's still the majority of patients saying telehealth is their favorite option for mental healthcare. As far as what this means for the future of teletherapy, I don't think it's any huge concern. It could simply be that some patients are still warming up to the idea of having intimate conversations with a therapist through a computer screen. It could be an age thing. It could be something else. Regardless, I suspect that if we were to run this survey annually for the next few years, that 49% would increase every time. Q. One-third of patients worry that an in-person exam, lab work or other testing is critical to properly diagnose and treat patients. How can telemedicine jump this hurdle? A. I'm not convinced telemedicine needs to jump this hurdle to prove itself valuable. Sure, there are incredible advancements being made in remote patient monitoring tools and other wearable devices that can help diagnose patients from a distance, but I think it's equally worth noting that telemedicine is a tool to be used in the right circumstances – it's not a one-size-fits-all approach to medicine. Yes, for a lot of medical conditions, doctors actually have to see the patient to perform physical tests. Those situations aren't ideal for telemedicine, and we shouldn't be thinking of them as hurdles – or even failures. If, instead, we reframe our thinking so that we recognize the situations that are ideal for telemedicine appointments – those that don't require physical tests for diagnosis, such as mental healthcare or common ailments like upper respiratory infection – we can see that telemedicine is a deeply valuable tool as it stands. So, to answer your question, the real hurdle for telemedicine here is teaching patients when it is best used instead of needing to find ways to provide lab work or physical exams remotely. In essence: It's a messaging problem instead of a technology problem. The good news is patients seem to be recognizing this on their own. If you look at patient preferences for in-person appointments versus telemedicine appointments broken down by symptom in our report, you see that patients intuitively understand which symptoms are best treated remotely and which are more likely to need physical exams. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/patients-prefer-telehealth-common-illnesses-study-shows < Previous News Next News >

Social Determinants of Health Continue to Limit Access to Care via Telehealth Center for Connected Health Policy April 2021 A study published in JAMA Network Open found that over 27% of visits were conducted virtually in socially advantaged neighborhoods, compared to nearly 20% in disadvantaged areas. While telehealth increased care delivery during COVID-19, social determinants of health continue to limit access and highlight existing disparities related to the digital divide. A study published in JAMA Network Open found that over 27% of visits were conducted virtually in socially advantaged neighborhoods, compared to nearly 20% in disadvantaged areas. Meanwhile 24% of visits in urban areas were virtual compared to 14% in rural areas. The study also found that virtual care occurred more frequently for mental health visits than medical, that higher age and number of chronic diseases also correlated with higher telehealth utilization, and that increased use of telehealth was seen in areas with “COVID-19 hot spots” as well. The researchers stated that they hope these findings guide policymakers when looking to address ensuring access to care for all populations via telehealth moving forward. JAMA Network Study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777779 < 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 >

82% of Americans Want Telehealth Flexibilities Extended Mark Melchionna November 30, 2022 A recent survey indicates that 82 percent of respondents with employer-provided coverage believe that the government should extend telehealth flexibilities. A recent survey conducted by America's Health Insurance Plans (AHIP) found that a majority of respondents are requesting that the government sustain the telehealth flexibilities enacted during the COVID-19 pandemic. In 2020, the number of people using telehealth increased dramatically, largely due to the withdrawal of various regulatory restrictions as well as the new barriers imposed on in-person care. According to data from market research firm Trilliant Health, telehealth use peaked in the second quarter of 2020. Though telehealth use has waned since 2020, it remains popular among patients and providers. As a result, Congress is faced with deciding whether to continue or terminate telehealth flexibilities. A survey from the Morning Consult on behalf of AHIP’s Coverage@Work campaign collected data on patient preferences regarding telehealth and how they feel about its future. The survey polled 818 voters with employer health insurance between Nov. 11 and 13. The main survey findings related to whether patients would consider seeing a doctor through telehealth, reasons for using telehealth, and their opinions on the government extending telehealth flexibilities. The survey shows that 65 percent of those with employer-provided coverage reported being likely to consider seeing a doctor or receiving treatment through telehealth. This finding was consistent across age, income, and ethnicity groups. Also, 49 percent claimed that interest in telehealth is mainly backed by convenience, and 35 percent stated that it saves time as it eliminates the need for travel. Among all respondents, 82 percent believe that the federal government extending telehealth flexibilities is important. This included a bipartisan majority of Democratic voters (95 percent), independent voters (77 percent), and Republican voters (70 percent). Considering the survey results, AHIP concluded that respondents would advocate for the government to continue telehealth flexibilities. This is not the first indication of healthcare stakeholders seeking this end goal. In September, a letter to the US Senate composed by the American Telemedicine Association (ATA) and its advocacy arm known as ATA Action asked for a continuation of expanded telehealth access. Specifically, the letter urged the US Senate to sustain telehealth flexibilities for two years through 2024. These flexibilities included waivers put into place during the pandemic, including removing initial in-person requirements for telemental health and eliminating restrictions on the location of providers and patients engaging in telehealth. Signed by 375 stakeholders, such as Amazon, the American Nurses Association, and Bicycle Health, the letter also detailed concerns about a forced return to in-person care. Also, in March, Senators Tom Carper (D-Delaware) and Tim Scott (R-South Carolina) introduced a bill known as the Hospital Inpatient Services Act, which allowed for a two-year extension of the federal acute hospital-at-home waiver. Introduced in November 2020 by the Centers for Medicare and Medicaid Services, the waiver enables treatment for common acute conditions in home settings. This waiver was highly used throughout the COVID-19 pandemic, with 92 health systems, comprising 203 hospitals across 34 states, using it as of March 4. See original article: https://mhealthintelligence.com/news/82-of-americans-want-telehealth-flexibilities-extended < Previous News Next News >

Study: Teletherapy program reduces OCD symptoms Emily Olsen May 23, 2022 Researchers found a 43.4% mean reduction in patient-rated obsessive-compulsive symptoms. A teletherapy program reduced symptoms of obsessive-compulsive disorder, and most patients maintained improvements up to a year later, according to a study published in JMIR. The treatment, from digital mental health company NOCD, included twice-weekly video appointments that used exposure and response prevention (ERP) therapy for three weeks. Patients then underwent six weeks of weekly half-hour video check-ins. Researchers followed up with the patients three, six, nine and twelve months after the therapy program. The study found a 43.4% mean reduction in patient-rated obsessive-compulsive symptoms as well as a 44.2% mean reduction in depression, a 47.8% mean reduction in anxiety and a 37.3% mean reduction in stress symptoms. Of the more than 3,500 patients included in the study, more than 1,600 participated in follow-up surveys. The study's authors were employed by NOCD or reported they had received payments from NOCD while conducting the study. "The effect size was large and similar to studies of in-person ERP. This technology-assisted remote treatment is readily accessible for patients, offering an advancement in the field in the dissemination of effective evidence-based care for OCD," researchers wrote. WHY IT MATTERS The study's authors noted the virtual intervention took about 12 weeks and fewer than 11 therapist hours. "Technology assistance likely played an important role in this treatment’s ability to both engage and treat a large number of patients in wide-ranging geographic locations and to achieve a high mean rate of symptom improvement and a high rate of treatment response," they wrote. "Teletherapy using video allows people in remote locations to access treatment and to be able to complete, in-session, in vivo exercises in places and situations that are most relevant to, or triggering of, their symptoms." THE LARGER TREND NOCD announced it had raised $33 million in Series B funding in September last year. That brought its total financing to $50 million, according to Crunchbase. Mental health technology funding increased 139% globally in 2021, compared with 2020, bringing in $5.5 billion, according to a CB Insights report. Meanwhile, mental healthcare makes up a large portion of telehealth utilization in the U.S. Though utilization fell nationally in February, mental health diagnoses still made up more than 64% of telehealth claim lines, according to FAIR Health's tracker. For original article: https://www.mobihealthnews.com/news/study-teletherapy-program-reduces-ocd-symptoms < 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 >

Top of Page Video Access Highlighted Webinars Clincal Innovation Business Funding NMTHA Town Hall Experts in TH Webinars, Interviews, & Videos Video Access Featured Webinar & Video Series Highlighted Videos NMTHA provi des videos by topic: Clinical Innovation Business Funding Town Hall Meeting Expert Interviews Webinars FEATURED WEBINAR NMTHA Town Hall Event: The Future of Telehealth As our world changed due to the COVID-19 pandemic, so did the world of telehealth. But, what happens next? Featuring nationally recognized speaker and telehealth pioneer Dr. Weinstein, plus Russel Toal from New Mexico's OSI. View Webinar FEATURED SERIES Experts in Telehealth: An Interview Series NMTHA brings "Experts in Telehealth" a video series interviewing experts from various areas within the Telehealth arena. View Series Featured The Modern-Day House Call. Duke City’s Medic Buddy: House Call/Telemed Hybrid August 24, 2022 Mark Maydew, CFO/COO and Kelly Spring, PA-C from Duke City Cares walk us through their Medic Buddy Mobile Medical Care service. Duke City Cares is not only making house calls but connecting patients when needed to physicians via telemedicine via this mobile service. Performing a Physical via Telemedicine April 15, 2022 Dr. Tarun Girotra, Clinical Educator and Assistant Professor of Neurology at the University of New Mexico. Dr. Girotra presents various levels of physical exam documentation over telemedicine and demonstrates how to perform the best possible physical exam during a telehealth visit. CLINICAL Leveraging Telehealth for Behavioral Health in Challenging Times December 14, 2022 Molly Brack, Clinical Director at the Agora Crisis Center and Wendy Linebrink-Allison, Program Manager of the NM Crisis Line and Elizabeth Glantz, 988 Project Manager with NM Behavioral Health Services Division. Presentation on how crisis line services can assist in closing gaps and build bridges for people who experience mental, emotional, and behavioral health and substance use concerns which do not replace community services, but fill in the gaps and create connections to support people in communities. Performing a Physical via Telemedicine April 15, 2022 Dr. Tarun Girotra, Clinical Educator and Assistant Professor of Neurology at the University of New Mexico. Dr. Girotra presents on the various levels of physical exam documentation over telemedicine and demonstrates how to perform the best possible physical exam during a telehealth visit. Addressing Provider Burnout December 01, 2021 Rick Vinnay, LCSW, CEAP - The Solutions Group EAP and Wellness Programs, and Pierce Ferriegel, CEO - The Community Lighthouse. Rick Vinnay and Pierce Ferriegel each have a different vantage point and discuss what their organization experienced and how they managed burnout. Telemedicine Clinical Specialties October 27, 2021 Dr. Randy Nederhoff, Neonatology, Dr. Rina Patel-Trujillo, Endocrinology, and Dr. David Phelps, Medical Director, PHS Urgent Care Clinics. For this webinar we bring you three medical specialists and their experience using telemedicine. They cover conducting a physical exam via telemed, using telemed for endocrinology, primary care, specialty care, surgical specialties and neonatal care. Telemedicine Clinical Specialties: Behavioral Health October 20, 2021 Lora Blazina, LPCC, Clinical Supervisor at The Mountain Center, Santa Fe’, Dr. Caroline Bonham, Vice Chair of Community Behavioral Health Policy, Department of Psychiatry and Behavioral Sciences, and Dr. Marita Campos-Melady, Clinical Psychologist and Director of Specialty Behavioral Health Therapy services at Presbyterian Medical Group. In this webinar we have three speakers as we explore tele behavioral health - the challenges, the successes and the innovations when using telehealth for serious mental illnesses, complex trauma, use in BH and medical settings and for adults as well as children. Expanding Your Telemedicine Services September 29, 2021 Dr. Elizabeth Krupinski, Phd, Southwest Telehealth Resource Center, and Dr. Van Roper, University of New Mexico. Whether you have been using telemedicine for 1 year or 10, Drs. Krupinski and Roper have some ideas for making the most of your telemedicine services, which can contribute to further sustaining your practice. Telehealth and COVID: Lessons Learned February 17, 2021 Van Roper, PhD, FNP-C, Associate Clinical Professor. This presentation covers telehealth basics, primary care specific applications, and lessons learned in the implementation of telehealth in small rural clinics during the COVID-19 pandemic. Care Integration in the Time of Covid: Focus on Patient Experience January 13, 2021 Elizabeth Krupinski, PhD, Southwest Telehealth Resource Center. This presentation focuses on ensuring patients have a positive experience during telemedicine encounters, starting from the first encounter at scheduling through the actual visit with the provider. Topics include incorporating the entire care team in telemedicine encounters and finding relevant quality indicators to measure success. INNOVATION The Ups and Downs of Digital Innovation in Healthcare November 16, 2022 Alex Carter, certified Physician Assistant, Presbyterian Healthcare Services’ Innovation Hub. A sought after speaker on this topic, Alex's presentation includes TytoCare as a case by which to discuss a system-wide Telehealth implementation, and get real with the many challenges they have. She weaves in other projects and tools as well. Rethinking How We Connect Hospitals, Specialists and Patients September 21, 2022 Darcy Litzen, MS, BSN, RN, VP of Sales for AmplifyMD. Physician video visits became necessary during the pandemic and are now widely accepted. But what if we take them a step further and use virtual care to provide a holistic solution to the ever-present cost-of-care and network adequacy pressures on health systems and insurers, while also addressing physician burnout and the complexities of providing timely specialty care locally? All with built-in continuous improvement? The Modern-Day House Call. Duke City’s Medic Buddy: House Call/Telemed Hybrid August 24, 2022 Mark Maydew, CFO/COO and Kelly Spring, PA-C from Duke City Cares walk us through their Medic Buddy Mobile Medical Care service. Duke City Cares is not only making house calls but connecting patients when needed to physicians via telemedicine via this mobile service. Growing Peer Support in the Virtual World. How Presbyterian Healthcare Service’s Community Health Built a Virtual Peer Network March 17, 2022 Valerie V. Quintana, MA, PTP, and Donald M. Hume, CPSW with Presbyterian Health Services, Community Health. Presbyterian Healthcare Service's Community Health department stood up a virtual peer network. In this presentation, Valerie Quintana and Donald Hume describe what they built and bring us their experience - the challenges, the successes, and what they learned in creating this new network. BUSINESS OF TELEHEALTH Telehealth Needs & Opportunities: Emerging Findings from BH Providers December 08, 2021 Margy Wienbar, MS, and Renee G. Sussman, RN, MA, MSN. This presentation briefly reviews the findings of the report “Telehealth Needs & Opportunities: F indings from Nonprofit Behavioral Health Providers in Northern New Mexico” that was published by the New Mexico Telehealth Alliance and Anchorum St. Vincent in July of 2021. Participants will hear from three of the organizations that were interviewed and contributed to the report’s findings. Telemedicine Billing & Coding: What You Need to Know September 08, 2021 Steve DeSaulniers from Blue Cross Blue Shield of New Mexico, Jennifer Sandoval from Molina Healthcare, Julie Wohrlin from Western Sky Community Care, Dr. Denise Gonzales from Presbyterian Healthcare, Lorelei Kellogg, NM HSD, and Moderator: Stetson Berg, UNM Center for Telehealth This full panel of speakers present and answer questions from attendees. Delta Variant is on the Rise: Is Your Telemedicine Practice HIPAA Compliant? September 01, 2021 Michael Herrick, Founder & CEO Matterform. With the rise of the Delta Variant, you may be thinking that we will be relying on telehealth more this fall. Are you compliant? Do you have concerns about your platform? Have you been relying on tools that won't be compliant once the Public Emergency Health order ends? Collective Learning of the Telehealth Learning Community March 31, 2021 Kate Gibbons, LCSW, LISW, Ph.D., of Janus LLC. A summation and update on the learning and data collected during the first cohort of the Telehealth Learning Community (TLC) for behavioral health providers. Show Me the Data: How COVID-19 Impacted Telehealth Claims & What Happens Next March 17, 2021 Stefany Goradia, MSIE-VP Health Analytics, RS21 Health Lab. COVID-19 caused a spike in telehealth as new payment models were approved and the healthcare industry pivoted rapidly to continue providing care via telehealth at the March onset. Since that time, organizations have witnessed declines in overall telehealth utilization, with some services slowly dwindling and others converting entirely back to in-person visits. In this case study, we will review an anonymized payer’s telehealth claim trends, services and conditions that were identified to be the most widely-adopted for telehealth between March and December 2020, and considerations for an ongoing telehealth strategy going into 2021. New Mexico’s Telehealth Stature Simplified: What You Need To Know March 10, 2021 Beth Landon, MBA, MHA-NMTHA Chair, and Stetson Berg, MHA-NMTHA Vice Chair. New Mexico enjoys one of the nation’s most progressive telehealth laws. Full payment parity and zero geographic restrictions comprise just part of the law; we also suffer zero limitations on eligible providers and no lifetime limits. This presentation and ensuing discussion intends to demystify the law, answer your questions, and gain your ideas on how to further improve the statute in subsequent legislative sessions. Developing Telehealth Workflow for Best Possible Patient and Provider Experience February 10, 2021 Jen Gruger, PMI-PBA. Delivering a successful telehealth visit is as much about the step-by-step workflow and how each individual involved executes their portion, as it is about the technology used and the clinical outcome we desire. This session will cover three essential components of building (or repairing) an effective and efficient workflow for this type of visit regardless of the telehealth platform being used. Using Remote Monitoring Technology to Improve Patient Outcomes & Retain Staff January 20, 2021 Arlene Maxim, RN. This presentation focuses on technology to augment home health care, an extremely valuable tool when clinicians use it effectively. Agency owners and managers are beginning to see the critical role that telehealth and remote care monitoring can play in keeping patients at home and improving patient satisfaction. Telehealth and remote care monitoring can also improve clinician satisfaction. During this session we discuss what to look for in a telehealth/remote care monitoring provider and how to market technology’s ability to improve patient outcomes and staff satisfaction. FUNDING FCC Rural Health Care Program Funding Opportunities March 24, 2021 Steve Constantine, SVP/CIO, Prairie Health Ventures & COO, and Marci L. White, FCC Rural Health Care Program Funding Specialist. The FCC Rural Health Care Programs provide funding opportunities for eligible healthcare providers across the U.S. to develop and grow their telemedicine programs. The two programs fund telecommunications and broadband services necessary for the provision of health care. In addition, the Healthcare Connect Fund allows opportunities for some urban participation as well as funding for data centers, administrative offices and certain network equipment. NMTHA TOWN HALL Town Hall: The Future of Telehealth September 22, 2021 Dr. Ronald S. Weinstein, na tional telemedicine pioneer, and Russell Toal, New Mexico Superintendent of Ins urance and local community. This special 90-minute town hall explores the possibilities of where we go from here. The town hall features speakers from local and state leadership, healthcare and YOU. INTERVIEWS: TELEH EA LTH EXPERTS Elizabeth Krupinksi , PhD, Southwest Telehealth Resource Center Jen Gruger , PMI-PBA, EHR Sup port Dept., Gerald Champion Regional Medical Center Geof Empey , Progra m Operations Director, University of New Mexico Center for Telehealth Kelly Schlegel , Director of the New Mexico Office of Broadband Access and Expansion Clincal Innovation Business Funding NMTHA Town Hall Highlighted Videos Experts in TH Highlighted NMTHA Webinar Series 10-week Educational Series From our 2021 10-week educational series, webinars focused on data, broadband in New Mexico, client engagement, and more! These webinars were hosted by the New Mexico Telehealth Alliance and made possible through funding by Health Resources and Services Administration Office for the Advancement of Telehealth and the Southwest Telehealth Resource Center. View Webinar Fall 2021 Webinar Series Topics include the future of telehealth, billing, using telehealth for clinical specialties, and more. View Webinar Webinars

Digital Health Tools Transforming Pediatric Telemedicine, Teletherapy & Telehealth Dr. Maheu February 24, 2022 The COVID-19 pandemic has led to an unprecedented rise in pediatric telemedicine to alleviate the strain of behavioral health issues. Unprecedented stressors abound. Children are now more often confined to their homes and are less able to socialize. They may be forced to adjust to their parents’ working from home. They may witness economic and emotional fluctuations that leave them more anxious than at any time in recent history. With the increased demand for care with a shortage of available pediatric behavioral professionals, many organizations have shifted to pediatric telemedicine and telehealth or teletherapy tools.. COVID 19 and Challenges for Pediatric Telemedicine for Behavioral Health A meta-analysis published in JAMA Network, pediatrics found that one in every four children suffered depression during the COVID-19 lockdown and the anxiety prevalence rate was 20.5%. According to the Centers for Disease Control and Prevention (CDC), compared to 2019, the number of mental health-related emergency visits in 2020 went up by 24% for children in the 5-11 age group and 31% in the 12-17 age group. The American Association of Pediatrics and the American Association of Child and Adolescent Psychiatry have officially declared an emergency as pediatric behavioral health went through a crisis countrywide. Parents had pretty tough times getting support for pediatric behavioral health following the closure of clinics and shortage of pediatric-trained therapists. Digital health tools primarily developed for adult health care have been adapted to connect parents to trained child therapists to overcome geographical and pandemic-related barriers. Full article here: https://telehealth.org/pediatric-telemedicine-2/?smclient=f760e669-8538-11ec-83c8-18cf24ce389f&smconv=5bc4c379-a4c1-484f-a411-33ec93777504&smlid=12&utm_source=salesmanago&utm_medium=email&utm_campaign=default < Previous News Next News >

Biden’s American Jobs Plan Increases Investments in Broadband Infrastructure Center for Connected Health Policy April 13, 2021 President Biden’s recently released American Jobs Plan includes $100 billion to increase access to affordable, reliable, and high-speed broadband throughout the country. President Biden’s recently released American Jobs Plan includes $100 billion to increase access to affordable, reliable, and high-speed broadband throughout the country. Comparing digital infrastructure today to affordable access to electricity in the 1930s, the Fact Sheet on the Plan released by the White House states how the pandemic has highlighted existing disparities related to the digital divide and the lack of broadband access to more than 30 million Americans. The $100 billion investment will prioritize broadband infrastructure in unserved and underserved areas to reach 100% high-speed broadband coverage. It also sets aside funds for tribal lands and promotes broadband providers less focused on profits, such as those affiliated with municipalities, and seeks to improve price transparency and competition among internet service providers. The plan will include internet subsidies to low-income consumers, but states that in the long-term, the President is committed to working with Congress to reduce internet prices negating the need for such short-term solutions. The full Fact Sheet on The American Jobs Plan can be accessed on the White House website, https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/31/fact-sheet-the-american-jobs-plan/. < Previous News Next News >

22 States Changed Telemedicine Laws During the Pandemic Kat Jercich June 2021 Most pursued changes via administrative action, according to a new Commonwealth Fund report, which may not be a permanent solution after the COVID-19 public health emergency ends. The Commonwealth Fund released an issue brief this week reviewing state actions to expand individual and group health insurance coverage of telemedicine between March 2020 and March 2021. It found that 22 states changed laws or policies during that time period to require more robust insurance coverage of telemedicine. "If telemedicine proves to be a less costly way to deliver care, payers and consumers may benefit from expanding coverage of telemedicine after the pandemic," wrote report authors. WHY IT MATTERS In March 2020, federal regulators temporarily relaxed restrictions for telemedicine visits for Medicare patients, raising payments to the same level as in-person visits and reducing cost-sharing, among other changes. Officials encouraged states and insurers to provide similar flexibility under private insurance – and many took that encouragement to heart. Of the 22 states that expanded access to telemedicine during the pandemic, the report found that most pursued changes via administrative action. "Use of executive authority allowed states to move relatively quickly during the crisis, though it has meant that the new telemedicine coverage requirements are temporary," wrote the researchers. They noted, for example, that seven governors included specific telemedicine coverage requirements in executive orders, which will expire after the public health emergency. Some states used bulletins, notices, or executive orders from the department of insurance or a similar agency to enhance coverage. New legislation, which takes more time, but is necessary for permanent changes, passed in eight states. Utah, Illinois, West Virginia, New Hampshire and Massachusetts – which had not previously required coverage – changed their policies during the pandemic. At this point, 40 states require coverage. These policies do not all carry equal impact. Eighteen states required coverage of audio-only services for the first time during the pandemic, bringing the total number up to 21. Four states eliminated cost-sharing for telemedicine services, and three added a requirement that cost sharing not exceed in-person identical services. And 10 states newly required insurers to pay providers the same for telemedicine and in-person visits. Report authors noted that insurers were cooperative with these changes, but longer-term adoption of policies like reimbursement parity "would likely be contentious." They pointed out the states will need data to inform debates on how best to regulate telemedicine. In 2021, at least 30 states have weighed legislation that would revise telemedicine coverage standards, found the Commonwealth Fund. Despite the known benefits of telemedicine, researchers also cautioned that it has not been equally beneficial to all patients. "Research shows telemedicine use is lower in communities with higher rates of poverty and among patients with limited English proficiency, potentially undermining goals of expanding access to underserved communities and exacerbating health inequities," read the report. THE LARGER TREND As the report notes, multiple states have implemented pro-telehealth policies to enable access during and beyond the COVID-19 public health emergency. But a major question remains regarding federal legislation, which could fill in many state-by-state gaps and prevent a so-called "telehealth cliff." "If Congress does not act before the public health emergency ends, regulatory flexibilities that now ensure all Medicare beneficiaries maintain access to telehealth will go away," said Kyle Zebley, director of public policy at the American Telemedicine Association, during a conference panel earlier this month. ON THE RECORD "Whether telemedicine reduces overall healthcare costs depends on how services are reimbursed and if virtual visits reduce other services or simply add to utilization," said Commonwealth researchers. "Having access to data can help stakeholders understand how longer-term expansion of telemedicine affects access, cost, and quality of care." Source: https://www.healthcareitnews.com/news/22-states-changed-telemedicine-laws-during-pandemic < Previous News Next News >

New FAIR Health White Papers Shows Large Telehealth Utilization Increases Before COVID-19 Center for Connected Health Policy April 2021 Results showed that telehealth utilization increased by 73% from 2018 to 2019 with telehealth claims comprising over one-third of all health care claims in 2019. In its fourth edition of the Healthcare Indicators and Medical Price Index White Paper, FAIR Health found that the fastest area of healthcare utilization growth from 2018 to 2019 occurred for telehealth services. FAIR Health conducted the annual analysis using its data repository of 32 billion claims for patients in commercial insurance plans. Results showed that telehealth utilization increased by 73% from 2018 to 2019 with telehealth claims comprising over one-third of all health care claims in 2019. FAIR Health also noted that the most common claim type for telehealth was for mental health services, bolstering other recent evidence that telehealth utilization continues to grow for behavioral and mental health services. The findings are an important contribution to ongoing policy discussions about where telehealth is going after the pandemic. While most telehealth experts have been paying close attention to telehealth utilization during the pandemic, these findings suggest that the story of telehealth’s rapid growth likely begins in 2019, one year prior to the public health emergency. FAIR Health is a national nonprofit organization that maintains a large database of privately insured healthcare claims data. The organization performs healthcare utilization and cost analyses on market trends for use by researchers, consumers, and industry stakeholders. For more information about FAIR Health's data, view their website. FAIR Health Consumer: https://www.fairhealthconsumer.org/#about FH Healthcare Indicators and FH Medical Price Index 2021: https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/FH%20Healthcare%20Indicators%20and%20FH%20Medical%20Price%20Index%202021--A%20FAIR%20Health%20White%20Paper--FINAL.pdf < Previous News Next News >