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

Could Telehealth Worsen Inequity? 'Not Under My Watch,' Says HHS Sec. Becerra Kat Jercich June 2021 Top health officials from HHS and VA have signaled their ongoing support for telemedicine in the long term, but also want to ensure that "technology is being used properly." In recent public appearances, U.S. Department of Health and Human Services Secretary Xavier Becerra and Veterans Affairs Secretary Denis McDonough both indicated their support for telemedicine in the long term. Even as states have moved to enact their own laws aimed at telehealth expansion, questions have persisted about a federal response. Becerra emphasizes equity in technology "We are absolutely supportive of efforts to give us the authority to be able to utilize telehealth in greater ways," said Becerra during a Washington Post live event earlier this week. "We want to make sure that we don't leave anyone behind … so that telehealth should be available to all Americans universally," Becerra continued. At the Post event, Becerra reiterated that the Biden administration is supportive of recent moves in Congress that would safeguard access to telemedicine after the COVID-19 pandemic. Becerra also emphasized the importance of making technology available to everyone, not just those with means. "That includes, of course, making sure broadband, and quality broadband, is out there for all communities," he said. When asked about the danger of telehealth exacerbating inequities – which many advocates have warned against – Beceerra said, "not under my watch." "We're going to do everything we can to include everyone. It should make no difference what Zip code you live in, in America," he said. "You should have access to whatever technologies we as a government through our taxpayer dollars make available, and so that's why we want to make sure we do this the right way and that there's accountability on both ends of the system," he continued. He also referred to concerns around spending and overutilization, which have dogged discussions of virtual care. "We want to make sure that these providers are providing a service that might not have been available had we not had telehealth, but that it also results in better quality services and treatment, because we don't want to be billed for things that don't result in better health for Americans," he said. When it came to interstate licensure, another sticky proposition, Becerra called it an "accountability issue." Though he avoided directly weighing in on whether doctors should be allowed to work outside their states, he seemed to lean against the issue. "The farther away you go from the direct connection between patient and provider, the more difficult it will be to try to provide for the accountability, quickly and fairly, for the patient," he said. "So if your doctor is 30 miles away, and you live in rural America, we can track down that doctor 30 miles away from you. But if your doctor was 3,000 miles away from you, that's a tougher sell for a consumer who is now trying to get accountability for a service that wasn't properly provided," he continued. When it came to broader technologies – beyond telehealth – Becerra pointed to the role digital health tools can play in strengthening U.S. public health infrastructure. "COVID-19 showed us where the holes are in our public health system. That's what happens when you have the most technologically advanced healthcare in the world, but it's not evenly distributed, and as a result, we had pockets in America where COVID was devastating," he said. "And technology helps us close those gaps faster, but once again, we want to make sure that technology is our friend and technology is being used properly, so accountability will be so important," he continued. Telehealth options are a hit with vets Meanwhile, VA Secretary McDonough appeared before the Senate Appropriations Committee this week to offer an update on veterans' use of telemedicine. "There were almost 230,000 visits at the end of February this year," said McDonough, as reported by the Military Times. "Nearly 2 million vets have had one or more episodes of video care. That tells us that there’s massive demand." McDonough noted that the department is working on addressing the reluctance of some staffers to pivot to virtual care. "There’s going to continue to need to be things that are done in person, but I think as a system we recognize the huge efficiency gains and and huge satisfaction gains which come from vets spending less time traveling to our facilities while still getting good care," he said. "We want to maintain it, because it’s ease of access for vets who don’t need to be seen in person," he said. The VA has faced scrutiny in other digital health arenas recently, with an Office of Inspector General audit finding that the Veterans Health Administration needs improvement when it comes to integrating non-VA medical data to veteran's electronic health records. Sen. Brian Schatz, D-Hawaii, said he'll encourage VA leaders to preserve the new telehealth options and explore avenues for Congress to enable them. "There’s going to be a tendency to want to snap back to pre-pandemic times, and I just think there’s going to be a patient revolt,” said Schatz, who praised telehealth in a recent interview for HIMSS TV. "Ten years ago, if you told someone to interact with their clinician via iPhone, it would be an insult. Now, if you can’t do that, that’s an insult," Schatz said. Source: https://www.healthcareitnews.com/news/could-telehealth-worsen-inequity-not-under-my-watch-says-hhs-sec-becerra < Previous News Next News >

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

Can digital health increase accessibility as mental health needs soar? HIMSS TV December 23, 2021 Deep Dive: Many adults with a mental illness won’t be able to access care, given greater levels of anxiety and depression during the pandemic. Digital tools can help. Learn more here: https://www.healthcareitnews.com/video/can-digital-health-increase-accessibility-mental-health-needs-soar < Previous News Next News >

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

Leveraging Telehealth Platforms to Enhance Provider Workflows, Adoption eVisit December 28, 2022 Implementing a telehealth platform can positively impact provider workflows in numerous ways, including easing administrative burdens, thereby leading to greater provider adoption and satisfaction. The pandemic drove telehealth use to new heights. Even though usage appears to be stabilizing, healthcare stakeholders largely agree that telehealth is here to stay, and they are making virtual care a vital part of their care delivery model. Polls conducted by the American Medical Association show that 80 percent of physicians said they were using telehealth tools in 2022, up from 28 percent in 2019 and only 14 percent in 2016. Further, in 2022, about 75 percent of physicians said being able to offer remote care was an important reason to use digital health tools, up from 60 percent in 2016. From the patient perspective, the benefits of telehealth, such as improved healthcare quality and patient experience, have become increasingly apparent. Epic conducted a research study analyzing 35 million telehealth visits between March 1, 2020, and May 31, 2022. They found that "in nearly every specialty studied, most patients who had a telehealth visit did not require an in-person follow-up appointment in that specialty in the next three months." Only two of the 31 specialties — fertility and obstetrics — saw in-person follow-up rates above 50 percent, while genetics, nutrition, endocrinology, and mental health/psychiatry had in-person follow-up rates of 15 percent or less. But, as telehealth is integrated alongside in-person care, provider organizations must ensure they are selecting the right platform for their facility's unique needs and implementing them in a way that addresses — rather than adds to — clinician workflow challenges. KEY TELEHEALTH CAPABILITIES TO IMPROVE PROVIDER WORKFLOWS Amid the rapid rise in the adoption and use of telehealth during the pandemic, providers have faced several challenges in setting up telehealth programs. One of the most significant difficulties is related to the technology available, notes Eric Thrailkill, Venture Partner, Founder of the Telehealth Academy, and Chairman of Project Healthcare at the Nashville Entrepreneur Center. "While these solutions 'worked' per se, they were not designed to help health systems facilitate a hybrid care model with a goal to provide personalized care, regardless of location," he says. "During the shutdowns, almost all provider organizations were completely dedicated to supporting COVID-related patients and/or working through the backlog of previously scheduled appointments. Telehealth, due to the relaxation of certain federal and state regulatory requirements, consisted of phone-based services and two-way video technologies — speed to deploy was the operating mantra." Provider organizations succeeded in rapidly deploying new technologies, but they did not have time to optimize their workflows to account for certain processes — like documentation and revenue cycle — and support overarching population health and chronic care goals. During the pandemic, 'offering telehealth' could simply mean offering a two-way video solution. But now, with a couple of years of experience and data to pull from, providers are able to build robust telehealth programs to pair with in-person care. In short, a telehealth program looks at creating both a personal and efficient experience for the provider and patient before, during, and after the visit. Two-way video technology is just one piece of the puzzle. "Telehealth platforms should contain a virtual triage where location and assignment of a provider could occur," Thrailkill says. "This would also enable an appropriate assessment to ensure higher acuity visits are prioritized over lower acuity visits." For effective triage, relevant care teams must be able to easily coordinate their team and the patients in the virtual waiting room, chat with the patient ahead of, during, and post-visit, access the appointment, and interact with the patients while accurately documenting the encounter in their EHR and scheduling follow-up appointments. The digital experience should be smooth and the UI/UX strong to support adoption and satisfaction. Anything captured by the telehealth platform, say an image or an attachment, must have bidirectional clinical data flows enabled with the EHR to ensure the complete patient picture is captured for the patient's health record and billing and reporting purposes. Additionally, Thrailkill notes that as provider organizations become increasingly focused on addressing social determinants of health needs, they should consider telehealth platforms that can ingest data from multiple sources. Having this data at their fingertips at the point of care can help clinicians provide wraparound care services, including connecting patients with social services and community resources. Not only is a platform's ability to gather data from various sources essential to the success of hybrid care models, but so is seamless data exchange, which helps ensure continuity of care. "Continuity of care is the set of processes whereby the patient and his/her physician-led care team are involved and cooperating over time to achieve the highest level of quality of care," Thrailkill says. "This is difficult, if not impossible, given the fragmentation and healthcare data silos that exist today — both outside and inside provider organizations and health systems." Thus, telehealth platforms should have integration capabilities that provide clinicians with data from prior visits and information from facilities outside the organization where the patient has received care. But Thrailkill also cautions that providers should keep in mind patient rights regarding consent, privacy, and security when developing hybrid care models that leverage telehealth. IMPROVING WORKFLOWS ENHANCES PROVIDER SATISFACTION Selecting the right platform can help healthcare organizations optimize provider workflows, thereby boosting provider adoption and satisfaction. Providers at every level want to practice at "the top of their license," that is, utilize the highest level of their education and experience to deliver care, Thrailkill notes. For physicians, the health system's most expensive clinician, tasks like documentation and prior authorization processes can get in the way of this goal. Prior authorization, in particular, is a critical pain point, as some healthcare payers have complex processes that require much time and effort. "All of these administrative burdens are no doubt contributing to workforce challenges present today across essentially every professional level," Thrailkill says. But by using telehealth platforms with integration capabilities and Fast Healthcare Interoperability Resources (FHIR)-based application programming interface structures, provider organizations can reduce administrative burdens like prior authorization processes through automation and enable them to lean on their medical assistants during the triage process of the telehealth visit. This increases the time available for patient care and optimizes capacity for the clinical team, he adds. Further, when implementing telehealth into hybrid care models, healthcare organizations should take a long-term view rather than regard telemedicine as a replacement for in-person care. "This will challenge the organization to think about the role of medical assistants, nurses, and specialty consult providers — not as follow-on activity, but incorporated into the visit," Thrailkill says. "This will ultimately lead to operational efficiencies and reduce the amount of administrative burden existing in early deployments of telehealth." As noted above, reducing administrative burdens and improving care delivery processes can lead to higher provider satisfaction, engagement levels, and adoption of virtual care across the health system. Incorporating telehealth is not a passing phase, and demand will likely grow in the years ahead. But to ensure its success, provider organizations must select technology that enhances provider workflows, thereby improving satisfaction and adoption. About eVisit eVisit is an enterprise virtual care delivery platform built for health systems and hospitals. It delivers innovative virtual experiences in care navigation, care delivery, and care engagement, improving margins at scale without sacrificing quality or patient and provider satisfaction. eVisit works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue. Based in Phoenix, Ariz., eVisit helps healthcare organizations innovate and succeed in today’s changing healthcare market. See original article: https://mhealthintelligence.com/news/leveraging-telehealth-platforms-to-enhance-provider-workflows-adoption < Previous News Next News >

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

Legislation Legislation New Mexico Legislation S.B. 93 - Broadband Access and Expansion Act H.B. 141 - ED Infrastructure Technology Definition S.B. 24 - Parity of Regulation of Telecommunication Federal Telehealth Legislatio n H.R. 7992 - Telehealth Act (2019-2020) H.R.3228 - VA Mission Telehealth Clarification Act (2019-2020) H.R.4900 - Telehealth Across State Lines Act (2019) H.R.5473 - EASE Behavioral Health Services Act (2019-2020) H.R.7233 - Knowing the Efficiency and Efficacy of Permanent Telehealth Options Act (2020) H.R.7338 - Advancing Telehealth Beyond COVID–19 Act (2020) S.2408 - Telehealth Across State Lines Act (2019) S.3988 - Enhancing Preparedness through Telehealth Act (2019-2020) S.4039 - TELEHEALTH HSA Act (2020) S.4216 - KEEP Telehealth Options Act (2020) Federal Broadband Legislation H .R.205 - To accelerate rural broadband deployment. H.R.4229 - Broadband Deployment Accuracy and Technological Availability Act S.4021 - Accelerating Broadband Connectivity Act of 2020

Patients Prefer Telehealth for Primary Care, Mental Health Needs Mark Melchionna October 31, 2022 A recent report shows that amid a return to in-person care, telehealth use has dropped among some populations, but it is still a popular modality for accessing primary and mental healthcare. October 31, 2022 - A recent report shows that although in-person care is the preferred channel of care, telehealth use remains highly used among young adults and those engaging in primary care and mental health services. Published by Stericycle Communication Solutions, the report was created in collaboration with Ipsos. It is based on a survey of 1,004 adults, 18 and older, from the continental US, Alaska, and Hawaii, conducted between July 5 and 8. In May 2022, over two years after the start of the pandemic, the FAIR Health Monthly Telehealth Regional Tracker reported an overall 10.2 percent increase in telehealth use. But while evaluating patient preferences related to healthcare access, the 2022 Stericycle Communication Solutions US Consumer Trends in Patient Engagement Survey shows that telehealth use has dropped amid a return to in-person healthcare. Within the year preceding the survey, 45 percent of adults claimed to have used telehealth on at least one occasion, while 25 percent only used it one to two times. This represents a drop from a previous survey, which showed that 39 percent of respondents used telehealth one or two times in the year prior. The report also noted that only 26 percent of older adults accessed telehealth one or more times within the past year. But the share of young adults between 18 and 34 that used telehealth remained high, reaching 61 percent. Further, the report showed that in-person care is popular among healthcare consumers. In total, 44 percent of survey respondents indicated that they prefer in-person visits. However, of those who are open to telehealth, patients prefer virtual visits for certain types of care, including primary care (55 percent) and mental healthcare (45 percent). On the other hand, patients do not prefer virtual visits for specialties such as dermatology, pediatrics, ENT, cardiology, urology, gynecology, orthopedics, and pulmonology. Patient satisfaction with telehealth is high. Among survey respondents, 90 percent indicated that their telehealth experience was either good or excellent. The top reasons for a patient choosing telehealth were convenience (58 percent) or safety (43 percent). Also, 24 percent said that telehealth helped them access a better provider. The report concluded that more evaluation is necessary to continue to optimize telehealth. For instance, since some patients requested in-person care for certain conditions, providers must consider the types of appointments that may be preferred via telehealth and invest accordingly, the report states. Several reports have provided further insight into patient satisfaction with telehealth. A study from the Journal of the American Geriatrics Society in October found that although patients over 65 preferred in-person care, they were also highly satisfied with telehealth. Using a seven-point scale, researchers evaluated the extent to which patients of this age felt satisfied with virtual care. They found that the median patient satisfaction score was six. More research from September found that telehealth continues to play a significant role in healthcare due to the satisfaction it provides patients. Following a survey, researchers found that 67 percent of patients claimed to have used telehealth within the preceding year. Of this population, 94 percent stated their intention to use telehealth again. See original article: https://mhealthintelligence.com/news/patients-prefer-telehealth-for-primary-care-mental-health-needs < Previous News Next News >

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

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

Telehealth QA – Is it all it’s QAcked up to be? Trudy Bearden, PA-C, MPAS February 16, 2022 In hopes of sparking renewed commitment to applying improvement science to telehealth, we offer this Telehealth QI and QA Miniseries. Today is the fourth in the series. Require expertise and excellence in telehealth service delivery. Expertise with telehealth requires deliberate practice which builds on or modifies existing skills, usually with the help and guidance of a coach or teacher with targeted feedback on what to improve and how to improve those skills. Send staff through telehealth training either internally or externally. The California Telehealth Resource Center Telehealth Course Finder is a great place to start for external telehealth trainings. Provide peer review of telehealth sessions by inviting a trusted clinician to join a telehealth visit – with patient permission. Debrief after the session to provide feedback and to discuss what went well, what did not go well and what changes can be made to improve Implement written triage protocols that are easily accessible by all staff to clarify which patients or patient issues are appropriate for telehealth and which need to be seen in person. Make a commitment to exceptional service delivery. Solicit and act on patient and staff feedback. Consider including a patient partner or advisor in these efforts. Below are some sample staff and clinician satisfaction survey questions. Some institutions may already incorporate some of these into their existing patient feedback systems (e.g., Press Ganey) so check to see if they are before duplicating efforts. Sometimes it’s best to collect feedback simply and in real time by asking, “How was your visit? What could have gone better?” Read full article here: https://southwesttrc.org/blog/2022/telehealth-qa-it-all-it-s-qacked-be < Previous News Next News >

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

Healthcare Breaches: 40.7 Million Patients Affected By Dr. Maheu April 5, 2021 There were 758 breaches publicly posted to the Department of Health and Human Services (HHS) breach portal in 2020, affecting 40.7 million patients. However, the breaches listed on the HHS breach portal only reflect breaches affecting 500 or more patients, making it likely that the number of breaches was much higher. Each year Protenus, along with databreaches.net, conducts a breach report to assess the state of healthcare cybersecurity. Their 2021 Breach Barometer examined healthcare breaches occurring in 2020 and compared the findings to 2019 breaches. Read more about previous healthcare breaches on TBHI blogs: Healthcare Data Breach compromised 295,617 patients, Major Healthcare Hack Targets Mental Health Provider and Healthcare Breach: Email Breach Affects Behavioral Health Organization. More details on healthcare breaches, hacking incidents, insider breaches of 2020 are discussed below. Healthcare Breaches in 2020 There were 758 breaches publicly posted to the Department of Health and Human Services (HHS) breach portal in 2020, affecting 40.7 million patients. However, the breaches listed on the HHS breach portal only reflect breaches affecting 500 or more patients, making it likely that the number of breaches was much higher. Through their analysis of 2020 breaches, Protenus determined a 30% increase in healthcare breaches compared to 2019. Hacking Incidents in 2020 The leading cause of 2020 healthcare breaches resulted from hacking incidents representing 62% of reported incidents, with a 42% increase in these types of incidents from the previous year. The 277 hacking incidents compromised the protected health information (PHI) of more than 31 million patients. Part of the reason hacking skyrocketed in the healthcare sector is due to hackers exploiting the COVID pandemic, in some cases posing as government agencies to gain access to sensitive information. The issue was a major cause for concern, with the FBI and HHS warning healthcare organizations against “an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.” Researchers stated, “By making investments to protect patients, health systems, in turn, protect themselves from severe reputational damage, financial penalties, or care disruptions stemming from hacking incidents. Under obligation to do no harm, healthcare organizations must adopt advanced tools capable of preventing hacks and their frightening consequences for patients.” Insider Breaches in 2020 The second most common cause behind healthcare breaches in 2020 was insider breaches. Insider breaches occur when an employee of a healthcare organization accesses PHI without cause. Insider breaches represented 20% of reported incidents, with 111 incidents of insider breaches compromising the PHI of 8.5 million patients. “A zero-tolerance stance on snooping is important, but it will never be enough to prevent innocent mistakes or nefarious hackers,” researchers wrote. “Only by using compliance analytics to calculate the risk score of any anomalous access can organizations surface and prioritize interactions with data that truly warrant attention…. Noncompliance is critically important to identify and prevent, especially when organizations are struggling financially. Compliance incidents are costly because of all that goes into reconciling them. On top of paying penalties, health systems must do damage control,” they added. HIPAA Resources Need assistance with HIPAA compliance? Compliancy Group can help! They help you achieve HIPAA compliance, with Compliance Coaches® guiding you through the entire process. Find out more about the HIPAA Seal of Compliance® and Compliancy Group. Get HIPAA compliant today! Link: https://telehealth.org/healthcare-breaches-2/?utm_source=ActiveCampaign&utm_medium=email&utm_content=New+COVID-19+FCC+Telehealth+Grant+%7C+TBHI+Telehealth+News+4%2F14%2F21&utm_campaign=April+13th+Newsletter&vgo_ee=L60XUD6gIFzXzaAzbkkf6r35hO7C%2FF3J%2FgQB9Uu3XAY%3D < Previous News Next News >

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

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

Policy & Legislation New Mexico: A Leader in Telehealth Laws New Mexico has one of the most progressive telehealth statutes in the entire U.S. New Mexico Legislation Federal Resources NEW MEXICO LEGISLATION Telehealth NMSA § 13-7-14 "Healthcare Purchasing Act" NMSA § 59A-22-49.3 "Health Insurance Contracts " NMSA § 59A-23-7.12 "Group and Blanket Health Insurance Contracts " NMSA § 59A-46-50.3 "Health Maintenance Organizations " NMSA § 59A-47-45.3 "Nonprofit Healthcare Plans " (see also S.B.354 (2019) "Coverage for Telemedicine Services" ) Broadband NMSA § 63-9J-1 thru 63-9J-4 "The Broadband Access and Expansion Act" ( see also S.B.93 (2021) "Broadband Access and Expansion Act" ) New Mexico Federal FEDERAL RESOURCES Center for Connected Health Policy (CCHP) Find up-to-date information for Medicare, Medicaid, Federal Employee Plans, and more... CCHP, a nonprofit, nonpartisan organization, has been the federally designated National Telehealth Policy Resource Center since 2012. CCHP provides technical assistance to twelve regional Telehealth Resource Centers (TRCs), state and federal policy makers, national organizations, health systems, providers, and the public. CCHP - Federa l CCHP - New Mexico

How Amazon, Walmart & 7 Others are Expanding Their Telehealth Business Katie Adams, Becker's Hospital Review July 2021 Companies are remaining active in their efforts to grow their telehealth businesses. It's unclear how widely telehealth services will be used once the pandemic subsides, but companies are remaining active in their efforts to grow their telehealth businesses. Below are updates on how nine companies are expanding their telehealth business, as covered by Becker's Hospital Review during the past three months. UnitedHealth Group subsidiary Optum on April 15 deployed a new telehealth product across all 50 states. The product, dubbed Optum Virtual Care, aims to integrate physical care, virtual care, home care and behavioral care. Amwell on April 28 unveiled its new Converge telehealth platform, which can host and operate digital offerings from Cleveland Clinic, Google Cloud and others. Ro, a direct-to-consumer telehealth app for pharmacy services, inked its first retail collaboration with Walmart April 28. Under the new partnership, Ro will launch its Roman health and wellness products and digital services in more than 4,600 Walmart stores across the country. On May 19, Ro acquired reproductive health company Modern Fertility for more than $225 million. Amazon on May 5 signed its first enterprise client for its telehealth service, Amazon Care. It has since secured multiple companies as clients for the telehealth service, and it is eyeing expansion into rural markets. Walmart Health on May 6 entered an agreement to acquire on-demand, multispecialty telehealth provider MeMD. By acquiring MeMD, Walmart will begin providing virtual care services for urgent, behavioral and primary care to complement its in-person Walmart Health Centers. Telehealth provider Doctor On Demand and clinical navigation platform Grand Rounds completed their merger May 11. On May 26, the combined company signed a definitive agreement to acquire Included Health, a comprehensive healthcare platform for patients who are LGBTQ and BIPOC. Teladoc Health on May 11 launched its new mental healthcare service MyStrength Complete, which offers personalized mental health services to consumers as an integration of Teladoc's virtual platform. On July 14, Teladoc integrated its hospital telehealth platform with Microsoft Teams. The Clinic, a joint digital health venture between Cleveland Clinic and Amwell, on May 18 launched new health offerings as part of its virtual second opinion service. The offering expansion is for patients with brain tumors and prostate cancers, since there are multiple treatment options for these conditions. Membership-based primary care network One Medical on June 7 entered an agreement to acquire Iora Health, a tech-powered primary care provider focusing on serving Medicare patients. The acquisition will allow One Medical to offer 24/7 digital and in-person care, as well as extend the provider into full-risk Medicare reimbursement models. < Previous News Next News >

The intersection of remote patient monitoring and AI Bill Siwicki October 25, 2022 Robin Farmanfarmaian, a Silicon Valley AI entrepreneur and author, explains how artificial intelligence can boost the efficacy of RPM and help democratize healthcare. Robin Farmanfarmaian is a Silicon Valley-based entrepreneur working in technology and artificial intelligence. She has been involved with more than 20 early-stage biotech and healthcare startups, including ones working on medical devices and digital health. With more than 180 speaking engagements in 15 countries, she has educated audiences on many aspects of technology intersecting healthcare, including artificial intelligence and the shift in healthcare delivery to the patient's home. She has written four books, including "The Patient as CEO: How Technology Empowers the Healthcare Consumer" and, most recently, "How AI Can Democratize Healthcare: The Rise in Digital Care." Healthcare IT News spoke with Farmanfarmaian to discuss where AI is impacting remote patient monitoring today and how AI can democratize healthcare. Q. Where is remote patient monitoring today? Where do you see RPM five and 10 years from now? A. Remote patient monitoring is still in the first five years of adoption and integration into the healthcare system, and the pandemic accelerated this trend by illustrating the need and value of RPM. There are many clinical-grade devices now that patients can buy or use to measure and monitor various vital signs, including EKG, heart rate, heart rate variability, blood pressure and blood oxygen level. The Centers for Medicare and Medicaid Services is one of the organizations that sets the standard of care in the U.S. healthcare system, and CMS launched CPT codes for remote physiological monitoring more than four years ago. CMS has expanded coverage and specificity over the past few years with additional and updated CPT codes. In 2022, CMS launched CPT codes for remote therapeutic monitoring (RTM). These codes cover RTM for respiratory and musculoskeletal (MSK) conditions, such as remote physical therapy and COPD inhaler tracking. Considering that most of healthcare happens in a patient's daily life, not the occasional clinic visit, this is a big step forward toward helping patients use their treatments in the best possible way on a daily basis. Many mainstream corporations have launched their own wearables that have cleared the FDA, blurring the lines between healthcare companies and consumer-facing tech companies. Apple, Amazon, Google and Samsung are some of the giants that can shift consumer habits on a national scale, and they all have launched mainstream wearables. For instance, the Apple Watch has outsold the entire Swiss watch industry multiple years in a row, and the device has an EKG monitor that has cleared the FDA for use with people over the age of 22 and with no history of arrhythmia. This trend is great news because many people may already be tracking something about their health, whether that's blood pressure monitoring, continuous glucose monitoring or even a simple accelerometer for step count. That makes it significantly more likely a patient will continue to use the device if their healthcare professional recommends it and has access to the data. In 10 years, remote patient monitoring will be mainstream, and likely reimbursed by all the major payers. We're already seeing that RPM has the ability to catch hospital readmissions days before they happen. The healthcare industry is experiencing a revolution in vital-sign measurement devices, with many companies innovating on ways to collect vital signs. New innovations include taking vital signs using a smartwatch, using just a smartphone or laptop camera, breathalyzer devices for standard vital signs like BP and Sp02, sensors in clothing, epidermal sensors and subcutaneous sensors. Within 10 years, tracking vital signs will be done in ways that are more seamless and effortless for the patient, such as subcutaneous sensors that last five years. Eversense already has an FDA-cleared implantable sensor for continuous glucose monitoring that passively records glucose levels 24/7. Q. How did artificial intelligence first come into the picture with RPM? What was the connection? A. Some of these new FDA-cleared devices measure vital signs continuously, which means they are collecting thousands of data points a day on each patient. BiolntelliSense has a medical-grade rechargeable sensor that sticks to the chest and passively measures more than 20 vital signs, recording 1,440 measurements a day. Humans don't have the ability to analyze and interpret thousands of data points every day for every patient – which is why these clinical-grade wearables and sensors have an AI software component to manage, monitor, analyze and interpret the thousands of daily data points per patient. The AI software typically flags or alerts the healthcare team and patient when the vital signs are outside predetermined ranges, personalized to the individual. While it is still early in this trend, there are examples of new innovations that only exist because of continuous, personalized data collection. January AI uses the previous three days of data from a continuous glucose monitor, combined with vital-sign data, to predict glucose response in real time to individual foods, educating the patient at the point of the decision-making. This helps manage diabetes in a more personalized and predictive way, instead of the standard reactive way diabetes is currently treated. But January AI isn't just for people with diabetes. They work with athletes, people with pre-diabetes or metabolic syndrome, and people who just want to be as healthy as they can be. This education in real time doesn't just assume the standard diet for diabetes is right for every individual or that there is any one healthy diet that works for everyone. People don't react the same way to food as others, or even to themselves. Everyone has a unique glucose response to food based on many factors, including that day's activity level, sleep, amount of fiber, stress, weight, age and many more data points. AI-based software, combined with RPM, allows personalized care 24/7. Q. Today, how does AI work with RPM to improve patient care and outcomes? A. When RPM is used for serious conditions, it can be the difference between life and death. VitalConnect ran a study on their single-lead EKG VitalPatch and was able to predict hospital readmission for cardiac patients 6.5 days in advance. Alacrity Care is working on RPM for oncology that combines vital signs taken with FDA-cleared devices including the Omron blood pressure watch and the Oxitone pulse-oximeter watch with a daily oncology practitioner check-in and blood labs taken in the home. This is to catch serious, life-threatening problems such as neutropenia, sepsis and cytokine storm days before a patient with cancer is in serious medical trouble. Catching these three conditions early can be the difference between life and death. New AI-based software tools are clearing the FDA, including one earlier this year for TytoCare that analyzes lung sounds for the patient and the remote clinician using a connected stethoscope in the home. There are other companies working on sensors in clothing that are covered by Medicare. SirenCare has socks available by prescription that monitor the temperature on the bottom of the foot. For patients with diabetes, a hotspot on the bottom of the foot could lead to a skin ulcer, which could eventually lead to an amputation if the wound doesn't heal. With access to the continuous data, the software can alert the patient and clinician when there is a problem so it can be treated before the skin breaks. The promise and goal of RPM is to keep patients safely in their homes and catch problems early, before they become serious or emergency issues. Q. You have a new book out with Michael Ferro, "How AI Can Democratize Healthcare." How does that theme fit in with the combination of AI and RPM? A. When dealing with AI, life begins at 1 billion data points. There are some major problems with traditional healthcare datasets that exist today to train software. Most healthcare data is locked into silos, whether that is the EHR, faxes, the payer or in clinical notes. In fact, when I get lab results from my physician through the hospital's patient portal, it is uploaded as a scanned fax and saved as a PDF that is not machine readable, and sometimes, not even human readable. While we are seeing interoperability move forward, there is still a long way to go. The typical healthcare data is collected on people at one point in time, such as their annual physical or if they are hospitalized. Frequently, that means the data doesn't include an individual's baseline, taken in their daily environment. It also means that most of the clinical-grade vital-sign data is on people who are already sick enough to be in a hospital. By shifting the data collection to the patient's daily life, RPM has the ability to collect clinical-grade data when people are in all stages of health and at all ages. When collected continuously in machine-readable databases, once RPM is more fully adopted, those databases have the ability to dwarf EHR data from a hospital or health system. That is the type of training data that can give healthcare a much deeper look and understanding of normal vital signs across ages, genders and genetics. RPM helps democratize healthcare in a way never before possible. Many people don't live within easy access to a doctor or clinic. Trying to get to a clinic during their open hours can be next to impossible for some people due to many factors – from not being able to take off work, school, finding transportation, distance, childcare and other barriers, to traveling to a physical clinic. Even for established patients, specialist doctors are frequently booked out one to three months in advance, which gives a medical problem time to advance and potentially get much worse. That, in turn, lowers the odds of a successful outcome when and if that patient is ever seen and treated by a healthcare professional. Instead of trying to physically get to a clinic, RPM can be used to determine when someone needs to see a healthcare professional and can make a virtual care visit much more effective. The best healthcare is the healthcare that actually gets done. RPM enables passive healthcare in someone's daily environment, 24/7. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/intersection-remote-patient-monitoring-and-ai?utm_source=twitter&utm_medium=social&utm_campaign=womeninhit < Previous News Next News >