New Mexico Telehealth Alliance TELEHEALTH RESOURCES | COMMUNITY | PROGRAM SUPPORT Connecting New Mexicans to Better Health. The New Mexico Telehealth Alliance (NMTHA) is a tax-exempt 501(c)(3) non-profit corporation dedicated to promoting telehealth solutions that deliver quality healthcare throughout the State. The NMTHA is a network of members representing a broad spectrum of public and private healthcare organizations. The NMTHA provides program support enabling members to eff ectively share resources. Board members and officers are all volunteers. Vision: Through the efforts of the NMTHA’s work on policy, quality, and equitable access to telehealth services, New Mexicans will be able to get the care they need when they need it. Mission: Advance effective use, equitable access, and sustainable telehealth service delivery in New Mexico. About Innovating Remote Access to Care Bridging Health Equity Gaps / Disparities AI + Digital Innovation Medicare Telehealth HCA/Turquoise Care Vision & Strategies View Presentations Why does New Mexico need a Telehealth Alliance? Click HERE to learn more... Be part of the solution! Join the Ne w Mexico Telehe alth Alliance Telehealth and telemedicine are no longer an innovative approach to healthcare - they are a necessary part of it. More than ever, access to quality healthcare, especially in New Mexico, is fundamental to the well-being of many communities, especially in rural and territorial areas. Supporting the New Mexico Telehealth Alliance through membership helps ensure access to meaningful information and supports the viability of telehealth services in New Mexico. Membership matters! Benefits of Membership Stay Connected! Stay connected with the NMTHA community by signing up to receive updates and notifications on industry trends, the latest telehealth news, events, and more. Thanks for connecting with NMTHA! Submit

Amazon Healthcare Building a National Telehealth Business Dr. Maheu, Telehealt.org January 2021 Amazon Care recently announced that it will expand nationally to all Amazon workers and other interested companies across the country in the summer of 2021. Amazon, the $1.6 trillion shipping giant, is launching a new service to provide essential medical services through Amazon Healthcare as a national telehealth business. Amazon Care uses an app that allows consumers to connect with doctors, nurse practitioners, and nurses virtually, 24 hours a day, via in-app chat or video. Initially launched and tested with Washington-based employees, Amazon Care recently announced that it will expand nationally to all Amazon workers and other interested companies across the country in the summer of 2021. “Making this available to other employers is a big step,” Amazon Care Director Kristen Helton said. “It’s an opportunity for other forward-thinking employers to offer a service that helps bring high-quality care, convenience and peace of mind.” Notice the last three descriptors: “high-quality care, convenience and peace of mind.” From the perspective of many healthcare providers, healthcare in the US has been lacking in each of these three areas. For employers registering for the service, which has partnered with Care Medical, employees near their headquarters will get online and in-person doctor visits. Employees elsewhere will get just the virtual components. Through Care Medical, Amazon Care currently offers an app to connect employees to a medical professional for a video consultation. It also offers follow-up care in the home for patients. The goal is to lower healthcare costs internally for Amazon and externally for some of the world’s most influential companies, using telehealth to meet people on their terms, with good care, wherever they are. Amazon’s Multi-Layered Business Strategy Anyone watching Amazon over the last year will be well acquainted with its accelerating moves to provide the early inklings of healthcare. Early Amazon Healthcare efforts were announced by Telehealth.org’s Telehealth News on 6/4/2020. In that article, it was reported that Amazon Health announced a pilot program offering virtual medical services to employees and their families. Amazon then expanded the presence of Alexa voice assistant, announcing that it was making it possible for voice assistant developers to offer HIPAA-compliant services for the Alexa platform. Amazon Pharmacy, a drug-delivering business in 48 states with steep discounts for Prime members was also released in November of 2020. Most recently Amazon has launched another offering called Amazon HealthLake, a HIPAA-compliant service that allows healthcare providers, health insurance companies, and pharmaceutical companies to store, transform, and analyze health data at a petabyte scale. As described on the Amazon HealthLake website: Amazon HealthLake removes the heavy lifting of organizing, indexing, and structuring patient information to provide a complete view of the health of individual patients and entire patient populations in a secure, compliant, and auditable manner. Using the HealthLake APIs, healthcare organizations can easily copy health data in the Fast Healthcare Interoperability Resources (FHIR) industry standard format from on-premises systems to a secure data lake in the cloud. HealthLake transforms unstructured data using specialized machine learning models, like natural language processing, to automatically extract meaningful medical information from the data and provides powerful query and search capabilities. Organizations can use advanced analytics and ML models, such as Amazon QuickSight and Amazon SageMaker to analyze and understand relationships, identify trends, and make predictions from the newly normalized and structured data. From early detection of disease to population health trends, organizations can use Amazon HealthLake to conduct clinical data analysis powered by machine learning to improve care and reduce costs. < Previous News Next News >

Telehealth Requires Efforts to Improve Access to Reach Full Potential Mark Melchionna November 29, 2022 New research found that telehealth expansion lacks benefits when efforts to improve access are not present, which may often lead to health disparities. Regions with limited healthcare resources may not benefit from telehealth expansion, prompting the need for efforts to improve access, a new JAMA Network Open study finds. Throughout the recent expansion of telehealth, researchers continuously gained insight into new methods for reaching areas with limited amounts of healthcare resources, highlighting many areas and populations facing limited healthcare resources. The fact and theories about the relationship between telehealth and health disparities led researchers to conduct a cross-sectional study containing 2015 to 2019 American Community Survey data which was linked to national, state, and county-level metrics of healthcare access. Prior to the study, the authors hypothesized that internet access was poor in areas that lacked sufficient access to traditional healthcare resources. Known as healthcare deserts, communities with limited healthcare services such as pharmacies, hospitals, PCPs, and low-cost health centers were reviewed for the study. The data sources included dataQ and GoodRx databases for 60,249 pharmacies, federal information on primary care health professional shortage areas, and geospatial information. Researchers calculated the proportion of populations with internet access and the expected number of healthcare deserts, which represented the population-weighted mean number of deserts in a given region. They also noted statistics for metropolitan status for each state. Among 3,140 counties reviewed in the study, researchers determined that healthcare access and internet service availability corresponded with one another. They found that the states with the largest percentage of households without internet service were Mississippi, Arkansas, Louisiana, New Mexico, West Virginia, and Alabama. The states with the lowest number of households without internet service and the lowest fitted number of healthcare deserts were Washington, New Hampshire, Colorado, Utah, California, and Maryland. Rural areas were more likely to have more health deserts and less internet service availability —78 percent compared to 26 percent of urban counties. Based on these findings, researchers concluded that telehealth expansion may not produce benefits within counties where telehealth is highly needed. Key factors that contribute to rural-urban health disparities in the US may include telehealth expansion without improving internet access as well as clinician shortages. Despite this conclusion, researchers noted limitations, which mainly related to the lack of digital literacy data that may have increased urban-rural disparities, along with the co-occurrence of poor internet and healthcare access across six domains. Previously, however, efforts have been made to support rural communities in obtaining telehealth resources. In September, Equum Medical worked with the National Rural Health Association to provide underserved rural communities with virtual resources. The goal of the collaboration was to assist rural hospitals as they aim to fill gaps in specialty care through tools such as of patient transfer assistance, remote patient monitoring, and help with telehealth implementation. See original article: https://mhealthintelligence.com/news/telehealth-requires-efforts-to-improve-access-to-reach-full-potential < Previous News Next News >

HIMSSCast: How emerging tech is opening new avenues in telehealth, RPM Mike Miliard October 28, 2022 Virtual therapeutics, voice recognition and fast-evolving artificial intelligence tools are transforming home-based care, says Robin Farmanfarmaian, co-author of the new book How AI Can Democratize Healthcare. Remote patient monitoring and other forms of virtual care are fast finding footholds in healthcare as patients get acquainted with these new care modalities, and as health systems learn to appreciate the cost efficiencies they offer. But telehealth and RPM are still in their early days, and fast-changing as they're augmented with other new and emerging digital health and artificial intelligence technologies. Robin Farmanfarmaian, a longtime Silicon Valley entrepreneur and co-author of the new book, How AI Can Democratize Healthcare, joined us recently to discuss how the growing momentum toward home-based care is being impacted by leading-edge innovations such as natural language processing, digital therapeutics and more. leading-edge-technologies-are-transforming-telehealth-and-rpm (1).mp3 Talking points: Where remote patient monitoring is now, and where it's headed How AI is changing how virtual care is delivered New approaches to patient engagement and experience What's next for digital therapeutics and other app-based interventions Innovative use cases for NLP and machine learning models More about this episode: The intersection of remote patient monitoring and AI How remote patient monitoring is moving into the mainstream AI-powered telehealth improves PT care at Essen Health Care Mayo Clinic working with Memora Health on virtual postpartum care AI-powered RPM can help address the rural neonatal care crisis How remote patient monitoring improves care, saves money AI and IoT device connects with concierge platform for RPM Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Healthcare IT News is a HIMSS publication. See original podcast: https://www.healthcareitnews.com/news/himsscast-how-emerging-tech-opening-new-avenues-telehealth-rpm < Previous News Next News >

Member & Sponsor Levels NMTHA offers multiple benefit levels: Membership Pricing structure based on organization size All Member benefits included Sponsorship Available to members and non-members All Sponsor benefits included Does not include member benefits Membership is not required for sponsorship Member benefits NMTHA Member benefits include: Tax-deductible annual dues as donation to 501(c)(3) organization NMTHA Committee membership and leadership opportunities Inform and influence local/state/national telehealth policy Gain industry insight, knowledge, professional development Networking, community forum, special events e-Newsletter, email updates, workshop notifications On-demand webinars, training videos, interviews View job postings, resume builder, skill-building content Members Select the plan that fits your organization type Health Systems, Health Plans $ 1,000 1,000$ Every year Provides access for up to 6 people Select Hospitals, Associations, Group Practices $ 500 500$ Every year Provides access for up to 4 people Select Individuals $ 150 150$ Every year Provides access for up to 1 person Select Students, Equity Members $ 20 20$ Every year Provides access for up to 1 person Select Membership dues renew annually until cancelled. For plans that include multiple users, click HERE to learn how to add users to your membership plan. For login instructions, click HERE . NMTHA Sponsor benefits include: Tax-deductible sponsorship is donation to 501(c)(3) organization Organization featured on NMTHA's dedicated Sponsor webpage Webinar presentation to NMTHA Board of Directors Poster presentation at NMTHA's Annual Town Hall Sponsor benefits Sponsors For Members and Non-Members NMTHA Sponsors (Membership not required) $2,500 $ 2,500 (Member benefits not included. Membership is available separately.) Valid for one year Select

Congress’ Last Minute Holiday Gift to Telehealth: The Omnibus Budget for FY 2023 Has Passed! CCHP December 23, 2022 Earlier today, Congress passed HR 2617, The Performance Enhancement Reform Act, the omnibus budget for FY 2023. HR 2617 includes several provisions impacting telehealth, including extending some of the telehealth COVID-19 telehealth flexibilities. In the budget bill passed for FY 2022, Congress had included a 151-day extension after the end of the public health emergency (PHE) for some COVID-19 telehealth flexibilities. However, with the passage of HR 2617, these flexibilities will now last until December 31, 2024. The main telehealth provisions in the bill include: For Medicare: Some telehealth flexibilities in Medicare are extended to December 31, 2024. These flexibilities include: temporary suspension of the geographic site requirement, continuing to allow the home as an eligible originating site, allowing certain providers, including FQHCs and RHCs to continue to be eligible telehealth providers during this period, delaying the in-person mental health visit requirement for services that take place when the patient is not in a geographically eligible location or at home that is found in non-pandemic telehealth policies, and continuing to allow audio-only to be used to provide some services. A study on telehealth and Medicare program integrity that will include a medical record review of claims from January 1, 2022 to December 31, 2024. Elements to be examined include the types of services furnished, where they were furnished, and duration of services. For the VA: Development of a strategic plan to ensure effectiveness of telehealth delivered by the VA to their enrollees. Other Items: Extension of safe harbor for absence of deductible for telehealth in health savings accounts for another 2 years (for plans after December 31, 2022 and before January 1, 2025). President Biden is expected to sign the bill which will allow telehealth providers and patients to have a little more clarity on the end date of federal telehealth provisions. For more information read HR 2617 in its entirety. Wishing a wonderful holiday season and a happy new year to all! See original article: https://mailchi.mp/cchpca/congress-last-minute-holiday-gift-to-telehealth-the-omnibus-budget-for-fy-2023-has-passed < Previous News Next News >

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 >

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 >

My Story: A Patient’s Perspective Tara Barry January 27, 2022 The pandemic has created a lot of new realities throughout the world, telemedicine being one of them. As someone with thyroid disease and other ailments, I have to get regular check-ups (sometimes every month when it’s really flaring up). With my health issues, I see multiple different doctors (primary, cardiologist, endocrinologist, allergist), and it’s often very hard for me to find time to fit them all in to my already jam-packed schedule. Telemedicine has been such a welcome adaption for me, as it has truly taken a lot of the usual “appointment” stress, like commute time, completely out of the equation. During the pandemic, I’ve been particularly cautious about in-person appointments. Since I am someone with a weakened immune system, it makes me nervous going into such a historically germ-filled location such as a doctors’ office. Telemedicine appointments truly put me at ease. I have had experience with ‘televisits’ for both primary care and specialty care. I’ve been able to have a quick appointment on my lunch break and sometimes even during a short 15-minute break. When I made my first appointment I was a little nervous about how it would be. I didn’t know if I’d feel more rushed and like they were just squeezing me into their busy day or not. It was a relief to find that wasn’t the case at all. I find these appointments to actually be much more conversational than in-person visits, and also feel like they really get down to the issues faster. You can learn about treatment options in mere minutes and have your prescriptions sent in while you’re still on the call! I am someone who is technologically savvy so I wasn’t too worried about being able to successfully hop on to a telemedicine call. I think the various systems different doctor’s offices use make all the difference. In my experience, I have always been given the telehealth links ahead of time and the instructions have been very clear and concise. Typically, the medical assistant will call prior to the appointment to go over your medical history, insurance information, what your appointment will be focused on, and the instructions to get on the call. Sure, there’s been a few times we’ve had some connection issues, but they always seem to resolve themselves quickly and don’t take away from the appointment itself. To read full article: https://telemedicine.arizona.edu/blog/my-story-patient-s-perspective < Previous News Next News >

Transforming Homes And Communities Into Healthcare Hubs In The Post-Covid Future Ryan Hullinger and Sarah Markovitz August 2021 Hospital design experts Ryan Hullinger and Sarah Markovitz discuss the inevitable shifts in healthcare delivery as technology leads to new care settings and rethinking hospitals. The explosion of telehealth prompted by the Covid-19 pandemic has accelerated a shift in care delivery away from the hospital and clinic and into homes and communities. While hospitals have historically been the main hub of care, technology and new care models are enabling a different approach to care delivery. Rather than episodic preventative care, in which a patient periodically goes to a physician or hospital with a health concern, this new model of care is continuous and ubiquitous—with ongoing care reinforced in the home, office, school and throughout the community. There are three key aspects to this shift: advancing technology, new care settings, and the future evolution of hospitals. Advancing Technology Healthcare may follow a familiar path blazed by online retail. It was not that long ago that virtually everyone preferred in-person retail experiences to shopping online. The technology that would later make online shopping experiences superior to brick and mortar just didn’t exist. Telehealth, by comparison, is still in the dial-up days. It’s difficult to imagine now, but based on the patterns we have seen clearly in other technology sectors, it’s probable that some healthcare experiences will be better remotely than in-person—more convenient, and less stressful and time consuming. The technology that will transform telehealth is on the horizon. It will take several R&D cycles, but it will come. In fact, there’s evidence that in areas like behavioral health telehealth is already comparable in efficacy to in-person care. What might the next generation of telehealth look like? For one, rather than sequential visits with separate specialists, patients may be able to connect to a suite of caregivers, all working collaboratively to provide more coordinated, effective care. The type of continuous, convenient touch-bases and flow of information enabled by telehealth and wearable devices could be particularly effective for the elderly and those with chronic conditions, where communication and ensuring compliance with medication and preventive care are often an issue. There will also likely be an expansion in the types of care and services that can be provided, including everything from post-surgical appointments, to ED triaging, and eventually more complex tests as new diagnostic technologies emerge. Automated technologies and artificial intelligence will also play an increasingly vital role in improving health throughout the community. AI technologies are being used to scan patient records, identify patients with hypertension and diabetes, and remind physicians to check in regularly with them. Hospitals have already shown good results using telehealth, texting and improved monitoring to help vulnerable populations and those with chronic conditions. Improved telehealth and health data capabilities could extend widescale efforts like these, improving population health efforts. New Care Settings With technology acting as a facilitator, more and more forms of care, especially routine procedures, will migrate away from hospitals and clinics. The home could become the new healthcare hub, with prefabricated telehealth units for the home that integrate medical technologies with telehealth capabilities. The explosion of smart home, home health and health monitoring devices, encompassing everything from sensors that detect sudden falls to smart watches that monitor heart rate and O2 levels, is only the tip of the iceberg. With the ability to monitor health data and communicate effectively with caregivers, the home could be a crucial site for preventive medicine, chronic disease management and ongoing care. The home health model is only one possible model—the technologies that enable it may have shortcomings, or prove unaffordable to large segments of the population, further exacerbating health inequities and the digital divide. But healthcare can still be provided in a wide range of locations distributed throughout communities. Libraries, schools, community centers, homeless shelters and pharmacies could become hubs for telehealth resources and care, serving a vital role in improving the health of communities. A key consideration will be access and location—ensuring that healthy equity and care for vulnerable populations drives where these new care hubs emerge. How Hospitals May Evolve As care becomes increasingly continuous and ubiquitous, the role of the hospital may evolve. Rather than serving as a destination for all patient types, it will become increasingly specialized and streamlined, focusing on high acuity cases. They may expand their capabilities and efficiency in areas like perioperative and high-end imaging that are not available in community settings. In the process, hospitals are likely to become more compact, high performing and efficient by narrowing their focus. As part of this evolution, hospitals may also need to bolster their ability to expand capacity by 50-100% in anticipation of emergencies like epidemics, mass casualties and weather-related crises. In the last 20 years, many hospitals have invested heavily in improving patient comfort and satisfaction, and have even borrowed processes and designs directly from the hospitality industry—creating patient environments that nearly resemble hotel lobbies and guestrooms. Patient satisfaction will continue to be a driver, but the environments that promote satisfaction are likely to change drastically. New environments that convey a sense of safety and cleanness will begin to feel more comfortable than the hospitality-informed designs of the past. As this shift and gradual downsizing takes place, there may be opportunities to adapt existing space for other uses. The Covid-19 pandemic has demonstrated the dramatic impact of stress on healthcare workers. Hospitals now have an opportunity to provide sufficient and appropriate space for staff, helping to build resiliency to counter staff burnout and ensure the well-being of these truly essential workers. Hospitals could also aim to provide more community, patient and staff resources, such as spaces to demonstrate telehealth technologies and how to use them, or new hybrid offices equipped for telehealth. As technologies, new care settings, and hospitals evolve, care will become more embedded in our daily lives. The pandemic may have spurred new interest in telehealth, but the trends shaping the future of care predate social distancing. They will continue to transform how and where care is delivered, ushering in a new era of ubiquitous healthcare. Source: https://www.forbes.com/sites/coronavirusfrontlines/2020/10/26/transforming-homes-and-communities-into-healthcare-hubs-in-the-post-covid-future/?sh=133370e04153 < 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 >

AMA survey shows widespread enthusiasm for telehealth American Medical Association March 23, 2022 CHICAGO — An American Medical Association (AMA) survey released today shows physicians have enthusiastically embraced telehealth and expect to use it even more in the future. Nearly 85% of physician respondents indicated they are currently using telehealth to care for patients, and nearly 70% report their organization is motivated to continue using telehealth in their practice. Many physicians foresee providing telehealth services for chronic disease management and ongoing medical management, care coordination, mental/behavioral health, and specialty care. The survey comes as Congress recently extended the availability of telehealth for Medicare patients beyond the current COVID-19 public health emergency. Additional action by Congress will be needed to permanently provide access to Medicare telehealth services. As physicians and practices plan to expand telehealth services, they say widespread adoption hinges on preventing a return to the previous lack of insurance coverage and little to no payer reimbursement. Payers, both public and private, should continue to evaluate and improve policies, coverage, and payment rates for services provided via telehealth. “Physicians view telehealth as providing quality care to their patients, and policymakers and payers have come to the same conclusion. Patients will benefit immensely from this new era of improved access to care,” said AMA President Gerald E. Harmon, M.D. “This survey shows adoption of the technology is widespread as is the demand for continued access. It is critical that Congress takes action and makes permanent telehealth access for Medicare patients.” Physicians strongly support that telehealth via audio-only/telephone remains covered in the future to ensure equitable access. That coverage has been permitted during the public health emergency and extended for several months afterward. According to the survey, 95% of physicians report patients are primarily located at their home at the time of the virtual visit. Allowing patients to be in their home is a key component of making telehealth more accessible. Before the pandemic, Medicare patients needed to be physically located in a rural area to access telehealth services, shutting out urban and suburban patients from receiving the same benefits of virtual care. Before the pandemic, rural patients needed to travel to an “originating site,” essentially another health care facility, outside of their home to access telehealth services. The temporary extension in the omnibus will allow patients with Medicare to receive telehealth services anywhere they are located, including in their home. The AMA will continue to urge Congress to make permanent this and other policies that have offered coverage and convenience to patients. Fewer than half of respondents report being able to access all of their telehealth platforms via their electronic health records, and more than 75% report that their support technology does not automatically collect and deliver patient-reported data. Improving interoperability between platforms and support technology would improve and streamline telehealth services. Physicians perceive technology, digital literacy, and broadband internet access to be the top three patient barriers to using telehealth. In addition, only 8% of physician respondents said they were using remote patient monitoring at this time. The AMA will advocate for patient populations and communities with limited access to telehealth service, including but not limited to, supporting increased funding and planning for telehealth infrastructure such as broadband and internet-connected devices. Read the survey here. To learn more about the results, register for an AMA Telehealth Immersion Program webinar at 10 a.m. ET March 31. Media Contact: Jack Deutsch ph: (202) 789-7442 jack.deutsch@ama-assn.org About the American Medical Association The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care. < Previous News Next News >

Sparrow Health System uses pandemic lessons to expand its virtual care strategic plan Bill Siwicki September 28, 2022 Today, the Michigan health system is seeing more than 1,000 e-visits per month, making greater use of its patient portal and successfully addressing the behavioral health caregiver shortage. Sparrow Health System in Lansing, Michigan, began developing a virtual care strategy in October 2019 – well before COVID-19 struck – with the hope of leveraging the technology as a tool to support patient care and the organizational strategy, rather than as a stand-alone strategy in and of itself. Sparrow's initial goal was to launch on-demand, virtual urgent care to increase access and provide another front door into the health system. It intended to go live in July 2020, using Amwell as the technology and services vendor for virtual urgent care for an estimated 1,500 visits in the first year. Telehealth plans quickly changed But then, COVID-19 hit, and plans quickly changed. "With most of our practices closed in late March of 2020, we needed an immediate solution that couldn't wait until July," said Patrick Sustrich, director of retail healthcare at Sparrow Health System. "What we thought would take months took us days, and we leveraged the capability of our Epic EHR to stand up on-demand and scheduled video visits using Zoom for Healthcare and our own providers. "In the first month, we surpassed our one-year goal of 1,500 virtual visits – telephone and video," he continued. "The benefit of staffing this ourselves was that it allowed our providers to access the patient's medical record, document directly into the chart and accept all the same insurance we do for in-person visits." Once the practices reopened, most thought they would resume normal operations and transition all their visits back to in-person. But this did not happen. Patients enjoyed virtual care "Not only was COVID not over, but patients enjoyed the convenience of virtual visits, and providers saw the value of this tool," Sustrich said. "Through August 2022, we have successfully completed more than 144,000 virtual visits. "Additionally, our health system has embarked on a strategy to tend to a situation that has plagued providers since the inception of the patient portal – the overwhelming number of medical advice requests," he continued. In fact, more than 16,000 medical advice requests are received each month. This uncompensated care takes hours out of a provider's day, and a solution was badly needed. Sparrow took a multi-tiered approach to resolve this issue. "The first approach was to leverage Epic to triage medical advice requests to the correct location – one direction for billing/finance, another for medication refills and another for scheduling questions/issues," he explained. "This significantly reduced the number of medical advice requests to the provider. "Next, we launched both patient- and caregiver-initiated e-visits in an effort to convert messages requiring medical decision-making into billable visits," he said. "Monthly reports were generated to providers showing them precisely the opportunity to convert medical advice requests into e-visits." More than 1,000 e-visits per month Although caregiver-initiated e-visits have only been available since Q2 of this year, Sparrow is averaging more than 1,000 e-visits per month. Additionally, a pilot is being conducted to evaluate the impact of using a centralized nurse triage process to resolve minor patient issues, freeing up providers' time to increase access. "Our main hospital campus struggled with LOS and a lack of beds, as most hospitals did during COVID," Sustrich recalled. "We needed to leverage the bed capacity of our community hospitals. We quickly looked for a telehealth solution to prevent unnecessary transfers and keep care local. "iPads with a Zoom video link provided patient-to-provider and provider-to-provider connections," he continued. "FCC funding we received has enabled us to purchase five telemedicine carts from Amwell, allowing an offsite provider to control the camera's pan/tilt/zoom features and access a digital stethoscope." Sparrow intends to place these carts at all five offsite ED locations. In the future, it plans on expanding specialist resources to provide care across the health system. Specialists such as those focused on pulmonology, behavioral health and infectious disease could never be supported at one community hospital, but collectively, and with the help of virtual care, these specialists can serve the entire health system, he stated. Staffing a 24/7 platform "Our current 24/7 on-demand platform's wait time is under 19 minutes, with an average completion rate of more than 80%," Sustrich reported. "It is rare to find a health system staffing its own 24/7 platform while having access to the patient's medical record and the ability to document within the EHR. "Many others have contracted this service out to a third-party vendor, which I believe sacrifices patient care quality and safety," he added. Additionally, Sparrow providers staffing this platform respond to e-visits from patients without a primary care provider, conduct COVID follow-up calls, and perform QR validation in the MySparrow Portal for patients who have received the COVID vaccination outside of the health system. After-hours coverage (8 p.m. – 8 a.m.) is conducted by three ED locations offsite from the main campus. "Another metric I am very proud of is our MySparrow Portal activation rates," Sustrich noted. "Early in the pandemic, it became apparent that patient success with our virtual health services was high in patients who already had a portal account. "In response, a campaign across Sparrow's entire medical group was launched to increase MySparrow Portal activation rates," he continued. "Patient tutorials were created, and the campaign began within ambulatory practices; each practice was given a goal, implemented best practices and shared a monthly scorecard." Caregivers hitting their goals Caregivers were rewarded with gift cards when their practice hit their goal, and the hospital's foundation funded the gift cards. Within two years (April 2020 to March 2022), Sparrow saw a 152% increase in its active MySparrow Portal users (146,768 to 369,916) and increased the percentage of patients with a portal account from 55.2% to 78.8%. The challenges Sparrow faced were similar to those of most other health systems, and this caused Sparrow to build the plane while in flight and struggle with training and experience gaps, Sustrich said. "Our assets included an engaged leadership team that supported our virtual health strategy and was willing to invest in it," he said. "We also leverage Epic and its ongoing development of virtual health tools. And I would be remiss if I didn't mention the resilience of our caregivers." Sustrich points to various signs of success: • More than 70,000 successfully completed video visits in the first two years. • More than $8 million in video visit revenue. • 40,000 hours of patient drive-time saved. • A 10% increase in the SUS Score. • Patient satisfaction went from 80% to 89%. • A 20% shift from telephone to video visits. A major FCC telehealth grant "Sparrow had the top FCC grant application in Michigan and was among 62 healthcare facilities nationwide that received funding from the FCC in Round 2 of its COVID-19 telehealth grant program," Sustrich reported. "The $586,000 was used for ambulatory virtual health hardware deployment, a virtual behavioral health program to expand access and cart technology to increase communication and improve care to our community hospitals out in the region. "Hardware purchased included 115 docking stations, 140 Bluetooth digital scales, 350 headsets, 230 monitors, 115 and keyboards with mouse," he continued. "This standardized virtual health equipment across our health system makes video visits accessible to a larger number of providers, thereby positively impacting patients and increasing access to care." Because of the nationwide shortage of psychiatrists and behavioral therapists, patients find it more difficult to access mental health services. "A portion of the FCC money purchased 40 iPads housed in five emergency rooms and throughout each inpatient floor at the main hospital to access virtual behavioral health services," Sustrich said. "Additionally, psychiatrists at Sparrow's St. Lawrence campus can virtually connect with patients in the adult psychiatric, geriatric psychiatric and outpatient units through an audio/video connection. "This will decrease wait time and increase access to behavioral health services," he concluded. "Additionally, bed capacity will increase from 60% to 85% occupancy." Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/sparrow-health-system-uses-pandemic-lessons-expand-its-virtual-care-strategic-plan < Previous News Next News >

Expansion of Telehealth Services Must Be Sustained Gerald E. Harmon, MD American Medical Association President July 2021 Now it’s time to cement that success by making permanent the temporary easing of restrictions that brought the full potential of telehealth into focus. The rapid growth and large-scale adoption of telehealth services over the past 18 months has allowed physicians to deliver a broad range of badly needed services to patients nationwide in an innovative, cost-effective manner. Now it’s time to cement that success by making permanent the temporary easing of restrictions that brought the full potential of telehealth into focus. Congress can brighten this picture by passing legislation already introduced into the current session that enjoys bipartisan support. Among other steps that need to be taken, the pending legislation—CONNECT for Health Act of 2021 (S 1512) and the Telehealth Modernization Act (HR 1332)—would strip away all geographic restrictions placed on telehealth services and allow Medicare recipients to receive this care in their own homes, rather than being forced to travel to an authorized health care center to receive it. Although this provision has been waived for the duration of the public health emergency trigged by the COVID-19 pandemic, the ability to provide telehealth services directly to patients regardless of their location will be lost unless Congress acts. Physicians and their patients who have witnessed firsthand the immense benefits and value of telehealth services must not be forced to stop using these widely available tools for better health simply because the pandemic is over. Telehealth has improved health care The benefits of telehealth are obvious. Telehealth enables physicians to strengthen continuity of care, extend access outside of normal clinic hours, and ease the impact of clinician shortages in rural areas and among underserved populations. By increasing the quantity and quality of communication between patients and physicians, telehealth has strengthened the trust that lies at the center of this relationship. Telehealth can slice overall health care costs by helping physician practices and health care systems better manage diabetes, heart disease and other chronic illnesses while increasing the overall quality of care and patient satisfaction. This technology can also prevent patients from delaying care for conditions that, if undetected and untreated, can trigger emergency department visits or lengthy hospital stays. Wide-ranging case-study examples of the comprehensive value that virtual care can provide are featured in the AMA’s Return on Health research issued in May. And let’s not forget the value of telehealth services to patients with impaired mobility, the immunocompromised, frail or elderly individuals who require the aid of a caregiver to travel, and those who cannot arrange the transportation or child care they need to receive care. The enhanced opportunities telehealth affords to assess the impact of patients’ social determinants of health lays the groundwork for better treatment and improved health outcomes for historically marginalized and minoritized communities. The widespread expansion of telehealth services we have witnessed serves all of these patient populations and others in an efficient and cost-effective manner that must be sustained. While the Centers for Medicare & Medicaid Services has expanded its coverage for telehealth services during the pandemic, only action by Congress will ensure that Medicare beneficiaries will enjoy full access to those services once the pandemic is behind us. The expansion of telehealth covered by Medicare at payment parity with in-person services during the COVID-19 public health emergency includes more than 150 services, including emergency department visits, hospital admissions and discharges, critical care and home care, to name just a few. Offering this equivalency remains a critical factor in ensuring that physician practices can cover the additional costs tied to virtual care provision. How we support greater telehealth adoption Our AMA’s commitment to telehealth technologies grows stronger each day. For example, our Telehealth Immersion Program helps individual physicians, physician practices and health systems expand and optimize telehealth services through interactive peer-to-peer training sessions, curated webinars, clinical best practices, virtual care boot camps and other assets. Additional resources, including a Telehealth Quick Guide, Telehealth Playbook, and STEPS Forward™ telehealth training module, are just three more examples among many available on our website. The Digital Medicine Payment Advisory Group is a collaborative initiative convened by the AMA to help integrate digital medicine technologies into clinical practice by knocking down barriers to widespread adoption while zeroing in on comprehensive solutions for issues with coding, reimbursement, coverage and related factors. The mission of this diverse cross section of nationally recognized digital medicine experts includes: Reviewing existing code sets—particularly CPT® and HCPCS—to ensure they accurately reflect current digital medicine services and technologies. Assessing factors that affect the fair and accurate valuation of services delivered in this manner. Providing information and clinical expertise that promotes widespread coverage of telehealth, remote patient monitoring and all other digital medicine services, including increased transparency of services covered by payers and improved enforcement of parity coverage laws. The expansion of physician-based telehealth services in 2020 ranks as one of the most important advances in health care delivery in many years. Allowing this progress to slip from our hands because of outdated and arbitrary restrictions will result in higher costs and poorer health outcomes for patients everywhere. The decisions made and the policies adopted in the near future will shape the direction of telehealth services for many years to come. We urge Congress and the Biden administration to take the steps necessary to build on the progress in virtual care we’ve made thus far while laying the foundation for greater innovation going forward. < Previous News Next News >

Telehealth's importance grows amid coronavirus pandemic Rick Ruggles March 12, 2022 The coronavirus compelled doctors to see patients in new ways, and one of those is through a computer monitor, miles away from the patient. The pandemic placed greater emphasis on telehealth, which has been around for years but was put to use urgently when the coronavirus spread in early 2020. Officials with Medicare, the government-sponsored insurance for senior citizens, also increased the number of the occasions in which telehealth could be covered during the pandemic. Whether vast telehealth use and broad insurance coverage for it will continue isn’t certain, those who know the benefits of telehealth say it has proved itself and is here to stay. “It’s become part of life,” said Sharon V. Nir, administrative director of strategic operations with Albuquerque-based Lovelace Medical Group. “I do think it’s the new world.” Lovelace created an extensive program in March 2020, with the arrival of the coronavirus, to make remote visits available to patients and doctors through laptop computers, iPads, cellphones and desktops with cameras and microphones. Presbyterian Healthcare Services, Christus St. Vincent Regional Medical Center, University of New Mexico Health, La Familia Medical Center and most other medical systems also increased their use of telehealth. Santa Fe Preparatory School teacher Brad Fairbanks went head over handlebars on his bicycle last month, breaking a collarbone and three ribs. He spent time in an emergency room, but his follow-up visits with his family physician, Dr. Carl Friedrichs of Presbyterian Medical Group, were done remotely. Fairbanks, 61, said the follow-up appointments and pain medication assessments were as effective by videoconference as they would have been in person. “This was the first time I’d done telehealth,” said Fairbanks, the performing arts chairman at his school. “Yes, it worked great.” He said the accident happened at a bad time, with his students preparing to put on the show 9 to 5 The Musical. He missed four days of work and two rehearsals and had to participate in two other rehearsals by Zoom technology. Friedrichs said there is plenty that can be accomplished in a telehealth appointment. “The patient has the choice,” he said. “It’s an extra tool for patients.” In a big state like New Mexico with vast rural expanses, it makes sense to lean on telehealth, he said. “This is a state that has limited medical resources.” Videoconferencing can’t be used for everything, of course. Annual physicals and diagnoses requiring the doctor to lay hands on the patient must be done in person. Blood draws for lab work require a visit, although the result of that lab work can be covered in a virtual appointment. And some patients aren’t at ease with the technology. But telehealth gives patients in rural areas and those who struggle to find transportation the chance to get some of their services done by videoconference. And when the highly contagious coronavirus roared through the world, patients who were reluctant to visit the doctor’s office had an alternative. Christine and Ed Shestak of Albuquerque have had about four videoconference appointments apiece through Lovelace since the start of the pandemic. “For routine things, it just kind of minimizes the risk of picking up anything anybody else might have” in the doctor’s office, said Christine Shestak, 69. She recalled when she took her children to the pediatrician many years ago, kids would cough, noses would run and children would share toys in the waiting room. Telehealth is a solution, she said, and if she has the flu, she doesn’t have to carry it into the clinic and possibly infect others. Ed Shestak, who will soon be 70, said he has hearing aids and sometimes struggles to absorb everything if there is background noise in the doctor’s office. At home, he puts on headphones for his virtual visits. “I can hear and understand better,” he said. Naturally, insurance coverage of telehealth is complicated. Before the pandemic, Medicare coverage for telehealth generally favored rural patients and also included some specific conditions such as end-stage renal disease and strokes. But when the coronavirus forced patients to work from home and limit travel, the Centers for Medicare & Medicaid Services expanded coverage on an emergency basis to patients in cities, to a wider variety of medical practitioners and for a broader set of reasons. Telehealth used by primary care doctors boomed. Specialists in psychology, the digestive tract, lungs and heart also saw increased use of telehealth. The federal government reported in December that Medicare-covered telehealth visits leaped from 840,000 in 2019 to 52.7 million in 2020. Presbyterian spokeswoman Amanda Schoenberg said scheduled telehealth visits with Presbyterian Medical Group went up by 100 times from 2019 through 2021. Medicare will continue to cover many of those services at least through 2023 while officials evaluate the system. Tennessee-based Baker Donelson law firm says on its website new Medicare provisions also permanently removed geographic restrictions on telehealth for diagnosis, evaluation and treatment of mental health disorders. Stetson Berg, chairman of the New Mexico Telehealth Alliance, said Congress will have to pass laws to cement much of the coverage that was added on an emergency basis during the pandemic. Berg said state law in New Mexico has provided some of the most progressive private insurance coverage of telehealth and has served as a “shining star” in the field for close to 10 years. New Mexico was ahead of the game in part because it is so rural, he said. Other states are catching up. In the journal Annals of Internal Medicine, researchers reported last month that analysis of 38 studies showed videoconferencing “generally results in similar clinical effectiveness, health care use, patient satisfaction, and quality of life as usual care for areas studied.” Those studies were limited to “patients seeking care for a limited set of purposes,” the report added. Christus spokesman Arturo Delgado wrote in a text message that virtual visits “are appropriate for most evaluations. Conditions that can be evaluated include anything from a cough or a cold to more complicated conditions like diabetes or heart disease.” Jasmin Milz Holmstrup, a spokeswoman for La Familia Medical Center in Santa Fe, said the use of telehealth increased considerably at her institution from 2020 to 2021. “It’s an effective way to see patients who have non-urgent needs,” she said. University of New Mexico Health said the institution “utilized all available options to continue to provide patient care, including telehealth. This was a successful way to ensure patients continued to receive care and access to a provider.” Prep teacher Fairbanks said his students prepared for the play while he was “in my recliner, all banged up.” The shows took place March 3 to March 6 and the medical appointments by telehealth and attendance of rehearsals by Zoom didn’t pose a problem. His students came through. “It worked out,” he said. “And the kids stepped up.” < Previous News Next News >

Transgender Telemedicine and Telehealth Services: A Tremendous Asset Dr. Maheu, Telehealth.org August 2021 Telehealth services can also be effective in reaching communities not isolated by location but marginalized by identity. One of the most significant arguments for telehealth services is their ability to reach people in underserved communities. Telehealth.org described some of the foundational issues in its article The Future of Telehealth, Teletherapy, and Telemedicine. The article specifically highlighted telehealth as a means of overcoming geographic limitations. However, telehealth services can also be similarly effective in reaching communities not isolated by location but marginalized by identity. In particular, transgender telemedicine & telehealth services provide significant benefits to the trans community. Challenges Facing the Transgender Community Telehealth.org outlined many challenges facing transgender individuals seeking services in its article Transgender Telemedicine: Inequities and Barriers in Health Care Access. In seeking therapy services, one of the most substantial dissuading factors reported by transgender individuals is fear of discrimination. This fear does not come without significant evidence. Last year, the Supreme Court decided to extend trans individuals the same discrimination protections other groups already experience under employment laws. Even after that landmark decision, 38% of Americans still indicate they do not support the rights of trans people. With so-called bathroom bills and legislation that prevents trans girls and women from participating on sports teams for women, the current American legislative landscape continues to be challenging. Location and marginalization often intersect. Trans individuals living in rural areas often face a general lack of available services. Additionally, available clinicians usually do not have a trans-informed perspective. Similar concerns exist in politically conservative areas. How Transgender Telemedicine and Telehealth Services Help the Trans Community As noted above, telehealth services have already been an asset to assist individuals who are geographically isolated. It should be just as effective in reaching trans individuals in those areas as helping others. For those isolated by discrimination and fear of discrimination due to their trans status, telehealth can also help. By allowing people in the trans community to reach beyond their geographic limitations, they immediately have access to a larger pool of supportive clinicians who can provide trans-informed services. Telehealth transgender services also provide increased anonymity to a degree for trans people. In many of rural America’s small towns, people know each other by vehicle. Seeing someone’s vehicle parked in front of a mental health or drug treatment facility can often send the town’s gossip mill into a tailspin. By accessing discrete trans telemedicine or telehealth services to their homes, people avoid this harmful exposure. Can Transgender Telemedicine & Telehealth Services Continue? Trans individuals used telehealth 20 times more in the past 18 months than they ever have before. This new safe therapy avenue, however, may not last. Just two weeks ago, four states either ended many of their telehealth expansion policies or announced their intention to do so. Federally, the waivers introduced by the CARES Act will expire in October unless renewed or made permanent. The system is in transition and it may well end up leaving behind some of the progress it has made. Transgender Telemedicine and Telehealth Advocacy The time is now to reach out to your officials, state and federal, and advocate for more permanent laws that expand telehealth services and reimbursement. Sharing case examples without client identifying information and your passion for the issue could be just the sort of personal advocacy needed. Your voice may persuade elected officials to act quickly and empathetically on behalf of the trans community and everyone else who will benefit from telehealth support. Rural Transgender Report: https://www.lgbtmap.org/file/Rural-Trans-Report-Nov2019.pdf < Previous News Next News >

Teletherapy Aimed to Make Mental Health Care More Inclusive. The Data Show a Different Story Jamie Ducharme June 14, 2021 Case studies suggest teletherapy can work well when it’s integrated into the traditional, in-person medical system. For years, teletherapy has been pitched as the next frontier in mental-health care. Unlike medical disciplines requiring a more hands-on approach—say, physical therapy or surgery—talk therapy has long seemed a natural and effective fit for telehealth. And by taking appointments off the therapist’s couch and into patients’ homes via their devices, advocates argued, telehealth could make counseling more accessible and convenient for everyone, with particular benefits for those who lived in health care deserts or who couldn’t regularly drive back and forth to see a clinician. The hope was that virtual therapy could help democratize a system that allowed almost 20% of white Americans to receive mental-health care in 2019, but fewer than 10% of people identifying as Black/African American, Hispanic/Latino, Asian or Pacific Islander. Then, of course, the pandemic hit, sending the U.S. health care system into a panic and shuttering clinics and private practices nationwide. Telehealth, once psychiatry’s up-and-comer, was suddenly its lifeline. With impressive speed, a system built around face-to-face visits shifted almost exclusively online. By May 2020, 85% of the American Psychiatric Association’s (APA) surveyed clinician members said they were conducting the majority of their sessions virtually, up from just 2% prior to the pandemic. It was the perfect pressure test for the promise of virtual mental-health care. If there was ever a time for teletherapy to shine, it was during the pandemic. But the data aren’t so shiny. Telehealth has indisputably improved mental-health care access—but not to such an extent that it delivers on promises of revolutionizing the mental-health system. The same problems that kept many people—particularly those who are lower-income or of color—from seeking care before the pandemic still exist, even with the expansion of telehealth. As a result, mental-health usage in the U.S. hasn’t changed as drastically as many advocates would have liked. In a series of TIME/Harris Poll national surveys conducted this winter and spring, about half of respondents reported using telehealth since the pandemic began, compared with about 25% who said they had beforehand. Increases in telehealth usage during the pandemic, broken down by demographic groups But only about 5% said they’d gotten mental-health care for the first time during the COVID-19 crisis. That suggests the expansion of telehealth didn’t bring in an influx of new patients to the mental-health system. Government data show a similar picture: about a quarter of U.S. adults received mental-health care in the winter of 2021, according to the U.S. Centers for Disease Control and Prevention (CDC), up from about 19% in 2019. That’s an improvement, but not an enormous one. The number of U.S. adults reporting mental health problems grew significantly during the pandemic, but the number of those getting treatment did not Similarly, a March 2021 study from California’s Kaiser Permanente health system found that telehealth allowed clinicians to conduct 7% more psychiatric visits in spring 2020 than 2019—but most of those were with patients who already had a psychiatric diagnosis. Among people without a pre-existing diagnosis, volume declined by more than 40%, suggesting that virtual appointments were more helpful for people already served by the mental-health system than those outside it. On the opposite U.S. coast, telehealth allowed McLean Hospital, a psychiatric institution near Boston, to increase outpatient volume by about 15%, counting both new and existing patients, but psychiatrist-in-chief Dr. Scott Rauch says there’s “absolutely the recognition that there are some populations,” like certain older adults, “that are having difficulty accessing the technology.” In fact, despite the increased availability of telehealth, the share of American adults with an unmet mental-health need increased from August 2020 to February 2021, from 9% to almost 12%, according to CDC data. That’s understandable, given elevated levels of anxiety, depression and stress during the pandemic, but it also suggests teletherapy is not a panacea. And that means the harder work is still ahead. There are lots of ways to think about access to care. The most obvious—making it easy for a patient to speak directly with a clinician, either in person or via a device—is only one. There are also financial barriers. A single therapy session can easily top $100 (without insurance) in many parts of the country, and telehealth has done little to change that. Rightly so, argues Dr. Joe Kvedar, a former president of the American Telemedicine Association, since there’s no evidence to suggest virtual therapy is lower quality than face-to-face. Be that as it may, high price tags mean both therapy and teletherapy remain unattainable for many. Another limitation: there are simply not enough therapists to go around. More than 125 million people in the U.S. live in an area with a shortage of mental-health practitioners, according to U.S. Health Resources and Services Administration estimates. Whether they’re seeing patients virtually or in the flesh, there are a finite number of mental-health professionals with a finite number of hours in their days. Rauch, from McLean Hospital, says telehealth can increase appointment capacity somewhat, mainly because patients are less likely to cancel or no-show, but “as long as it requires an hour of clinician time to deliver an hour of clinical service, expanded access won’t be drastically enhanced.” To meet demand, the U.S. needs not only more therapists generally, but also more therapists from diverse backgrounds. A 2020 study concluded that just 10% of U.S. psychiatrists identify as Black, Hispanic, American Indian, Alaska Native, Native Hawaiian or Pacific Islander. That means many patients of color can’t find a therapist whom they trust and with whom they can form a close rapport, a barrier that dissuades many people from getting the help they need or prevents them from reaping the full benefits of therapy, says Dr. Amanda Calhoun, a psychiatry resident at Yale and a fellow on the APA’s Council on Minority Mental Health and Health Disparities. “There are many patients who want a Black therapist and they can’t get it,” Calhoun says. “If we truly want to reduce the gap [in mental-health care usage] we need to make it a trustworthy system where people feel they can connect with their therapist or psychiatrist.” Patients who do not speak fluent English, or who feel more comfortable using another language, may also struggle to find a therapist with whom they can communicate freely. Increased use of language interpretation could be an essential tool for expanding access, Calhoun says. It seems naive, or at least wildly optimistic, to think telehealth could overcome some of these entrenched structural issues. And in some cases, virtual care actually worsens disparities. Some people don’t have a reliable Internet connection or a smart device, for example. About 7% of American adults don’t use the Internet at all, according to Pew Research Center, and those without advanced education and people of color—i.e., those already often underserved by the mental-health system—are least likely to be “digitally literate,” according to a 2020 Health Affairs article. Further, elderly adults, an estimated 20% of whom have some sort of mental-health condition, may struggle to navigate virtual platforms even if they have quality Internet access. And online platforms aren’t perfect. Some people feel uncomfortable sharing their most intimate thoughts through a screen, and any digital system runs the risk of malfunctioning or being hacked. That recently happened in Finland, when a data breach led thousands of patients’ sensitive appointment notes to land in hackers’ hands. Plus, teletherapy is only convenient if you’re able to step away from work and other responsibilities to conduct the call in a private place. While the pandemic has many white collar workers drowning in time at home, surrounded by devices, that’s far from a universal experience. For essential workers, a disproportionate number of whom are people of color, it may be only slightly easier to steal away for a teletherapy appointment than it would have been to schedule an in-person visit with a clinician. Perversely, teletherapy may be making it easier than ever for people who already had access to mental-health care to get it, while leaving behind the people who arguably need it most. If teletherapy isn’t doing the trick, the question then becomes how to better serve those still not getting the mental-health care they need. Calhoun says any real solution needs to take a step backward and investigate why many people either cannot or choose not to seek help. For people of color, centuries of neglect and mistreatment by the medical institution are not easily forgotten. In the 1700 and 1800s, influential American doctors coined since-discredited diagnoses like “drapetomania” (psychosis or madness causing an enslaved person to run away) and “negritude” (essentially, the “disease” of not being white). Many contemporary providers aren’t aware of those offensive diagnostic frameworks, Calhoun says, but the cultural legacy of that racism is still widely felt in communities of color. Training more clinicians from underserved backgrounds is the single most impactful way to encourage people of color to get help, Calhoun says. But that process takes time. In the interim, she says, all clinicians need to be educated about psychiatry’s problematic past so they can acknowledge and understand why some patients may not feel comfortable seeking help, and then hopefully address those issues in their own practices. Looking beyond telehealth and focusing on community-based programs—like church-run mental-health groups or the Confess Project, a nationwide initiative that trains barbers to be mental-health advocates—may also help build that trust. Case studies also suggest teletherapy can work well when it’s integrated into the traditional, in-person medical system. For the past decade-plus, Massachusetts has run a program that allows participating primary-care providers to teleconference in a psychiatrist during a child’s checkup, for example. Such programs don’t eliminate mistrust of the medical system, but they can at least make it easier to introduce people to the mental-health system. Mental-health apps—while not appropriate for patients with serious diagnoses, and clearly not an option for those without a smartphone—can also provide a cheap (or even free) stopgap measure for people struggling to find or afford an appointment with a clinician, Rauch says. And in some cases, adds Dr. Adrienne Robertson, a family medicine physician who works with the online medical startup Nurx, through which people can request prescription medicines and diagnostic tests simply by filling out a form, eliminating face-to-face interactions with providers can actually put patients of color at ease, because they can “just [be] a patient like everyone else.” Policy also plays a role. Nordic countries, like Sweden, have among the most robust and widely used telemedicine programs in the world, boosted by affordable, state-sponsored medical networks. Unlike in the U.S., where insurance limitations and out-of-pocket costs are roadblocks for some patients regardless of platform, many people in Nordic countries have a public option for virtual care. Last year, the Centers for Medicare and Medicaid Services made it easier for Medicare holders to use telehealth services, a policy that allowed more than a quarter of Medicare beneficiaries (and more than 30% of Black and Hispanic beneficiaries) to use telehealth during the fall and summer of 2020, but it’s not clear what will happen after the pandemic ends. Permanent federal action for Medicare and Medicaid holders—many of whom are low-income or elderly adults—could open up therapy to millions of people who can’t currently afford it. And changing federal policies that currently limit clinicians to treating patients located in the state where they are licensed could help even out distribution of the mental-health workforce. All of these fixes are considerably more complex than bringing appointments online; they require rebuilding the system, rather than simply shifting it to a new platform. That work needs to happen sooner rather than later, Calhoun says. Already, according to TIME/Harris Poll data, many people are returning to in-person medical appointments, both psychological and physical. In May, more than half of respondents who’d received mental-health care said they’d had an in-person appointment since the start of the pandemic, up from 37% in February. While some patients and clinicians are sure to stick with teletherapy after the pandemic, much of the system will seemingly revert back to how it was—and without concerted effort, the same problems may persist for years to come. This article can be found at https://time.com/6071580/teletheraphy-mental-health/. < Previous News Next News >

Advances in telemedicine are on the way in 2022 Bill Siwicki Dec. 20, 2021 A physician expert in virtual care talks technological advances, reimbursement legislation and the continued evolution of remote patient monitoring. 2020 and 2021 saw the mainstreaming of telehealth and the rise of remote patient monitoring. These changes to the healthcare landscape were helped partly by requirements of the COVID-19 pandemic and partly by the subsequent loosening of telemedicine reimbursement and licensure regulations by the government. But what's to happen in 2022? Will the government and commercial payers continue to reimburse for telemedicine? Will new virtual-care legislation pass? Will there be technological advances that push the care paradigm further forward? And what of the future of remote patient monitoring? Healthcare IT News sat down with Dr. Ian Tong, chief medical officer at Included Health, a telehealth technology and services company, to get his read on these questions and his predictions for telehealth in 2022 and beyond. Q. What do you see in the realm of technological advances in telemedicine in 2022? A. While 2021 saw many healthcare technology mergers and acquisitions in response to the pandemic, and growing virtual-care adoption among payers, providers and consumers, much of the technology of these combined entities remains fractured. Though promoted as one offering, consumers still are having to navigate two or more platforms and work to connect the dots themselves. The technology needs to become invisible – so good that you don't even realize it's there. The technology for virtual-care appointments also will continue to advance beyond 1:1 doctor-patient video conferencing. For example, in response to the rising behavioral health provider shortage, we can expect to see technology that can enable group sessions with multiple patients receiving counsel and support at once. Whether it's behavioral, acute or chronic care, the most important role that technology will play is enabling all physicians to have the same window into a patient's medical history and care plan so they can provide integrated, longitudinal care. The technology is what will enable this industry to realize the full potential of virtual care beyond transactional, one-time interactions. Q. All the temporary reimbursement moves by government and payers for the sake of the pandemic really pushed telehealth into the mainstream. What do you foresee happening with reimbursement for virtual care in 2022? Will it become permanent? Will it be expanded? A. With usage rates 38 times higher than pre-pandemic, and the inarguable value for the people who need it most – seniors and the immunocompromised who can't afford in-person exposure – I believe the government will and should expand virtual-care access. Pre-pandemic virtual care was used for urgent, low-complexity issues – cough, cold, rashes. But today, the real value is for integrated chronic-disease management or ongoing behavioral-health therapy, where people need not be burdened by the constant travel in and out of doctors' offices. The more care that shifts to virtual, the less burden of disease the patients will have, which will lead to better outcomes. This is an opportunity that should be afforded to everyone, especially our most vulnerable and historically underserved communities. Q. Remote patient monitoring is a form of telehealth that is of growing interest to healthcare provider organizations. What do you see happening with RPM in 2022? A. Adoption of remote patient monitoring devices continues to rise, and we don't see it slowing down any time soon. Today, one third of consumers are more likely to choose a provider that allows them to share data from a connected health device, which only promotes more positive outcomes. The more real-time data that we can collect in the comfort of people's homes, the more personalized, data-driven virtual care we can provide. However, to really launch adoption in this sector, the costs of these devices need to come down. As costs come down, health plans can more easily find an ROI [return on investment] to subsidize the use of these devices. https://www.healthcareitnews.com/news/advances-telemedicine-are-way-2022 < Previous News Next News >

NMTHA Webinars Available on Website New Mexico Telehealth Alliance Dec. 14, 2021 Did you miss one of our webinars this year? Did you know you can access them on the NMTHA website and view them at your leisure? Topics include HIPAA compliance, expanding telemed services, billing and coding and more. Did you miss one of our webinars this year? Did you know you can access them on the NMTHA website and view them at your leisure? Topics include HIPAA compliance, expanding telemed services, billing and coding and more. < Previous News Next News >

2021 National Telemedicine Summit World Conference Forum, LLC Sept. 13, 2021 Key Strategies to Revolutionize & Transform Healthcare Delivery, Optimize Quality Patient Care & Outcomes, Increase Accessibility, Enhance Data Analytics, and Reduce Costs! September 13 – 14, 2021 • The Ritz-Carlton, South Beach • Miami, FL Today, telemedicine is one of the fastest growing sectors in healthcare. Specifically, COVID-19 has enhanced and accelerated the role that telemedicine plays within our healthcare system. It is reshaping the landscape of healthcare delivery in the United States, and is being recognized as the future of global healthcare. Telehealth addresses and achieves the basic tenants of Healthcare Reform: providing the population with access to improved and convenient, high quality patient centric care, enhancing outcomes, while reducing per capita expenditures. Today, more than 70 percent of hospitals throughout the United States are engaged in telehealth programs. Studies have shown that the benefits of telehealth include significantly improved outcomes, efficient care delivery as well as reduction in mortality rates, hospitalizations, length of stay, readmissions and healthcare costs. Telehealth has greatly enhanced access to quality care in rural areas and patient satisfaction has increased due to its convenience and patient centric approach. We have created an exciting, high level forum featuring knowledgeable leaders and executives from the nation's leading Hospitals and Health Systems who will share their perspectives, valuable insights and expertise on how to be best equipped for the rapidly evolving and exciting landscape of telehealth. This exclusive event targets senior level executives in order to maximize educational and networking opportunities. By attending the 2021 National Telemedicine Summit, you will learn what highly regarded Hospitals and Health Systems are doing to be prepared for the challenges that lie ahead in 2021 and beyond! We look forward to greeting you in Miami! Link: https://www.wcforum.com/conferences/telemedicine < Previous News Next News >