Call for Presentations: gpTRAC Regional Telehealth Forum 2014

Telehealth & HIT:  Partners in Patient Care
gpTRAC Regional Telehealth Forum
April 3-4, 2014

The Great Plains Telehealth Resource & Assistance Center (gpTRAC) has opened the Call for Presentations for this year’s Telehealth Forum.

We are looking for presentations that support this year’s theme and can:
1) expand the understanding that telehealth is indeed a technology that creates and uses various kinds of health information in the care of a patient;
2) share how an organization intertwined their  telehealth services with their HIT services;
3) encourage others to look to their own organizations and say “We should do that too!”.

Anyone with expertise is invited to submit an abstract.  Click here for more guidance and directions surrounding your submission and to access the abstract form.

Forum Registration: Watch for the official registration information…coming soon!!
Hotel Registration: Click here to make your room reservations at the Embassy Suites, Minneapolis, Airport/Mall of America. There is a limited number of rooms reserved for this event.

If you have any questions, please email gptrac@umn.edu or call 888-239-7092.
We are looking forward to a great event!

 

Is there a place for Telehealth within ACOs?

The answer is yes.  Absolutely.  Telehealth,  as a mode of healthcare delivery, provides a means to more efficiently and effectively achieve ACO goals.  Read on to find out how.

First, what are ACOs and what are ACO goals?

ACO stands for Accountable Care Organization.  ACOs are groups of healthcare providers including doctors and hospitals that voluntarily join forces to provide coordinated care to Medicare patients.  The philosophy of ACOs is that coordinated care leads to better outcomes, because patients get the care they need without unnecessary duplication of services.  This is especially true for the chronically ill.

Successful ACOs lead to higher quality care and reduced health care spending within the Medicare program.

Telehealth,  as a mode of delivery provides a means for an ACO to more efficiency and effectively achieve their goals.  Here’s how:

  1. Telehealth technology has demonstrated costs savings.  By utilizing telehealth technology, an ACO can deliver care at a lower cost in many cases than traditional in-person office visits.
  2. Telehealth provides the possibility of greater access to care for those patients who are homebound for any of a variety of reasons or live in locations where travel to sites of care is time-consuming and difficult.  Including these patients expands the ACOs patient base.
  3. Telehealth promotes more timely access to care which can result in fewer emergency room visits and hospitalizations.  Preventative care is essential in reaching ACO goals.

Summary:  Telehealth promotes the goals of ACOs by lowering the costs of care while maintaining and improving the quality of care.  Through providing the means for greater access to care telehealth can increase the numbers of individuals who can participate in an ACO.  Read more on the benefits of telehealth for ACOs in the gpTRAC Resource Center here.

Telehealth News Flash, July 29

Telehealth news and events we have been talking about around our office this week:

Telehealth coverage broadens through state legislature
State legislatures are hearing a lot about telehealth these days.  Missouri became the 19th state to mandate reimbursement by private insurers to healthcare providers for telehealth services.  Kentucky has expanded telehealth reimbursement to Medicaid beneficiaries.  Mississippi passed a private insurer reimbursement mandate.  In the last 7 months, 12 states have introduced or enacted telehealth reimbursement legislation.  Around the gpTRAC office, we are discussing ways to get Minnesota involved in doing the same!

South Central Telehealth Resource Center Quarterly Thought Conference Webinar:  Telehealth Reimbursement in Mississippi
A great webinar presented last week by UMMC’s Dr. Kristi Henderson on the process of passing state-wide telehealth legislation.  Archived and available at learntelehealth.org

Nurses use Google Hangout to collaborate on technology
Google hangout isn’t just for teenagers and chatting with friends who are abroad anymore.  These providers discuss the usefulness of media for healthcare collaboration in a 25 minute youtube video between nurses in Toronto and Australia. 

Telehealth News Flash, June 20

Telehealth news and events we have been talking about around our office this week:

“The telemedicine tourniquet”
By Denise Logeland, Minn Post, Twin Cities Business
Mayo Hospital’s Center for Innovation is bringing together providers from all campuses to offer telemedicine services under the name “Mayo’s Center for Connected Care.”  According to Bart Demaerschalk who is the current director of Mayo’s telestroke and teleneurology programs, the goal is to provide telemedicine services both locally and globally, for “every medical and surgical discipline that our institution provides service for.”  The article covers the expansion plan of the Center for Connected Care and potential gains for the healthcare system.  Also included is an overview of related “e-visit” telemedicine programs in the great plains region, such as Virtuwell and Zipnosis, and the usefulness of datamining among all telemedicine programs.  Read the full article here.

“Innovation with Information Technologies in Healthcare.”
Book review and Q&A with author Dr. Lyle Berkowitz.
Dr. Berkowitz and his collaborator Chris McCarthy gathered stories about innovation from organizations across the country.  The goal of the book is to highlight the learning of others and inspire healthcare organizations to use IT in creative ways to improve quality of care, increase patient satisfaction, and lower costs.  In reference to Telemedicine, the authors say:  “In the telemedicine section, one of the important things we realized was that usually it was not the technology which was innovative; rather it was the innovative business models or regulatory changes which made the real difference.”  The takeaway:  IT is a powerful tool to leverage for innovation in healthcare.

A note on ATA’s upcoming Federal Telemedicine Policy Summit
From Jonathan Linkous, Chief Executive Officer for ATA:  “In 18 weeks the enrollment period for state–based health insurance exchanges (a key element of the 2010 Health Reform Bill) will open.  Coverage through these exchanges will start 13 weeks later. The same day Medicaid coverage will be expanded in a majority of the states.  All told, by January 1, 2014—less than 8 months from now—there could be 35-50 million more people with health insurance in the US.…There is a broad consensus that one critical change can greatly relieve [the future physician shortage]: empower health professionals to use available technologies to efficiently expand patient care through pooled practices, patient portals and various forms of telemedicine.”

ATA’s upcoming Federal Telemedicine Policy Summit is June 27-28 in Washington DC.  The goal of the summit is to explain the implications and opportunities brought about by health reform.  Details are available at http://www.americantelemed.org/summit

 

Telehealth News Flash

The telehealth news articles we have been talking about around our office this week:

New York Times Well:  My Stroke of Luck
How one man learned about telestroke technology through a stroke of his own.  His response to reimbursement resistance:  “Well, there was no living, breathing stroke specialist at my bedside to bill in those first vital hours. Give me a virtual doctor any day.”

Washington Post:  Telemedicine makes new advances, all the way to Antarctica
Videoconferencing enables a partnership between the University of Texas Medical Branch and National Science Foundation workers living at a scientific research station in Antarctica.

Healthcare IT News:  Why not MU for telemedicine?
Noteworthy reflection on Ryan Spaulding’s presentation at this year’s American Telemedicine Association meeting.  The topic:  Meaningful use of telemedicine and how Telehealth Resource Centers can help create a national strategic plan.

Argument: It is not necessary to include mid-level providers in telemedicine policy

Advocates for telemedicine policy that includes mid-level providers will likely face opposition.  Three likely arguments will be: (1) patients aren’t interested in telemedicine, (2) telemedicine should not replace in-person visits and (3) if telemedicine policy does change, there is no need to include mid-level providers.  Below is a sample evidence-based response to the third argument.

Argument:  It is not necessary to include mid-level providers in telemedicine policy.

Response: Unless mid-level providers are reimbursed for services provided via telemedicine, they will remain underutilized.  In the proposed policy we include nurse practitioners (NP), physician assistants (PA), nurse midwifes, and clinical nurse specialists (CNS). There are three main reasons they should be included as reimbursable for telemedicine services.

1.  According to the Association of American College work force projections “nationwide physician shortages are expected to balloon to 62,900 doctors [by 2015] and 91,500 by 2020 (Krupa, 2010).”  Mid-level providers can help fill this gap.

2.  It has been suggested that “in telemediated heath care nurses or physicians’ assistants are the key actors who have to perform many tasks in the absence of physicians (Oudshoorn, 2009).”  Mid-level providers are an ideal workforce to train as technology experts for delivering telemedicine services.

3.  Under the Interstate Nurse Liscensure Compact, a nurse that is liscenced to practice in one state of the compact, may practice in any state of the compact (Bailey, 2011).  This means that nurses are not subject to the same laws governing licensing of physicians which prohibit them from practicing medicine (or telemedicine) outside of their state.  There are currently 24 states that have adopted the compact (Bailey, 2011).  Nurses, therefore, are able to offer telemedicine to a wider range of patients nationwide than primary care physicians.

The utilization of mid-level providers is integral to maximizing the potential benefits of telemedicine.

Bailey, R.A. (2011). The Legal, Financial, and Ethical Implications of Online Consultations, HEINONLINE, 16, J. Tech. L. & Policy, 53

Krupa, C. (2010) Physician Shortage Projected to Soar to More than 91000 in a Decade, American Medical Association. Retrieved from http://www.ama-assn.org/amednews/2010/10/11/prsb1011.htm

Oudshoorn, N.(2011) Telecare Technologies and the Transformation of Healthcare. United Kingdom, Palgrave MacMillan.

Argument: Telemedicine should not replace in-person doctor visits

This is part 2 in our 3 part series on responding to arguments against telemedicine. 

Background:  Advocates for telemedicine policy that includes mid-level providers will likely face opposition.  Three likely arguments will be: (1) patients aren’t interested in telemedicine (covered here), (2) telemedicine should not be allowed replace in-person visits and (3) if telemedicine policy does change, there is no need to include mid-level providers.  Below is a sample evidence-based response to the second argument.

Argument:  We should not let telemedicine replace in-person doctor visits

Response:  It is true that a patient-doctor interaction is different through telemedicine.  Without the physical ability to touch the patient, the doctor is limited in the care they can provide.  However, telemedicine is a tool meant to complement existing healthcare methods, not replace them.  As specified in the American Medical Association guidelines about online medical consultations, “E-visits are not intended for new patients or for established patients with an urgent medical issue, a condition with a significant visual component, such as a rash, or one requiring a physical exam.  Those patients would be asked to visit the patient’s practice for an on-site evaluation (Bailey, 2011).”  Telemedicine will not replace traditional in-person visits; only expand the range of care providers are able to offer.

Bailey, R.A. (2011). The Legal, Financial, and Ethical Implications of Online Consultations, HEINONLINE, 16, J. Tech. L. & Policy, 53

Argument: Patients don’t want to use telemedicine services

Advocates for telemedicine policy that includes mid-level providers will likely face opposition.  Three likely arguments will be: (1) patients aren’t interested in telemedicine, (2) telemedicine should not be allowed replace in-person visits and (3) if telemedicine policy does change, there is no need to include mid-level providers.  Below is a sample evidence-based response to the first argument.

Argument:  Patients don’t want to use telemedicine services

Response: Telemedicine patients have reported good acceptance rates and satisfaction with the technologies and treatment via telemedicine has been proven to be efficacious (Whitten, 2007).  Additionally, a recent Price Waterhouse Cooper Study found that 50% of people surveyed stated that they “would seek healthcare through online consultations” and that “email consultations were the most preferred method”, followed by “Webcam/video consultations (Thompson et al, 2011).”

Thompson, M., Isgur, B., & Foong, S. (2011) Focusing on Healthcare Value, Price WaterHouse Cooper, Retrieved from http://www.pwc.com/us/en/view/issue-12/focusing-on-healthcare-value.jhtml

Whitten, P. & Buis, L. (2007) Private Payer Reimbursement for Telemedicine Services in the United States, Telemedicine and e-Health, Vol. 13, DOI: 10.1089/tmj.2006.0028

Telehealth Resource Center Upcoming Webinar

The National Telehealth Webinar Series presents: If I Knew Then What I Know Now… Building A Telehealth Network From The Ground Up – October 18, 2012

Image of The National Telehealth Webinar Series
October 18, 2012
10:00 AM HST, 12:00 PM AKDT, 1:00 PM PDT, 2:00 PM MDT, 3:00 PM CDT, 4:00 PM EDT

Presented by:

Brian Coltharpe, MA – Director of Innovation, Health Resources of Arkansas

“We built our network without any grant money or any outside advice; not because we were arrogant and self-sufficient, but because we weren’t aware of the multitude of resources available to help us do it cheaper and easier. If I knew then what I know now. . .”

Telemedicine is a rapidly expanding service field: an invaluable resource for those in remote areas and cost effective from all points of view.  But, the process for setting up a network and making it all work together can be a challenge.  In this educational webinar, Brian Coltharpe, Director of Innovation for Health Resources of Arkansas will be sharing valuable lessons based on what he’s discovered over the last 8 years.

Simultaneous streaming with the Quarterly Thought Conference from SCTRC at LearnTelehealth.org.

Registration for this event is FREE, at:  Click HERE

For GoToMeeting system requirements: Click HERE

The National Telehealth Webinar Series provides timely information to support and guide the development of your telehealth program by experienced telehealth professionals from the HRSA-designated Telehealth Resource Centers.  These webinars are FREE to the public on the 3rd Thursday of each month.

The Institute of Medicine (IOM) is paying attention!

I have to say…The Role of Telehealth in an Evolving Health Care Environment Workshop, hosted by the Institute of Medicine in Washington, DC on August 8-9, 2012, was one of the better telehealth-focused conferences or meetings I have attended in a while.  It was exciting to have the Institute of Medicine commit their time to improve their understanding of where and how telehealth is currently playing a role in patient care.  The agenda was well-balanced, sharing information on various applications, policy issues and concerns, as well as current and expected challenges.  We heard from many who are currently providing telehealth services and the positive effects they were experiencing.  But it was also good to hear from some of the folks who aren’t necessarily that excited about or support the expanding telehealth opportunities.  Only by understanding their concerns, those of us in the telehealth field can work to better address these issues and, in the longer-term, improve the overall provision of telehealth-related services.

As I understand it, the IOM is considering conducting a full study as a follow-up to this workshop.  I hope this happens, I am anxious to see their results!