Telehealth in the News

Check out the latest in telehealth news and updates:

  • AMA, AAFP lobbied against part of telemedicine provision in Senate bill

    MobiHealth News

    The American Medical Association spent some portion of the $3.87 million it spent on lobbying this quarter trying to kill part of a telemedicine provision in a Senate bill, as did the American Association of Family Physicians, which spent a total of $1.46 million. Politico broke the news. The bill in question, S-2943, is a lengthy appropriations bill for the Department of Defense. In section 705, it allows for the military's TRICARE program to reimburse for telehealth, including mobile health applications. The AMA and AAFP generally support the provision -- their objection to the bill is limited to one subsection of 705, which reads "For purposes of reimbursement, licensure, professional liability, and other purposes relating to the provision of telehealth services under this section, providers of such services shall be considered to be furnishing such services at their location and not at the location of the patient." 

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  • Telehealth Reimbursement and Its Interstate Licensure Problem

    mHealth Intelligence

    Telehealth’s great promise lies in allowing a doctor to treat a patient no matter where each are located. One of the biggest challenges to that platform is licensing. A clinician must apply for a license in each state in which he or she wants to practice. For multi-state health systems, telehealth programs and specialists who work across the country, that means holding dozens of licenses and spending tens of thousands of dollars to keep them up to date. Interstate licensure looks to solve those problems. Licensing compacts seek to make it easier for clinicians to practice in multiple states, offering an expedited licensing process while keeping each state’s right to regulate its clinicians and take punitive action, if necessary. The most noteworthy is the Interstate Medical Licensure Compact launched in 2014 by the Washington D.C.-based Federation of State Medical Boards, a non-profit representing more than 70 medical and osteopathic boards. The FSMB’s compact, which reached its threshold for implementation in 2015, now counts 17 states as members, with another two states awaiting action on legislation. 

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  • Payers urge CBO to Give Telemedicine a Fair Shake

    mHealth Intelligence

    Nearly a dozen national health plans have asked the Congressional Budget Office to pay more attention to telemedicine when scoring Congressional bills on Medicare. In a letter to CBO Director Keith Hall, 11 health plans say telemedicine programs serve “as an important tool in increasing consumer access to high quality, affordable healthcare, improving patient satisfaction and reducing costs.” Yet federal legislation has thrown up roadblocks to the expansion of telemedicine platforms, especially in Medicare Advantage programs. “While many of us are embracing telemedicine in our offerings outside of Medicare Advantage (MA), we want to clearly note that the barriers in Medicare hamper our ability to offer these services to our MA customers,” the letter states. “We have worked closely with [the Centers for Medicare & Medicaid Services] to find ways to provide telemedicine through MA plans, but can only do so as a supplemental benefit.”  “Our options are also limited without Congressional action to reduce barriers in the Medicare fee-for-service benefit,” the letter continues. “Congressional action depends, in part, on a budget impact analysis from your office.” This isn’t the first time the CBO has been asked to pay attention to telehealth. 

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  • Payers Push Congress to Expand Medicare Telemedicine

    Health Leaders Media

    Eleven of the nation's largest commercial plans offer to share their data and experience on cost-savings and improved access to care with the Congressional Budget Office, as Congress crafts legislation to expand telemedicine within Medicare.  Commercial health insurance companies are offering to share their data on the value of telemedicine to federal actuaries who are estimating the cost of expanding remote coverage under Medicare. "We view telemedicine as an important tool in increasing consumer access to high quality, affordable healthcare, improving patient satisfaction and reducing costs" 11 commercial payers said in a letter this week to Congressional Budget Office Director Keith Hall. "We believe our experience in the commercial market can inform estimates of the impact of policy changes in Medicare." Telemedicine in Medicare is reimbursable only on under a narrow set of circumstances, but Congress is examining ways to expand it. Any legislation to expand Medicare telemedicine that comes with a price tag attached will require scoring by the CBO, which has limited experience in estimating the value and cost of telemedicine because of the federal government's limited exposure. 

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  • How Telehealth Can Enable Big Declines in Readmission Rates

    HealthData Management

    High readmission rates are a $17 billion problem across the U.S. for hospital administrators. What’s even more alarming is that a portion of 30-day readmissions are preventable. According to a recent University of California-San Francisco (UCSF) study published in the New England Journal of Medicine, 27 percent of readmissions could be avoided. This study shows that hospitals must improve communications between patients, physicians, hospitals and primary care providers, while providing better post-discharge resources. Upon discharge, if a patient is readmitted within 30 days, the Center for Medicare and Medicaid Services (CMS) requires payment from the hospital because of the guidelines of the Affordable Care Act (ACA), which penalizes preventable readmissions. However, the burden of keeping abreast of each patient’s unique recovery isn’t an easy task for both providers and hospitals.Imagine that, as a patient, you are sent home from the hospital with a stack of discharge papers. Are you more likely to read every sheet carefully or to put those information sheets in a corner, never to be looked at again? Solutions to the readmissions problem are emerging in today’s market, and they are designed to support the management and monitoring of every patient’s unique recovery during their most critical time post-discharge from the hospital—the first 30 days. 

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  • Texas Drops Appeal Against Teladoc Lawsuit

    Modern Healthcare

    Texas and its state medical board on Monday withdrew their appeal that questioned whether Teladoc could challenge the state's controversial telemedicine restrictions. The Texas Medical Board said its board on Friday voted to withdraw the appeal before the U.S. Court of Appeals for the 5th Circuit. The board had vehemently opposed Teladoc's suit that alleges the state's telemedicine rules violate federal antitrust laws, launching an unusual appeal after a lower court refused to dismiss Teladoc's case. The board's proposed rule requires physicians to meet with patients in person before they can treat them remotely, or another provider must be physically present during the first telemedicine appointment to establish a doctor-patient relationship. Lewisville, Texas-based Teladoc maintains that the board violated the law because federal antitrust laws require the board to be supervised by the state in order to create the rules, which the company maintains will affect access to care. According to the board, the restrictions are to ensure quality of care. But the U.S. Justice Department and the Federal Trade Commission recently took Teladoc's side in the dispute, telling the 5th Circuit the state rules were anticompetitive and lacked appropriate review.  The federal agencies encouraged the appeals court to reject the medical board's appeal and maintained the underlying rule should be eliminated.

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  • Telemedicine Closes the Gap in Specialty Referrals

    mHealth Intelligence

    A San Diego-based health system is expanding its telemedicine platform after a four-month pilot showed that more than 60 percent of patient visits requiring a specialist consult could be done virtually, without the need for an extra visit. North County Health Services, a not-for-profit community health provider with 13 clinics around the city, found that 65 percent of its patient visits could be augmented by AristaMD’s eConsult platform, giving patients and their doctors near-real-time access to a specialist. Through that collaboration, doctor, patient and specialist were able to successfully conclude the initial visit without the need for a second appointment. Denise Gomez, MD, clinical director of adult medicine at NCHS, says the telemedicine platform not only saves the patient a lot time, effort and worry, but guides the clinician toward a better diagnosis. 

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  • WorldClinic Founder: Telehealth Needs a New Revenue Model

    mHealth Intelligence

    Why is telehealth struggling to find its footing? Dan Carlin blames the billing code. “We’re still in an age where the vast majority of healthcare still exists in billing codes,” says the founder and CEO of WorldClinic, a New Hampshire-based concierge care service. “This encourages poor health,” with codes that address and pay for crises instead of wellness.”  “And this crazy world of connected healthcare is not supported by current revenue models,” Carlin says. “We need new models.” Carlin, who’s giving the luncheon keynote at Xtelligent Media’s Value-Based Care Summit on November 15 in Boston, knows a thing or two about the “crazy world” of connected care. A former Naval officer and ER doctor who’d treated “the poorest of the poor” in far-flung regions of the world, he launched WorldClinic in 1998 with an eye toward providing real-time healthcare to remote people who could pay for it – starting with, interestingly enough, sailors on round-the-world races and cruises. Equipping each with a “prescription medical kit,” or PMK, filled with common medications and medical devices, the sailors were promised a real-time link via telehealth to a WorldClinic doctors who could diagnose their health problems and prescribe care. In time, those sailors were joined by rich and elite families who wanted instant access to healthcare no matter where they were in the world; in many cases those families headed large corporations whose executives and board members wanted that type of access for themselves and their families.

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  • Using Telehealth, mHealth to Advance Value-Based Care

    mHealth Intelligence

    Healthcare’s march toward value-based care is complicated. And with roughly three-quarters of the industry still focused on volume, it’s safe to say the revolution isn’t happening overnight. But some forward-thinking health systems are finding success. And they’re using telehealth and digital health tools. “We have to define value in lots of different ways, but I think that’s an advantage in the telehealth space,” says Sarah N. Pletcher, MD, founder and medical director of Dartmouth-Hitchcock Medical Center’s Center for Telehealth, which uses telehealth to reach out to a network of rural communities across northern New England. “There are all sorts of barriers, more to delivery than adoption,” she says. “But when you talk about (providing care) to people who don’t have access, that’s a good start” to defining value. 

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  • NJ Lawmakers Consider Bill to Regulate Telemedicine

    NJTV News

    New Jersey legislators are considering a bill to regulate telemedicine: the use of videoconferencing between a medical professional and patient. “You have the access to see a physician, say, at 10 o’clock at night, 11 o’clock at night. They’re available,” said St. Luke’s University Health Network Director of Telemedicine Phil Witkowski. “We’re looking at telemedicine to not only handle the urgent care use case, we’re also looking at following up on chronic care disease management and follow-up for post surgical.” The technology is already being used at St. Luke’s University Health Network and in more than 60 percent of health care institutions nationwide, according to a federal study released in August. A state Senate committee approved legislation to set standards for the growing practice. Karen Olanrewaju testified before the Senate Health, Human Services and Senior Citizens Committee. “It allows us to match the best professional with the most highly skilled strategists to work with a child and family regardless of their location throughout the state. So we don’t have concerns about availability of practitioners in certain neighborhoods.  

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  • mHealth Group Wants to Define Store-And-Forward Telehealth

    mHealth Intelligence

    mHealth proponents have drafted a definition for “asynchronous” telehealth, and they’re hoping federal officials will use it when dealing with MACRA issues and CPT codes. The Connected Health Initiative (CHI), a group organized by ACT | The App Association, has released a definition and four uses cases for asynchronous – also called store-and-forward – telehealth, noting that existing definitions “are inconsistent and have unfortunately led to confusion and in some cases has limited the ability of American patients to leverage the most effective technological solutions available in their treatments.” An ideal example of that lies in Arkansas, where the state’s medical board has included language in proposed telehealth regulations that specifically exclude online questionnaires from the store-and-forward definition. The issue hampers telehealth vendors like Teladoc, which does a majority of its business via phone.The CHI is recommending that asynchronous of store-and-forward be defined as “the sharing of data from one party to another through the use of a device or software that records, stores, and then sends such data via any communications or technological means.” 

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  • Touting Success, Mississippi Telehealth Effort Expands Beyond Diabetes

    Fierce Healthcare

    The University of Mississippi Medical Center's pilot program to remotely monitor Delta diabetes patients has been so successful that it has expanded to cover patients with chronic obstructive pulmonary disease, hypertension, kidney disease and a number of other conditions. While UMMC has had a telehealth center since 2003 to provide specialized care, the Diabetes Telehealth Network kicked off in 20 Delta counties in 2014. It allowed real-time remote care of diabetes patients in their homes, reports The Clarion-Ledger. The benefits from the first 100 patients were positive that leaders expanded the program to other chronic conditions before completing the pilot. The UMMC telehealth center provides service in 35 specialties at 218 locations, including local clinics and hospitals, as well as the care management for chronic conditions. “A lot of our patients hadn't touched technology before the Diabetes Telehealth Network. Many didn't have internet,” Michael Adcock, administrator of the Center for Telehealth at UMMC told the Clarion-Ledger. “But once they found out how easy it was and how useful the information is, they embraced it.” 

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  • Kaiser CEO: Telehealth Outpaced In-Person Visits Last Year

    mHealth Intelligence

    Kaiser Permanente is seeing more patients online than in person, according to its CEO. The California-based health network, one of the nation’s largest integrated health systems, saw some 110 million people last year, with some 59 million connecting through online portals, virtual visits or the health system’s apps, Bernard J. Tyson told attendees at the recent Salesforce.com Dreamforce conference in San Francisco. That accounted for 52 percent of the health system’s total visits that year, he said. “We are going through a major transformation in healthcare,” Tyson pointed out during his keynote presentation. “Because we were all-knowing, we built the entire healthcare industry where everyone has to come to us, but now we are reversing the theory where people have to come to us for everything, so we’ve invested billions in our technology platform.” The announcement represents an important milestone in telehealth: the first time a large health system has reported more virtual encounters than in-person encounters. It’s also testament to the growing popularity of mHealth and telehealth among consumers. In a study conducted late last year by the University of Missouri School of Medicine, roughly 80 percent of providers and patients said they were satisfied by the care delivered and received through a video visit. 

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  • Telehealth May Help Fill Mental, Behavioral Health Needs in Rural Nebraska

    Live Well Nebraska

    Telehealth — offering medical services via remote technology — might be one solution for rural Nebraskans with little access to mental health and substance abuse resources, according to a look at the state’s needs released last week by the Nebraska Department of Health and Human Services. The Comprehensive Behavioral Health Needs Assessment is the most complete report HHS has compiled on the topic, said Linda Wittmuss, deputy director with the department. The data — much of it pulled from census statistics, past studies and focus groups and surveys — will inform HHS’s 2017-2020 strategic plan. That plan will have to include innovative ways to use technology to reach Nebraskans who may be hours away from behavioral health care, Wittmuss said. 

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  • Arkansas Medical Board OKs Telemedicine Rule Again

    Times Record

    The Arkansas State Medical Board voted Thursday to approve a proposed regulation concerning the online transferal of patients’ medical records after two legislative panels previously declined to review the rule. The Medical Board voted in June to approve the proposed regulation and one other, both governing the use of audio and video technology to care for patients. But in July the House and Senate committees on public health declined to review the proposals after Bradley Phillips, a lobbyist for Dallas-based telemedicine company Teladoc, spoke against them. Regulation 38 states that a patient completing a medical history online and forwarding it to a physician is not sufficient to establish a doctor-patient relationship and does not qualify as “store-and-forward technology,” which under the state’s telemedicine law, Act 887 of 2015, is not restricted by law. Regulation 2.8 states that a doctor-patient relationship may be established through an examination conducted using real-time audio and video technology that provides at least as much information as the doctor could obtain through an in-person examination. Phillips told the public health committees in July that the language about store-and-forward technology, which was recommended by the state Medical Society, was approved by the Medical Board at the last minute and was not in the regulation during a required public-comment period. 

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