Filed under: Telemedicine | Tags: 20 states, ACT, AcuteCare Telemedicine, american telemedicine association, American Well Systems, ATA, Blue Choice HealthPlan of South Carolina, BlueCross BlueShield of South Carolina, Connected Health Symposium, doctors, er, healthcare, HIPAA, insurers, Lisa Johnston, matthews gwynn, patients, providers, South Carolina, state lawmakers, State legislators, telemedicine, WellPoint
Historically the healthcare industry has been notoriously slow to adopt innovation but one health insurance company is stepping out in front of their industry when it comes to demonstrating a willingness to pay for telemedicine services, recognizing the potential for cost savings and simplification of services.
At this year’s Connected Health Symposium in Boston, John Jesser, VP of Provider Engagement Services for WellPoint, explained that his company is partnering with American Well Systems, a telemedicine services vendor, to set up the program for its members. Before the program was set up, patients who needed to see a physician during off-hours had limited options: Visit the ER and spend about $600; see a physician in an urgent care center for about $150; or wait until the doctor is back in the office. WellPoint introduced a new choice for its members, which only costs about $49.
Patients are able to use a laptop computer, mobile device or tablet to connect with a primary care physician. The encounter takes about 10 minutes to initiate, is HIPAA compliant and the service can be paid for with a credit card. Medical history is available to the attending physician. In addition to WellPoint, a number of other insurers including; Aetna, Highmark and Cigna are experimenting with similar programs for their member policy holders. Following South Carolina’s State legislators recent introduction of SB 290 and HB 3779, requiring private insurers to cover telemedicine services, BlueCross BlueShield of South Carolina and Blue Choice HealthPlan of South Carolina announced that they would start paying for some telemedicine services.
But a recent tally from the American Telemedicine Association indicates that nationwide coverage will be a slow journey. As of October 2013, there were only 20 states, and the District of Columbia, that required insurance companies to pay for some form of telemedicine services: Arizona, California, Colorado, Georgia, Hawaii, Kansas, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Montana, New Hampshire, New Mexico, Oklahoma, Oregon, Texas, Vermont, and Virginia.
Insurers and state lawmakers aren’t the only ones with reservations about telemedicine. Ron Dixon, MD, the Director of the Virtual Practice at Massachusetts General Hospital (MGH), says, “I’ve found trying to get telehealth moving at MGH has been impeded by the way insurers pay for things. It’s been a big barrier to get it rolled into the way physicians actually practice.” He also believes that doctors resist offering telemedicine care because they simply have too much to do. “If you are going to get doctors involved, there has to be a win for them, and the win is usually time. It’s not always about the money.”
Massachusetts General Hospital has built a tool that allows existing patients to get their follow-up care online. The hospital pays providers for the service, and while the fees they receive are less than what they get for in-person visits, it also takes them less time to see a patient online, so it tends to balance out.
If the full benefits of telemedicine services are to realized, more insurers and practitioners will need to step up and overcome their reluctance to technologies that promise to revolutionize the traditional healthcare delivery model.
Filed under: News | Tags: AcuteCare Telemedicine, telemedicine, Dr. Matthews Gwynn, healthcare, teleneurology, ACT, Technology, Southeast, Keith Sanders, stroke, Lisa Johnston, James Kiely, matthews gwynn, stroke care, atlanta healthcare, telehealth, acute care, alabama partnership for telehealth, network, care, SAMC, APT, tele health, Southern Alabama Medical Center, Stroke Care Network, Alabama Rural Stroke Award Health and Telehealth Summit, ACT AcuteCare Telemedicine, SAMC Network, SAMC Stroke Care Network, tele neurology
The Southern Alabama Medical Center (SAMC’s) Stroke Care Network was recently named “Partner of Year” at the Alabama Rural Stroke Award Health and Telehealth Summit. The award was presented by the Alabama Partnership for Telehealth (APT) during the October summit in Prattville. Jason DeLeon, MD, Emergency Medicine; Cecilia Land, division director SAMC Rehabilitation Services and Levonne Outlaw, SAMC Stroke Network Coordinator accepted the award.
“This is an award that we give out to the partner who we feel has done the most outstanding job when it comes to not only using, but advancing telemedicine,” said Lloyd Sirmons, executive director of APT. “SAMC has done a great job, not only building their program, but advancing telemedicine in the state of Alabama.”
AcuteCare Telemedicine (ACT), the Southeast region’s largest practice based telemedicine provider, joined in collaboration with SAMC earlier this year to remotely diagnose and treat acute care neurological patients and to offer advanced cost-effective solutions that deliver improved stroke patient outcomes throughout the expanded SAMC Network of participating hospitals. The SAMC Stroke Care Network ensures that patients in surrounding rural communities have access to the most experienced stroke care available. “SAMC sets the standard in the state when it comes to providing stroke care in rural areas,” said Dr. DeLeon.
On hand to present the award were Matthews Gwynn, MD, Acute Care Telemedicine, SAMC TeleNeurology Providers; Lloyd Sirmons, Alabama Partnership for Telehealth; Ron Sparks, Alabama Department of Rural Development and David White, Alabama Governor’s Office.
Filed under: Telemedicine | Tags: 21st Century Care, ACT, acute care, AcuteCare Telemedicine, American Telemedicine Associate, Armed forces, ATA, bill, California, congressmen, Defense Department, H. R. 3507, healthcare, medicare, Military & Veterans Act, Technology, tele-med, telehealth, telemedicine, telemedicine for Medicare, teleneurology, TRICARE, VA, veterans, Veterans Administration
Two California Congressmen have submitted a bill that would expand telehealth coverage to active-duty service members, their dependents, retirees and veterans. The 21st Century Care for Military & Veterans Act (H.R. 3507) was submitted earlier this month by U.S. Reps. Mike Thompson (D-Calif.) and Scott Peters (D-Calif.). Co-sponsored by Reps. Gregg Harper (R-Miss.) and Peter Welch (D-Vt.) and endorsed by the American Telemedicine Association, the bill would establish and expand current reimbursement policies for telehealth coverage under the Veterans’ Administration (VA) and The Defense Department’s TRICARE.
The VA has seen a 40 percent reduction in bed days and 87 percent reduction of annual per-patient costs when compared to home-based care programs, according to VA studies. Adam Darkins, MD, the VA’s chief consultant for telehealth services, anticipated that some 825,000 veterans would be served through telehealth by the end of 2013.
This new bill will offer members of the Armed Forces and their families the highest quality healthcare in a timely manner no matter where they live or how far away they are from the doctor they need to see. Technology can create a responsive and more efficient healthcare system that provides for better care and lower costs.
Earlier this year, U.S. Rep. Devin Nunes (R-Calif.) joined U.S. Rep. Frank Pallone (D-N.J.) in sponsoring the Telemedicine for Medicare (TELE-MED) Act (H.R. 3077), which would enable healthcare providers to treat Medicare patients in other states with telemedicine tools and services but without needing a different license for each state.
The VA, which launched telehealth services in 2003, appears to lead the way for the rest of the federal healthcare bureaucracy by eliminating many, still well-entrenched, barriers to the rapid expansion of telemedicine technology. Given the history of the VA’s percieved poor performances in delivering much needed traditional healthcare services to our veterans, their leadership in advancing the use of telemedicine is a trend that is more than just a little encouraging.
Filed under: Telemedicine | Tags: ACT, acute care, AcuteCare Telemedicine, advanced technology research center, army, care, dr. ronald poropatich, EKGs, health, healthcare, medical conditions, military, modern medicine, physical health, providers, Technology, tele medical technology, telehealth, telemedicine, teleneurology, United States, us, veterans
As we honor our American Veterans this month, it is fitting to examine how Telemedicine, the exchange of medical information via electronic communications, has vastly changed the way deployed soldiers receive access to health care and how the new communication system promises to offer better access to care for veterans in the future as well.
When Dr. Ronald Poropatich first joined the military 30 years ago, the digital cameras and web cams required for the use of telemedicine barely existed. Yet, during his career as the deputy director of the Telemedicine and Advanced Technology Research Center in the United States Army, Poropatich helped revolutionize health care for soldiers by bringing telemedicine technology to army bases and field hospitals around the world including in Somalia, Iraq and Afghanistan.
Today, soldiers in Iraq or Afghanistan can get second opinions on tricky medical situations from doctors located halfway around the world and can receive diagnoses from medical specialists, even when none are stationed at their base. Telemedicine has advanced greatly, allowing soldiers to email photos of electrocardiograms (EKGs) or skin rashes back to physicians back in the U.S., and receive feedback within hours.
This technology has allowed the military to spot medical conditions that would have otherwise been missed or quickly garner second opinions on cases that have the potential to warrant costly evacuations. Telemedicine has also provided a way to treat soldiers for conditions like post-traumatic stress disorder, or depression, while preserving their privacy.
The survival rate, if you can get to a combat support hospital level 3 facility in Afghanistan, is a fantastic 90 percent, but that means a lot of guys and gals are surviving horrific wounds once thought to be fatal. So providing a telemedicine lifeline to veterans once they are back home is imperative in order for veterans to communicate with health care providers outside of in-office visits. Accessing their care through the use of a cellphone or webcam, recovering soldiers will be more likely to stick with rehabilitation programs and outpatient treatment, ultimately ensuring better mental and physical health outcomes in the long term.
Perhaps the best way to honor our veterans is to provide them the best of medical care through the use of Telemedical Technology.
Filed under: Telemedicine | Tags: ACA, ACT, acute care, acute stroke, AcuteCare Telemedicine, affordable care act, care, doctor, europe, global growth, global telemedicine, health, healthcare, patient, pennsylvania medical society, practitioner, remote monitoring, tele, telecommunications, telemedicine, United States, UPMC
Though the United States has been dominating the global telemedicine market, Europe and developing nations are rapidly catching up. The global telemedicine market is expected to grow at a compound annual growth rate of 19 percent, driven mainly by growth opportunities in Europe, but the enthusiastic growth may be tempered by the lack of standardized classifications. However, the increase in remote monitoring of patients is expected to keep driving the market, which is also boosted by the increase in telesurgery. The shift is occurring mainly because of the increase in the number of patients with chronic diseases and the increasing availability of online healthcare services.
The remote delivery of healthcare services over the telecommunications infrastructure, or telemedicine, is a topic of interest to the vast majority of Italian general practitioners (GPs), with 73 percent stating that they are prepared to use the technology according to a study conducted by the Italian Family Doctor’s Association FIMMG. Over half of the doctors surveyed, 52 percent, are in favor of using these new technologies if they help to develop organizational aspects of the profession, while 30 percent state that telemedicine could even improve the doctor-patient relationship.
Global virtual doctor visits could become as common as face-to-face appointments because health insurers, hospital systems and employers view it as a way to clamp down on rising medical costs. They hope that by giving patients easy access to a primary care physician, it will discourage them from visiting a costly emergency room when they get sick. The trend in the US is expected to escalate as an influx of new patients, caused by the implementation of the Affordable Care Act (ACA), promises to put a strain on some doctors’ offices for treatment of routine illnesses. Health giants UPMC and Highmark Inc. are rolling out new services that allow patients to video-conference with doctors through computers, tablets and smartphones. “We think more and more people, as they become more familiar with telemedicine, will see this as something that is just going to be commonplace,” said Natasa Sokolovich, executive director of telemedicine at UPMC. Convenience is the big selling point of telemedicine services to patients. Rather than having to wait days or weeks to schedule an appointment at a doctor’s office, a video conference could be scheduled within minutes or hours, and the patient wouldn’t have to leave their home.
While such convenience is enticing to an increasingly busy society, some doctors and medical care providers are warning that an E-visit can’t entirely replace face-to-face consultations in a physician’s office environment. Nonverbal cues can be very important in accurately diagnosing patients, said Dr. Bruce MacLeod, president of the Pennsylvania Medical Society. “Some details could be missed in a video conference.”
But as the availability and quality of telemedicine advances globally, a increasing majority of patients are willing and eager to invite the technology into their relationship with their health care providers. The desire to make medical care more accessible and less-costly is global. Whether E-visits replace face to face medical care completely or just become some relative portion of interaction between patients and physicians, the medical services delivery model is going to be altered dramatically for the future. The rate of acceptance of communication technology in the medical care process will be driven more by necessary changes to the well-established regulations, licensing requirements, and cost reimbursement policies from within the health care community.
Filed under: Telemedicine | Tags: ACT, acute care, acute stroke, AcuteCare Telemedicine, bill, communications, copley, federal, governments, health care, health education, health information, local, Medicaid, medicare, ohio, patient, physician, rural health care, state, Technology, tele, tele health, tele health conference, tele health enhancement act of 2013, tele-med, telehealth, telemedicine, teleneurology
Dr. Teresa Myers, a family practice physician in Copley, Ohio, describes what she can see on her computer screen during a telehealth conference. “You know what HD television looks like. You can actually see the pimples on the actors’ faces,” she says. “I had a patient who was able to shine her iPhone flashlight to the back of her throat. I could see the exudates [pus-like fluid]. If you see that, you can be pretty sure.” A few more questions, as well as having the patient take her temperature and feel and describe her lymph nodes, and Myers felt confident diagnosing strep throat and prescribing an antibiotic. The consultation started less than five minutes after the patient logged in, cost $49 and lasted 10 minutes. The patient never left home, learned a few things about examining her own body and, two days later, said she felt much better when Myers followed up.
The rural health care workforce is stretched to its limits in most states. Despite programs operated by state, federal and local governments aimed at recruiting and retaining primary care professionals to these areas, the need outpaces the supply in many communities. Also, many of the current primary care physicians are nearing retirement and the numbers to replace them are insufficient.
For many states with large rural populations, telehealth has emerged as a cost-effective alternative to traditional face-to-face consultations or examinations between provider and patient. Telehealth is the use of technology to deliver health care, health information or health education at a distance. Real time telehealth communications allows the patient and physician to connect and interact through video conferencing, telephone or video health monitoring device. Store and forward telehealth refers to the transmission of data, images, sound and video from one care giver to another.
Forty-two states currently provide some form of Medicaid reimbursement for telehealth services and 17 states require private insurance companies to cover telehealth services. While individual states appear to be well out in front of the federal government on supporting telehealth innovation, the federal government is finally moving to catch-up with the recent introduction of “The Telehealth Enhancement Act of 2013 (H.R. 3306).” The bill promises to strengthen Medicare and enhance Medicaid through expanded telemedicine coverage and calls for the adoption of payment innovations to include telehealth and to make other incremental improvements to existing telehealth coverage. Another Congressional bill, “TELE-MED Act of 2013” (H.R. 3077) would permit certain Medicare providers in a state to provide telemedicine services to Medicare beneficiaries in a different state.
The convergence of medical advances, health information technology, and a nationwide broadband network are transforming the delivery of health care by bringing the health care provider and patient together in a virtual world, especially those in disadvantaged areas. Telemedicine has the potential to improve health care access and quality to patients in urban and rural America alike, but a variety of barriers, such as reimbursement and licensing issues, continue to stand in the way of more aggressive, widespread adoption.
The recent progress by state and federal governing bodies to recognize the significant advantages of increased telehealth services for all Americans with the introduction of new and meaningful legislation to address and remove established barriers to expansion, is encouraging to those in the health care community whose fundamental goal is to provide the best quality medical care to their patients no matter where they live.
Filed under: Telemedicine | Tags: ACA, accountable care organization, ACT, acute care, Acute Care Telemedicine, AcuteCare Telemedicine, affordable care act, alabama partnership for telehealth, Alabama Rural Health Association, APT, ARHA, dr. matt gwynn, health insurance, medical, network coordinator, SAMC, Southeastern Alabama Medical Center, Technology, telehealth, telemedicine, teleneurology
The Alabama Rural Health Association (ARHA) and the Alabama Partnership for Telehealth (APT) held the 2nd Annual Alabama Rural Health & Telehealth Summit on October 16th thru the 17th in Prattville, Alabama. The conference provided an excellent opportunity to learn about the current uses and capabilities of telehealth and telemedicine and included updated information on the Affordable Care Act (ACA) and more specific information on the Health Insurance Exchange program, Navigator program, and Accountable Care Organization program.
Cecilia Land, Director of Rehab Services, presented a session titled, “Reaching Out to Alabama with Telestroke Services.” Land discussed the stroke mortality rates in Alabama, and more specifically stroke mortality in the counties that fall inside the Southeastern Alabama Medical Center (SAMC) footprint and its desire to help bring down those rates in the counties surrounding the SAMC Telestroke Hub and their partner spokes in southeastern Alabama.
Levonne Outlaw, SAMC Stroke Network Coordinator, discussed education and training of the individual hospital staffs at the spokes. Initial training proved to be very successful and adoption of the telemedicine and telestroke platforms was well received by the staffs. The initial concern for a potentially long learning curve on implementation was not realized.
Dr. Matt Gwynn, Acute Care Telemedicine, the leading practice-based provider of Telemedicine services in the southeast, discussed the national statistics on stroke and their dramatic impact on quality of life of survivors. His discussion centered on the unique nature of stroke and how telemedicine can best be implemented to treat this disease. “Stroke is a perfect fit for demonstrating the life saving and life enhancing benefits of telemedicine, given that telemedicine can reduce the time to treat patients in the narrow, 3-hour window, which is so critical to stroke victims”, said Dr. Gwynn. He went on to share a specific case of a 46-year old female stroke patient at Dale Medical Center and how she had benefited from SAMC’s new telemedicine presence. Dale Med Center had been live with telestroke not more than a week, and the patient presented into the ER with stroke symptoms, was treated with the clot-busting drug tPA and discharged within 48 hours with minimal long-term neurological damage.
Other key topics were presented by: Gary Capistrant, Senior Director of Public Policy for the American Telemedicine Association and panelists from Auburn University, University of Alabama and Alabama College of Osteopathic Medicine. Updates were presented on the Affordable Care Act and its effects on telemedicine throughout the United States.