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Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life


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While not under the sign of telemedicine, the Institute of Medicine just released a report on preferences at the End of Life.

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Posted by: C3O Telemedicine News

Posted on: September 17th, 2014

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Growth of telemedicine: new studies reviewed by CTel


 From CTel

As The Robert J. Waters Center for Telehealth and e-Health Law (CTeL) and others have previously reported, seemingly countless studies of recent have projected tremendous growth in the use of telemedicine in the years to come, particularly in the areas of remote monitoring and mHealth.  Yet still others have been more measured in their estimations, highlighting hesitancy among some providers and patients to adopt telehealth technologies.

The past few weeks have seen the release of several studies that have come to somewhat discrepant conclusions, including one from HIMSS Analytics, which points to somewhat limited provider adoption; one from Deloitte that forecasts a rise in telemedicine visits in the coming year; and still another from Towers Watson, which identifies an increased willingness among large employers to offer telehealth services to their employees, though utilization so far has been low.  Below, CTeL offers an overview of the three studies and their conclusions; essentially, based on this body of research, telemedicine—despite past and projected future growth—still has some maturing to do.

In its “2014 Telemedicine Study,” which surveyed health care providers, executives, and IT staff, HIMSS Analytics found that “telemedicine is becoming increasingly important to organizations both tactically and strategically,” including as a way to deliver cost savings and improve care coordination.  Yet only about half of providers are taking advantage, and the landscape remains complicated.  “The study found that organizational needs will vary based upon provider type while the numerous technologies under the telemedicine umbrella will add to the complexity of the market,” HIMSS Analytics Research Director Brendan FitzGerald explained in a news release.  FitzGerald, however, is optimistic about expanded utilization: “Regardless of these challenges, organizations will continue to look for and utilize technology to fill gaps and enhance initiatives in patient care.”

The Deloitte study, which focused on North America, also projects growth in telemedicine this year, estimating “up to 75 million telehealth visits in 2014, representing an increase of 400% over 2012 levels.”  Worldwide, the number may reach 100 million, fueled by provider shortages, expanded use of smartphones, and a number of newly insured patients.  “With 110 million office visits a year related to low-level conditions like sore throats, earaches, and skin rashes, these quick and efficient remote interactions could ease the burden of overworked primary care providers with little time to spare,” EHR Intelligencer’s Jennifer Bresnick sums up in her discussion of the researchers’ findings, pointing also to new legislation designed to address regulatory barriers.  However, “providers will need to be educated about the value of remote consults if telehealth is to succeed.”

Finally, the Towers Watson researchers highlight the potential savings that telemedicine can deliver, noting also that more and more large employers are choosing to embrace it.  “Thirty-seven percent of employers surveyed said that by 2015 they expect to offer their employees telemedicine consultations as a low-cost alternative to emergency room or physician office visits for nonemergency health issues, and another 34% are considering offering telemedicine for 2016 or 2017,” the company said in a news release accompanying its study of large U.S. employers.  Yet currently, “utilization is low,” often coming in at “less than 10%.”

Still, employers appear increasingly enthusiastic, given the potential to save money.  As health care consultant and blogger Jane Sarasohn-Kahn sums up of the study’s results, “Employers could save over $6 billion if industry replaces virtual health consultations with face-to-face visits at doctors’ offices, emergency rooms, or urgent care centers.”  For her part, Sarasohn-Kahn appears to be a firm believer in telemedicine.  “The beauty of telehealth, from a health-economic standpoint, is that it scales from [one] to many,” she asserts.  “As we seek to conserve health costs in a resource-constrained health environment, telehealth can scale primary care—which is needed for bolstering the American primary care infrastructure.”

 

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Posted by: C3O Telemedicine News

Posted on: September 3rd, 2014

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The New Face Of Healthcare Innovation: 7 Ways Telemedicine Changes The Healthcare Landscape, And What It Means For You


From:  Jeff Boss of FORBES

 

It’s no secret that the healthcare space is broken. A 2013 study conducted by the Journal of Patient Safety estimates that between 210,000 and 440,000 patients die in the US each year from accidental practice. To put this into perspective, an estimated 600,000 Americans die from heart disease each year and another 565,000 from cancer (source: www.cdc.gov), which puts healthcare incompetence as the third leading cause of death in the United States.

The pool of entrepreneurs in the race to offer mobile health consulting is growing larger by the day. With telemedicine, users have the power of accessibility in their hands with apps such as TouchCare and iBluebutton (see below). While the concept of telemedicine isn’t anything new, having the accessibility to one’s doctor is. Here are seven ways telemedicine changes the healthcare landscape—for the better:

1. Stronger relationships. Relationships are everything. If there was ever a person not to make angry, it’s your doctor. More important, your relationship with your doctor is everything, which is why mobile healthcare is so ideal. It offers the luxuries of personalization and convenience without exposing yourself or your child to the 15 other sickly patients normally waiting in your doctor’s office.

2. Convenience. TouchCare takes mobile healthcare to the next level as it creates an entirely new user experience for the customer. Rather than having to trek into the doctor’s office for a consult, you can now do so from the comfort of your own smartphone for follow up visits, after hours calls, or while traveling. Additionally, parents gain a stronger piece of mind because they can immediately reach their doctor for relatively benign symptoms such as a cough or runny nose.

3. Reduced complexity. Complexity is defined by the speed at which industries change and the interdependence of relationships therein. Telemedicine reduces both.

4. Greater awareness. iBlueButton is perhaps the most comprehensive app for telemedicine as it allows users (currently only for active duty military and veterans) to carry their own medical records  with them in their smartphone. For physicians, pop-up windows alert the provider of possible medication side effects for greater drug reconciliation.

5. Shared purpose. The focus of healthcare today appears to be more towards earning a profit rather than serving its purpose of patient care. The purpose of an organization is (ideally) to serve as a value differentiator to its customers because of what they (the company) stand for. Whatever a company’s flavor, its purpose is defined by a certifiable element that distinguishes it from all else, and that element is what attains and retains customers and fulfills a societal need. Bettina Experton, MD, MPH, and President & CEO of Humetrix, which is the company behind iBluebutton, believes that “collaborating for a higher purpose is a key corporate value… We work to empower patients and make them more informed healthcare consumers, and we think about ways to make life easier for parents, caregivers and families in an increasingly complex healthcare environment.” (source: http://www.ibluebutton.com/post-be-16/).

6. Improved efficiency. Smaller practices get bought out by larger organizations, which means new regulations and more bureaucracy are added into their daily routine. Nancy Zimmerman, head of Marketing for TouchCare, cited one practice in North Carolina who was recently bought out by a larger company who needed to scale back from seeing their normal 60 patients per day to 20 due to the added bureaucracy. Telemedicine eliminates phone consults and the addiction to answering emails.

7. Enhanced flexibility for physician. The immediacy of telemedicine provides direct access to the customer. iBlueButton users can directly share critical parts of their medical record with their doctor via secure messaging.

The changing landscape of healthcare offered through smartphone apps allows doctors to build stronger relationships with their patients rather than be just another MD—critical to the “patient” component of “patient care.”

–follow Jeff on Twitter

–Jeff’s upcoming book “Navigating Chaos: How to Find Certainty in Uncertain Situations” will be out in 2015. Read about it here.

 

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Posted by: C3O Telemedicine News

Posted on: August 23rd, 2014

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TelePharm gets $2.5M to help pharmacists be in two places at once


By: Jonah Comstock | Aug 12, 2014

from MobiHealth News

Iowa-based TelePharm has raised $2.5 millionfrom venture capitalist John Pappajohn and Bruce Rastetter, president of the Iowa state Board of Regents. The company, which is also a member of the Rock Health accelerator, will use the funds to scale its business, which connects pharmacists to one another and to patients via cloud-based mobile apps.

“I think the pharmacists’ position is changing,” TelePharm CEO Roby Miller told MobiHealthNews. “Instead of just counting pills and dispensing drugs, they are repositioning themselves to become more of a provider of healthcare and I think we’re trying to help them and enable them to become healthcare professionals.”

TelePharm has several different businesses that help pharmacists spread their expertise across multiple pharmacies. This allows local chains with spaced out rural pharmacies to reduce their overhead significantly. One business, TeleCheck, allows for remote verification of medications, one of the most important and time-consuming jobs pharmacists do.

“What a pharmacist does is, they have two different responsibilities: verifying it’s the right drug for that patient and basically making sure the patient will be safe with that drug, and making sure what the technician dispensed was the right drug,” Miller said. “What TeleCheck does, is it takes that workflow and puts it in the cloud. So a pharmacist has an image of the drug they’re dispensing, the label on the bottle, and the [prescription] as well. So they can compare those images and make sure the drug is the right prescription for that patient.”

The other service, which actually allows pharmacists to virtually interact with the patient directly, is called TeleCounsel. It’s used by hospitals with a pharmacist on staff to provide discharge counseling for patients leaving the hospital. Talking with a pharmacist before leaving the hospital leads to better adherence, Miller said, but is again often difficult to facilitate because it requires one pharmacist to be in so many different places in a large hospital or hospital system. With TeleCounsel, a pharmacist can talk to many different patients and even counsel patients after they go home.

This is the first round of funding for the company, which was founded in August 2012. TelePharm’s software is currently in eight small, regional pharmacy chains in three states: Iowa, Illinois, and Texas.

“We’re trying to prove that you don’t have to be on the East or West coast to make a company successful,” he said. “You can do it in a smaller midwestern setting.”

In an era of large chain pharmacies like Walgreens and CVS, which use mobile and web to add to the convenience of their many locations, it can be challenging for small local pharmacies to stay relevant. McKesson’s Health Mart franchise service, which went mobile last fall, is another effort to help those small chains keep pace with new technology.

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Posted by: C3O Telemedicine News

Posted on: August 16th, 2014

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ATA Applauds Congressional Push for Federal Telemedicine Improvements


According to Jon Linkous, CEO of the ATA “On Thursday, Sens. Cochran and Wicker, both Mississippi Republicans, introduced the Telehealth Enhancement Act as S. 2662, which is a companion bill to a House version, H.R. 3306, introduced by Rep. Gregg Harper (R-MS). S. 2662 includes several provisions that may be budget savers, building on recent payment innovations such as accountable care organizations, and other incremental budget-sensitive proposals. H.R. 3306 already has 20 bipartisan co-sponsors. These bills are instrumental in demonstrating widespread congressional support and in prompting the Congressional Budget Office to provide a budget estimate.”IPRqUxyy_normal

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Posted by: C3O Telemedicine News

Posted on: July 29th, 2014

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FSMB updates April compact for state medical licenses


According to FierceHealth IT

July 25, 2014–The Federation of State Medical Boards, a national nonprofit representing the 70 medical and osteopathic boards of the U.S. and its territories, issued the following statement today after unveiling an updated  draft interstate compact for physician licensure during its recent board meeting. The proposed changes to the draft compact would strengthen patient protections and streamline requirements for physician licensure.

“The goal of the Compact is to ensure that qualified physicians are able to practice medicine in a safe and accountable manner and that the strongest health care consumer protections are maintained,” said Dr. Humayun J. Chaudhry, president and CEO of FSMB. “The revised compact helps ensure that as the practice of telemedicine continues to expand, patient protection remains a top priority. We look forward to sharing the revised compact with state medical boards across the country and look forward to working with them to achieve implementation.”

The Compact, which offers a streamlined alternative pathway for state-based licensure, would create a new process for faster licensing for physicians interested in practicing in multiple states, including those who practice telemedicine, and reaffirms the location of a patient as the jurisdiction for oversight and patient protections. Those physicians ineligible for the compact may still use the current pathway to acquire one or more state medical licenses. The changes unveiled during FSMB’s board meeting would strengthen the requirements for licensure eligibility for physicians and help ensure patients are safe when they’re in the care of physicians. Specifically, the revisions to the draft compact would:

  • Require physicians who wish to participate in the compact to submit to fingerprinting or other biometric background checks to be eligible for licensure in additional states;
  • Alter specialty board certification requirements of the compact to clarify that those with time-unlimited certification are also eligible under the compact; and
  • Require that physicians who wish to participate in the compact pass each component of the U.S. Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medicine Licensing Examination (COMLEX-USA) within three attempts.

The new interstate compact system is expected to significantly reduce barriers to the process of gaining licensure in multiple states, helping facilitate licensure portability and telemedicine while widening access to health care by physicians, particularly in underserved areas of the nation. Although the Compact doesn’t establish standards for telemedicine practice, it is expected to enhance telemedicine by significantly expediting multi-state licensure.

 A copy of the draft can be found here.

 

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Posted by: C3O Telemedicine News

Posted on: July 25th, 2014

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Congressman Mike Thompson is a strong advocate for telemedicine: Medicare Telehealth Parity Act of 2014


Congressman Thompson, who has introduced other telemedicine legislation, is on the verge of introducing the Medicare Telehealth Parity Act of 2014. Check it out.

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Posted by: C3O Telemedicine News

Posted on: July 24th, 2014

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This month in telemedicine: ATA webinar


IPRqUxyy_normalJon and Gary gave another outstanding summary of the world of telemedicine:

  • FSMB small steps forward with Interstate Compact but not the total fix.
  • AMA more welcoming to ATA and current president and president-elect with strong IT backgrounds.
  • ACO wants the HHS to mitigate rules for allowing them to use telemedicine.
  • H.R. 3306 and 3077 still alive and Rep. Harper will introduce new bill in July related to telemedicine.
  • FDA proposed to remove requirement for 510K process for medical device data systems and storage devices for imaging
  • Twelve states are currently discussing telemedicine legislation.
  • ATA is preparing a packet of information for physicians to speak to their own state medical licensure boards to inform them of the need for reform.
  • Charlie Rangel’s HR 2001 is important as it adds VA physicians along with DOD physician’s the ability to have one license to practice in all 50 states. Was to be discussed last evening at VA health subcommittee but it wasn’t.
  • Closer ties with the American Hospital Association and the ATA are being addressed.

 

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Posted by: C3O Telemedicine News

Posted on: June 24th, 2014

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Incomplete Washington Post article on telemedicine and the AMA position


An article appearing in the Washington Post describing that a telemedicine consultation must be associated with a face-to-face first encounter or through a physician on the ground is not entirely complete. The AMA also stated that videoconferencing which is a form of telemedicine is also acceptable. That was omitted from the following article:

AMA: Doctors must be licensed in patient’s state to practice telemedicine

 

BY MOHANA RAVINDRANATH June 18
“The American Medical Association recently offered policyrecommendations that, if implemented, would place restrictions ontelemedicine, or virtual medical care.The recommendations came as the Chicago-based organization of physicians and medical students formally announced its support for the practice, claiming telemedicine could “greatly improve access and quality of care while maintaining patient safety.”

The group recommended, for instance, that physicians be licensed in the state their patient is in, and that patient-physician relationships should be established before the provision of telemedicine services (such as through a face-to-face examination or consultation with another physician).

The AMA also recommended that physicians and other health practitioners should abide by the state medical practice laws of the state the patient receives services.

“Whether a patient is seeing his or her physician in person or via telemedicine, the same standards of care must be maintained,” AMA President Robert Wah, said in a statement.

The policy also proposed that the AMA would work with Centers for Medicare & Medicaid Services and others to develop a reimbursement system for telemedicine care, similar to payment for traditional consultations.

Some telemedicine lobbying groups — such as the Alliance for Connected Care, helmed by former senators Tom Daschle (D-S.D.), Trent Lott (R-Miss.) and John Breaux (D-La.) — have argued that state and federal laws should be changed to better accommodate telemedicine. (The group could not be reached for comment for this post.)

State regulation could discourage physicians from treating patients virtually if they are in other states, for instance.

Still, Wah said in a statement, the new policy is meant to establish a “foundation for physicians to utilize telemedicine to help maintain an ongoing relationship with their patients, and as a means to enhance follow-up care, better coordinate care and manage chronic conditions.”

Mohana Ravindranath covers IT and small business for the Washington Post and its weekly Capital Business publication. She joined the Washington Post after graduating from the University of Pennsylvania and has interned for Business Insider and the Philadelphia Inquirer. She is a native of Pittsburgh.”

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Posted by: C3O Telemedicine News

Posted on: June 19th, 2014

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House approves amendment to enhance rural telemedicine, distance learning


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House approves amendment to enhance rural telemedicine, distance learning

Rep. Cory Gardner

The House of Representatives approved a measure on Thursday that was introduced by Rep. Cory Gardner (R-Colo.) to improve healthcare access and distance learning in rural areas.

Gardner introduced an amendment to the Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations Act that would provide more funding for telemedicine and distance learning services.

“In eastern and western Colorado, people often find themselves hundreds of miles and hours away from specialized medical services, trauma centers and oncology centers,” Gardner said. “We are blessed with extraordinary primary care physicians, but they often need help with the necessary resources to treat specialized cases. My amendment gives physicians in rural areas the tools they need to provide patients access to the best possible healthcare.”

Under the amendment, $3.4 million in funding would be transferred from the Grain Inspection, Packers and Stockyards Administration to fund telemedicine and distance learning opportunities in rural areas, according to Northern Colorado Business Report.

“Additionally, my amendment provides support for distance learning services, so that students will not miss out on educational opportunities simply because of their location,” Gardner said. “By increasing funding for telemedicine and distance learning services, we are giving rural communities the tools they need to thrive.”

SOURCE: RIPON ADVANCE

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Posted by: C3O Telemedicine News

Posted on: June 17th, 2014

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