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Telehealth-news

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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AAN Legislative Position Statement on Telemedicine


The American Academy of Neurology’s position paper on Telemedicine:

Background Information
The American Academy of Neurology (AAN) is a professional organization of
more than 28,000 practicing neurologists and neuroscientists with a deep
and abiding interest in assuring the best possible care of patients with all types
of neurologic disorders. With policymakers at the state and federal levels
considering new policies regarding telemedicine, and with many neurologists
moving to include telemedicine within their practices, it is important for the
American Academy of Neurology to have an official position on the issue in
order to advocate appropriately for its members.
Description of Issue
With telemedicine rapidly emerging as a form of patient care, it is important
that policymakers consider access issues, reimbursement, liability issues, and
licensing across state borders when discussing telemedicine policy.
AAN Position
While telemedicine cannot replace many of the hands-on skills and in-office
assessments neurologists provide, patients in all US states, territories, and the
District of Columbia should have access to telemedicine, regardless of location,
and should have telemedicine services included in all subscriber benefits
and insurance plans (Medicare, Medicaid, and private insurance). Physicians
should be reimbursed equitably for telemedicine services and have access
to a streamlined state medical license process. Comprehensive malpractice
insurance policies are also needed.
Rationale
Definition of Telemedicine
Telemedicine involves the use of electronic communications—telephone, email,
videoconference, digital imaging, and other forms of Internet technology—
to practice medicine from a location that is remote for the patient. It is an
effective and efficient form of health care delivery, instantly connecting
patients and physicians. The telephone and email are commonly used forms of
communication to address patient care issues and are often used to develop
or share a fairly detailed assessment of the patient’s condition, including
ordering tests, starting or changing medications, with discussions of side effects,
expected effects, etc. Telemedicine is a rapidly developing field, evolving as
communications technologies change. It is enabling high-quality care, often
allowing patients to avoid transfer to another facility while also improving the
financial viability of the hospital that receives the service. Rural populations and
military personnel in combat are increasingly using telemedicine to overcome
barriers of distance and delay by bringing the physician and patient together in
real time. It is used in the inpatient setting to provide care to patients who are

seen in a remote emergency room, or are admitted to a remote hospital for an
acute illness or chronic disorder.
Access Issues
Telemedicine for neurologic care, often called teleneurology, is most often
applied to emergency stroke care and neurocritical care (Ganapathy, 2005). But
it also has evolved to include long-term care for chronic neurologic conditions
such as epilepsy (Ahmed et al., 2008), Parkinson disease (Samii et al., 2006),
multiple sclerosis (Kane et al., 2008), dementia (Loh et al., 2007), and migraine
headaches (Cottrell et al., 2007).
Patients should have access to telemedicine in all states, the District of
Columbia, and US territories, as it is well-suited to provide medical care in
both rural and urban locations lacking access to physician specialists such as
neurologists. Access issues also can affect patients residing in nursing homes
and rehabilitation facilities, as well as those unable to drive due to physical
deficits.
Legislative action is recommended at both state and federal levels to include the
benefits of telemedicine to populations with limited access to care regardless of
location and the health insurance coverage they might have.
Cost-effectiveness and Reimbursement/Payment Parity
Telemedicine has been shown to be cost-effective, efficient, and equal in
therapeutic value to face-to-face encounters. However, the technical costs and
incongruent physician and hospital reimbursement have been a barrier to further
dissemination. Telemedicine costs include the increased workforce of dedicated
network program managers and personnel, higher estimates of inpatient care,
inter-hospital transfer, rehabilitation, long-term care, caregiver costs, and a
wider range of spoke-to-hub hospital network transfer rates.
Present data support the cost effectiveness of telemedicine for stroke from both
the societal and hospital perspectives. For example, researchers at the Mayo
Clinic have found that rural patients treated for stroke care via telemedicine
incurred cost savings of $1,436 per patient, while also increasing their quality of
life, when compared with seeing the stroke patient in person (Demaerschalk et
al., 2013).
These results demonstrate that an upfront investment in telemedicine
technology, connectivity, infrastructure, and stroke network personnel can
be justified in our health system. The AAN supports the reimbursement of
telemedicine consultations in the same fashion as face-to-face, telephonic, and
email clinical encounters.
Liability and Multistate Licensing
Risk management is an important consideration in telemedicine practice, as
physicians could be legally liable across state borders. The major issues include
defining what constitutes telemedicine malpractice and determining where
and against whom claims can be brought, because the care provided as part of
telemedicine may be across state borders.
For example, the decision to administer or not administer thrombolysis for
acute stroke is a prominent source of malpractice claims for neurologists, and
telemedicine physicians managing acute stroke patients may be exposed to FOR MORE INFORMATION
memberservices@aan.com
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(800) 870-1960 • (612) 928-6000
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©2013 American Academy of
Neurology – All Rights Reserved
AAN Legislative Position Statement on Telemedicine 3
complex liability issues. Legislative policies are needed to clarify liability issues in
the practice of telemedicine as well as to protect patients from adverse events.
Broad, comprehensive malpractice insurance policies and clear telemedicine
practice guidelines are required to protect physicians.
Standards for the engagement, training, and supervision of telemedicine
providers are necessary. Advocating for appropriate competency of telemedicine
physicians in evaluation and management; readily available technological
support; careful and detailed informed consent discussions; and detailed,
accurate chart documentation may best protect telemedicine physicians and
patients alike. Guidelines for protecting patient confidentiality and following
HIPAA regulations are important aspects that should be standardized to be
applicable to telemedicine services.
The AAN also supports efforts to streamline state medical license processes for
those physicians looking to practice across state borders and use telemedicine
to treat patients living in rural areas.
Position Statement History
Drafted by Vernice Bates, MD; Pushpa Narayanaswami, MBBS, MD, FAAN; Sarah
Song, MD; Jeffrey A. Switzer, DO; Jack W. Tsao MD, DPhil, FAAN; Tim Miller (AAN
Staff)
Reviewed and approved by the following AAN Committees: Government
Relations, Medical Economics, Practice, and the AAN Board of Directors.
References/Resources
Ganapathy K. Telemedicine and neurosciences. Journal of clinical neuroscience: Office Journal of the
Neurological Society of Australia 2005;12:851-862.
Ahmed SN, Mann C, Sinclair DB, et al. Feasibility of epilepsy follow-up care through telemedicine: a pilot study

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Posted by: C3O Telemedicine News

Posted on: July 22nd, 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


By 

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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IOM publication: The Role of Telehealth in an Evolving Health Care Environment


Now available in published version:th-nap13466-lrg

In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers.

Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others.

The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.

Rapporteur: A. Lustig Tracy.

This activity was supported by Contract/Grant No. HHSH250200976014I between the National Academy of Sciences and the Department of Health and Human Services. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.

 

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Posted by: C3O Telemedicine News

Posted on: June 7th, 2014

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New slate of ATA board leaders


Board of Directors

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Posted by: C3O Telemedicine News

Posted on: June 5th, 2014

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The Alliance for Connected Health at Work


New Telemedicine Literature Review Released

According to the Parkinson’s Action Network, “The Alliance for Connected Care held two Hill briefings this week to announce the release of a new literature review titled, The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management. The literature review looked at published literature on telemedicine management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. The authors of the literature review concluded that the current evidence “attests to the potential of telemedicine for addressing problems of access to care, quality of care, and health care costs in the management of the three chronic diseases chosen for this review.”

Speakers at the House briefing on May 20 included:

  • Krista Drobac, senior policy advisor at DLA Piper, LLP and executive director of the Alliance for Connected Care;
  • Former Sen. Trent Lott;
  • Former Senate Majority Leader Tom Daschle, senior policy advisory at DLA Piper, LLP;
  • Rashid Bashshur, executive director of eHealth at the University of Michigan Health System;
  • Rep. Fred Upton (R-MI), chairman of the House Energy and Commerce Committee;
  • Rep. Dave Camp (R-MI), chairman of the House Committee on Ways and Means; and
  • Rep. Henry Waxman (D-CA), ranking member of the House Energy and Commerce Committee.

Speakers at the Senate briefing on May 21 included Drobac; Sen. Daschle; Sen. Lott; Bashshur; former Sen. John Breaux; Sen. Ron Wyden (D-OR), chairman of the Senate Committee on Finance; and Sen. John Thune (R-SD).

The New York Times also wrote a piece about Sens. Lott, Daschle, and Breaux working together on telemedicine.

Click here to read the literature review’s executive summary.”

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Posted by: C3O Telemedicine News

Posted on: May 24th, 2014

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Dr. Herb Rogove: “Join us at the ATA TeleICU panel May 20th”


On Tuesday, May 20th at 1:15pmimages, Dr. Herb Rogove, CEO of C3O Telemedicine, will moderate a panel of national intensivists discussing the hard questions about TeleICU. The panelists include Dr. James Marcin (director of pediatric teleICU at UCDavis), Dr. Craig Lilly ( director of the ICU and TeleICU at the University of Massachusetts), Dr. Chad Miller  (director of Neurocritical Care at The Ohio State University), and Dr. Neal Reynolds (director of one of the ICU’s at the University of Maryland’s R. Adam Cowley Trauma Center). A diverse group of adult and pediatric intensivists, general and neurocritical care, and users of a centralized and a de-centralized model of care.

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Posted by: C3O Telemedicine News

Posted on: May 14th, 2014

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ATA Summary of Key News Events: Keep Current


May 07, 2014
The House Energy and Commerce Subcommittee on Health seeks input on how 21st-century technology can improve healthcare and help patients.
May 07, 2014
ATA recently submitted public comments urging the Tennessee Medical Board to adopt regulatory standards that would hold providers using telemedicine to the same standard as those practicing in office settings.
May 07, 2014
The Florida Senate passed an omnibus healthcare bill stripped of two of its biggest provisions with minutes left in the Legislative session.
May 07, 2014
Using technology from cellphones to video chats to expand the availability of healthcare is popular these days from hospitals to rural farm towns. Right now, Idaho is grappling with how to standardize care, and the process isn’t without controversy.Related article: Idaho must embrace telemedicine (Idaho Press-Tribune editorial)
May 07, 2014
Two industry organizations recently drafted guidelines and policies to clarify murky rules surrounding telemedicine, demonstrating the struggle many providers continue to have with this approach to care.
May 07, 2014
New guidelines issued by the Federation of State Medical Boards could have a chilling effect on the growth of telemedicine — especially in rural areas and among low-income patients, say some patient advocates, healthcare providers and healthcare companies. But the federation says the updated guidance will safeguard patients’ privacy and ensure high-quality care in the current fast-changing healthcare delivery environment.
May 07, 2014
The Federation of State Medical Boards’ move to leave out telecommunications in its guidelines for the use of telemedicine has divided the national telemedicine community. But it also calls attention to the enormous challenge of instituting nationwide policies to states that may have widely differing healthcare needs and policies for addressing them.
May 07, 2014
Telemedicine is lauded for advancing the public good, improving the quality of life and transforming the patient/doctor relationship for the betterment of both. Broadband-driven telemedicine also impacts economic development. But are communities prepared to ride this particular technology wave to better economic health?
May 07, 2014

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Posted by: C3O Telemedicine News

Posted on: May 8th, 2014

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