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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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C3O Telemedicine News

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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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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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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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June 7th, 2014

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New slate of ATA board leaders


Board of Directors

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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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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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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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May 8th, 2014

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FSMB Document Passes: What About License Portability?


FOR IMMEDIATE RELEASE

Contact: Drew Carlson, (817)868-4043;  dcarlson@fsmb.org

State Medical Boards Adopt Policy Guidelines for Safe Practice of Telemedicine

Denver, Colorado (April 26, 2014) – Representatives of state medical licensing boards today approved updated guidelines to help ensure the safety and quality of medicine when it is practiced using telemedicine technology – which can connect a patient in one location with a care provider in another location.

The Model Policy on the Appropriate Use of Telemedicine Technologies in the Practice of Medicine, adopted by the Federation of State Medical Boards (FSMB), provides much-needed guidance and a basic roadmap that state boards can use to ensure that patients are protected from harm in a fast-changing health-care delivery environment.

Among its key provisions, the model policy states that the same standards of care that have historically protected patients during in-person medical encounters must apply to medical care delivered electronically. Care providers using telemedicine must establish a credible “patient- physician relationship,” ensuring that patients are properly evaluated and treated and that providers adhere to well-established principles guiding privacy and security of personal health information, informed consent, safe prescribing and other key areas of medical practice.

“Telemedicine offers wonderful tools to help expand treatment options for patients – particularly in helping provide care in remote areas, lowering costs and helping support preventive care efforts,” said FSMB President and CEO Humayun J. Chaudhry, DO, MACP. “But as telemedicine has grown, so too, has the need for clear, common-sense guidelines that help health care providers transition to this exciting new environment in a safe way.”

Dr. Chaudhry noted that the new guidelines are designed to provide flexibility in the use of technology by physicians – ranging from telephone and email interactions to videoconferencing as long as they adhere to widely recognized standards of patient care.

The policy adopted by the FSMB’s House of Delegates, which represents all of the nation’s 70 state and territorial state medical licensing boards, is advisory, meaning state boards are free to adopt it as is, modify it, or retain their own current policies regarding telemedicine.

Representatives of the telemedicine industry expressed support for the guidelines following their adoption on Saturday.

“CTEL appreciates the FSMB’s guideline efforts as a first step to help put a definition to safe telemedicine,” said Greg Billings, Executive Director of the Robert J. Waters Center for Telehealth and e-Health Law (CTEL), which represents some of the nation’s leading telemedicine providers.

The Policy at a Glance:

ï        Standards of care that protect patients during in-person medical interactions apply equally to medical care delivered electronically

ï        Providers using telemedicine should establish a credible “patient-physician relationship” and ensure that their patients are properly evaluated and treated

ï        Providers should adhere to well-established principles guiding privacy and security of records, informed consent, safe prescribing and other key areas of medical practice.

The new policy is available at www.fsmb.org/pdf/FSMB_Telemedicine_Policy.pdf. For more information, please contact Drew Carlson at dcarlson@fsmb.org or (817) 868-4043.

Commentary: If you have been following the issues surrounding this long awaited meeting and the public letter sent to the FSMB by the American Telemedicine Association, there are many questions still remaining after these issues have been on the table for seventeen years. According to the document, medical license portability still remains a major barrier to the practice of telemedicine. While the expedited process or compact approach is a baby step forward, the onerous task of obtaining fifty medical licenses is still yet to be solved.

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April 28th, 2014

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A novel insurance plan to be watched and it’s incorporation of telemedicine


Evergreen, a non-profit health insurance cooperative is impacting healthcare in Baltimore. Maryland hadn’t had a health insurance co-op for 20 years until Dr. Peter Beilenson came along. So, using federal funds allocated by the Affordable Care Act, he founded Evergreen Health Cooperative, which debuted this past October for open enrollment on Maryland’s glitch-ridden health exchange.

According to Beilenson, “We’re a nonprofit insurance company. As a co-operative, it’s governed by a member majority. We have two major product lines. One side is the point-of-service insurance plan, which is like a PPO, with a network of providers. They take many kinds of insurance, so we don’t have a lot of leverage over their behavior.”

“The other product line is our four care centers: in the Rotunda in Baltimore city, White Marsh, Columbia and Greenbelt. They’re Patient Centered Medical Homes, where you get all your primary care, mental health services, wellness coaching . and the doctors are salaried, so there’s not this perverse incentive to do more testing if it’s not really necessary. They have smaller patient loads, there’s a social worker to deal with any behavioral health issues on the same day as your appointment, a health coach to set you up on wellness plans and a care coordinator to follow you at home.”

And telemedicine ties it all together. . A diabetic could have a blood sugar monitor at home that will trigger a note to tell the care coordinator that his sugars are too high and to monitor it. . You want to keep them from tipping into an emergency situation, because hospitalization will cost much more.

Reported by

ALISSA GULIN, The Daily Record | April 27, 2014

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April 27th, 2014

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