News
“Power to the People”: The Virtual IPA
Just the other day as I was speaking to Dr. Andy Barbash, President of NowDox, did it become evident that the virtual medical community is analogous to the days when I was Vice-President of Physician Development at the 2,000 physician IPA located in Ohio. Everyone knows how fragmented we are as physicians. It is and will always be about the “critical mass” of those of us who want to work together to implement quality programs, provide leadership in pursuing the goal of access to care for all patients, and finally to deal with payers and the challenge of reimbursement. The virtual IPA will be a vehicle as healthcare accepts the telemedicine model as inevitable and more importantly invaluable. “Right On”!
c3o and NowDox Announce Strategic Alliance
Dr Herb Rogove, President announced to the C3O staff today the following:
OpEd – Why No Reimbursement: It’s Always About the Pie
Here we are 15 years after Vice President Al Gore asked the Secretary of HHS to focus on eliminating the barriers to telemedicine, one of which has been reimbursement, we are still talking! One major factor that has not received national attention is the inner circle of physicians who sit around the decision making table, supposedly representing ALL their colleagues, to discuss reimbursement for telemedicine physician services. Want to take a guess why the discussion seems to end in a thumbs down for reimbursement? You guessed it, protect my turf. After all the “pie”, the dollars on the Medicare table that represent what monies are available for payment, never gets much bigger but only has more mouths to feed. Take Critical Care, the argument by physicians around that special table suggest “abuse” may occur and the on-site physician will not be paid. That is a separate argument, but when quick access utilizing TELEMEDICINE to make immediate and accurate diagnoses for the most critically ill is put on hold because of unproven reasoning, we have a major problem. I feel confident, that soon public pressure and the leadership of committed physicians will find it in their hearts and minds to do what’s right.
CMS Administrators Support Telemedicine
According to the ATA, Dr. Don Berwick, current administrator of the Centers for Medicare and Medicaid Services, and Mark McClellan, past administrator of CMS, jointly spoke at the ATA Summit 2010, delivering impassioned arguments for the increased adoption and reimbursement for telemedicine services. Both leaders urged the need for greater collaboration between CMS and the telemedicine community to improve the quality of medical services, expand access to underserved populations and reduce health care costs. McClellan’s comments focused on telemedicine’s huge potential cost savings. Given an impending budget crunch, telemedicine will become an essential element of the U.S. health care system.
Emergency Neurological Life Support – ENLS announced
According to Dr Chad Miller, of Cedars Sinai Medical Center in Los Angeles, the Neurocritical Care Society at their annual scientific meeting in San Francisco last week announced their new ENLS program. Dr. Miller said this will be the ACLS course for neurocritical care. The actual date for release of the program is pending. With the emergence of Neurocritical Care as a recognized specialty, the need for these physicians has been gaining as in depth knowledge of caring for the critically ill patients with acute neurological illnesses is essential in ICU’s across the United States.
Lack of Rural Stroke Care – Bring in Telemedicine!
Once again the obvious is documented as rural communities lacks adequate stroke care. In a released report today and reported by eHealth and Telemedicine “Acute stroke care capacity and services are lacking in many hospitals in the Northwestern region of the U.S., particularly in rural hospitals. In a newly released survey of hospitals and other healthcare providers in this region, a majority of respondents, 88 percent, said their rural communities suffer from a lack of stroke neurologists. Sixty four percent are either developing or considering the development of a telestroke program to address the lack of local neurology resources.” The report represents eight states in the Northwest and is another reason why telemedicine has a prominent role in providing access for expected care!
Rogove Discusses Barriers to Entry for Telemedicine
Rogove at RPCIF
Dr. Herb Rogove discussed the results of an international suvery on barriers to entry for telemedicine at the annual InTouch symposium. Sixty percent of the institutions that utilize remote presence responded to the survey. Hospital executives, nursing leadership, patients and their families were not barriers. Most physician agreed that remote presence was acceptable but buy-in from some physicians was a significant barrier. Regulatory issues such as obtaining out of state medical licenses and hospital staff credentialing are still significant barriers for the implementation of telemedicine programs. Rogove along with Drs.Paul Vespa, David McArthur, and Bart Demaershalk are the lead authors in this study.
Another reason why hospitals should consider telemedicine
A sobering report from Mark Unroe, MD of Duke University’s ICU’s appeared in the Annals of Internal Medicine August 3, 2010 edition which discussed quality of life in patient’s who were on mechanical ventilation for prolonged periods of time. At one year only 9% of the patients had be alive with no functional dependency. This amounted to an estimated $3.5 million per independently functioning survivor at 1 year. Here’s another eye opener – of the survivors the median transitions to other levels of care including skilled nursing facilities and readmissions was four! In this cohort of patients, consideration of follow up at home. LTACS, or in skilled nursing facilities utilizing telemedicine may have been a tremendous help in triaging patients or even providing care to keep patients at their current location. Proper handoff, discharge instructions to the receiving telemedicine physician can potentially have a significant impact upon patient outcomes and ultimately upon reducing readmissions to hospitals.
Rogove to discuss Telemedicine Barriers to Entry
At the annual InTouch Health symposium in Santa Barbara, California on Friday July 23rd, Dr. Herb Rogove will discuss the results of the International Survey of Remote Presence Users. With an over 60% response rate, attendees will understand the barriers of implementing and maintaing a telemedicine program. The work is the result of the Research Consortium of Remote Presence.
c3o supports ATA’s response to CMS ruling on credentialing
The concern by all involved in telemedicine regarding the difficulty of obtaining multiple hospital staff privileges to perform telemedicine consultation is being addressed by CMS. c3o supports the ATA and the clarifications as mentioned on the ATA website. Please address your comments to Dr. Berwick before July 28, 2010. The concept of “by proxy” has been debated for some time and CMS is listening to the need of telemedicine groups who have to undergo numerous hospital credentialing processes.
