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Telemedicine Checklist

Telemedicine Checklist | Healthcare and Technology news | Scoop.it

Telemedicine services are rapidly expanding, with many providers realizing that they can expand their reach and revenue by utilizing improved connectivity and convenient technology.

 

Telemedicine takes several forms, including consultation directly in the office, school-based consultation to provide emergency services to students, home video consultations, and even integration of biometric data from a person’s health wearables.

 

While telemedicine is indeed beneficial for all stakeholders, it is equally important for providers to make sure they are well-versed with the entire process before they step into it.

 

In order to offer effective primary care and enable truly coordinate care, providers must consider all the planning element that are part of successful telemedicine ventures.

 

Here are the important steps to be taken care of when starting telemedicine.

 

1. Identify Your Mission and Goals

 

Before you do anything to start the process at all, you must sit down and ask yourself certain questions. Why do you want to engage in telemedicine? What are your goals? Do you want to grow your practice? Are you looking to increase your access? Are you interested in saving time or making extra money? Do you think these goals are realizable?

 

It is imperative to have the answers to these basic questions in mind, so you know which path to take right from the beginning.

 

2. Identify Your Patients

 

Once you know what you want to do and have a rough plan on how to achieve it, you must determine your target market and create your patient panel.

 

Do you want to acquire new patients or merely communicate better with your existing patients? Which areas will your patients be in? What health issues will you focus on? Will your patients be tach-savvy millennials or older patients with caregivers? Knowing your patient panel will automatically narrow down and simplify the next steps in the process.

 

3. Create a Relevant Profile

 

As a provider, while you may have all your work experience listed down on your resume, it is essential to update it before diving into telemedicine and to make yourself seem suitable for the job.

 

It is important to update and highlight licenses, since these are critical in matching you with potential positions and patients. Additionally, make sure you make your remote experience stand out, if any. You should also emphasize on the additional skills needed for a telemedicine provider, for example, listening and conversational skills.

 

4. Manage Your Licenses

 

Having multi-state licenses will ensure that you get the most-suited telemedicine position. While telemedicine recruiters may help you in obtaining licenses, there is no denying that they are looking for providers who already have licenses secured before they apply for the job.

 

5. Research HIPAA-Compliant Platforms

 

When considering where to apply, you must research which telemedicine platforms are HIPAA compliant. You should also consider whether the platforms you are looking at are cloud-based, what equipment do they require, what are the training requirements and options, what are the billing procedures, will you need IT support, will you be able to import patient data into your EHR, etc. 

 

6. Reach Out to Telemedicine Recruiters

 

Do some research on the latest clinical outcomes and trends in telemedicine, and then reach out to a recruiter to find you jobs in the area of expertise you would like to focus on.

 

While you may search for jobs online, remember that this area of medicine is still relatively new, and recruiters can guide you and help you find the best jobs at top companies. Following this, make sure you speak to a few companies and evaluate their benefits before finalizing one.

 

7. Acquire Legal Consultation

 

It is wise to obtain legal advice on your telemedicine contract before you finalize it. This is especially necessary and beneficial if there are two organizations involve through your telemedicine practice.

 

You must take into account state laws like prescribing laws, which may be different in the area your patients are. To keep a track of these matters, it is recommended that you have a legal counselor’s services handy.

 

8. Assess Needs and Identify Resources

 

Identify the needs of your telemedicine practice and identify the resources that you have at hand, and those you will need to acquire.

 

At this point, you will also have to determine whether you need a team. If you do, you must focus on administrators, finance managers, clinical operations supervisors, and technical support personnel.

 

9. Set Up Your Office

 

This is perhaps the most important part of the telemedicine experience, because you will have to pick the perfect place to facilitate your telemedicine practice. Ideally, this can be a quiet and secluded corner of your home and must be set up to look professional on video calls.

 

It is also important to make sure you acquire the best technological equipment, since your computer and your internet connection will be your most important tools in the process.

 

10. Engage in Networking

 

Once you are ready to indulge into the process, you must then insert yourself into the telemedicine circle of professionals. If you don’t find any people doing this in your area, it is wise to use social media to reach out to fellow professionals. Communicate with peers and follow different organizations.

 

Additionally, attend telemedicine events around the country to create a constructive network and to learn from those doing similar work.

 

Taking care of these essential steps should ensure the smooth beginning of your telemedicine career. Over time, successful providers not only continue to take steps to improve their care delivery and maximize patient satisfaction, but they also stay connected with industry peers.

 

Eventually, if done right, this could be a life-changing move in your career and could potentially help you excel in the modern care delivery landscape.

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New HIPAA Regulations in 2019

New HIPAA Regulations in 2019 | Healthcare and Technology news | Scoop.it

While there were expected to be some 2018 HIPAA updates, the wheels of change move slowly. OCR has been considering HIPAA updates in 2018 although it is likely to take until the middle of 2019 before any proposed HIPAA updates in 2018 are signed into law. Further, the Trump Administration’s policy of two regulations out for every new one introduced means any new HIPAA regulations in 2019 are likely to be limited. First, there will need to be some easing of existing HIPAA requirements.

 

HIPAA updates in 2018 that were under consideration were changes to how substance abuse and mental health information records are protected. As part of efforts to tackle the opioid crisis, the HHS was considering changes to both HIPAA and 42 CFR Part 2 regulations that serve to protect the privacy of  substance abuse disorder patients who seek treatment at federally assisted programs to improve the level of care that can be provided. Other potential changes to HIPAA regulations in 2018 included the removal of aspects of HIPAA that impede the ability of doctors and hospitals to coordinate to deliver better care at a lower cost.

 

These are the most likely areas for HIPAA 2019 changes: Aspects of HIPAA Rules that are proving unnecessarily burdensome for HIPAA covered entities and provide little benefit to patients and health plan members, and those that can help with the transition to value-based healthcare.

How are New HIPAA Regulations Introduced?

The process of making HIPAA updates is slow, as the lack of HIPAA changes in 2018. It has now been 5 years since there was a major update to HIPAA Rules and many believe changes are now long overdue. Before any regulations are changed, the Department of Health and Human Services will usually seek feedback on aspects of HIPAA regulations which are proving problematic or, due to changes in technologies or practices, are no longer as important as when they were signed into law.

 

After considering the comments and feedback, the HHS then submits a notice of proposed rulemaking followed by a comment period. Comments received from healthcare industry stakeholders are considered before a final rule change occurs. HIPAA-covered entities are then given a grace period to make the necessary changes before compliance with the new HIPAA regulations becomes mandatory and enforceable.

New HIPAA Regulations in 2019

OCR issued a request for information in December 2018 asking HIPAA covered entities for feedback on aspects of HIPAA Rules that were overly burdensome or obstruct the provision of healthcare, and areas where HIPAA updates could be made to improve care coordination and data sharing.

 

The period for comments closed on February 11, 2019 and OCR is now considering the responses received. A notice of proposed rulemaking will follow after careful consideration of all comments and feedback, although no timescale has been provided on when the NPRM will be issued. It is reasonable to assume however, that there will be some at least some new HIPAA regulations in 2019.

OCR was specifically looking at making changes to aspects of the HIPAA Privacy Rule that impede the transformation to value-based healthcare and areas where current Privacy Rule requirements limit or discourage coordinated care.

 

Under consideration are changes to HIPAA restrictions on disclosures of PHI that require authorizations from patients. Those requirements may be loosened as they are considered by many to hamper the transformation to value-based healthcare.

 

OCR is considering whether the Privacy Rule should be changed to make the sharing of patient data with other providers mandatory rather than simply allowing data sharing. Both the American Hospital Association (AHA) and the American Medical Association (AMA) have voiced their concern about this aspect of the proposed new HIPAA regulations and are against the change. Both organizations are also against any shortening of the timescale for responding to patient requests for copies of their medical records.

 

OCR is also considering HIPAA changes in 2019 that will help with the fight against the current opioid crisis in the United States. HHS Deputy Secretary Eric Hargan has stated that there have been some complaints about aspects of the HIPAA Privacy Rule that are stopping patients and their families from getting the help they need. There is some debate about whether new HIPAA regulations or changes to the HIPAA Privacy Rule is the right way forward or whether further guidance from OCR would be a better solution.

 

One likely area where HIPAA will be updated is the requirement for healthcare providers to make a good faith effort to obtain individuals’ written acknowledgment of receipt of providers’ Notice of Privacy Practices. That requirement is expected to be dropped in the next round of HIPAA changes.

 

What is certain is new HIPAA regulations are around the corner, but whether there will be any 2019 HIPAA changes remains to be seen. It may take until 2020 for any changes to HIPAA regulations to be rolled out.

Changes to HIPAA Enforcement in 2019

Halfway through 2018, OCR had only agreed three settlements with HIPAA covered entities to resolve HIPAA violations and its enforcement actions were at a fraction of the level in the previous two years. It was starting to look like OCR was easing up on its enforcement of HIPAA Rules. However, OCR picked up pace in the second half of the year and closed 2018 on 10 settlements and one civil monetary penalty – One more penalty than in 2018.

 

2018 ended up being a record year for HIPAA enforcement. The final total for fines and settlements was $28,683,400, which beat the previous record set in 2016 by 22%.

At HIMSS 2019, Roger Severino gave no indications that HIPAA enforcement in 2019 would be eased. Fines and settlements are likely to continue at the same level or even increase.

 

Severino did provide an update on the specific areas of HIPAA compliance that the OCR would be focused on in 2019. OCR is planning to ramp up enforcement of patient access rights. The details have yet to be ironed out, but denying patients access to their medical records, failures to provide copies of medical records in a reasonable time frame, and overcharging are all likely to be scrutinized and could result in financial penalties.

 

OCR will also be continuing to focus on particularly egregious cases of noncompliance – HIPAA-covered entities that have disregarded the duty of care to patients with respect to safeguarding their protected health information. OCR will come down heavy on entities that have a culture of noncompliance and when little to no effort has been put into complying with the HIPAA Rules.

 

The failure to conduct comprehensive risk analyses, poor risk management practices, lack of HIPAA policies and procedures, no business associate agreements, impermissible PHI disclosures, and a lack of safeguards typically attract financial penalties. OCR is also concerned about the volume of email data breaches. Phishing is a major problem area in healthcare and failures to address email security risks are likely to attract OCR’s attention in 2019.

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Scripps, Sharp HealthCare to Fully Participate in San Diego HIE

Scripps, Sharp HealthCare to Fully Participate in San Diego HIE | Healthcare and Technology news | Scoop.it

The San Diego-based Scripps Health and Sharp Healthcare are beginning full participation in the San Diego Health Connect, a regional health information exchange (HIE) that now facilitates the data exchange of more than 2.7 million San Diego County residents.

In October of 2013, both of these provider organizations originally announced they were participating in San Diego Health Connect, but according to reports, integration and consent issues kept them from fully being on board until this summer.  


In 2013, San Diego Health Connect officially evolved from the San Diego Beacon, the largest of the 17 Beacon Community projects that received a total of $250 million in three-year grants from the Health and Human Services Office of the National Coordinator for Health Information Technology (ONC). Funding for that project ended on Sept. 30. The regional health information exchange was one of the initial projects of that Beacon community.


“The real-time exchange of medical information between San Diego providers will ensure patients receive timely and cost-efficient care,” Mike Murphy, Sharp HealthCare CEO, said in a news release statement. “Lives will undoubtedly be saved as result of sharing critical patient care information in a secure and confidential manner."

Through the program, information is shared with healthcare professionals at the point of care and only by authorized requests and with patient permission. Patients served by Scripps Health and Sharp HealthCare can opt-out at any time. “Using San Diego Health Connect offers real advantages for everyone involved,” said Scripps Health president and CEO Chris Van Gorder. “It not only facilitates better care, in many cases it also eliminates the likelihood of tests and procedures being repeated unnecessarily.”


San Diego Health Connect acts not as a keeper of information, but rather as a conduit, its officials say. Requests from providers are sent to a data hub, where pertinent information is assembled and routed for real-time electronic delivery. More than 200,000 messages are safely exchanged through the system every day among the San Diego hospitals and community clinics currently in the system, the organization says.


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Telemedicine Platforms Attracting Big-time Investments

Telemedicine Platforms Attracting Big-time Investments | Healthcare and Technology news | Scoop.it

We’ve seen enormous changes in the healthcare industry in recent years, mostly relating to the more efficient storage and usage of patient data through blockchain technology and the digitisation of patient files.

 

In the past two decades, the growing penetration of technology in the industry has yielded new medical devices, automated treatments, and improved diagnostic processes, giving doctors, scientists and patients renewed hope for the treatment of diseases some of which, until now, have been largely untreatable.

 

Blockchain has enabled the seamless global exchange of patient information in real time with reduced transaction costs and fewer administrative delays, enabling much faster, more secure and more efficient exchanges of health records between medical personnel.

 

But technology isn’t only transforming the way patient information is handled; it is also revolutionising the way patients receive medical care.

 

Telemedicine -- the use of information technology to remotely diagnose, treat, or continuously monitor patients - has been hailed the ‘next disruptor’ of the healthcare industry.

 

In other words, the industry has at last recognised that waiting for hours at a doctor's office to ask a simple question or get a prescription can in some cases be so burdensome and frustrating that it can prevent patients from seeking medical help.

 

About time, too. If every other aspect of our lives has been digitised -- from job hunting, to online dating, to doing the groceries -- why haven’t we yet digitised the process of receiving medical care?

 

Often, a doctor’s check-up is so simple that all that is required is a quick verbal check of symptoms and a quick glance into the patient’s eyes.

 

If this could be done remotely through video technology in less than five minutes, it benefits both the physician -- who can in turn help more patients on average -- and the patient, who needn’t risk becoming even more sick by leaving home and sitting in a crowded waiting room with other ill people.

 

By empowering caregivers to remotely interact with their patients, telemedicine has the power to completely transform health care delivery, by making it far more affordable and available.

 

In fact, it has already begun to do this: in 2018, over 7 million patients used some sort of a telemedicine service in the U.S., and that number is only expected to rise over the next few years. Over half of America’s hospitals already use some sort of telemedicine, and there are more than 200 telemedicine networks in the US alone. Inevitably, with anticipated growth comes unprecedented industry investment - and the telemedicine industry is no exception.

 

There have been huge investments in the global telemedicine market in recent years, so much so that it is anticipated to grow from its current $38.3 billion valuation to an impressive $130.5 billion by 2025.

 

This encompasses value derived not only from the services provided through telemedicine but the devices and platforms that support service delivery. 

 

As healthcare companies look for ways to reduce costs and improve patient-centered care, more and more providers -- as well as investors -- are choosing to invest in shares in telehealth.

 

According to recent studies, 56 percent of healthcare executives say they have already integrated telemedicine - and more specifically, software as a service (SaaS) business models - into organisation, while another 24 percent are currently looking to invest in telemedicine solutions.

 

The remaining 20 percent are just beginning to become familiar with the opportunities presented by telehealth and telemedicine.

 

One particular platform - Colorado-based CirrusMD, which gives patients access to a board-certified physician in less than a minute on the app or on the web - has seen the largest investment to date in the telemedicine world, with a further US$15 million in funding having just been granted for the expansion of its telemedicine portfolio.

 

The money was raised through a series B funding round led by Drive Capital, bringing its total venture capital raised to $26 million altogether.

 

Founded in 2012 by an emergency physician, the platform is available across 50 states and differs from other telemedicine platforms in that members don’t pay upfront to physicians. Instead, it teams up with integrated delivery networks who pay doctors by the hour to deliver services via its platform.

 

CirrusMD is far from alone in the telemedicine sphere, mind you. It vies for the attention of patients alongside competitors Heal, Pager, Kry, HealthTap, Snap MD, Mfine, Pager, K Health, and Doctor on Demand, the latter of which just pulled in $50 million to continue expansion of its virtual doctor platform.

 

Maven - the first telemedicine platform made specifically for women - just launched with $2.2 million in seed funding, and Spruce just raised a further $15 million for its new platform which caters to people with dermatology conditions.

 

With 25 percent of consumers admitting they would willingly switch their primary care provider for one that offers more telehealth services, and with 75 percent of people saying they would be happy to attend a doctor’s appointment remotely, it's extremely likely that the telehealth and telemedicine industry will grow at an exponential rate in the next few years, paving the way for huge opportunities for those willing to invest in the digital infrastructure that supports it.

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How Telemedicine Can Help Stroke Victims Faster 

How Telemedicine Can Help Stroke Victims Faster  | Healthcare and Technology news | Scoop.it

In developed countries like the United States, stroke is still the third leading cause of death. In fact, each year stroke occurs in more than 700,000 patients, leaving many with disabilities and unable to resume a normal life.

 

When a stroke occurs, every second counts. The sooner a stroke victim is treated with medication that breaks up blood clots and restores blood flow to the brain, the less chance the patient will suffer permanent damage such as the loss of muscle control, mobility, or the ability to speak.

 

According to the American Stroke Association, ‘time lost is brain lost.’ That’s because every minute that passes before a stroke patient is treated, means the death of millions of brain cells.

 

Unfortunately, less than 30% of stroke victims receive clot-dissolving medication inside a recommended window of an hour or less for maximum effectiveness, according to information from Healthcare delivery network Kaiser Permanente.

 

But the same study reveals how telemedicine – or a telestroke system to be precise – can be a vital tool in getting stroke victims faster treatment – and thereby limiting the debilitating effects of the attack.

 

A Race Against Time

Basically, a telestroke system requires a neurologist and attending nurse to have a high-speed Internet connection and videoconferencing capabilities on a laptop, tablet or desktop computer.  The purpose is for the consulting neurologist to be able to talk to the patient or an emergency response team about what symptoms the patient is experiencing, evaluating the patient’s motor skills, viewing a computed tomography (CT) scan, making a diagnosis and prescribing treatment.

 

Data gathered from 300 stroke patients being treated in 21 Kaiser emergency rooms in Northern California shows that those who were diagnosed as having a stroke via a telehealth consultation received clot-busting medication intravenously much faster than the 60-minute guidelines from the American Heart Association and American Stroke Association.

 

The Kaiser emergency rooms were equipped with telestroke carts, which included a video camera and access to patients’ electronic scans and test results. When emergency room staff contacted a staff neurologist and a radiologist via a telestroke cart, patients received anti-blood clot medicine in an average of 34 minutes. Eighty-seven percent of stroke patients received the intravenous medication in 60 minutes or less, 73% in 45 minutes or sooner and 41% in 30 minutes or less.

 

A Clear Priority

According to the American Stroke Association, American Heart Association, and the American Telemedicine Association, telestroke services could save thousands of lives each year and cut costs by $1.2 billion over the next decade.

 

The reason is because processes that used to happen sequentially during a stroke alert are now happening at the same time. That allows medical staff to provide evaluation and treatment to stroke patients more quickly, safely, and confidently, to avoid further brain damage.

 

The addition of specialized stroke services helps hospitals improve patient outcomes, decrease patient disability related to stroke, and reduce costs, while keeping patients in the community. Providing expert stroke consults remotely via telemedicine allows prompt care close to home for these patients, making a priority for health care providers nationwide.

 

If you are interested in bridging the gap of care for patients in need, whether they be in remote areas or unable to leave home, telemedicine can help provide quality care to more people in need. Contact TeleMed2U today, at (855) 446-TM2U (8628).

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Telehealth Program at Banner Health Reduced Costs, Hospitalizations

Telehealth Program at Banner Health Reduced Costs, Hospitalizations | Healthcare and Technology news | Scoop.it

The Phoenix, Az.-based Banner Health has announced successful results from its at-home telehealth pilot program for patients with multiple chronic conditions.


The Intensive Ambulatory Care (IAC) pilot program, done in partnership with the Netherlands-based Royal Philips, focuses on the most complex and highest cost patients —the top five percent of patients who account for 50 percent of healthcare spending. The program first launched in 2013 and aims to improve patient outcomes care team efficiency and prevent IAC patients from entering the acute care environment where costs are significantly higher.


As part of the pilot, Philips and Banner assessed the results of 135 patients to determine the effectiveness of the IAC program in meeting its clinical and financial goals. An analysis of the results of each patient's first six months demonstrated that the program:

  • Reduced costs of care by 27 percent. This cost savings was driven primarily by a reduction in hospitalization rates and days in the hospital as well as a reduction in professional service and outpatient costs.
  • Reduced acute and long term care costs by 32 percent. This cost reduction was primarily due to a significant decrease in hospitalizations.
  • Reduced hospitalizations by 45 percent. Prior to enrollment in the IAC program there were 11.5 hospitalizations per 100 patients per month; after enrollment the acute and long-term hospitalization rate dropped to 6.3 hospitalizations per 100 patients per month.
  • What’s more, the acute short term hospital stays decreased from 7.7 hospitalizations per 100 patients per month to 4.9; long term care home health or other facility stays decreased from 3.9 hospitalizations per 100 patients per month to 1.4; and the average number of days in the hospital per 100 patients per month also trended down from approximately 90 to 66.   


“The results of our at-home telehealth pilot with Philips have been dramatic and are indicative of the exponential success such a program could have by engaging patients in their own care and building a strong support system around them" said Dr. Hargobind Khurana, senior medical director of health management Banner. "As we continue to expand this program we anticipate seeing further proof that telehealth programs can address readmissions rates reduce costs and improve the health and quality of life for patients with multiple chronic diseases."


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