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The in-person care services telemedicine reimbursement bill aims to make telemedicine reimbursement equal to in-person care services. Senator Elder Vogel brought the bill to the Pennsylvania Senate on June 28, 2017 to define major components of telemedicine and to set telemedicine licensing requirements. Pennsylvania is bound to be the next state to allow complete telemedicine reimbursement equality for care services. The legislation requires all healthcare payers to provide telemedicine reimbursement if the same services are paid in person.

The bill will ensure that all telehealth services provide reimbursement under the ancillary service plans. The group or individual health insurance plans provide exclusive coverage for vision and dental services. The healthcare services a person purchases through the ancillary plans cannot be absent from the coverage because they were done through telemedicine.

Pennsylvania Department of Human Services will offer medical assistance for reimbursement of the fee for service, medical assistance and managed care programs or general healthcare done through telemedicine under Medicaid.

Healthcare providers must follow strict guidelines set to enable them to receive payments for telemedicine. Providers must establish a provider-patient relationship using appropriate diagnostic tests and virtual exams to give an accurate diagnosis. The provider can use an interactive audio without video IF after carefully reviewing the medical records of the patient.

The provider will give equivalent healthcare to the person. The bill also states that the provider must have an emergency action plan during the telemedicine consultation. Apart of the emergency action plan includes verifying the location of the patient and disclosing the identity of the providers. It also includes obtaining informed consent and establishing a diagnosis and treatment plan. The healthcare provider can create an EHR record using the records of the visit.

The legislation will enhance statewide care delivery using proper payment providers that include Hospital and Health system Association of Pennsylvania (HAP). HAP will ensure the technology provides greater access to quality care irrespective of where the patient is living in the commonwealth.

HAP supports telemedicine as a way of improving healthcare delivery and encourages other hospitals to support the bill so that telemedicine can become a viable care solution. Telemedicine reimbursement gives providers the financial support to enable them to pursue telemedicine care as a means of delivering care to under-served and remote communities in the state.

Similar legislation is before other state legislation and has been passed by other states as well to empower providers to consider telemedicine. The bill offers numerous benefits to patients across the country and strengthens the US Healthcare system.

When Hurricane Harvey caused flooding throughout Houston, it displaced hundreds of thousands of citizens. It is estimated that more than 27,000 homes were destroyed by the savage water, resulting in an extreme number of now-homeless people who lost access to vital prescriptions and medical treatments they need to stay healthy. The field of telemedicine provided displaced patients with the immediate care that they couldn’t get from their local physicians, in addition to medication and treatments for chronic conditions.

Displaced Houston residents with chronic or flood-related conditions can receive the medical care through technology-driven, virtual office visits provided at local disaster shelters through the cooperation of local hospitals such as Children’s Health. It is estimated that for every adult patient there are three children who need medical attention, and a shortage of pediatricians available for 24-hour care means some of these patients could not be treated without telemedicine services.

The use of telemedicine in the aftermath of Hurricane Harvey is made possible by the passage of SB 1107, a law passed in May that allowed Texas residents to see a doctor remotely without an initial visit in person. Texas is the last state in the country to implement this new law, and state physicians were still getting used to a higher influx of new patients even before Harvey struck.

They expect to see patients from Harvey who have been exposed to mold and bacterial infection from clean-up in addition to diagnosing new cases of anxiety or depression as families face an uncertain future. The use of telemedicine in post-disaster situations is relatively new. When Hurricane Katrina blasted through New Orleans in 2015, emergency personnel were often stretched to the limit with the constant traveling between office, hospital and shelters.

Telemedicine allows physicians to “see” dozens of patients a day using just a computer monitor and simple machines to measure vital signs. It is hoped that telemedicine can become the new normal for those who need medical treatment after going through a natural disaster.

Telemedicine has the potential to transform the delivery of mental health care by allowing healthcare providers to connect with patients better and increase their flow. According to a report by the National Institute of Mental Health (NIMH), an estimated 43.8 million adults in the US (1 in 5 people), experience mental health illness every year. Many of these individuals may also be struggling with multiple chronic conditions, phobias, substance use disorders, and suicidal tendencies, and need specialized care from several providers.

Unfortunately, these needs are met with a national shortage of mental health providers, which results in delayed appointment times and missed consults. Many of these people go untreated leading to deterioration in mental health with serious consequences.

Video conferencing and remote monitoring technology can help alleviate the backlog in appointment schedules and provide mental health patients with faster and convenient services. It is saving both hospitals and patients thousands of dollars each year by making consultation with healthcare professionals available from anywhere. This has increasingly supported patient’s access to psychological services at the time they need it the most, without the potential barriers of having to travel to see a healthcare provider or counselor.

By making consultation with healthcare professionals available from anywhere, psychologists can improve continuity of care and follow-up between visits and establish an emotional bond and rapport with the patient in a more private setting. Patients feel more comfortable and safe when care is delivered in the privacy of their homes as they can avoid the perceived social stigma associated with seeking behavioral health support.

Through the virtual visit model, psychiatrists are able to reach more mental patients in distant locations with even shorter appointment times. Patients should plan ahead of their appointments with any relevant records and information, including prescriptions, and a list of questions to address.

Medicaid programs reimburse for some telepsychiatry services in 48 states. Medicare and several other private health insurance companies also cover telemedicine.

As adoption of the technology grows and consumers’ awareness increases, telemedicine companies need to ensure that the systems they provide allow greater operational efficiencies through appropriate reporting and scheduling options.

The phenomenon of telemedicine has taken the American and international health care systems by storm. Research shows the manifold benefits of this kind of medical advancement, which delivers online diagnosis and treatment of patients via video conferencing and other specialized technologies. From efficiency, to convenience and cost-savings, telemedicine has all the hallmarks of a win-win for both patients and health-care providers.

Particularly when it comes to stroke neurology monitoring care, telemedicine stands out in the state of Massachusetts. In 2012, the Massachusetts General Hospital/Brigham & Women’s Hospital Tele-Stroke network, which continues to operate today, saw impressive results with its 24/7 acute stroke neurology services provided to emergency rooms in 11 counties across the state. This amounted to timely and efficient care for more than 700 patients who may not have otherwise received immediate care due to the many inefficiencies of in-person treatment. A deeper analysis of the Tele-Stroke network’s results in 2012 confirmed its effectiveness in curtailing approximately 400 would-be patient transfers to the state’s university hospitals, saving the Massachusetts health-care system upwards of $2 million. Which state couldn’t benefit from millions in savings?

With positive outcomes like these, some lawmakers are energized to expand telemedicine services in the state. Such is the case with Massachusetts State Senator Jason Lewis, who enacted legislation designed to do just that. Lewis said the law “will ensure parity in insurance coverage for telemedicine services at equivalent payment rates as in-person treatment; streamline the credentialing process for Massachusetts licensed clinicians using telemedicine services within the state; and ensure a uniform and consistent approach when defining telemedicine services.” The legislation has gained widespread support across a broad spectrum of health-care organizations, including the American Heart Association/Stroke Association, AARP Massachusetts, and the Massachusetts Health and Hospital Association, to name a few.

If the results of Massachusetts’ 24-hour Tele-Stroke Network says anything is that more health-care providers (and patients) would do well to get in on it. You’ll be happy you did.

Telemedicine on Vacation Better than Urgent Care or a Hospital Emergency Room for Minor Medical Conditions

The perfect situation for receiving medical care is when you see your doctor in person. However, if your family is away on vacation and one of you falls ill, a telemedicine visit can salvage the vacation for the rest of the household. Telemedicine is usually a substitute to a hospital emergency room or urgent care center for minor medical conditions.

This alternative allows those people on vacation to visit a qualified doctor if they need to address a health dilemma for their children or themselves. Telemedicine, also referred to as remote medical care is a situation where the patient and the health provider are in two different localities connected by a secure video or telephone link.

Univera Healthcare officers predicted that the residents of New York State are expected to use remote medical care over 50,000 times by 2018. The emergence of user-friendly applications for all computerized gadgets, developments in clinical management and many people having health insurance policies that are high-deductible are the primary reasons propelling the remote medical care trend.

Telemedicine services are accessible to anyone, irrespective of having a health insurance or not. However, simple platforms are being established by most health insurance providers to make it easy to arrange for a telemedicine visit. The Univera Healthcare also found that ten medical conditions represented over 2 million annual visits to emergency rooms in the state of New York, and nine out ten appointments could have been avoided or taken care of elsewhere, including a telemedicine appointment.

If you are away from home for a family vacation this summer and one of you falls sick and is in need of medical attention due to minor illness, telemedicine offerings can address most natural conditions and also recommend medication once medically indicated.

Having a simple telemedicine app in your smartphone can salvage your family’s trip this summer. This app will give you access to a certified telemedicine doctor from your place of vacation in case of any medical eventualities.

Thomas Lee, MD, Children’s Hospital Los Angeles Uses Telemedicine To Treat Child Blindness

Armenia EyeCare Project

Many healthcare systems and hospitals have decided to leverage telemedicine to connect patients living in underserved locations with health care providers.

A particular group of pediatric ophthalmologists, subspecialists at Children’s Hospital Los Angeles are using technology to provide specialist care in various developing nations. Their main goal is to kick out preventable infant blindness.

Within the Children’s Hospital, Los Angeles, there is the Vision Center, which is a large multispecialty medical group operating within the facility. This facility works as a referral center for children who are suffering from complex eye illnesses and provides expertise in different pediatric ophthalmologic subspecialties.

Vision Center’s director is known as Thomas C. Lee, M.D., who is also a pediatric retina surgeon. He leads an innovative and professional telemedicine project that focuses on offering remote training for eye surgeons in Armenia. This is done in partnership with the Armenian EyeCare Project –AECP.

Together with a team of doctors, Dr. Lee traveled to Armenia to offer assessment, care as well as programming.

Their main aim is to assist in lowering the rates of preventable blindness mostly experienced in infants. This condition is known as retinopathy of prematurity. According to Lee, the condition happens three times as often in Armenia as in the USA and most western states.

Working with Armenian EyeCare Project for eight years has enabled Lee to understand some of the main challenges specialists face in dealing with complex eye illnesses. He began to diagnose and treat this kind of infant blindness through an affordable online remote training program, and the program has advanced with developments in the sector of health IT.

Since this telemedicine program began in 2009, over 4000 infants have been screened with retinopathy of prematurity. The number of procedures that have been completed to treat the ROP exceeds 309. About 40 operations have been performed so far.

In the beginning, Lee observes that there were certain limitations to this form of technology. Most of these problems were connected to latency since the system had first to buffer the signal before it could operate.

One of the reasons why this is the best option for treating infant blindness is because it enables sub specialists to work with other providers in a cost effective and accessible manner.

A diabetic patient will have a hard time trying to reach the city for a medical appointment. On the other hand, a doctor in Mexico requires a specialist in U.S for opinions. These are the just some of the many examples where telehealth can be of help in improving healthcare.

Two health organizations using telehealth technology in San Diego are the Telemedicine Program at UC San Diego Health and La Maestra Community Health Centers and have given positive reports concerning the invention.

Telemedicine is very convenient especially for individuals who cannot reach their physician probably due to lack of funds or due to their severe health condition, as stated by the Telemedicine Program at UCSD Health’s manager, Lisa Moore.

Moreover, considering a situation of busy people like parents, they need to work and also take care of their kids. It gets hard for them to work and take their children to the doctor, and this is where telemedicine comes in. Telemedicine provides them with access to see their doctor at anytime from anywhere.

The primary goal of telemedicine is to make health care more convenient and accessible for all patients. It is the same objective that drives telemedicine at La Maestra. It has four main clinics and two school based sites. They serve patients below the poverty level. Also, they serve patients who speak about 30 languages and dialects and therefore, they are trained cultural liaisons to assist them in the telehealth process.

The two organizations” leaders have overseen telemedicine as a success in healthcare. They believe that it will bring in positive results and will make things much easier for both the patients and the physicians. A study showed that previously, most patients did not turn up for appointments with their doctors. Some gave excuses like language barrier while others complained of the lack of funds, but this was going to end.

With telehealth, patients will have a video visit with a physician who speaks their language, and this reduces the no-show rate. The rate went down from 50% to 13% in the first year which is a great achievement for the health organizations. This will help in both primary and ICU health care where the patient is in severe condition.

According to a new study by TransUnion, two-thirds of hospital patients are not paying their hospital bills in full. TransUnion also suggests that, by 2020, this number may rise to 95 percent. This seems to be mostly due to the increase in deductibles that came with the Affordable Care Act. However, it must be noted that while the act did increase deductibles, it has also given more people access to health insurance.

This could have long-lasting consequences for many hospitals across the country. According to The North Carolina Rural Health Research Programs, 79 rural hospitals have closed between 2010 and the present. According to reports, hospitals in states who chose not to expand Medicare with the Affordable Care Act are under much higher pressure to either expand profits or close compared to hospitals in states that did expand Medicare.

John Yount, the vice president of product within the TransUnion’s healthcare division warn that this number will only increase if more and more patients choose or are not able to pay their bills. Yount believes the healthcare industry should both move to an outcome-based payment structure and help keep healthcare costs down in order to help keep hospital closures from happening, as studies show that the main reason that patients do not fully pay their hospital bills is due to the high healthcare costs. In fact, it has been reported that 99% of patients with hospital bills that total more than $3,000 do not completely pay their bills.

With this said, even though healthcare costs are high, hospitals are not making an overabundance of profit. Currently, hospital profit margins range from two to four percent, and that margin tightens when patients refuse or are not able to pay their bills. Lastly, while the repeal of the Affordable Care Act currently seems dead in the water, future healthcare laws and provisions may increase or decrease the severity of the aforementioned hospital related financial crises.

Telemedicine involves remotely treating and diagnosing patients. A study in the North Carolina Medical Journal has proven that patients who suffer from type 1 and type 2 diabetes benefited from a telemedicine program.

Working with over 10 care facilities in North Carolina, between the years of 2013-2016, the program featured a diverse group of physicians, psychologists and physical therapists who worked alongside the patients. The program also worked with pharmacists at critical steps along the way, treating formerly neglected patients whose type 2 diabetes had been allowed to run its course, without proper medical treatment.

The majority of these patients lived in rural areas and were unable to locate adequate health care practitioners. The Health Resources & Services Administration of United States sponsored the telemedicine program.

The patients engaged in multiple teleconference appointments, working with the health care team using telemedicine systems for various assessments. The patients were studied for adherence, insulin injection techniques and their general knowledge of diabetic conditions. Pharmacy experts were able to analyze the data within the patient’s medical records to further assist patients in knowledge of glucose and proper usage of diabetic medications.

Patients became knowledgeable about specific medications and correct self-management techniques, including addressing proper dietary issues and exercise techniques. The pharmacists worked on improving various aspects of the patients care plan, working on lifestyle interventions and condition monitoring.

Health care practitioners from a multitude of disciples would all focus on a single patient together and indicate effective interventions. Dietitians worked with pharmacists to create effective diet and insulin coordination efforts.

More than one thousand telecare visits were coordinated over the span of the program, and over 350 patients were assisted, with an average of 3 to 4 appointments per patient.

Health information such as weight, hemoglobin counts and lipoprotein densities were reported by the health team. They found that the majority of the patients showed signs of depression. However, towards the end of the study more than two thirds of those same patients noted a general improvement from these symptoms.

The same health care team was able to make comparisons between the telemedicine treatment and personal care. The results were almost identical.

Research has proven that there is no difference between the safety and efficiency of the telemedicine treatment and the official clinic visits for a chronic headache. A headache is one of the most common neurologic disorder, yet most people do not receive adequate treatment. The good thing is that a new technology is now available to diagnose people through telemedicine, but there have been various studies to determine if it is effective like the in office visits.

This study involved 402 individuals who suffered non-acute headaches or a problem that came gradually. These were people who were referred from a primary care physician to a neurologist. Half of the patients had a traditional office visit at a hospital, and the other half went to the hospital but saw the neurologist through a video call. The participants were asked to take questionnaires about the effects of the headache on their daily lives and also about the level of pain at the start of the study and after three months and after a year.

The researchers said that there was no difference between the patients treated via telemedicine and those who had clinic office visits.

This study, known as a non-inferiority study is designed to show that the new treatment is not clinically different from the traditional type. To conclude the safety of using telemedicine, researchers checked whether the participants experienced a secondary headache a year after the practice. A secondary headache means that it is a sign of another underlying condition.

The researchers imagined a situation where a patient has to travel for 40 km to the airport to reach the nearest airport and then take a flight to go for a consultation. There could also be other barriers like weather conditions which would prevent the patient attending the meeting.

The northern England covers a large area covered with mountains and valleys and thus, patients traveling to see a doctor can be challenging and cumbersome and expensive for many individuals. Telemedicine will be helpful and convenient to everyone suffering from headaches and wishes to see a specialist without any hassle. This will help in diagnosing and treatment of the condition before it worsens.