NQF Telehealth Draft Report Provides Opportunity For Stakeholders

Posted by Rene Quashie on June 15, 2017
HHS, Telehealth / No Comments

Close up of male doctor with laptop computerThe National Quality Forum (“NQF”) has published a draft report (“Report”) recommending various methods to measure the use of telehealth.  By way of quick background, NQF is a non-profit, nonpartisan organization that seeks national collaboration to improve health and healthcare quality through measurement.  The Department of Health and Human Services (“HHS”) requested NQF to convene a multi-stakeholder committee to recommend various methods to measure the use of telehealth as a means of providing care. Among other things, the Report analyzes the best way to ensure clinical measures are appropriately applied to telehealth, proposes a measure framework, sets some guidelines for future telehealth measurement, and identifies measurement gaps.

To help develop a telehealth measurement framework, NQF began by conducting a comprehensive scan identifying existing measures and potential measure concepts related to telehealth. As explained in the Report, the “framework is a conceptual model for organizing ideas that provides high-level guidance and direction on priorities for what is important to measure in telehealth and how measurement should take place in order to assess its impact on healthcare delivery and outcomes.” The Report analyzed reports and white papers from organizations such as the American Telemedicine Association, the Health Information Management and Systems Society, and the Office of the National Coordinator for Health Information Technology. Continue reading…

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Telemedicine Benchmark Study Provides Great Insight

Posted by Rene Quashie on May 09, 2017
ACA, Healthcare, Hospital, Telemedicine / No Comments

A recent telemedicine industry benchmark survey published by REACH Health provides great insight into where the industry has been and where it is headed. The survey was conducted among U.S. healthcare executives, physicians, nurses and other professionals. Organizations represented in the survey were diverse and included representatives from organizations with a $1 billion or more in revenue (about a third of respondents), and almost half with revenues under $50 million.

 

In reviewing the survey report, there were some significant takeaways:

  • Telemedicine is evolving from a specialty offering to a mainstream service.
  • More than half of respondents consider telemedicine to be a top or high priority.
  • Patient-oriented objectives—including improving patient outcomes, improving patient convenience, and increasing patient engagement and satisfaction—are the three top objectives for telemedicine programs.
  • There is an emphasis on better leveraging specialists with a large majority of respondents ranking this a top or high priority.
  • Nearly half of hospital and integrated delivery network respondents who began their telemedicine programs/initiatives with a departmental approach are transitioning to an enterprise approach.
  • The maturity of telemedicine programs varies widely among service lines and settings of care. Generally, settings requiring highly specialized treatment continue to be more mature than those requiring generalized treatment.
  • Telemedicine technology, reporting and analytics, as well as in-house physicians are viewed as highly important to the success of a program, whereas outsourced physician coverage services less so.

Continue reading…

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The Telehealth Cost Wars

Posted by Rene Quashie on March 22, 2017
Telehealth / No Comments

How to properly evaluate and weigh cost savings in health care has long been a controversial subject—perhaps nowhere more so than when technology-enabled health care is evaluated. A recent study is a case in point. The journal Health Affairs recently published a study that has caused quite a stir in the telehealth community. Without getting into details regarding methodology and results—best left for a more in-depth article—the study acknowledges that reimbursement for direct-to-consumer (“DTC”) telehealth visits are lower than would be the case for in-person physician or ED visits. However, the study raised two concerns. First, the researchers posited that there could be increased spending for DTC visits “if the direct-to-consumer telehealth visit is more likely to result in follow-up appointments, testing, or prescriptions, compared to similar visits to other settings.” Second, the researchers believe that DTC physicians “may be more likely to recommend that patients have a subsequent in-person visit with a provider.”  The basis for these concerns is not made entirely clear, and quite frankly doesn’t square with my discussions with DTC telehealth stakeholders.

The study also broadly concludes that DTC telehealth may lead to increased utilization as patients will seek care for illnesses for which they would not have sought care had telehealth not been available. More to the point, the researchers calculated that about 88 percent of telehealth usage represents new utilization. In other words, only 12 percent of DTC telehealth usage replaced or substituted visits to other providers. Ultimately, the study argues that DTC telehealth may increase access by making care more convenient for some individuals, and, thereby, may also increase utilization and health care spending. Continue reading…

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Telemedicine Liability – The Real Numbers

Posted by Rene Quashie on February 28, 2017
Telemedicine / No Comments

stethoscope keyboard and phoneAmidst all the interesting legal and regulatory issues implicated by telemedicine, one issue less discussed is the potential liability exposure associated with telemedicine. Many critics have argued that the nature of how telemedicine services are provided will naturally lead to increased risk for malpractice. Available data does not support the argument—at least not yet.

While not a lot of data exists, the Physician Insurers Association of America (“PIAA”) published a July 2015 article comparing telephone treatment medical professional liability (“MPL”) claims versus overall MPL claims reflected in the PIAA Data Sharing Project (“DSP”)—a very large database of MPL claims. Here are the numbers:

  • Of the 94,228 total claims in the DSP during the period from 2004-2013, a total of only 196 claims were linked with telephone treatment.
  • Of those 196 reported claims, 56 resulted in some form of claim payment.
  • The total indemnity loss related to telephone treatment was only $17 million, compared to $8 billion for the total of all MPL losses.
  • Telephone treatment claims represented only about 0.21% of all MPL losses.
  • The average indemnity loss was also lower for telephone treatment at $303,691, compared to $328,815 for all MPL claims within the DSP.

Continue reading…

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The Critical Role of Telemedicine in the Addiction Crisis

Posted by Rene Quashie on February 17, 2017
Telemedicine / No Comments

doctor at laptopTelemedicine is now mainstream. Surprisingly, however, one area in which telemedicine has not been used to its fullest capability is drug addiction treatment. As you are aware, the country is in the midst of an addiction crisis.  The statistics are daunting:

Adding to the woeful statistics are the fairly dismal rates of addiction recovery—assuming that such recovery services are even available. Relapse rates are over 50 percent for certain drugs, and higher for opioid addicts. According to one survey, almost 9 percent of the population needs treatment but only 1 percent actually receives it. The National Institute on Drug Abuse notes that effective substance abuse treatment combines treatment medications with behavioral therapy—and traditional treatment is limited by the availability of treatment professionals who often are not available outside of in-person care settings. Continue reading…

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FSMB and ATA Documents Shed Light on States’ Views on Telemedicine

Posted by Rene Quashie on February 16, 2017
Telemedicine / No Comments

stack of official documentsOver the past year, the Federation of State Medical Boards (FSMB) and the American Telemedicine Association (ATA) have published documents regarding telemedicine that shed some new light on how state regulatory bodies view telemedicine. Taken together, the documents are generally cause for optimism underscoring the trend towards greater acceptance of telemedicine—but there are some notes of caution as well. By way of quick background, the FSMB represents 70 state medical and osteopathic boards and helps support member boards around the country. The ATA is the largest telemedicine-focused trade association made up of industry leaders and health care stakeholders.

FSMB Survey

According to a survey report issued in December 2016, telemedicine is currently the most important regulatory topic to state medical boards. The survey was completed by 57 of the 70 medical and osteopathic medical boards in the country. Interestingly, 75 percent of boards chose telemedicine in their survey responses as one of the most important topics “making it the topic impacting the largest number of boards.” Seventy percent chose resources regarding opioid prescription. The five most important issues were:

  • Telemedicine;
  • Opioid prescribing (resources related to);
  • Physician licensure compact;
  • Physician re-entry to practice; and
  • Medical marijuana.

Surprising in these survey results is the degree to which telemedicine continues to be top of mind for state boards despite the slew of state activity that generally facilitates greater use of telemedicine (discussed more below in the ATA Gaps Report section). A reasonable explanation is that despite all the recent progress in law and policy, many state boards continue to be uneasy about telemedicine.  What that ultimately means for the industry will bear watching. Continue reading…

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