In-office visits and overnight stays at healthcare facilities can be difficult for individuals in poor health. Telehealth services reduce hospital readmission rates by enabling doctors to monitor patients outside the office. Because of this, many hospitals have already started to include some form of remote monitoring as part of their post-discharge plans. By equipping patients with wearable devices or other wireless technologies, clinicians can monitor vital signs and symptoms and adjust care as needed without an in-office visit. Alignment Healthcare, for example, developed a program to remotely monitor chronically ill and recently discharged patients and reduce 30-day readmission rates. Enrollees were given a package of Bluetooth-enabled monitoring equipment, including a Samsung tablet, blood pressure cuff, pulse oximeter and scale.
States may submit a coverage SPA to better describe the telemedicine services they choose to cover, such as which providers/practitioners are; where it is provided; how it is provided, etc. In this case, and in order to avoid unnecessary SPA submissions, it is recommended that a brief description of the framework of telemedicine be placed in an introductory section of the State Plan and then a reference made to telemedicine coverage in the applicable benefit sections of the State Plan. For example, in the physician section it might say that dermatology services can be delivered via telemedicine provided all state requirements related to telemedicine as described in the state plan are otherwise met.
^ Parikh, Mili; Grosch, Maria C; Graham, Lara L; Hynan, Linda S; Weiner, Myron; Shore, James H; Cullum, C. Munro (2013). "Consumer Acceptability of Brief Videoconference-based Neuropsychological Assessment in Older Individuals with and without Cognitive Impairment". The Clinical Neuropsychologist. 27 (5): 808–17. doi:10.1080/13854046.2013.791723. PMC 3692573. PMID 23607729.
Teladoc Health enjoys a killer advantage with its head start in telehealth. Around 40% of the largest companies in the world contract with Teladoc to provide virtual healthcare services to their employees. Over 35 of the biggest health plans in the U.S. have partnered with Teladoc. More than 290 hospitals and health systems have teamed up with the telehealth leader.
Telepsychiatry – Telepsychiatry allows qualified psychiatrists to provide treatment to patients remotely, expanding access to behavioral health services. Telepsychiatry is incredibly popular, in part because of the nation-wide shortage of available psychiatrists, and because psychiatry often does not require the same physical exams of the medical field.
Billions of investment dollars have been poured into apps and websites that offer this virtual consultations with physicians, ranging from Doctor on Demand to American Well. The theory behind them is that millennials would opt for a digital alternative to an in-person physician's visit, if the option were available. And patients in remote, rural areas who are miles away from the nearest doctor would have few alternatives.
According to a May 2017 article by Alignment Chief Medical Officer Ken Kim, the organization’s efforts paid off. “Because of the program, Alignment’s seniors are seeing reduced 30-day readmission rates … compared to the national Medicare average readmission rate of about 18%. In 2016, Alignment members enrolled in remote [monitoring] across all markets saw hospital readmission rates of 7.2%.”
Telehealth and Patient Engagement: With telehealth technologies, patients are taking more control of their well-being. Educational videos, health management apps for mobile devices, and online health learning and support communities empower patients to manage chronic conditions, lose weight, increase physical activity levels, and gain emotional support. Diabetes patients are benefiting from carbohydrate tracking apps and are using glucose monitoring devices to document and report their blood sugar measurements. Other patients are interacting with their providers and scheduling appointments through secure online communication portals. Additionally, they are accessing health education content via smartphones and computers to add to their self-care toolboxes. They are also using wearables and monitoring systems to gain knowledge about their sleep patterns, vital signs, and activity levels.
This expectation for more convenient care, combined with the unavailability of many overburdened medical professionals (especially primary care providers) have led to the rise of telemedicine companies. Many offer patients 24/7 access to medical care with an on-call doctor contracted by that company. Others offer hospitals and larger health centers access to extra clinical staff and specialists, for outsourcing of special cases (common model among teleradiology companies). Still others provide a telemedicine platform for physicians to use to offer virtual visits with their own patients. Increasingly, telemedicine is becoming a way to give medical practices an edge in a competitive healthcare landscape where it’s difficult to stay independent or maintain a healthy bottom line.
In December 2018, it was revealed that Teladoc's chief financial officer, Mark Hirschhorn, 54, had an extra-marital affair with a lower-level employee, 30. He is also alleged to have passed tips to her about when to sell Teladoc company stock. Hirschhorn sold over $20,000,000 in company stock during and after the alleged affair. Several law firms launched investigations of potential securities law violations. Company stock fell roughly 20% in the days following the report.
In Australia, during January 2014, Melbourne tech startup Small World Social collaborated with the Australian Breastfeeding Association to create the first hands-free breastfeeding Google Glass application for new mothers. The application, named Google Glass Breastfeeding app trial, allows mothers to nurse their baby while viewing instructions about common breastfeeding issues (latching on, posture etc.) or call a lactation consultant via a secure Google Hangout, who can view the issue through the mother's Google Glass camera. The trial was successfully concluded in Melbourne in April 2014, and 100% of participants were breastfeeding confidently. Small World Social Breasfteeding Support Project.
Jay McGraw and Adam Jackson, both 35, are changing the way that people interact with their doctors. Along with Dr. Phil, who is McGraw’s father, they launched Doctor On Demand in 2013. The San-Francisco-based startup offers online video consultations with 1,400 credentialed physicians around the country. One million people have downloaded the app -- and it’s raised $74 million in VC funding to date.
This isn't to say that you should jump right in and begin providing services via telehealth. You'll first need to consider federal and state legislation and regulations that govern your practice, risk management implications, billing and coding issues, and hardware/software requirements. The resources below aren't meant to give you detailed instructions on developing and using telehealth in your practice, but they identify areas most important for you to investigate and consider.
Telehealth is part of APTA's Frontiers in Research, Science, and Technology (FiRST) Council. FiRST grew out of identification of high priority areas to advance science and innovation that our profession needs to understand and incorporate into our practice, education, and research. FiRST is intended to serve as a community for interested stakeholders. Ideas generated by the council may be implemented by participants' stakeholder groups (sections, academies, external groups, APTA, etc) at the discretion of each entity's governing body.
A patient might find themselves in need of services from Express Med Refills for a variety of reasons, the most common being inaccessible family doctors. From time to time, even the most dedicated physician takes a vacation, and while most leave a proxy, or address patient needs before departing, there is the odd case of a patient being left in dire need of a prescription refill. Through our website, Americans can gain access to a U.S. registered online doctor, conduct a one on one consultation, and have a prescription sent to a nearby local pharmacy all on the same day.
$49/visit or co-pay if not fully covered by health plan LiveHealth Online powered by AmericanWell / Vidyo has been picked up by health insurer WellPoint / Anthem. First piloted in 2013 in California and Ohio. WellPoint / Anthem began a mass rollout to several states in 2014 including Minnesota, Virginia, Kentucky, Maine…and most recently, Massachusetts.
Flexibility & work/life balance Very open organization with immediate access to executive leadership Transparent and communicative Promotes within organization Celebrates employee milestones and company wins Good benefits Salaries are competitive (at least to my knowledge) Open to new ideas Organization is doing very well and growing really fast Work being done has a positive influence on the current healthcare...
Several physicians and patients are finding it difficult to adapt to telemedicine, especially older adults. Physicians are very concerned about patient mismanagement. While advances in medicine have made it more efficient to use technology, there are times when system outages occur. There is also the potential for error as technology cannot always capture what the human touch can.
In August 2017, hospitals across the country were penalized with Medicare reimbursement cuts due to high 30-day readmission rates. The potential to reduce these rates and avoid penalties has made telehealth a financial priority. Healthcare provider TripleCare was the subject of a study conducted by the TRECS Institute, which found that virtual physician services had both increased care quality and averted 91 unnecessary admissions. The result was $1.3 million in Medicare savings. Telehealth services can also provide patients and healthcare facilities in rural areas with additional benefits. NTCA — The Rural Broadband Association released a report in March 2017 that estimated the average annual cost savings per facility could add up to:
Telemedicine/Telehealth: Basically, these two terms are used to describe the use of technology and telecommunications to exchange medical information from one place to another with an aim of improving the patient’s health status. Telemedicine is sometimes involved in direct patient clinical services which include diagnosis and treatment of patients.
Telenursing is achieving significant growth rates in many countries due to several factors: the preoccupation in reducing the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses.
Teladoc charges an annual subscription fee for its service plus a $40 co-pay per video or phone appointment with a doctor, though employers sometimes subsidize or cover the co-pay completely for their employees. Health insurance startup Oscar (co-founded by venture capitalist Joshua Kushner), for one, has promoted its ACA-compliant health plans with the perk of getting to talk to doctors 24 hours a day—through Teladoc—for free.
As a caregiver for a loved one, you have enough to worry about. That’s why Teladoc® gives you a convenient and affordable way to provide care, letting you arrange a 2- or 3-way video or phone visit with a licensed doctor 24/7 for just $45/visit. Add the individual you care for to your Teladoc® account, even if they’re not covered by your health plan.
However, for a while, adopting and investing in telehealth services had been too high, and the distribution of telehealth resolutions and hospital-based networks proved to be too costly. But now, due to technological improvement, improved broadband services are now powerful and easily affordable which makes the level of return on investment in telehealth higher than ever before. Across almost all medical specialties, telehealth services can be applied in connecting providers with different patients in different locations via real-time audio and video. In other cases, service centers can use telemedicine to collect remotely as well as send data to a central monitoring system for interpretation.
While telemedicine has shown to be a game changer in the field of medicine, there are still a number of barriers to overcome. Physicians face challenges regarding how they’ll be paid and where they can practice, while patients voice security concerns. Once these barriers are removed, we can anticipate greater access to care and improved patient outcomes.
VSee urges organizations interested in implementing telemedicine to find a telemedicine provider that offers HIPAA compliant software. This means that all data must be fully encrypted, have secure peer-to-peer network connections and have no storage of video. Telemedicine providers should also be comfortable signing a business associate agreement, which asserts that they will take responsibility in keeping patient information safe.
Healthcare systems, physician practices, and skilled nursing facilities are using telemedicine to provide care more efficiently. Technologies that comes integrated with telemedicine software like electronic medical records, AI diagnosis and medical streaming devices, can better assist providers in diagnosis and treatment. The latter allows providers to monitor patients in real-time and adjust treatment plans when necessary. Ultimately, this leads to better patient outcomes.
Bao Ng has worked in primary care since 2013 and provided virtual care since 2013. Obtaining her Doctor of Nursing Practice from the University of Washington, she began working in telemedicine shortly thereafter. Her medical interests include international health, and maternal and child health. She works at an international community health clinic near her home, and is fluent in Vietnamese and proficient in conversational Cantonese. She volunteers as a caregiver in her church nursery and is an executive board member for a local pediatric and behavioral health clinic. Outside of work, she enjoys spending time with her husband and children and exploring new cuisines.