Physician Panel on Practicing Virtual Care: Marc Dean, MDVSee
Objectives:
Review the value and efficiency that telemedicine provides
Demonstrate real world examples of telemedicine impact and benefit
Highlight how telemedicine can become an integral component of today’s healthcare delivery
Discuss new trends and advances in technology and how they facilitate a virtual exam
Visit: https://vsee.com/blog/telemedicine-101-reimbursement/ for more info
Anjali and Mary Jean will present on the changing landscape of telemedicine reimbursement what it was in the past, where it is now during the National Emergency, and probable future outcomes based on her experience and insight. Additionally, she will provide practical guidance on coding to avoid fraud and abuse issues to avoid post-pandemic audits and investigations
Learning Objectives:
Allowable Telemedicine Reimbursement Past, Present, Future
Telemedicine Reimbursement Codes and How to Example
Considerations for Practicing Across State Lines and Documentation
Avoiding investigations: Fraud & Abuse
Telemedicine offers increased access to doctors, improved quality and continuity of care, and reduced time lost from work and travel costs. It can be provided by physicians, nurse practitioners, physician assistants, hospitals, skilled nursing facilities, and community mental health centers. Common telemedicine services include telehealth consultations and visits for inpatient or outpatient care. Telemedicine does not include audio-only calls, home video, Skype, email, faxes, or telephonic monitoring. Referrals and preauthorizations may still be required depending on the insurance plan. Telemedicine services are billed using specific codes, with the originating site billing Q3014 and the provider billing evaluation and management codes with a GT modifier.
The Rural Health Care (RHC) Program provides reduced rates to eligible rural health care providers for telecommunications and internet services used for health care. The program is administered by the Universal Service Administrative Company on behalf of the Federal Communications Commission. It has two components: the Primary Program provides discounts for monthly connectivity costs and 25% off internet access, while the Pilot Program previously supported up to 85% of costs for building broadband networks. Eligible providers include rural hospitals, clinics, health departments, and mental health centers. The application process involves requesting services, selecting service providers, and notifying the program once services are received to receive discounts.
Virginia Medicaid has expanded coverage of telemedicine services over time. Currently, 35 states provide Medicaid reimbursement for telemedicine. Virginia Medicaid covers telemedicine statewide for services like consultations and evaluations. Future possibilities include adding coverage for telemedicine in home health and expanding store-and-forward and telepractice coverage. The presentation discusses Virginia Medicaid's telemedicine policies and interests in expanding access to care through telemedicine.
This document discusses evolving telecare services from traditional fixed-line systems to integrated mobile telehealthcare solutions. It outlines how standard telecare uses devices like fall detectors and pull cords (1), but mobile solutions allow remote monitoring via smartphones (2). This allows a strategic shift toward combining chronic disease support with telecare into telehealthcare (3). The integration of mobile technologies enables features like medication reminders, vital sign monitoring, personalized health notifications and social support on smartphones (4).
The document summarizes a pitch deck for Mobilin, a mobile and web-based system for referring tuberculosis (TB) patients between health centers in the Philippines. Mobilin aims to digitize the referral process and generate automatic reports to improve patient tracking. It currently serves DOTS health centers and plans to expand to all health providers and diseases. The system uses a mobile app and web app with a central server. Key details include the TB burden in Philippines, the target market, system features, timeline, comparisons to current referral process, stakeholders, and financial projections.
Physician Panel on Practicing Virtual Care: Marc Dean, MDVSee
Objectives:
Review the value and efficiency that telemedicine provides
Demonstrate real world examples of telemedicine impact and benefit
Highlight how telemedicine can become an integral component of today’s healthcare delivery
Discuss new trends and advances in technology and how they facilitate a virtual exam
Visit: https://vsee.com/blog/telemedicine-101-reimbursement/ for more info
Anjali and Mary Jean will present on the changing landscape of telemedicine reimbursement what it was in the past, where it is now during the National Emergency, and probable future outcomes based on her experience and insight. Additionally, she will provide practical guidance on coding to avoid fraud and abuse issues to avoid post-pandemic audits and investigations
Learning Objectives:
Allowable Telemedicine Reimbursement Past, Present, Future
Telemedicine Reimbursement Codes and How to Example
Considerations for Practicing Across State Lines and Documentation
Avoiding investigations: Fraud & Abuse
Telemedicine offers increased access to doctors, improved quality and continuity of care, and reduced time lost from work and travel costs. It can be provided by physicians, nurse practitioners, physician assistants, hospitals, skilled nursing facilities, and community mental health centers. Common telemedicine services include telehealth consultations and visits for inpatient or outpatient care. Telemedicine does not include audio-only calls, home video, Skype, email, faxes, or telephonic monitoring. Referrals and preauthorizations may still be required depending on the insurance plan. Telemedicine services are billed using specific codes, with the originating site billing Q3014 and the provider billing evaluation and management codes with a GT modifier.
The Rural Health Care (RHC) Program provides reduced rates to eligible rural health care providers for telecommunications and internet services used for health care. The program is administered by the Universal Service Administrative Company on behalf of the Federal Communications Commission. It has two components: the Primary Program provides discounts for monthly connectivity costs and 25% off internet access, while the Pilot Program previously supported up to 85% of costs for building broadband networks. Eligible providers include rural hospitals, clinics, health departments, and mental health centers. The application process involves requesting services, selecting service providers, and notifying the program once services are received to receive discounts.
Virginia Medicaid has expanded coverage of telemedicine services over time. Currently, 35 states provide Medicaid reimbursement for telemedicine. Virginia Medicaid covers telemedicine statewide for services like consultations and evaluations. Future possibilities include adding coverage for telemedicine in home health and expanding store-and-forward and telepractice coverage. The presentation discusses Virginia Medicaid's telemedicine policies and interests in expanding access to care through telemedicine.
This document discusses evolving telecare services from traditional fixed-line systems to integrated mobile telehealthcare solutions. It outlines how standard telecare uses devices like fall detectors and pull cords (1), but mobile solutions allow remote monitoring via smartphones (2). This allows a strategic shift toward combining chronic disease support with telecare into telehealthcare (3). The integration of mobile technologies enables features like medication reminders, vital sign monitoring, personalized health notifications and social support on smartphones (4).
The document summarizes a pitch deck for Mobilin, a mobile and web-based system for referring tuberculosis (TB) patients between health centers in the Philippines. Mobilin aims to digitize the referral process and generate automatic reports to improve patient tracking. It currently serves DOTS health centers and plans to expand to all health providers and diseases. The system uses a mobile app and web app with a central server. Key details include the TB burden in Philippines, the target market, system features, timeline, comparisons to current referral process, stakeholders, and financial projections.
This episode continues our COVID-19 COVID-19 Insights Webinar discussing CMS changes, available grants and loans, existing opportunities in telehealth, and more state openings for elective surgeries.
President Trump’s 2018 VA MISSION Act removed all geographic and licensing barriers for doing VA telehealth. This has made it possible to provide greater access and better care to more veterans. Join Sean O’Connor from the Oregon VA health system to learn:
- How is the VA using telehealth to deal with COVID-19 today?
- What are some key lessons learned from past telehealth deployments?
- What are key technology and clinic considerations that need to be taken into account?
- Where is VA telehealth going in the future?
Interested in becoming a community provider? More information at
https://www.va.gov/COMMUNITYCARE/providers/Veterans_Care_Agreements.asp
France face tracks draft law to create national health databaseDaniel Kadar
The British Standards Institution published a new code of practice for healthcare app development to provide quality standards and principles for developers. The code covers the entire app lifecycle from development to updating. It aims to build trust in health apps for both professionals and the public.
The UK's Royal College of Physicians also released guidance for doctors stating they should only use medical apps that have a CE mark, which certifies they were designed and tested for patient safety. This will increase awareness of regulated apps.
France passed draft legislation to create a national health database by aggregating data from various sources such as hospitals, insurance claims, and deaths. This aims to make anonymized data available for public use, but access to personal data will
Healthcare costs are rising faster than the economy and new solutions are needed. Mobile devices and telehealth can help by reducing missed appointments, improving medication adherence for chronic conditions, and allowing remote monitoring to reduce hospitalizations. Studies show text messaging appointment reminders through mobile phones in primary care reduced missed appointments by 15-20% and increased response rates for high-risk patients. Telehealth trials in the UK showed reductions in hospital admissions and visits through remote monitoring of conditions like COPD, congestive heart failure and diabetes. Vensa is working on a telehealth network and trial in New Zealand to further these opportunities through mobile devices.
CPT E/M codes are changing January 1, 2021. This webinar unpacks those changes for you, outlining everything you need to know including:
How to navigate all the changes
What these mean for reimbursement
What you need to know to make sure your providers and coders are ready.
Telemedicine history and evolution 25.04.2021Shazia Iqbal
Telemedicine has a long history dating back to the 19th century, with early attempts to reach remote patients. It involves using telecommunications technology to evaluate, diagnose and treat patients remotely. Teleconsultation refers specifically to interactions between clinicians and patients to provide diagnostic or therapeutic advice electronically. Telemedicine provides benefits to both patients and physicians by increasing access to specialized care, improving diagnoses and treatment, and reducing costs. Major telemedicine organizations work to advance the field internationally and in Saudi Arabia through applications, platforms, and programs.
Access to healthcare is a major problem in the United States, especially for low-income and rural populations. AccessMyDoc.com aims to increase access through live video interactions between patients and doctors, allowing physicians to provide remote care for non-life threatening issues. This has the potential to reduce emergency room wait times, increase access to specialists, and lower overall healthcare costs without compromising patient health.
Video-visits are more convenient and efficient than in-person appointments, yet adoption of this technology has remained low.
The root of low adoption rates centers around regulatory complexities and challenging reimbursement associated with telemedicine.
The variation between states, payers, and even specific plans is simply too complex for an average practice to handle internally. Register for this webinar to simplify telemedicine reimbursement for your practice.
Private sector participation in animal health services: Requirements and expe...ILRI
Presented by Indraph M. Ragwa, C.E.O., Kenya Veterinary Board at the Workshop on Enhancing Private Sector Participation in Animal Health Services, ILRI, Nairobi, 7 November 2019
The document summarizes federal and state policy issues and activities related to telemedicine. It discusses 3 easy fixes for CMS policy, other CMS activities, rulemakings by the FCC and FDA, and potential federal legislation. It also covers state Medicaid policy, initiatives, and licensure issues. Finally, it lists ATA activities like meetings and member networks, as well as developing practice guidelines and identifying market changes.
Prof Diana Schmidt's Talk at AIIMS on 8th January 2008Sukhdev Singh
Prof Diana Schmidt, School of Medical Informatics of Heidelberg University and Heilbronn University Germany, would be gave a talk on “Factors for success and failure of Telemedicine in Germany and USA” on 8th January 2008. She has permitted me to upload her presentation for the benefit of "Indian Association for Medical Informatics" members. It is being shared through IAMI Delhi Chapter Blog - http://iamidelhi.blogspot.com
Health Care Industry - An Overview - ROJosonReynaldo Joson
The health care industry involves the organized activities related to health care services provided to a community. It includes health care services, suppliers of these services like physicians and nurses, and users of the services. The logistics of providing and acquiring health care services involves costs related to infrastructure, personnel, delivery, marketing, and payment sources like users, insurance, and government funds. Key factors that affect all aspects of the health care industry are demand for services, supply of providers, regulations, competition, and sustainability.
Coroporate Practice of Medicine - TelemedicineAlex Marz
Start your own telemedicine medical practice
One stop shop (Scheduling, Video, EMR, Billing, & Remote Patient Monitoring and we do the complete practice management including billing and collections)
GoTelecare is the only telehealth and medical billing franchise
This document provides an overview of interactive health communication systems and telehealth technologies. It discusses physician perspectives on adoption barriers like workflow integration and reimbursement issues. It also profiles two AHRQ grants that utilize telehealth to improve cancer care in rural areas and provide remote monitoring for heart failure patients.
The information reflects information available as of June 2, 2020.
We encourage monitoring subsequent regulation updates pertaining to telehealth in wound care
This episode continues our COVID-19 COVID-19 Insights Webinar discussing CMS changes, available grants and loans, existing opportunities in telehealth, and more state openings for elective surgeries.
President Trump’s 2018 VA MISSION Act removed all geographic and licensing barriers for doing VA telehealth. This has made it possible to provide greater access and better care to more veterans. Join Sean O’Connor from the Oregon VA health system to learn:
- How is the VA using telehealth to deal with COVID-19 today?
- What are some key lessons learned from past telehealth deployments?
- What are key technology and clinic considerations that need to be taken into account?
- Where is VA telehealth going in the future?
Interested in becoming a community provider? More information at
https://www.va.gov/COMMUNITYCARE/providers/Veterans_Care_Agreements.asp
France face tracks draft law to create national health databaseDaniel Kadar
The British Standards Institution published a new code of practice for healthcare app development to provide quality standards and principles for developers. The code covers the entire app lifecycle from development to updating. It aims to build trust in health apps for both professionals and the public.
The UK's Royal College of Physicians also released guidance for doctors stating they should only use medical apps that have a CE mark, which certifies they were designed and tested for patient safety. This will increase awareness of regulated apps.
France passed draft legislation to create a national health database by aggregating data from various sources such as hospitals, insurance claims, and deaths. This aims to make anonymized data available for public use, but access to personal data will
Healthcare costs are rising faster than the economy and new solutions are needed. Mobile devices and telehealth can help by reducing missed appointments, improving medication adherence for chronic conditions, and allowing remote monitoring to reduce hospitalizations. Studies show text messaging appointment reminders through mobile phones in primary care reduced missed appointments by 15-20% and increased response rates for high-risk patients. Telehealth trials in the UK showed reductions in hospital admissions and visits through remote monitoring of conditions like COPD, congestive heart failure and diabetes. Vensa is working on a telehealth network and trial in New Zealand to further these opportunities through mobile devices.
CPT E/M codes are changing January 1, 2021. This webinar unpacks those changes for you, outlining everything you need to know including:
How to navigate all the changes
What these mean for reimbursement
What you need to know to make sure your providers and coders are ready.
Telemedicine history and evolution 25.04.2021Shazia Iqbal
Telemedicine has a long history dating back to the 19th century, with early attempts to reach remote patients. It involves using telecommunications technology to evaluate, diagnose and treat patients remotely. Teleconsultation refers specifically to interactions between clinicians and patients to provide diagnostic or therapeutic advice electronically. Telemedicine provides benefits to both patients and physicians by increasing access to specialized care, improving diagnoses and treatment, and reducing costs. Major telemedicine organizations work to advance the field internationally and in Saudi Arabia through applications, platforms, and programs.
Access to healthcare is a major problem in the United States, especially for low-income and rural populations. AccessMyDoc.com aims to increase access through live video interactions between patients and doctors, allowing physicians to provide remote care for non-life threatening issues. This has the potential to reduce emergency room wait times, increase access to specialists, and lower overall healthcare costs without compromising patient health.
Video-visits are more convenient and efficient than in-person appointments, yet adoption of this technology has remained low.
The root of low adoption rates centers around regulatory complexities and challenging reimbursement associated with telemedicine.
The variation between states, payers, and even specific plans is simply too complex for an average practice to handle internally. Register for this webinar to simplify telemedicine reimbursement for your practice.
Private sector participation in animal health services: Requirements and expe...ILRI
Presented by Indraph M. Ragwa, C.E.O., Kenya Veterinary Board at the Workshop on Enhancing Private Sector Participation in Animal Health Services, ILRI, Nairobi, 7 November 2019
The document summarizes federal and state policy issues and activities related to telemedicine. It discusses 3 easy fixes for CMS policy, other CMS activities, rulemakings by the FCC and FDA, and potential federal legislation. It also covers state Medicaid policy, initiatives, and licensure issues. Finally, it lists ATA activities like meetings and member networks, as well as developing practice guidelines and identifying market changes.
Prof Diana Schmidt's Talk at AIIMS on 8th January 2008Sukhdev Singh
Prof Diana Schmidt, School of Medical Informatics of Heidelberg University and Heilbronn University Germany, would be gave a talk on “Factors for success and failure of Telemedicine in Germany and USA” on 8th January 2008. She has permitted me to upload her presentation for the benefit of "Indian Association for Medical Informatics" members. It is being shared through IAMI Delhi Chapter Blog - http://iamidelhi.blogspot.com
Health Care Industry - An Overview - ROJosonReynaldo Joson
The health care industry involves the organized activities related to health care services provided to a community. It includes health care services, suppliers of these services like physicians and nurses, and users of the services. The logistics of providing and acquiring health care services involves costs related to infrastructure, personnel, delivery, marketing, and payment sources like users, insurance, and government funds. Key factors that affect all aspects of the health care industry are demand for services, supply of providers, regulations, competition, and sustainability.
Coroporate Practice of Medicine - TelemedicineAlex Marz
Start your own telemedicine medical practice
One stop shop (Scheduling, Video, EMR, Billing, & Remote Patient Monitoring and we do the complete practice management including billing and collections)
GoTelecare is the only telehealth and medical billing franchise
This document provides an overview of interactive health communication systems and telehealth technologies. It discusses physician perspectives on adoption barriers like workflow integration and reimbursement issues. It also profiles two AHRQ grants that utilize telehealth to improve cancer care in rural areas and provide remote monitoring for heart failure patients.
The information reflects information available as of June 2, 2020.
We encourage monitoring subsequent regulation updates pertaining to telehealth in wound care
Starting Your TeleMental Health Program outlines key steps for developing a tele-mental health program, including conducting a needs assessment, establishing policies and procedures, ensuring HIPAA compliance, obtaining proper equipment, providing training to staff, and documenting medical records. Tele-mental health programs allow for the delivery of mental healthcare through videoconferencing technology regardless of patient location. Reimbursement for tele-mental health services varies by state and insurance provider.
The meaning of meaningful use 2010 05-14 missouri rural hospital hit conferencelearfield
This document summarizes a presentation about meaningful use of health information technology. It discusses the national drivers behind implementing health IT, including several reports identifying medical errors as a major issue. It outlines the HITECH Act which provides financial incentives through Medicare and Medicaid to encourage providers and hospitals to meaningfully use certified electronic health records. It describes the proposed objectives and measures for stage 1 meaningful use, including both clinical quality reporting and other objectives requiring data submission or attestation. Regional extension centers are introduced as resources to help providers achieve meaningful use.
Telemedicine reimbursement can be tricky, to say the least. How do you ensure you get paid for live video medical visits via Medicare, Medicaid, and third-party payers? What kinds of guidelines do you need to follow?
In this SlideShare, all these questions are answered by billing consultant Adella Cordova, our resident expert on how telemedicine reimbursement works. While there are no guarantees in this shifting policy landscape, each of the main payers does has specific requirements and billing rules for delivering telemedicine.
You'll learn:
-Medicare's guidelines for telemedicine reimbursement
-How to research the Medicaid guidelines for telemedicine in your state
-Trends in billing for telemedicine through private payers
-Guidelines for coding and verifying telemedicine coverage
These slides were originally used in our webinar on telemedicine reimbursement. Request the free recording here: http://try.evisit.com/september-webinar-how-to-get-reimburse/?utm_source=Blog&utm_medium=post&utm_campaign=webinar
Webinar - Telehealth: Bridging the Doctor-Patient DivideCareSkore
Do you risk negative outcomes due to poor patient engagement? Without technology, you can’t fully enlist patients to participate in their own care. This leads to rising no-show rates, medication non-adherence, and uninformed patient decisions, resulting in readmissions, lower MIPS scores, and lower reimbursements.
The document summarizes the American Recovery and Reinvestment Act (ARRA) and its impact on electronic health records. It provides incentives for hospitals and physicians to implement qualified electronic health records systems and demonstrate meaningful use by 2015. Those that do not implement EHRs will face penalties after 2015. The ARRA sets standards for qualified EHRs and meaningful use, and provides Medicare and Medicaid incentive payments to support implementation from 2009 to 2015.
This document discusses CMS' Condition of Participation regarding medical record services and the impact of the HITECH Act and meaningful use incentives. It outlines the rules requiring hospitals to maintain complete and organized medical records for each patient. It then summarizes the HITECH Act provisions providing Medicare and Medicaid incentives for hospitals that meaningfully adopt health IT by certain deadlines. Hospitals must meet criteria around electronic ordering, clinical decision support, information exchange and quality reporting to qualify for incentives or face penalties. The document explains how these new policies will drive hospitals to transition to electronic medical records.
This document summarizes key points from a presentation on the Medicare Access and CHIP Reauthorization Act (MACRA) and its implementation. It discusses the new Merit-based Incentive Payment System (MIPS) which will consolidate existing quality programs, and Alternative Payment Models (APMs) which aim to shift physicians from fee-for-service. Key advocacy issues are outlined, including setting initial performance periods, defining financial risk for APMs, and ensuring physician-focused models can qualify as APMs. The AMA plans to shape MACRA rules through comments and outreach to ensure all physicians can succeed under the new law.
Building a Telemedicine Program in a Skilled Nursing FacilityAndrea Lee
As health care becomes more accepting of and reliant on technology, the concept of telemedicine has caught the attention of long term care facilities. Increasingly, skilled nursing and assisted living settings have adopted telemedicine programs in an effort to reduce hospital readmissions, increase access to practitioners, differentiate themselves from competition, improve overall quality of care, decrease costs, and increase revenue. Recent studies confirm that telemedicine is a powerful tool for transforming health care and can positively impact the quality of care for long term care patients. This presentation will feature Rebecca Miller, attorney and Senior Telehealth Project Manager at Michigan Medicine and
Andrea Lee, post-acute care health care attorney from Honigman Miller Schwartz and Cohn, LLP, on the key operational and legal considerations when implementing a telemedicine program.
Telemedicine uses telecommunications and digital information technologies to provide remote clinical healthcare services. It began in the late 19th century with the development of telecommunications like the telegraph. Today, most people have access to basic telemedicine devices like mobile phones and computers. Telemedicine applications include remote chronic disease management, preventative care support, and post-hospitalization care. It offers benefits like increased access to care and cost savings but also faces challenges like licensing issues and technological restrictions.
Health Care Panel presented to the Minnesota Ultra High-Speed Broadband Task ...Ann Treacy
This document discusses broadband technologies and their applications in healthcare, including telehealth. It provides examples of how telehealth is used in different specialties like tele-ICU, telepsychiatry, and teleradiology. It also discusses the benefits of telehealth, barriers to adoption like reimbursement and infrastructure issues, and the potential return on investment for hospitals that implement telehealth programs.
This presentation is from the TMLT webinar, Telemedicine: Managing Your Risks. The presentation reviews regulatory requirements for physicians and health care organizations using telemedicine in Texas.
Trends, Strategies, and Payment Models in TelemedicineVMG Health
Presentation by Ben Ulrich, CVA
2015 Becker’s Hospital Review CIO/HIT + Revenue Cycle Summit, July 21, 2015
At Becker’s Hospital Review CIO/HIT Summit CVA, Ben Ulrich, explained the reimbursement environment, strategies and structures, and fair market value considerations involving telemedicine arrangements.
Telemedicine has moved to the forefront of healthcare, opening up opportunities for both practices and their patients. To help unpack some of the enormous amounts of new information, This presentation focuses on:
- Relaxing of Regulatory Issues
- How Telemedicine Can Help Your Practice
- Challenges
- The Future of Telemedicine
The document discusses meaningful use of electronic health records and the process for healthcare providers to qualify for incentive payments. It outlines the stages of meaningful use, including capturing and sharing data in stage 1 and advancing care processes in stage 2. It also describes the Medicare and Medicaid EHR incentive programs that provide payments of up to $44,000 and $63,750 respectively to help providers adopt electronic records. Eligible professionals must register with CMS and demonstrate meaningful use of certified EHR technology to qualify for payments.
Missouri hospital association technical assistance presentationlearfield
The document summarizes components of the HITECH Act and proposed rules around meaningful use of electronic health records. It discusses incentives for hospitals and providers to adopt EHRs, outlines objectives for meaningful use in 2011, and notes concerns that the timeline is too aggressive. It also describes services available through Missouri's Regional Extension Center to help providers select and implement EHRs to meet meaningful use criteria.
The document appears to be the beginning of a conversation between two individuals, Kuehn and Korbin. It does not provide much context or content beyond introducing the names of the participants.
Discussion of using workflows, technologies and architecture to adapt to the changing world of medicine. Presentation given at the Digital Health Innovation Summit in Philadelphia, PA on 5/14/2015
The document discusses the patient centered medical home model and its implications. It begins with an overview of problems with the current US healthcare system based on international comparisons. It then outlines the rationale for patient centered medical homes, describing their core principles of being patient-centered, comprehensive, coordinated, accessible, and committed to quality and safety. Key aspects discussed include the use of care teams, standards for medical home recognition from NCQA, and the shift towards population health, quality-based reimbursement, and around the clock access. The implications discussed are that truly patient-centered care requires personal and practice transformation, appropriate support and resources, and a long-term transition away from fee-for-service models.
Leveraging Technology at the Point of CareDavid Voran
This document discusses leveraging healthcare technology to maximize efficiency at the point-of-care. It describes how younger providers sometimes struggle more with technology application than older providers. It also discusses seminal moments in computing and recent influencers, including how the rate of technological change is accelerating. The document advocates for preparing for the next healthcare inflection point by effectively using technology, which depends on willingness to change non-technology practices. It provides suggestions such as exploiting new user interfaces, embracing self-tracking apps, and changing workflows.
Description of how large screen monitors are being used in the clinic and improving productivity. Also includes small tutorial on how to set multiple monitors up.
The document provides an overview of a typical day for a primary care physician at the Heartland Clinic of Platte City. It discusses the physician's schedule, use of electronic medical records, remote access capabilities, messaging with patients, clinical decision making, interruptions, and use of ePrescribing. It also outlines opportunities for innovative technologies, such as improving drug selection, pharmacy selection, and enabling real-time connections between prescribing systems and additional resources for physicians and patients.
Day in the life of a primary care for pdr net p pt version 4David Voran
The document summarizes a typical day for a primary care physician at a clinic located 30 miles from the nearest hospital. The physician sees 20-24 patients per day, conducts 1-3 procedures, attends 1 meeting, and responds to 20-40 asynchronous messages from nurses, patients, and colleagues. They also face 10-15 interruptions from pharmacies, phone calls, and drug representatives. The implementation of an electronic medical record system has helped by eliminating paper chart pulls and creation, allowing instant access to patient records and test results instead of 24-48 hour delays, and reducing phone calls by 1-2 hours per day. However, interruptions remain a challenge and decision support could be improved, such as smarter pharmacy selection
Healthcare Innovation Technology Group MeetingDavid Voran
Presentation to a Kansas City Healthcare Innovation Technology Group Meeting on June 28, 2011.
Describes Innovation processes, needs, some examples and advice for those creating innovative technology products to be used in Healthcare.
Dr. David Greene R3 stem cell Breakthroughs: Stem Cell Therapy in CardiologyR3 Stem Cell
Dr. David Greene, founder and CEO of R3 Stem Cell, is at the forefront of groundbreaking research in the field of cardiology, focusing on the transformative potential of stem cell therapy. His latest work emphasizes innovative approaches to treating heart disease, aiming to repair damaged heart tissue and improve heart function through the use of advanced stem cell techniques. This research promises not only to enhance the quality of life for patients with chronic heart conditions but also to pave the way for new, more effective treatments. Dr. Greene's work is notable for its focus on safety, efficacy, and the potential to significantly reduce the need for invasive surgeries and long-term medication, positioning stem cell therapy as a key player in the future of cardiac care.
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Joker Wigs has been a one-stop-shop for hair products for over 26 years. We provide high-quality hair wigs, hair extensions, hair toppers, hair patch, and more for both men and women.
Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
Feeding plate for a newborn with Cleft Palate.pptxSatvikaPrasad
A feeding plate is a prosthetic device used for newborns with a cleft palate to assist in feeding and improve nutrition intake. From a prosthodontic perspective, this plate acts as a barrier between the oral and nasal cavities, facilitating effective sucking and swallowing by providing a more normal anatomical structure. It helps to prevent milk from entering the nasal passage, thereby reducing the risk of aspiration and enhancing the infant's ability to feed efficiently. The feeding plate also aids in the development of the oral muscles and can contribute to better growth and weight gain. Its custom fabrication and proper fitting by a prosthodontist are crucial for ensuring comfort and functionality, as well as for minimizing potential complications. Early intervention with a feeding plate can significantly improve the quality of life for both the infant and the parents.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
9. Brief History
Period Billing System
Pre 1960 Paper invoices designed by each physician, group or hospital
Each had their own internal “coding” system
Submitted to whomever was the payer
Mid 1960’s AMA developed a standardized system, Common Procedural
Terminology CPT, for use by members
1970-1980 Government and many 3rd party payers adopted AMA’s CPT
and standardized on HCPCS codes for those services not
rendered by physicians
1996 Health Insurance Portability and Accountability Act mandated
use of CPT, HCPCS, ICD-9-CM and other leading code sets
10. +
Why did AMA develop CPT?
• AMA developed and published the 1st Current Procedural
Terminology (CPT®) in 1966
• Designed to encourage use of standard terms and descriptors to
document procedures in the medical record
• Helped communicate accurate information to agencies concerned
with insurance claims
• Provided basis for a computer oriented system to evaluate operative
procedures
• Contribute basic information for actuarial and statistical purposes
CPT (Current Procedural Terminology)
11. +
HCPCS
• Established in 1978 as a way to standardize identification of medical
services, supplies and equipment
• Consists of 2 code sets
• Level I: CPT – owned and maintained by the AMA
• Level II: code set for medical services not included in Level I and maintained
by CMS HCPCS Workgroup
• Durable medical equipment, prosthetics, orthotics and supplies
• Mandated by Congress as part of the Health Insurance Portability and Accountability Act
of 1996 (HIPAA)
Healthcare Common Procedure Coding System
16. Key Medicare TeleHealth Points
Balanced Budget Act of 1997 mandated Medicare coverage of telehealth
Funded many telemedicine demonstration projects
Coverage not required until 1999
Required a practitioner be with the patient during the event
Telehealth reimbursement shared with consulting (75%) and referring (25%) physician
Benefits Improvement and Protection Act of 2000
Further definitions (originating & distant sites)
Extended coverage for demonstration and non-metropolitan statistical areas
Eliminated fee sharing requirement (originating = facility fee, distant = E&M)
Expanded services to include direct care, consultations and psychiatry
Eliminated need for tele-presenter
Permitted store-and-forward
Specified types of providers eligible for telehealth reimbursement
Medicare Improvements for Patients and Providers Act 2008
Added hospital based or critical access hospital renal dialysis centers, skilled nursing and community health
centers as qualifying origination sites
18. 2-way, real time, interactive
communication between patient
and physician
Audio & Video
Not recognized by
Federal Medicaid
Asynchronous store and
forward not telemedicine
States can choose which
codes to reimburse
Telehealth includes phones,
faxes even though not
meeting Medicaid’s
telemedicine definition
States have broad
license to determine
what services are
reimbursed
And can limit who or where
those services are covered
Whenever I am asked to speak about technology and medicine the scene above comes to mind. The rocks in the stream make their way down very slowly pushed hither and thither by the rushing water.
I think of traditional medicine as the rocks slowly rolling in whatever direction the fast moving water representing non-traditional medicine flows in response to gravity.
This is true for technology as it is in medicine. Traditional technologies have an inertia that doesn’t constrain nimble, rapid flowing newer technology.
Telehealth is also represented by this picture. Reimbursement rules constrain the “rocks” of traditional rule-based telemedicine and telehealth while every day medical services are quietly being used to meet peoples needs in a direct-to-consumer framework that is limited only by imagination and market forces.
The big disconnect is that each one of us today carries in our pockets more sophistication and technology on which almost all of the current traditional telemedicine programs were created. Yet, we’ve not been able to truly leverage this. I keep asking myself, “ why aren’t 90% of all office visits done on the phones?”
Many people would immediately argue that phone cannot “see” or “feel” yet what is remarkable is there are literally hundreds of inexpensive devices that far surpase a clinician’s ability to see or measure and in many respects outperform the typical devices found in most exam rooms. The overwhelming majority of these devices (many which are FDA certified) are available to consumers directly without prescriptions. They include otoscopes, stethoscopes, temperature gauges, EKG’s and a host of other devices that measure one function or another.
Some, such as Cellscopes OTO are so good I haven’t used a regular otoscope for several years now. This device enables me to use a totally non-threatening device that is familiar to every child and adult to very conspicuously see the ear drum and immediately share that with the patient, pointing out the presence or lack of pathology to their satisfaction. I’ve found nothing engages a patient more than visual images of what they cannot normal see and makes treatment decisions a much easier.
So why is this type of care mainstream?
Sadly, we all fall back on doing what we get paid to do.
And right now getting paid, especially from 3rd party payers that cover all but a tiny fraction of our services is “in the code”. There is a code for just about every thing we do. If there’s no code …. They won’t pay.
For several decades, medical billing was done almost entirely on paper. However, with the advent of medical practice management software, also known as health information systems, it has become possible to efficiently manage large amounts of claims. Many software companies have arisen to provide medical billing software to this particularly lucrative segment of the market. Several companies also offer full portal solutions through their own web-interfaces, which negates the cost of individually licensed software packages. Due to the rapidly changing requirements by U.S. health insurance companies, several aspects of medical billing and medical office management have created the necessity for specialized training. Medical office personnel may obtain certification through various institutions who may provide a variety of specialized education and in some cases award a certification credential to reflect professional status. The Certified Medical Reimbursement Specialist (CMRS) accreditation by the American Medical Billing Association is one of the most recognized of specialized certification for medical billing professionals.
The American Medical Association (AMA) first developed and published CPT in 1966. The first edition helped encourage the use of standard terms and descriptors to document procedures in the medical record; helped communicate accurate information on procedures and services to agencies concerned with insurance claims; provided the basis for a computer oriented system to evaluate operative procedures; and contributed basic information for actuarial and statistical purposes.
The first edition of CPT contained primarily surgical procedures, with limited sections on medicine, radiology, and laboratory procedures. The second edition was published in 1970 and presented an expanded system of terms and codes to designate diagnostic and therapeutic procedures in surgery, medicine, and the specialties. At that time, a five-digit coding system was introduced, replacing the former four-digit classification. Another significant change was a listing of procedures relating to internal medicine.
In the mid to late 1970s, the third and fourth editions of CPT were introduced. The fourth edition, published in 1977, represented significant updates in medical technology, and a system of periodic updating was introduced to keep pace with the rapidly changing medical environment. In 1983 CPT was adopted as part of the Centers for Medicare and Medicaid Services (CMS), formerly Health Care Financing Administration's (HCFA), Healthcare Common Procedure Coding System (HCPCS). With this adoption, CMS mandated the use of HCPCS to report services for Part B of the Medicare Program. In October 1986, CMS also required state Medicaid agencies to use HCPCS in the Medicaid Management Information System. In July 1987, as part of the Omnibus Budget Reconciliation Act, CMS mandated the use of CPT for reporting outpatient hospital surgical procedures.
Today, in addition to use in federal programs (Medicare and Medicaid), CPT is used extensively throughout the United States as the preferred system of coding and describing health care services.
The Healthcare Common Procedure Coding System (HCPCS) was established in 1978 as a way to standardize identification of medical services, supplies and equipment. It is composed to 2 code sets. The first level, or Common Procedural Terms, is owned, maintained and licensed by the AMA. The second level, is the code set developed and maintained by the government for all medical services that are not included in the the first level. As mentioned, it is maintained by the Centers for Medicare and Medicaid Services or CMS. Specifically it’s maintained by the HCPCS Workgroup.
As referenced earlier, this workgroup was essentially created by regulation to implement the HIPAA requirement for standardized coding systems in the Administration Simplification Act of 1996 or what is better known as the Health Insurance Portability and Accountability Act also known as the Kennedy Kassebaum Act, a joint bill sponsored by Democrat Senator Edward Kennedy and Republican Senator Nancy Kassebaum.
Periodically, often yearly, the master code set is published as the Physician Fee Schedule available on CMS’ web site.
This spreadsheet defines every procedure but more importantly lists the amount of work on a Relative Value Scale (RVU) that is required of the professional (aka, physician) and the facility (aka hospital) to deliver this amount of work. This spread sheet contains columns that define certain circumstances the code may be applied. More importantly this spreadsheet contains a current conversion factor (the dollar amount per RVU) that is to be reimbursed for a given code.
The 2017 version of this spreadsheet has 16458 codes.
Here is a simplified version of the spreadsheet that I keep up-to-date with me for grins and to read when I really want to drill a hole in my head! Speaking of which let’s take a look at Gode 61108, Drill skull for drainage. An work RVU has been established for this of 11.64 RVUs. The professional or physician’s RVU is 10.28, the hospital’s work is also 10.28. Malpractice costs are also listed in RVU’s and for this procedure are quite high at 4.55. Combine these and you get 26.47 RVU’s no matter what the location to put a hole in your head and drain your brains.
As of yet there’s no currency called RVU but fortunately there’s a conversion factor of $35.8887 per RVU. The result? $949.97 per hole no matter where it is performed!
So now we get to discuss the subject of this meeting: Telehealth. The definition of telehealth by CMS is undergoing constant changes. You can begin the rat-hole journey here: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/index.html
Medicare has been liberalizing and expanding its coverage of telemedicine.
But there are significant restrictions depending on where the patient is. These can be discovered very quickly on line.
But is leaving most of the decision making up to the states for Medicaid
Fortunately the American Telemedicine Association, or more accurately Latoya Thomas and Gary Capistrant, have been surveying and updating their State Telemedicine Gaps Analysis volumes that clearly compare how states are handling Physician Practice Standards and Licensure as well as Coverage and Reimbursement.
The following slides are images extracted from both of these volumes and cover:
Telehealth Parity
Medicaid Coverage
Medicaid Patient Settings
Medicaid covered technologies
Full parity is classified as comparable coverage for telemedicine-provided services to that of in-person services. Thirty-one states and the District of Columbia have enacted full parity laws. Only Alaska and Arizona have enacted partial parity laws that require coverage, but limits coverage and reimbursement to a predefined list of health care services. Since our initial report, some parity laws have included restrictions on patient settings. For this report’s purpose, we added this component to our methodology, and continue to measure other components of state policies that enable or impede parity for telemedicine-provided services under private insurance health plans.
States with the highest grades for private insurance telemedicine parity provide state-wide coverage, and have no provider, technology, or patient setting restrictions (Figure 3). This year Rhode Island joins other high ranking states with the passage of its 2016 parity law. Among other states with parity laws, Alaska and Vermont scored about average (C). Alaska’s law only covers mental health services, while Vermont lawmakers have placed patient setting restrictions on those services eligible for coverage parity. Arizona removed it’s rural only restrictions and now offers telehealth parity statewide, yet still continues to limit coverage to interactive audio-video only modalities and specific types of services and conditions that are covered via telemedicine.
Despite enacting a parity law in March 2015, Arkansas maintains a failing grade because it places arbitrary limits on patient location, eligible provider type, and requires an in-person visit to establish a provider-patient relationship. Forty-four percent of the country ranks the lowest with failing (F) scores, a drop from the initial report.
Each state’s Medicaid plan was assessed based on service limits and patient setting restrictions. Provider eligibility and the type of technology allowed were also examined to determine the state’s capacity to fully utilize telemedicine to overcome barriers to care. For this report’s purpose, we measured components of state policies that enable or impede parity for telemedicine-provided services under Medicaid plans.
Eleven states have the highest grades for Medicaid coverage of telemedicine-provided services. New Hampshire ranks the lowest with a failing (F) score because it still applies geography limits in addition to restrictions on service coverage, provider eligibility, and patient setting. Connecticut, Florida, Hawaii, Idaho, Utah, and West Virginia have all made improvements to expand coverage of telemedicine for their Medicaid populations. Rhode Island joins the ranks with telemedicine Medicaid coverage with reimbursement for some initial and follow-up telemedicine consultations.
In telemedicine policy, the place where the patient is located at the time of service is often referred to as the originating site (in contrast, to the site where the provider is located and often referred to as the distant site). The location of the patient is a contentious component of telemedicine coverage. A traditional approach to telemedicine coverage is to require that the patient be served from a specific type of health facility, such as a hospital or physician's office. With advances in decentralized computing power, such as cloud processing, and mobile telecommunications, such as 5G wireless, the current approach is to cover health services to patients wherever they are e.g. home, place of work, school, etc.
For this report, we measured components of state Medicaid policies that, for conditions of coverage and payment, broaden or restrict the location of the patient when telemedicine is used. The following sites are observed as qualified patient locations:
hospitals
doctor’s office
other provider’s office
dentist office
home
federally qualified health center (FQHC)
critical access hospital (CAH)
rural health center (RHC)
community mental health center (CMHC)
sole community hospital
school/school-based health center (SBHC)
assisted living facility (ALF)
skilled nursing facility (SNF)
stroke center
rehabilitation/therapeutic health setting
ambulatory surgical center
residential treatment center
health departments
renal dialysis centers
habilitation centers
pharmacy.
States received one (1) point for each patient setting authorized as an eligible originating site. Those states that did not specify an originating site were given the maximum score possible (21).
Twenty-eight states do not specify a patient setting or patient location as a condition of payment for telemedicine (Figure 6).
Aside from this, 40 states allow the home as an originating/patient site, while 23 states and D.C. recognize schools and/or SBHCs as an originating site (Figures 7-8).
Telemedicine includes the use of numerous technologies to exchange medical information from one site to another via electronic communications. The technologies closely associated with services enabled by telemedicine include videoconferencing, the transmission of still images (also known as store-and-forward), remote patient monitoring (RPM) of vital signs, and telephone calls. For this report, we measured components of state Medicaid policies that allow or prohibit the coverage and/or reimbursement of telemedicine when using these technologies.
Twelve states score above average on our scale with Alaska and Arizona taking the highest ranking (Figure 9). Alaska covers telemedicine when providers use interactive audio-video, store-and-forward, remote patient monitoring, and audio conferencing for some telemedicine encounters. Arizona allows numerous modalities including phone, video, or store-and-forward to enable its remote patient monitoring service. Alaska, Arizona, Hawaii, Minnesota, Mississippi, Nebraska, Texas, and Washington all cover telemedicine when using synchronous technology as well as store-and-forward and remote patient monitoring in some capacity. A little less than 50 percent of the states rank the lowest with failing (F) scores either because they only cover synchronous only or provide no coverage for telemedicine at all.
Further, Idaho, Missouri, New York, North Carolina and South Carolina prohibit the use of “cell phone video” or “video phone” to facilitate a telemedicine encounter.
We measured components of state policies that enable or impede parity for telemedicine-provided services under state-employee health plans.
Most states self-insure their plans therefore traditional private insurer parity language does not automatically affect them. Oregon, an exception, amended its parity law to include self-insured state employee health plans.
Twenty-six states provide some coverage for telemedicine under their state employee health plans with all of them extending coverage under their parity laws. North Dakota’s parity law only covers state employee health plans. Roughly 50 percent of the country is ranked the lowest with failing scores due to partial or no coverage of telehealth.
The American Telemedicine Association does a bang up job of comparing states as to the Covereage offered …
…And how they regulate who can practice and under what circumstances.
Medicare is recognizing the importance (and reality) of medical care provided outside a face-to-face meeting
Has added these codes to the physician fee schedule
However, there’s one glaring deficiency when it comes to reimbursing for the water that flows around the “stones”
The AMA and the HCPCS Working group haven’t assigned RVU’s for many of the online, virtual services. The impact of this is that whether we like it or not almost all physician practices use RVUs as a measure of productivity. So even those organizations that want to and are able to provide telemedicine often can’t find physicians who are willing to give up what they are doing now to do telemedicine because they don’t accumulate RVU’s and risk losing out on incentive payments based on RVUs.
The rushing water around us bombards us in daily e-mails enticing physicians to sign up with their solutions that reach out directly to patients as well as describe innovating organizations use of telehealth services.
I have been dabling with HealthTap to see what’s happening in direct-to-consumer medicine.
The entry point was very low.
Learning curve is acceptable.
Overall I wasn’t really pleased with the overly commercial aspects of this and actually had deleted the app after using it for about a year.
But then I saw this: