This document summarizes a teleconference between behavioral health organizations discussing policy changes and operational strategies for rapidly implementing telehealth in response to COVID-19. It outlines recent federal and state telehealth policy changes, including expanded Medicare and Medicaid coverage. Technology platforms, service models, billing codes, and strategies for transitioning to telehealth are discussed. Challenges of virtual care and ways to ensure quality of care are also addressed. The organizations aim to help providers implement telehealth quickly while maintaining standards of care.
Overcoming Telehealth Barriers to Mobilize Your Practice and Maximize RevenueKareo
In this live webinar, Director of Product Marketing and Partner Alliances, Sonny Singh, will:
-Discuss current industry trends and telehealth statistics
-Outline what healthcare services can be provided remotely
-Discuss how offering a telehealth option (including telemedicine) will help your practice grow amidst uncertainty
-Address the common pitfalls that you told us you’re experiencing
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
Getting Started With Telemedicine #3 - ReimbursementVSee
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
Peoplelink Corporate solutions Pvt ltd is an Indian based It Telecom product development company has launched a Video conferencing solution which uses Software based codec’s and can be accessible from any Laptop/desktop from any where at any time, hence this is a software based video conferencing solution this saves 75% cost on the investment for video conference infrastructure also it saves the recurring cost to the band width.
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.
Overcoming Telehealth Barriers to Mobilize Your Practice and Maximize RevenueKareo
In this live webinar, Director of Product Marketing and Partner Alliances, Sonny Singh, will:
-Discuss current industry trends and telehealth statistics
-Outline what healthcare services can be provided remotely
-Discuss how offering a telehealth option (including telemedicine) will help your practice grow amidst uncertainty
-Address the common pitfalls that you told us you’re experiencing
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
Getting Started With Telemedicine #3 - ReimbursementVSee
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
Peoplelink Corporate solutions Pvt ltd is an Indian based It Telecom product development company has launched a Video conferencing solution which uses Software based codec’s and can be accessible from any Laptop/desktop from any where at any time, hence this is a software based video conferencing solution this saves 75% cost on the investment for video conference infrastructure also it saves the recurring cost to the band width.
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.
Kareo Billing Product Overview and Training: Success SummitKareo
kareo.com - Learn how to leverage the most efficient billing workflows using the most impactful Kareo Billing features. Get top tips and tricks to supercharge your billing operations.
The 2018 Kareo Success Summit offered key industry insights, best practice training, networking and idea-sharing to support the success of medical billing companies across the country.
Kareo is an easy-to-use, cloud-based business growth platform built for medical billing companies and the independent practices they serve.
Tristan Schlotz is a Training Specialist at Kareo.
Visit kareo.com/billing-companies to learn more.
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
Modernize Your Mental Health Practice to Save Time and Improve Care DeliveryKareo
Join Dr. Nina Vasan and Dr. Ganielle Hooper as they use their expertise in the mental health industry to help you run a successful mental health practice amidst uncertain times. They will discuss:
-The current state of the mental health industry and the public “stigma” of seeking mental health services
-Recent policy changes pertaining to insurance reimbursement, telehealth and MACRA
-How technology can support your practice’s growth and success
-Lessons learned in running a successful practice from a provider who has recently expanded her practice and what she did to overcome common barriers
Title: Establishing Connections – Infrastructure Enabling mHealth Description
Description: The first educational session is focused on how hospitals and health systems can leverage the FCC’s Connect Fund to acquire and build out broadband infrastructure and connections. These connections form the backbone of digital communications in healthcare. However, the Connect Fund remains largely untapped by potential beneficiaries.
Speakers: Tom Reid & Ali Youssef
Objectives: Identify wired and wireless needs in healthcare settings. Identify funds and solutions which enable mHealth technologies. Assess the impacts of sourcing funding to increase capacity.
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
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
More info, visit: https://vsee.com/blog/aacma-telemedicine-101-getting-started/
Get practical tips on choosing a technology platform that is right for your practice. Learn about how the right telehealth technology can save you and your staff valuable time in set up, onboarding, and patient flow. Set the right expectations about what telehealth can and cannot do. Find out best practices for launching your telehealth service fast.
Learning Objectives:
Learn important technology considerations for doing telemedicine & telehealth
Limitations of telehealth technology
Learn about other considerations for evaluating a vendor
What is the minimum technology setup necessary to start offering telehealth?
Telemedicine is a collection of means or methods for enhancing health care, public health and health education delivery and support using telecommunications technologies. With more than 95% of adults, and 100% of young adults between the age of 18-29 owning a cell phone in the United States, a technology-based health intervention can be available to hard-to-reach populations or underserved areas.
Panelists will engage a rich dialogue and showcase innovative and effective ways to create prevention programs for HIV and STDs using the potential telehealth can offer, specifically with linking young people to HIV pre-exposure prophylaxis, or PrEP. This plenary brings together leaders in the field of HIV prevention, research and policy along with private organizations and companies that are currently active on the field of biomedical prevention.
Telecommunication systems applied to telemedicineShazia Iqbal
Telemedicine allows health care professionals to evaluate, diagnose and treat patients at a distance using telecommunications technology.
The approach has been through a striking evolution in the last decade and it is becoming an increasingly important.
Kareo Billing Product Overview and Training: Success SummitKareo
kareo.com - Learn how to leverage the most efficient billing workflows using the most impactful Kareo Billing features. Get top tips and tricks to supercharge your billing operations.
The 2018 Kareo Success Summit offered key industry insights, best practice training, networking and idea-sharing to support the success of medical billing companies across the country.
Kareo is an easy-to-use, cloud-based business growth platform built for medical billing companies and the independent practices they serve.
Tristan Schlotz is a Training Specialist at Kareo.
Visit kareo.com/billing-companies to learn more.
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
Modernize Your Mental Health Practice to Save Time and Improve Care DeliveryKareo
Join Dr. Nina Vasan and Dr. Ganielle Hooper as they use their expertise in the mental health industry to help you run a successful mental health practice amidst uncertain times. They will discuss:
-The current state of the mental health industry and the public “stigma” of seeking mental health services
-Recent policy changes pertaining to insurance reimbursement, telehealth and MACRA
-How technology can support your practice’s growth and success
-Lessons learned in running a successful practice from a provider who has recently expanded her practice and what she did to overcome common barriers
Title: Establishing Connections – Infrastructure Enabling mHealth Description
Description: The first educational session is focused on how hospitals and health systems can leverage the FCC’s Connect Fund to acquire and build out broadband infrastructure and connections. These connections form the backbone of digital communications in healthcare. However, the Connect Fund remains largely untapped by potential beneficiaries.
Speakers: Tom Reid & Ali Youssef
Objectives: Identify wired and wireless needs in healthcare settings. Identify funds and solutions which enable mHealth technologies. Assess the impacts of sourcing funding to increase capacity.
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
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
More info, visit: https://vsee.com/blog/aacma-telemedicine-101-getting-started/
Get practical tips on choosing a technology platform that is right for your practice. Learn about how the right telehealth technology can save you and your staff valuable time in set up, onboarding, and patient flow. Set the right expectations about what telehealth can and cannot do. Find out best practices for launching your telehealth service fast.
Learning Objectives:
Learn important technology considerations for doing telemedicine & telehealth
Limitations of telehealth technology
Learn about other considerations for evaluating a vendor
What is the minimum technology setup necessary to start offering telehealth?
Telemedicine is a collection of means or methods for enhancing health care, public health and health education delivery and support using telecommunications technologies. With more than 95% of adults, and 100% of young adults between the age of 18-29 owning a cell phone in the United States, a technology-based health intervention can be available to hard-to-reach populations or underserved areas.
Panelists will engage a rich dialogue and showcase innovative and effective ways to create prevention programs for HIV and STDs using the potential telehealth can offer, specifically with linking young people to HIV pre-exposure prophylaxis, or PrEP. This plenary brings together leaders in the field of HIV prevention, research and policy along with private organizations and companies that are currently active on the field of biomedical prevention.
Telecommunication systems applied to telemedicineShazia Iqbal
Telemedicine allows health care professionals to evaluate, diagnose and treat patients at a distance using telecommunications technology.
The approach has been through a striking evolution in the last decade and it is becoming an increasingly important.
Telehealth, also known as telemedicine, is the use of technology to deliver healthcare services remotely. Telehealth can include videoconferencing, remote monitoring, electronic health records, and mobile health apps.
Join HRG Executive Director of HIM Coding, Teresa Tate as she discusses telehealth documentation issues and identifies how to best avoid these issues. She will discuss patient consent & the differentiation between payers, the time factor & how to understand when telehealth is NOT separately reimbursable.
DoD/VA mHealth 2013 returns on November 18-20, 2013 for its second annual mobile health event, a collaborative summit dedicated to advancing and supporting mobile health initiatives in the Departments of Defense and Veterans Affairs.
This event will showcase the latest military medical technologies, regulations, applications and security. In-depth sessions will include a focus day and 2 main session days covering critical topics such as: Streamlining DoD Health IT Infrastructure, Integrating Medical Information through mHealth, Improving User Engagement through the Use of Mobile Applications, and Combating Traumatic Brain Injury through mHealth.
5 Common telehealth billing challenges.pptxMithaliParekh
Since the outbreak of COVID, the usage of telehealth services has exploded as a viable means of accessing and delivering care. From expanding the types of cases, to a rapidly growing number of digital devices that cover multiple patient care needs, the telehealth business continues to extend its range of solutions. However, as telehealth services have grown in popularity, new problems have evolved in the fields of licensing reimbursement, acceptance, EMR integration, and accessibility of health and awareness.
5 Common telehealth billing challengesPDF.pdfMithaliParekh
Since the outbreak of COVID, the usage of telehealth services has exploded as a viable means of accessing and delivering care. From expanding the types of cases, to a rapidly growing number of digital devices that cover multiple patient care needs, the telehealth business continues to extend its range of solutions. However, as telehealth services have grown in popularity, new problems have evolved in the fields of licensing reimbursement, acceptance, EMR integration, and accessibility of health and awareness.
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.
Top 5 Telemedicine Regulatory Hurdles To OvercomeVSee
For more information please visit: https://vsee.com/blog/top-5-telemedicine-regulatory-hurdles-to-overcome/
For other webinars:
https://vsee.com/webinars/
Or join our Linkedin Group: https://www.linkedin.com/groups/Telehealth-Failures-Secrets-Success-13500037/about
Or Join our Facebook Group:
https://www.facebook.com/groups/tfssgroup/?ref=group_cover
The 2017 Texas Legislature adopted a new definition and a new approach to telemedicine and the remote delivery of health care. Two health care lawyers prepared this deck to help Texas physicians understand the new law, how it came about, and what it could mean for the practice of medicine in Texas.
"Telemedicine and Digital Health: New Texas Law, Opportunities, and Challenges" was presented at the Texas Medical Association 2017 Fall Conference, Sept. 16, 2017, as the Philip R. Overton Annual Lectureship in Medicine and the Law.
7 Tips for Educating Patients/ Clients for Telehealth & Teletherapy Best Prac...Marlene Maheu
This professional training will give concise suggestions for optimally approaching 7 key issues related to client/patient education for safe, effective clinical interventions.
Need CME(s), CNE(s), or CE(s)?
Register for full CME, CNE, or CE credit(s) for multi-modal, 100% online, on-demand telehealth professional training programs. Registration gives you access to slides, handouts, course materials, and course completion certificates for your licensing board: http://telehealth.org/course-catalog.
Read our 700+ no-cost blog posts at https://blog.telehealth.org, and register for one of our 55+ no-cost telehealth newsletters at https://telehealth.org/signup. If you are seeking telehealth-specific vendors to provide technology, visit https://guide.telehealth.org.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
1. Telebehavioral Health:
Policy, Technology & Operations
Tom Chard, CEO, ABHA
Thad Dickson, CEO, Xpio Health
Bart Andrews, CCO, Behavioral Health Response
Monday, April 6th, 2020
2. ABHA
Alaskans have access to quality, cost-effective
behavioral healthcare.
Xpio Health’s mission is to improve the health of
organizations, and the people they serve
BHR ensures compassionate and immediate
barrier free access to healthcare servicesBHR
Missions Joining Forces
3. AGENDA
• Review of federal policy and legislation changes
applicable to behavioral health providers
• Review of state policy and legislation changes in
Alaska
• Review of EHR Configuration and Policy (Xpio)
• Telehealth Service Provider Option (BHR)
• General strategies and best practices for selecting
and implementing telehealth quickly
5. COVID Emergency Response for Behavioral Health
Policy & LegislativeTimeline
March
13th
March
6th
March
17th
March
18th
March
19th April 2nd
Coronavirus
Preparedness &
Response
Supplemental
Appropriations Act
Congress passed this legislation
Medicare to pay for telehealth
nationally
Stafford Act & National
Emergencies Act
President Trump announced
emergency declaration
CMS expanded Medicare’s
telehealth benefits under 1135
wavier authority
Provides regulatory flexibility to
ensure behavioral health clients
are able to receive services via
telehealth
CMS Expansion of
Telehealth Coverage &
HIPAA Penalty
Suspension
Implementation of 1135 Waiver,
enabling clients to receive a
wider range of healthcare
services via telehealth.
Medicare will make payments in
any setting
OCR and DHHS issued guidance
that enforcement of HIPAA
penalties around telehealth
would be suspended
DEA e-prescribing
Requirement Change
Lifted in-person requirement
to allow for easier e-
prescribing during pandemic
SAMHSA Waiving
42CFR Part 2
Requirements
Waiving the patient consent
requirement for disclosure of
health information during an
emergency, with providers
being allowed to make their
own determination whether a
bona fide medical emergency
exists for purposes of providing
needed treatment to clients.
State 1135 Waivers
Implementing telehealth for
Medicaid patients!
13 States have applied and
received a response to 1135
waivers
https://www.congress.gov/bil
l/116th-congress/house-
bill/6074/text
https://www.whitehouse.gov/brief
ings-statements/letter-president-
donald-j-trump-emergency-
determination-stafford-act/
https://www.hhs.gov/about/news/20
20/03/17/secretary-azar-announces-
historic-expansion-of-telehealth-
access-to-combat-covid-19.html
https://mhealthintelligence.com
/news/dea-okays-telehealth-to-
prescribe-opioids-amid-covid-19-
emergency
https://www.samhsa.gov/sites/defa
ult/files/covid-19-42-cfr-part-2-
guidance-03192020.pdf
6. Telehealth Service Models
• Many providers do not have access to HIPAA-approved technology required to
conduct a video-enabled virtual session, or video chat platforms. In these
situations, telephonic services are able to be delivered in most states.
• Providers that have access to HIPAA-approved technology with video options are
able to conduct virtual video-enabled session. The only requirement is that it is
a non-public facing remote communication product that is available to
communicate with members in accordance with OCR’s notice.
8. • Nebraska
• New Hampshire
• New Jersey
• New Mexico
• North Carolina
• Virginia
• Washington
DRAFT PROJECT UNDERSTANDING
Medicaid 1135 Waivers
• Alabama
• Alaska (April 2nd)
• Arizona
• Arkansas
• California
• Florida
• Illinois
• Louisiana
Approved Medicaid waivers under Section 1135 of Social Security Act:
10. Telehealth Service Models
• Many providers do not have access to HIPAA-approved technology required to
conduct a video-enabled virtual session, or video chat platforms. In these
situations, telephonic services are able to be delivered in most states.
• Providers that have access to HIPAA-approved technology with video options are
able to conduct virtual video-enabled session. The only requirement is that it is
a non-public facing remote communication product that is available to
communicate with members in accordance with OCR’s notice.
11. Alaska COVID Emergency Response for Behavioral Health
Policy & LegislativeTimeline
March
16th
March
11th
March
20th
April
2nd
Emergency Declaration &
Emergency Response Policy
Guidance
Telemedicine is temporarily being expanded,
during the Covid-19 public health
emergency, to include telephone and online
digital services.
The effective dates of these changes is
March 11, 2020 which is the date Governor
Dunleavy declared a State of Emergency due
to Covid19.
Changes to Coverage for
Telehealth in Alaska
The bill revises AS 21.42.422 to expand
telehealth coverage to all covered services of
health care insurance plans in the individual
and group markets
Services must be provided by a health care
provider licensed in Alaska. A prior in-person
visit must not be required.
This requirement is applicable to telehealth.
Consumers must be able to access telehealth
services from both network and non-network
providers.
HSS Temporary Expansion
of Medicaid Healthcare
Services
Alaska Medicaid expansion of telehealth
coverage
Location of member and provider for live
interactive, telephone, and online digital
modes of delivery are unrestricted
Alaska 1135 Waiver
Approved
Submitted and accepted by CMS
https://gov.alaska.gov/newsroom/
2020/03/11/governor-issues-
public-health-disaster-emergency-
declaration-for-covid-19/
http://bnaregs.bna.com/?id=AK_-
33355
http://manuals.medicaidalaska.com/docs/
dnld/Update_Temp_Expansion_of_Medic
aid_Telemed_Coverage.pdf
12. Summary of Alaska Medicaid Telehealth Levels
Level of Service Type of Service Description
Level 1 In person-individual If individuals are able to attend face-to-face while also adhering to
CDC guidelines, they should
Level 2 Telehealth - video Providers may utilize any methods of face to face technology;
Skype, Facetime, Zoom, Duo
Level 3 Telephone Telephonic is an acceptable form of service; however, only utilize
level 3 if level 1 or 2 is not an option
Level 4 Email Email or exchanges via secure patient portal when available.
Level 5 Text Messaging Absolute last resort option, and must have documenting indicating
no other options were available.
Member and Provider Location: The location of the member or provider for telehealth services including telephone
and online digital services is unrestricted to allow for multiple patient and provider settings such as home of facility.
Hierarchy of Individual Services
13. DRAFT PROJECT UNDERSTANDING
Alaska DBH Telehealth Service Codes
Telehealth and Quality Assurance:
Agencies are encouraged to implement Quality Assurance efforts to insure all services are provided and billed
appropriately. Providers may utilize a variety of methods to do so:
Having providers submit copies of email or screen shots with progress notes. Utilizing screen shots of text messages
will insure that the length of service was adequate for billing and also meets medical necessity.
Place of Service is: 02 Telehealth
14. DRAFT PROJECT UNDERSTANDINGDBH Telehealth Service Codes for
Community Behavioral Health
Place of Service is: 02 Telehealth
Modifier for codes is: GT via interactive audio and video
telecommunications systems
16. • Providing Complimentary
Educational sessions for Regions
and Clients as needed
• Focusing on Policy and
Procedure driven Disaster
Response and Protocols
• Enhancing Documentation to
ensure Emergency Protocols are
adapting to the fluid situation.
• Updating EHR Systems with new
telehealth codes
• Documenting / Reporting /
Measuring / Metrics related to
emergency provisions that have
been implemented State /
Federally
• Advising on technology solutions
18. BHR Services
Crisis Lines
ED/OP Clinic support
Phone, Telehealth and
Onsite
Continuous Placement
Services
I/P Unit Onsite support
for Staff/MDs
Care
Collaboration/Follow-up
19.
20. Transition to Phone/Tele-Barriers
Clinicians often a larger barrier to implementation than clients:
1) Identify your early adopters and start with them
2) Let staff ask questions and state concerns
3) Most staff make this transition well
4) Debrief staff after they have implemented
5) Use debrief as lesson learns/process improvements
21. Verbal Consent
• Verify name and DOB
• Request CONSENT for telehealth after explaining
• Risks: using a secure platform but still includes risk
• Limits of confidentiality (same as usual)
• Benefits: response time, same quality of service
• Alternatives: telephone
• Explain clearly purpose and goal of assessment
• Document consent was given
22. Beta testing/Work Arounds
• Identify tech savvy champions to beta
• Create workflow as you test
• Identify areas you can’t replicate remotely
• Work around it (or not)
• Mitigate security concerns and document
• Use office as backstop
23. Phone Work
•Yes, it is harder
•Set expectations
•Who is there/with you?
•Need to attend to something, let me
know
•Normalize what’s different so you can
focus on what is the same
•They can’t see you, so you must be overt
with “listening” sounds/vocalizations
24. Easy Steps: RECEIVE
Respond warmly/positively
Explore need/explain process
Check in and get permission
Expect to go off protocol
Include customer in your actions
Validate emotional content
Evaluate and adjust as needed
25
25. Irvin Yalom - 2017
• Authentic Healing Relationship is key
• We cannot anticipate what will or will not be key
• DX may impair or distort understanding
• Existential crisis MORE common and important
• Don’t lose sight of whole person
• PROCESS CHECKS
• What is state of our encounter in the moment
• Do you have questions for me?
• Comment on relationship
• Honest and transparent with focus on BOND between
• The goal is helping on how to have a meaningful life 26
26. Discussion Points
•When is face-to-face is preferable?
•Client concerns about privacy?
•Mitigate tech issues
•Documentation tips
•Documenting clinician's work/quality
outcomes
•Recording – DON’T*
28. • Bullet Points
• Potential risks and limits to confidentiality and
encryption methods to secure communication
• Process for documentation and storage of
information including how electronic information is
stored, accessed and disposed of
• Possibility of interruption caused by technology
failure
• Methods of alternative communication if
technology fails
• Methods, expectations and frequency of contact
and protocol for contact between sessions
• Emergency Contact information and Plan
• Involvement of third parties and procedures for
coordination of care with other professionals
TECHNOLOGY & PRIVACY RISKS
29. AMA’s Quick Guide to Adopting Telehealth
• Set up a team that will help facilitate the expedited
implementation of telemedicine services and be able to make
decisions quickly to ensure launch as soon as possible.
• Check with your malpractice insurance carrier to ensure your
policy covers providing care via telemedicine.
• Familiarize yourself with payment and policy guidelines
specific to various telemedicine services. Ensure that you are
providing services in accordance with your state laws and
regulations.
• Licensure
• If you are licensed in the state where the patient is located, there
are no additional requirements
•
https://www.ama-assn.org/practice-management/digital/ama-
quick-guide-telemedicine-practice
30. Vendor Evaluation, Selection & Contracting
• Check with your existing EHR vendor to see if there is telehealth
functionality that can be turned on.
• Reach out to your state association/society for guidance on
vendor evaluation, selection and contracting.
• Introducing new technology into practice quickly can be
challenging, but a few things to keep in mind as you navigate a
speedy implementation:
• Ensure HIPAA-Compliance/BAA in place
• Make sure you understand who has access to and owns any data
generated during a patient visit
•
31. Workflow & Patient Care
• Determine when telehealth visits will be available on the schedule
• Set up space in your practice to accommodate telehealth visits. This
can be an exam room or other quiet office space to have clear
communication with patients.
• Ensure you are still properly documenting these visits – preferably
in your existing EHR as you normally would with an in-person visit.
or telehealth visits.
• Ensure you receive advanced consent from patients for telemedicine
interactions. This should be documented in the patient’s record. Check
to see if your technology vendor can support this electronically.
• Let your patients know the practice is now offering telehealth
services when they call the office. Have your office staff help
support pro-active patient outreach. Additionally, post
announcements on your website, patient portals and other patient-
facing communications.
• Have a plan for supporting patients on how to access telehealth visits
based on your practice’s technology and workflow to keep the clinic
flow moving and avoid disruptions to care.
After several weeks, our world community is still in the wake of the coronavirus pandemic. Behavioral health providers are quickly acting and ramping up to be able to provide remote care – so clients are still able to receive mental health and addiction services – while also ensuring social distancing practices are in place to limit exposure to the virus. This is a time where panic and uncertainty can cause mental illness to worsen, and clients to become more symptomatic, so ensuring access to care via telehealth has never been more critical. Clients struggling with mental health or substance use disorders are depending on agencies to understand policy and legislative changes in order to leverage technology to ensure that they receive continuity of care; providing medically necessary behavioral health supports that could prevent relapse or decompensation.
Tom would like us to mention this:
The Alaska Department of Behavioral Health provided a webinar last Friday 3/27 focusing on SUD treatment providers and telehealth. They provided a clinical checklist, reviewed legal, ethical, and patient safety concerns, as well as privacy/HIPAA concerns.
Providers are quickly searching for virtual technology solutions – if they don’t already have them in place. They are looking to augment care delivery models or completely change them temporarily in some states. Technology will enable you connect with and serve your clients in their homes, but finding the right technology platform and implementation plan is important. In this webinar, we will cover the following:
Review of federal policy and legislation changes applicable to behavioral health providers
Review of state policy and legislation changes in Alaska
Telehealth service provider option
General strategies and best practices for selecting and implementing telehealth quickly
On March 6th, Congress passed the Coronavirus Preparedness and Response Supplemental Appropriations Act. This legislation allowed for CMS announced that Medicare will temporarily pay clinical professionals to provide telehealth services to beneficiaries across the entire country.
On March 13th, president Trump announced an emergency declaration under the Stafford Act and the National Emergencies Act. In conjunction with the president’s declaration, CMS expanded Medicare’s telehealth benefits under 1135 wavier authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. This provides regulatory flexibility to ensure that our most vulnerable populations – those struggling with mental illness and addiction – are still able to receive the services that they may need even more with the fear associated with a pandemic.
On March 17th, CMS announced expansion of the Medicare telehealth coverage that will enable clients to receive a wider range of health care services via telehealth remote services. The Office for Civil Rights (OCR) and the Department of Health and Human Services issued guidance that the enforcement of HIPAA penalties around telehealth, patient communication, and remote communication technologies will be suspended during the COVID19 emergency.
On March 18th, the DEA temporarily lifted that in-person requirement to allow for easier e-prescribing during the COVID-19 emergency.
CMS being a part of the Department of Health and Human Services that administers the Medicare program, works in partnership with state governments to administer Medicaid and other health insurance programs. State governments are working with CMS towards 1135 waivers to ensure all Medicaid beneficiaries are able to receive remote services from healthcare facilities with reduced barriers.
March 19th, Substances Abuse and Mental Health Services Administration has also issued guidance around 42 CRF Part 2, and waiving the patient consent requirement for disclosure of health information during an emergency, with providers being allowed to make their own determination whether a bona fide medical emergency exists for purposes of providing needed treatment to clients.
Due to aforementioned legislation, a wide range of health care professionals are now able to provide telehealth services to beneficiaries for a wide range of behavioral health and addiction services.
Tele-health was once thought of to be a fad that would not be useful in mainstream healthcare, with the exception of care delivery in rural settings. That said, we are now at the precipice of a change in paradigm due to a pandemic – coupled with a generation of technology enabled digital natives – that will demand services being delivered remotely in the future. Innovation, technology, and human compassion are paramount in reducing the cost of care, improving population outcomes, and improving upon continuity of care and overall client satisfaction. Healthcare leaders are very concerned about the long-term impact on service lines and overall revenue, and are quickly looking into virtual care options for now and that impact their long-term strategies moving forward. The two primary methods being used are telephonic and virtual video-enabled sessions.
Tele-health was once thought of to be a fad that would not be useful in mainstream healthcare, with the exception of care delivery in rural settings. That said, we are now at the precipice of a change in paradigm due to a pandemic – coupled with a generation of technology enabled digital natives – that will demand services being delivered remotely in the future. Innovation, technology, and human compassion are paramount in reducing the cost of care, improving population outcomes, and improving upon continuity of care and overall client satisfaction. Healthcare leaders are very concerned about the long-term impact on service lines and overall revenue, and are quickly looking into virtual care options for now and that impact their long-term strategies moving forward. The two primary methods being used are telephonic and virtual video-enabled sessions.
This is an example of the most common service to be provided in client’s homes, and the services level hierarchy that has been established.
Regional and national approach to provide 24/7 services
Next Day Urgent Appointments – made by our Mobile Outreach Team, there are certain number of slots available. No appointments for the weekend
St. Louis and St. Charles County for Texting and Chat