Seniors and Telehealth: Physicians’ 2021 Goal

Seniors and Telehealth: Physicians’ 2021 Goal

Most seniors hope to be able to ‘age in place.’ The idea of living at home as one grows older can extend life, maintain independence, and keep costs lower. Families generally support this desire, but because of increased health concerns they worry. Who will get mom or dad to the doctor?

The potential for telehealth and remotee patient monitoring (RPM) in terms of its impact on aging in place is enormous. It helps with tracking vital signs, communicating with physicians and their offices, and even receiving on-the-spot care via video chat.

Telehealth makes life easier.

Only if it works though, and if it’s easily accessible. We know this to be true, not just intuitively.

McKinsey’s May 2020 report showed a significant uptick in telehealth between 2019 and May of 2020… from 11% of American adults utilizing it to 46% using it as a replacement for in-office visits. And that’s just in May. COVID had barely reared its ugly head by then.

But what about seniors? If someone didn’t grow up using Internet, then will they be less comfortable with utilizing the technology?

Not necessarily. There has been a massive increase in use of telehealth from those on Medicare. Telehealth visits rose from about 10,000 virtual visits per week to about 1.7 million per week, with older Americans comprising a significant percentage of that total.

And from now on, according to AARP, 20 – 30% of all medical care is expected to be delivered digitally. And that’s good, in part because according to a study at Brigham and Women’s Hospital in Boston, patients heal better at home.

Better Access. Better Communication.

What then can we do to make seniors feel comfortable with the technology?

Address their concerns: access and communication.

There are two kinds of barriers to telehealth access: access to the Internet; and accessible/easy-to-use technology. Internet access restrictions are worse in rural areas. In fact, nearly one quarter of all rural residents do not have access to reliable broadband (FCC 2019).

That is changing rapidly, however, with public/private partnerships and both federal and state funding increases. Healthcare associations can influence, however, by putting more pressure on government agencies to assure equal access. Once broadband to the home is available, however, raises the question of cost. Will fees associated with adoption be palatable to seniors on a restricted budget? For some, no. But just as many are reviewing cost of care, learning that telehealth is covered may encourage them to try.

Accessible technology – hardware and software — is changing rapidly.

Hardware has become easier to use, with voice automation technology and touchscreen input. From inexpensive tablets to devices such as Amazon Echo, it is easier than ever to make the technology connection.

Software, on the other hand, has taken a bit longer to evolve. The interface that physicians choose for their patients can make the difference between accepting the technology and rejecting it. At DocsInk, we created a user interface that makes it simple to get onboard.

In fact, it’s a simple four step process:

1. The physician’s office simply sends an email notification to the patient with instructions on creating a unique password.

2. The patient clicks on the link and downloads the DocsInk patient care app.

3. The app walks them, step-by-step, through a simple onboarding process.

4. Within minutes, they are connected and sharing health data with their provider in real-time.

Simplicity is key. The bottom line is that the provider should select the solution that simplifies technology adoption not only for the practice but for the patient as well.

Bridge the gap between patient and technology.

Not all seniors are put off by telehealth. Not all patients are afraid of technology. Most all patients do need technology support, however!

It’s important for the staff to understand where each patient is, individually, in terms of how technology is perceived. Is it a boon or a barrier? Are they welcoming the change or pushing back against it?

Take the time before the first telehealth visit to offer insight into what the visit will be like. Provide a written checklist that reassures the patient that they will have an experience that works.

The American Psychological Association Services posted a list of things that can be done to make it easier for older adults to adapt to telehealth. You can access that list by clicking here.

The right direction.

The pandemic pushed us to take seriously adoption of telehealth for home health. According to Andrew Gettinger, M.D., chief clinical officer in the Office of the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services, it has pushed us in the right direction.

“This new ecosystem is potentially far more powerful than going to see a doctor once or twice a year. Home health is very rich and provides a whole new way of caring for folks.”

It’s up to us to make it easy enough to work. If your system is lacking, DocsInk can help.

To learn more about DocsInk and our solutions, visit us at www.DocsInk.com or contact us here.

RPM: Lowering Hospital Readmissions, Improving Outcomes

RPM: Lowering Hospital Readmissions, Improving Outcomes

Hospital readmissions are a dreadful reality for facility and patients alike. Remote Patient Monitoring is a viable solution for both.

Adverse effects for hospitals include enormous costs. Costs estimated to be in the vicinity of $26 billion annually. Operations suffer and HCAHP scores fall.

The negative effect on patients is also noticed. The undue stress and frustration may make them feel as their health issues are unmanageable.

There is hope, however. Research has demonstrated that the use of Remote Patient Monitoring (RPM) can positively impact both hospitals’ concerns and the patients’ worry.

Although the effect of readmissions on hospitals is widespread, the populations experiencing readmission most are chronic and acute care patients. The top two of these chronic conditions are congestive heart failure (CHF) and diabetes.  For these chronic conditions, remote patient monitoring reduces readmissions and generates recurring revenue. It has also has proven to increase health outcomes in those patients with CHF and diabetes.

    Impact on CHF

    Congestive heart failure is the leading cause of death in the United States. According to the CDC, one person dies every 36 seconds in the U.S. from cardiovascular disease. Progress in fighting the disease, however, improves annually with better medications, use of wireless sensors, and advances in sleep apnea treatment. Yet still, readmittance in this population is staggering. One in every five patients is readmitted within the first 30 days of discharge with a median readmission time of 12 days from initial discharge.

    Readmission is expensive. The national mean cost of a CHF admission per year is $34,000 with an average 30-day, 60-day and 90-day readmission rate of 22.3%, 33.3% and 40.2% respectively. According to the American Heart Association, the costs of CHF readmissions continue to rise, at a current average of $13,500.

    What is being done to help lower readmissions for heart patients?

    Improvements in the management of Medicare beneficiaries, prior to and after initial hospitalization for CHF. This alone has the potential to prevent hospital readmissions. Not only are there cost savings, but persons living with this chronic condition see big benefits as well.

    Secondly, we’re seeing more proof that RPM could be the key. The National Library of Medicine includes a study that demonstrates how RPM directly reduces mortality, hospitalizations, and improves quality of life for CHF patients.

    By remotely monitoring  blood pressure, heart rate, weight and ECG, health plans such as Geisinger have effectively managed patients with heart failure. Since 2008, Geisinger Health Plan has used RPM to reduce the risk of all-cause readmission for their Medicare Advantage members by 77%.

    Geisinger is not alone. Similar studies demonstrate that when RPM is used to treat cardiac patients, readmissions related to heart failure are reduced by 64%. In turn, that results in a net savings of $5,034 per patient, per year when compared to standard care without RPM.

    Impact on Diabetics

    Diabetes is another leading chronic condition. In fact, more than 34 million Americans had diabetes as recently as 2018, according to the CDC. It’s an expensive illness, for those with diabetes incur average medical expenses of $16,752, roughly 2.3 times higher than those incurred by patients without diabetes.

    Diabetes impacts Americans of all backgrounds, all ages. Veterans seem to suffer from it in larger numbers with a quarter of all veterans having diabetes. This led the Veterans Health Administration (VHA) to conduct a study on diabetic veterans, each of whom had two or more prior hospitalizations or ER visits.

    The VHA found when RPM was used for one year re-hospitalizations were reduced by 50% and emergency room visits were down 11%.  Additionally, the average number of bed days were three days shorter. And finally, 95% of these veterans reported a high patient satisfaction rate with the RPM program. Satisfaction drives usage, and therefore ongoing health benefits can be expected.

    Of course, it’s not just the VA that is looking to determine the efficacy of RPM programs. Comparison studies have been conducted by many other independent researchers, and the results are encouraging. Those using RPM saw a 77.2% improvement in their health, versus only 70.4% improvement in stability for those not using RPM solutions.

    Benefits: Clinical and Fiscal

    Based on the results of the above-mentioned research, patients benefit greatly from use of remote patient monitoring solutions. And of course, we have noted the benefits that hospitals and physician groups see. But there is also great benefit to insurance payers.

    The Coalition to Transform Advanced Care (CTAC) and America’s Health Insurance Plans (AHIP) published an article which sites several studies. Each of these reported positive clinical and fiscal benefits of RPM programs.

    Patients in RPM programs reported significantly fewer care requests:

    • 51% fewer on-call urgent visits
    • 47% fewer physician visits
    • 41% fewer phone calls related to patient care
    • 40% reduction in hospitalization of senior citizens
    • Medicare members are 76% less likely to experience hospital readmissions when using RPM
    • 94 – 97% of patients noted their satisfaction with the RPM programs.

    Implementing RPM with DocsInk

    With DocsInk’s RPM solution, implementation is seamless. Account setup and EHR integration takes only minutes to complete and patient onboarding has never been easier. DocsInk’s solution allows clinicians to quickly monitor, assess and address their patient’s health in real time and instantly bill for services rendered. With 475+ integrated monitoring devicesand multi-configurationRPM programs, DocsInk was built to fit the needs and workflow of any size healthcare facility. DocsInk’s solution can help manage chronically ill patient populations and in turn, decrease hospital visits, increase provider’s monthly revenue and improve overall health outcomes.

    To learn more about how your organization can benefit from DocsInk’s RPM Solution, email or call 888.577.7409.

    Increase patient engagement. Reduce costs. Maximize efficiency. Improve health outcomes.

     

    Click Here to learn more about DocsInk’s RPM solution

    Behavioral Health: The Next Tele(mental) Health Frontier

    Behavioral Health: The Next Tele(mental) Health Frontier

    Anxiety. Depression. Substance abuse. Treating these and other behavioral health issues has historically meant in-person meetings with practitioners, therapists and physicians. However, the isolation-induced times in which we now live have escalated both the underlying issues and restricted access to traditional forms of treatment.

    According to the National Institute of Mental Health, nearly one in five U.S. adults live with mental illness. Now more than ever there is a series of barriers that keep the experts from reaching their patients – namely social distancing and quarantining. As these precautionary mandates continue, the need for behavioral health services has increased.

    The Need for Telehealth Services

    Even before the current pandemic, research conducted by the University of Michigan showed only 18% of those needing substance abuse disorder treatment were receiving care. Prior to COVID-19, less than 10 percent of the US population used telehealth for a clinical encounter and only 18% of physicians provided such services. The study concluded a telehealth solution was needed in order to reduce this treatment gap.

    Now, everything has changed. COVID has sparked an unprecedented urgency that pushed telehealth to the top of providers’ priority lists. The underlying technology supports this fast adoption. Advances in usability and access to broadband has increased; the result, therefore, is an enormous uptick in usage.

     Telehealth not only reduces the need for travel, but also facilitates more appointments. It also address the spike in behavioral health issues caused by the novel coronavirus. One example of this comes from a report distributed by the CDC, that states 40% of U.S. adults reported struggling with mental health or substance use.

    Mental health conditions are worsening. To address this growing need, the Centers for Medicare and Medicaid Services (CMS) has broadened access to Medicare telehealth services so that a wider range of services can be made available. In March, CMS explained the 1135 waiver, where Medicare can pay for office, hospital and other visits furnished via telehealth. This includes mental health.

    The new focus on utilizing telehealth to reach those with behavioral health needs has spawned a new term: Telemental Health (TMH).

     

    Bringing Telemental Health to Life

    Nearly all who struggle with mental health can benefit from TMH especially veterans and citizens of rural communities.

    Veterans Benefit

    When it comes to Veterans, most of the research revolves around PTSD treatment focusing on the success of treatment delivered via video teleconferencing. According to Veterans Affairs (VA) PTSD and telehealth studies, the major benefit of TMH is the elimination of travel. Travel can be costly, transportation may be unavailable, or, more importantly, it may be disruptive to treatment.

    An additional benefit, TMH can be a useful tool in unusual situations. For example, some correctional and forensic settings make it difficult to transport the patient to a clinician. And finally, telemental health allows for care when unexpected circumstances make clinic access less possible, such as the patient’s need to travel or providing service within a disaster zone.

    The impact and effectiveness of Clinical Video Teleconferencing (CVT) initially raised questions, especially as it pertained to suicide. However, the VA has gathered research that proves CVT delivery is feasible and clinically effective for PTSD treatments. Therefore, the VA has expanded the populations served via telemental health.

    Rural Households Benefit

    Unlike other types of health care, behavioral health care includes unique challenges facing the provider and the patient. These challenges are made worse in rural areas as discussed in the University of Michigan article mentioned above, The Use of Telehealth Within Behavioral Health Settings.

    Several challenges to the provision of behavioral health services exist. The first is the unequal distribution of access to behavioral health providers. These workforce shortages in certain geographic areas are driven by multiple issues, yet telehealth can help alleviate those effects. TMH provides a link between clients in their home communities and behavioral health providers in other locations.

    Additionally, anonymity and privacy can be important to individuals seeking services associated with mental illness. In small rural communities, individuals may face a lack of privacy and might resist face-to-face treatment. By offering services via TMH, individuals can maintain a higher level of privacy.

    Who is serving, and how?

    Telemental health has opened opportunities for providers to reach patients that would otherwise not be receiving treatment for behavioral health problems. Hospitals and even pharmacists connect with patients and consulting practitioners wherever they are. Additionally, studies have found psychiatrists, specifically, are the most common behavioral health professional to use telehealth, followed by mental health counselors.

    Whether that patient is a Veteran, living in a rural community, or at risk for COVID-19, mental health professionals have stepped up their use of TMH. Here are a few applications:

    • For assessments, providers offer online substance use questionnaires
    • Cognitive-behavioral therapy is being offered via videoconferencing
    • Medication management and monitoring is being done through text message reminders
    • Continuing care is offered through group chats, which is helping to prevent relapses
    • Webinars are offered to further educate both clients and providers
    • Interactive video is being used for collaborative consultation

    What are the barriers?

    First, internet connectivity issues. Patients may still face lack of reliable internet access. Especially internet-disabled rural communities. That, however, has been being addressed one county at a time. Since October of 2019, the USDA has invested $744 million to bring high-speed broadband connectivity to 34 states. Many states have their own initiatives, and many internet service providers are working closely with local governments to enable households, healthcare centers and businesses with the high speed required by TMH.

    Second, implementation costs and lack of reimbursement options. DocsInk’s One-tap Telehealth solution addresses these barriers. Their Mobile Charge Capture feature allows for instant billing, drastically reducing reimbursement concerns. Hosting all solutions on a single platform reduces implementation costs making their solution an affordable fit for any size practice.

    Behavioral Health Success = Telemental Health

    Telehealth is important to the success of hospitals and individual practices. More importantly, it is becoming an invaluable tool for improving access to services and quality of care.

    With easy integration, virtual waiting rooms and no apps for patients to download, DocsInk’s One-Tap Telehealth is the solution for improving behavioral health outcomes allowing for more timely access to providers servicing patients in need of psychiatric and mental health services.

    To learn more about how your organization can benefit from Telemental Health through DocsInk’s One-Tap Telehealth Solution, email or call 888.577.7409.

    Increase patient engagement. Reduce costs. Maximize efficiency. Improve health outcomes.

    Wearables and Virtual Care: Engaging Patients, Improving Outcomes

    Wearables and Virtual Care: Engaging Patients, Improving Outcomes

    When Congress passed its 2018 bill expanding Medicare coverage to include telehealth and remote patient monitoring (RPM), options for delivery of patient care expanded. The government and insurance approval set the stage: clinicians could now offer virtual care via RPM and telehealth. It was officially a viable, safe, and effective alternative to traditional services and wearable technology is at the forefront of this healthcare industry change.

    The onset of the COVID-19 pandemic early in 2020 further spurred adoption of RPM and telehealth. It became the primary solution for delivering care outside typical brick and mortar offices. Telehealth became the answer to the question: how can we protect the health of our nation’s population?

    With government, insurance, and patients on board, we are well on our way to widespread implementation of these technologies. A 2019 study conducted by the Consumer Technology Association (CTA) found that 68% of physicians strongly intended to use RPM. Now is the time for the remaining 32% to fully understand the positive impact that remote access to real-time data can have, specifically as it pertains to overall wellness, behavior change, and the treatment of both acute and chronic illnesses.

      Consumers Like Wearable Technologies – Apple Health. Google Fit. Samsung Health.

      While wearables come from many brands and in many forms, most people rely on at least one of these platforms to help them interpret the data their digital coach offers. More than one in four Americans currently use at least one wearable device. According to IDC, wrist-worn wearables are projected to increase to 105.3 million units by 2023.

      These growing numbers demonstrate that consumers increasingly have a keen interest in taking some level of personal responsibility for their health. Clinicians have found that patient engagement is a critical component in meeting clinical goals and improved health outcomes.

      According to the World Health Organization, 60% of factors related to individual health and quality of life are correlated to lifestyle choices. When medical professionals take advantage of technologies already adopted by their patients, they encourage positive habits and provide the feedback necessary for best results.

      The combination of wearable devices and doctor/patient engagement has numerous benefits, including:

      • Correctly taking prescriptions
      • Getting enough exercise
      • Reducing stress

      If people, then, are interested in being more involved, how can physicians better leverage this opportunity? How can they encourage these benefits for patients who are high risk due to acute or chronic illness?

      It’s become a simple answer: incorporate RPM to promote proactive medical care, accessing real-time data and intervening when necessary, based on changes/declines in patient’s vitals and other physiologic metrics.

      Impacting Crucial Metrics

      Remote patient monitoring (RPM) is shown to impact numerous factors, from curtailing recurrent rehospitalizations to better patient/provider care coordination. The holy grail, of course, is improving patient outcomes and reducing costs of care, while balancing workflow efficiency. All this can happen with the application of affordable RPM and telehealth technology.

      • Outpatient services is easily expanded. This is good news for all, but especially for underserved populations and patients in rural areas.
      • Reducing hospitalizations and hospital stays is one of the biggest demonstrable effects. A University of Pittsburgh study from 2020 indicated a 76% reduction in readmissions when RPM is utilized.
      • Improved patient outcomes are seen in more than 49% of those using this technology to manage health, according to the University of Pittsburgh study.
      • Reduced costs of care are reported by many independent studies, which specifically show a net savings of over $5k per patient per year for cardiac patients.
      • Improved compliance is near the top of the list of benefits for both critically and chronically ill patients. Clinical goals are met and conditions improve.
      • Patients more engaged in their health tend to remain healthier. Patient knowledge can result in fewer invasive procedures, fewer missed appointments, and authentic discussions on care options – all of which lead to better clinical outcomes.

      Make It Easy To Implement, Easier To Measure

      As with all science, measurement is the only way to improve. But it’s more than having a watch that tells you things about your health. Patients benefit from clinicians who can connect with them about their daily wellness monitoring. They also benefit from the capability to pair with medical devices which leads to disease management and recovery. The key is to simplify the implementation for both physicians and patients.

      A recent addition to the DocsInk platform for example, provides the ability for clinicians to synch with over 200 wearables. This kind of accessibility takes the pressure off care givers and office managers. It also aligns the devices patients have already invested in with the platform used in the office. Giving patients the flexibility to use the device of their choice makes them more likely to remain engaged in its use.

      In addition, when clinicians need to write an order for specific RPM devices to manage disease process(es), DocsInk connects to countless wearable devices to provide real-time data, notifications and alerts to promote best outcomes.

       Many physicians have historically been concerned about what to do with all this data. How do they begin to sort through all the information to get to insights about the direction of patients’ health? DocsInk research found the best approach is to customize the information being analyzed. Then, deliver only the specific information requested back to each clinician. That data then alerts the appropriate clinical team member to initiate patient touch points and interventions.

       While devices can monitor everything from respiratory rate, oxygen levels, pulse, blood pressure, body temperature and more, we understand that every patient and each provider that cares for them are different. That’s where DocsInk shines. 

      Now Is The Right Time

      When the pharmaceutical industry began its meteoric rise in the 1950s and 1960s, the populations began searching for the next pill that would make them feel better. Today’s patient relies on technology more than pills as they proactively participate in their own health.

      This monumental shift in how consumers approach health management results in an entirely new class of healthcare consumers who expect to be able to solve care problems without an in-person appointment. Patients, now more than ever, look for the option of remote care as they choose their medical providers.

      Now is the time to take advantage of new approaches. Advancements in this field had been on the sensor technology in consumer products, but now there are technologies that provide improved ROI for the medical industry, in addition to providing better patient care.

      Now is the time to implement RPM. The groundwork is laid with more than 284 million internet users in the USA – and that climbs daily with pandemic-inspired rural broadband implementation. Factors like global physician shortages and the evolving healthcare policy landscape should inspire pursuit.

      Increase patient engagement. Reduce costs. Maximize efficiency. Improve health outcomes.

       

      Click Here to learn more about DocsInk’s RPM solution

      Telehealth and COVID19 – General Update

      Telehealth and COVID19 – General Update

      The healthcare industry continues to navigate the challenges caused by COVID-19. Clinicians are working tirelessly to provide high-quality care via Telehealth rather than face to face. Yet it seems that now, more than ever, there is a need for simple, secure, and reliable technology to connect patients to their care teams.

      To that end, telehealth services guidelines have been relaxed. The Centers for Medicare and Medicaid Services (CMS), State Medicaid programs, and many major insurance payers including Blue Cross Blue Shield and United Healthcare have responded. This does two things: firstly, it simplifies reimbursement, and secondly, it expands patient access to care.

      Telehealth changes

      On March 6, 2020, CMS began paying physicians and qualified non-provider professionals (QPPs) for all telehealth visits. For example, 80 additional codes were added for use during the public health emergency.

      Meanwhile, there are other highlights of note:

      • Telehealth is now available to HPSA areas (federally defined rural areas);
      • Patients may receive telehealth visits at home;
      • Providers can get paid as they would if the patient was in the office;
      • CMS will not include “established patient” audits with the billing provider. This allows clinicians to bill for medical services for new patients.

      Here is another conundrum. Telehealth services are typically subject to CMS’ standard co-insurance and deductible amounts. As a result, Medicare patients can be left with a balance due. However, reducing the amounts owed by Medicare beneficiaries can violate the Federal Anti-Kickback Statute, the civil monetary penalty rule, and exclusion laws.

      Consequently, new guidance has been issued. The Health and Human Services (HHS) Office of Inspector General (OIG) has determined that providers should not be subject to these sanctions. This allows for reduced or eliminated beneficiary cost share for telehealth or e-visits.

      In addition, CMS is recognizing new virtual check-in codes for communication-based technology services (CBTS). These CBTS codes include remote evaluation of pre-recorded patient information (CPT code G2010) and virtual check-ins (CPT code G2012). Each has an average allowable amount of between $12 – $15.

      New Resources

      CMS has published two valuable resources. We recommend both: General Medicine Telehealth and Telemedicine Toolkit; and Medicare Learning Network (MLN) Booklet on Telehealth Services. They offer details on telehealth services and billing requirements in response to the COVID-19 health crisis.

      One last recommended reading: COVID-19 State Medicaid & CHIP Telehealth Toolkit. Released in April, its goal is to expand telehealth services as the preferred means of delivering and receiving healthcare.

      Who is DocsInk

      DocsInk differentiates its software from the competition by simultaneously addressing the fiscal, communication, and connectivity needs of medical professionals. Delivered as Software-as-a-Service (“SaaS”), DocsInk is improving the way technology integrates with the various workflows of the healthcare industry. By utilizing the SMART on FHIR platform and protocols, DocsInk has set its platform to create truly integrated and system agnostic services with EHR/PM systems. Beyond our technology, that is native to Mac, PC, iOS, and Android, our team is dedicated to providing customer support and a user experience that is second to none.

      Today, DocsInk provides simple, effective solutions that improve the speed, efficiency, accuracy, and adaptable methods in the delivery of patient care not just as a Telehealth Solution but also Remote Patient Monitoring (RPM), Chronic Care Management (CCM) and Mobile Charge Capture. To learn more visit us at www.DocsInk.com.

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