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.

What You Need to Know: Final 2021 CMS RPM Guidelines

What You Need to Know: Final 2021 CMS RPM Guidelines

We’ve done the hardwork so you don’t have to.

On December 1, 2020, the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS) issued a Final Rule which went into effect January 1, 2021. The Rule published in the Federal Register on 12/28/20, includes changes to the 2021 Physicians Fee Schedule (PFS), various payment policy updates and finalized provisions of the interim final rules which were issued in 2020 and related to the Public Health Emergency (PHE) and COVID-19.

This 2021 CMS Ruling contains critical updates to codes, especially for Remote Patient Monitoring which we have formatted into a short pdf just for you.

We read every page and brought the key elements down to five pages. If you’re concerned about how the CMS ruling will impact RPM in your practice, click here to read on… we’ve done the hard work for you.

Final 2021 CMS RPM Guidelines

General Guidelines

During the pandemic, a physician may order RPM for both new and established patients. Post-pandemic, RPM may only be ordered for established patients, requiring a prior visit with the billing provider either in person or via telehealth.

Patients must consent to receive RPM services, but consent may be obtained at the time that RPM services are first furnished rather than ahead of time.

RPM may be ordered for patients with either chronic OR acute conditions. RPM codes….read full overview

Learn More

To learn more about DocsInk and our solutions, please visit www.DocsInk.com.

One Patient’s Perspective

One Patient’s Perspective

Working for DocsInk

As marketing director for DocsInk, I’m excited to work in an atmosphere of innovation and collaboration, but my focus is usually on the product and business itself. However, I’m sometimes reminded that what we do goes beyond the product, impacting the lives of real people. COVID-19 has pushed our healthcare system to its limits, and because of this caregivers need integrated, efficient technology solutions more than ever. I recently spoke to a patient who expressed his frustration connecting with his doctor:

2020 has been a hard year for me, health wise. I’ve had nagging respiratory issues that have cost lost wages and sparked COVID fears. I’ve been tested three times, all negative, but had to miss several weeks of work in order to meet quarantine requirements. In the last few months, persistent symptoms have prompted frequent telehealth visits. These visits have often resulted in frustration due to the technology being used.

In my daily life, I’m constantly connected to coworkers, friends, and businesses through my phone and laptop. Social media and e-commerce are slick and seamless; why is my telehealth app so dated and clunky? This is a large organization with hundreds of doctors, they should have access to the latest tools! Every visit is plagued by technical glitches—sometimes resulting in abandoning video chat for phone calls—and the doctors are consulting other devices or paper notes for my records. I have electronic notes on my laptop; why is my doctor wasting time fumbling for them? While I understand caregivers are under tremendous strain this year, my health issues are putting real pressure on me and my family. It just seems to me that updating their systems would help them help me AND relieve some of the pressure they’re feeling.

What it means to me

Hearing stories like this reminds me that “improving patient outcomes” is not just an abstraction. Sure, streamlining the process of telehealth improves efficiency, but that efficiency has a real impact on real people. And, at this point in the game, not using the technology best suited to respond to the needs this pandemic has demanded has an even bigger impact on patients’ lives.

2020 has provided doctors and patients alike with ample challenges; DocsInk ensures that your telehealth solution doesn’t have to be one of them. 

If you would like to learn more about DocsInk, please visit us at www.DocsInk.com.

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

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.