By Jay Eisenstock, principal, JE Consulting and WEDI board chair.
Virtual visits help providers increase productivity by adding revenue and reducing travel to different clinical settings. However, despite these obvious advantages, 2019 saw an abysmally low utilization rate of less than 10%. Things have monumentally changed. As a local physician characterized telehealth today, convenience is the new quality. Love it or hate it, telehealth is here to stay.
The primary care collaborative conducts a weekly survey of physicians, nurse practitioners, and physician assistants working in primary care on how their practices are responding to the COVID-19 outbreak. Over 80% of respondents indicate their patients accept telehealth visits and nearly half of the respondents plan to continue using telehealth after the COVID-19 crisis is controlled.
Prior to the pandemic, telehealth was seen as convenient and time efficient for patients. It also showed promise for providing access to care for various underserved populations. Today we’ve gone beyond convenience as telehealth has become a necessity for both patients and providers. Increased utilization has been made possible by the relaxation of rules and requirements by both government and commercial health plans. Notably, the use of telehealth had been restricted by design.
Health plans wanted to control how and where telehealth was offered along with who could provide the service. For the duration of the COVID-19 health emergency, most health plans are allowing telehealth to be used in place of in-person encounters. Many are waiving patient cost share and paying providers the same rate as an in-person visit.
Medicare has made the following changes effective during the COVID-19 health emergency: telehealth can be used with both new and established patients, telehealth via telephone will be reimbursed, and providers are allowed to treat patients across state lines. In addition, the Centers for Medicare and Medicaid Services (CMS) is waiving HIPAA violation penalties for utilizing technologies such as FaceTime or Skype.
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The alcohol addiction problem has been there since forever. But with today’s stressful lifestyle and extra exposure, this problem has increased significantly. Many people suffer from this problem. And most of them are teenagers and young people. Also, these people are scared of accepting that they have a problem. They usually live in denial until the problem is clearly visible to everyone around them.
Earlier, people did not have the proper knowledge and information about addiction. So even if they were suffering from it, they would not have known it. Now that people are becoming more aware of things, they know when they have an addiction problem. While the number of people asking of help has increased in the last few years, there are still many out there who do not seek any help. The main reason for them not asking for help is that they are scared of going to a rehabilitation center. But as times have gotten better now, so there are many options for them to choose from.
For a start, they can opt for a home detox plan. These plans help them in getting safety detox from alcohol while living with their family. But this is only possible for the people who have a mild addiction. As their bodies can cope without alcohol easily. But this is not the case with people who have a strong alcohol addiction. They need to be admitted to a rehabilitation center, to receive proper care and treatment.
They can choose from a public program and a private rehab center. Though both of them are equally effective, there are several benefits that one can receive in a private rehab. Some of them are:
Better attention from doctors
As private rehabs have a limited number of patients, so they provide better attention to each one of them. They also customize various treatments and plans according to individual patients. So that each patient is able to recover better and fast. They even examine the patients’ drinking history in order to provide them with a better treatment plan.
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Although we know that medical professionals are trustworthy and discreet, some health conditions of a personal nature mean that you just don’t want to talk to someone else face to face about it.
There can be a wide range of reasons for this to happen and they don’t all necessarily mean that you might be embarrassed about the condition itself. Sometimes it can be that the problem is something that you don’t feel warrants the time or expense involved in going to a medical facility because it is something that you know can be dealt with at home.
Today there are many ways to treat yourself and also to seek advice without having to go through a stressful personal examination. However, if you are unsure about a health problem or are concerned that it might be something serious, you must always do your best to seek out the correct medical intervention.
Discretion
The basic idea of ‘patient confidentiality’ means that your relationship with health professionals across the spectrum should be on the same basis as you would expect from a lawyer or attorney. So if the basis of discussions with a doctor or other medical expert means that discretion will always be taken for granted, what is there to be worried about?
For many, health problems can be an intensely personal thing which they don’t want to share with anyone else, and that can include doctors who might know them quite well. Thankfully, there are ways that you can treat a condition at home without too much fuss.
Digital doctors
As with so many other areas of day to day life, the internet has revolutionized healthcare. This means that engaging with doctors online is now common practice and is becoming increasingly popular from both sides of the equation.
For healthcare professionals themselves dealing with patients and clients online can lead to faster results, less reliance on time-consuming appointments and it also, of course, lowers the risks of infections for all concerned.
When it comes to patients who are worried about privacy or discretion, dealing with a doctor online can make things a lot easier and be much less embarrassing than having a physical examination.
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| The Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS), in conjunction with the HHS Office of Inspector General (OIG) announced a policy of enforcement discretion to allow compliance flexibilities regarding the implementation of the interoperability final rules announced on Mar. 9, 2020, in response to the coronavirus disease (COVID-19) public health emergency. ONC, CMS, and OIG will continue to monitor the implementation landscape to determine if further action is needed.
“ONC remains committed to ensuring that patients and providers can access electronic health information, when and where it matters most. During this critical time, we understand that resources need to be focused on fighting the COVID-19 pandemic. To support that important work and the information sharing efforts we are already seeing, ONC intends to exercise enforcement discretion for 3 months at the end of certain ONC Health IT Certification Program compliance dates associated with the ONC Cures Act Final Rule to provide flexibility while ensuring the goals of the rule remain on track.” – Don Rucker, MD, National Coordinator for Health Information Technology.
“Today’s action follows the extensive steps CMS has taken to ease burden on the healthcare industry as it fights COVID-19. Now more than ever, patients need secure access to their healthcare data. Hospitals should be doing everything in their power to ensure that patients get appropriate follow-up care. Nevertheless, in a pandemic of this magnitude, flexibility is paramount for a healthcare system under siege by COVID-19. Our action today will provide hospitals an additional 6 months to implement the new requirements.” – Seema Verma, CMS Administrator
For the CMS announcement, visit: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index
For the ONC announcement, visit: https://healthit.gov/curesrule.
For the OIG announcement, visit: https://oig.hhs.gov/reports-and-publications/federal-register-notices/index.asp |
By Christopher Maiona, M.D., SFHM, chief medical officer, PatientKeeper, Inc.
With all that the healthcare system has to worry about these days, perhaps it’s time to hit the “Pause” button on health IT deployment.
Or not.
While it’s certainly true that provider organizations can ill afford any disruption or downtime in their health IT infrastructure right now – one could argue a massive EHR replacement project might not be advisable at this moment – it’s equally true that effective, practical health IT is needed now more than ever. Clinicians on the front lines of the COVID-19 response need accurate and relevant patient data from the EHR system, instantly (meaning with one click, not dozens); and they need to be able to collaborate with their colleagues on urgent patient care issues at a moment’s notice, anytime, anywhere.
To that end, nothing could be more practical or timely amidst the COVID-19 patient surge than patient data access and care team collaboration capabilities on mobile devices. Smartphones and tablets are the information access and communication tools of choice for most clinicians, wherever they may be – within the hospital, in a triage tent, quarantined at home, or anywhere in between.
But for hospitals under the gun in the midst of this pandemic, is implementing such functionality really feasible?
Let’s back up, and consider a fundamental truth of healthcare IT: EHRs aren’t supporting doctors the way they were intended to, and are diverting valuable time that could be spent with patients.
Ironically, before the EHR, a physician’s biggest pain point was not having access to enough data. Patient information was siloed, typically in dusty paper charts buried in the basement or out of reach in off-site storage. Physicians didn’t have a comprehensive view of the patient. Now with EHRs, providers should have better access to patient information. Alas, that often is not the case, as vital information is buried in a sea of redundant or irrelevant data within electronic clinical notes.
It is crucial that the healthcare industry empowers physicians with tools that will make them better. Unfortunately, forcing physicians to wait their turn for one of too-few hospital workstations is not making them better. The inexplicable persistence of UIs that fail to effectively parse information in a manner consistent with a physician’s workflow or thought process isn’t helping. Obtrusive, non-emergent automated queries that foster alarm fatigue aren’t helping. System design predicated on a one-size-fits-all user experience strategy hinders delivery of care.
On the other hand, well-designed mobile apps, which afford ready and actionable access to relevant patient data, can accelerate care. And if such apps are (a) an extension of the existing EHR, and (b) as intuitive to use as any consumer app on your phone today, then training and adoption shouldn’t be a problem.
The value of “mobilizing” the hospital EHR goes far beyond effectively caring for patients under crisis conditions. It has become essential for provider collaboration on patient care generally, as physicians today are as “siloed” as patient records once were. We are not all in the same hospital at the same time. Remote access to records and the ability to easily communicate with each other within the context of a patient chart are key to the kind of collaboration that fosters better care.
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By April Gill, senior vice president, solution management, Welltok.
The future of COVID-19 remains a giant question mark right now. But what is clear in this uncertain time is the significant impact everyday factors, commonly called social determinants of health (SDOH), have on a person’s health. Literature shows that up to 70% of a person’s overall health is driven by SDOH, including factors like race, income, education level and more. Knowing about these factors can improve how providers keep patients healthy year-round, but also how they engage, counsel and treat patients as individuals during a crisis like the one we are currently experiencing.
If providers understand what kinds of SDOH their patients are facing, they can better understand what health risks they have today, as well as to anticipate their future needs and risks. They can use this insight to tailor what information they share with whom, using the most effective communications channels.
Consider an elderly patient who does not own a car and relies on public transportation for everyday needs. Before COVID, a provider may have leveraged this insight to connect them to Lyft to get to a clinical appointment.
Now, a provider with this insight would likely do much more – have a telehealth appointment instead, connect them with local volunteers who will deliver groceries so they can maintain a healthy diet without leaving home, and email them facts about how to minimize risk while using public transportation to pick up a prescription, if absolutely necessary. This is just one example of how providers can improve patient care and support by understanding what they experience every day.
But are patients aware of the impact SDOH have on their own health? To find out, Welltok conducted a survey of over 2,000 consumers earlier this year, to get their views on what factors they think affect health, and which ones they would share with their provider. Surprisingly, consumers underestimated how much SDOH influenced their overall health and wellbeing – responding that they only make up about 50% of a person’s overall health. (It’s really 70%). They did have a good understanding of some factors that drive health status – like type of work or who they live with – but not more than half did not understand how daily factors like length of commute also play a role.
Not surprisingly, three out of four people also told us they experienced a change in life in the last year that impacts health. The top ones were a change in 1) stress level, 2) annual income and 3) the amount of debt they have. With most provider interactions being episodic in nature, the opportunity to get to know patients at a personal level and/or stay apprised these changes is extremely difficult. Building off this, consumers were asked to list who they would share these life changes with.
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By Kayla Matthews, freelance journalist, Productivity Bytes.
As COVID-19 cases push hospitals around the country to their limits, medical facilities are facing challenges beyond sick patients. Long hours and an uptick in cyberattacks are putting serious strain on existing cybersecurity defenses. Without the right practices, these defenses may fail, exposing patient and hospital data to hackers and cybercriminals.
Here is why security remains key as the coronavirus outbreak grows more severe — and how hospitals can rise to meet current cybersecurity challenges.
Why Healthcare Data Security Remains Important
While cybersecurity may seem overshadowed by other healthcare concerns, the current crisis makes hospital data security more essential than ever.
Many hospitals and health systems are currently expanding or introducing COVID health data collection programs to get the information needed to combat the novel coronavirus. Many of these same systems are also ramping up data-sharing between institutions to ensure that medical providers around the country have the best possible information to work with.
New operating conditions — like hospitals that set up tents in parking lots to expand their number of available beds — have also changed how hospital systems, like electronic health records, are used and secured.
At the same time, hackers are stepping up their operations and trying to take advantage of the chaos. Security researchers have already noticed a serious rise in attacks like phishing emails, as well as new malicious health tracking and COVID-19–related apps.
Current stress on staff may make hospitals more vulnerable to hacks. Cybersecurity professionals were, on average, overworked before the crisis began — an issue that has likely gotten worse as the crisis has progressed. Doctors, nurses and hospital administrators are working overtime, and organizations are bringing on new workers to manage the increased need for professionals. Existing staff may struggle to keep up with good security practices, and new team members may not receive the full training they need to keep data safe.
New information collecting schemes are critical for medical providers — but if the data they collect isn’t secured, it may also put a lot of patients at risk. This patient information may not seem like the most valuable target for hackers — but health data is actually widely sought after by cybercriminals. These hackers use health information, along with other personal information, to construct comprehensive identity packages about individual patients.
What Hospitals Can Do to Handle Security
There are steps hospitals can take to ensure that patient and hospital data stays as safe as possible — even while the staff is under immense pressure.
During the crisis, operational security will become more critical. Doctors, nurses and hospital staff should be highly aware of what they are sharing on social media. Personal information should be kept private, and employees must take note of any information in the background of the photos they take. A cybercriminal scouring the posts of doctors and hospital workers may find what they need to break into a network — like a password taped to a monitor.
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By A.J. Hanna, vice president client advocacy, SYKES.
People’s knowledge of telehealth isn’t necessarily leading to usage — at least, that is what we found at SYKES as a part of our survey on attitudes toward telehealth. Telehealth, in its purest form, has existed for decades. Physicians, whether by phone, radio, or other forms of transmission, have been calling on clinicians from outside of their communities to assist them with second opinions or provide specialty expertise for many years.
And while the internet has opened up new and more expansive opportunities for telehealth — including making it easier for the remote caregiver and the patient to interact via both video and audio — regulatory restrictions, reimbursement inconsistency, attitudes toward effectiveness and other factors have prevented it from finding its full promise.
COVID-19 and its ability to spread easily and rapidly has pushed the healthcare system in the United States and around the world to take a more expansive view of how telehealth can be used. Given the growing importance of this tool for triage of those potentially infected by the novel coronavirus, we wanted to first assess how many people even knew what telehealth was.
When presented with the question, “Telehealth is the use of communication technologies to support long-distance health care, instead of an in-person appointment. Are you familiar with telehealth?,” over 42 percent of those contacted for this survey were not even aware of the service (in excess of 1400 people). While usage of telehealth services has increased over the last several years, there are still many people who do not equate services available to them as being telehealth.
Of those few in our survey who knew what telehealth was and had actually used the service, satisfaction rates were very high. This follows trends from other studies that find that telehealth satisfaction levels exceed other parts of the healthcare industry. And not surprisingly, the primary benefit that they cite is the ability to avoid being with others in a clinical waiting room. But for those who had not been engaged in a telehealth visit, or had not considered the service, some expressed concern that telehealth would only be effective for minor illnesses and diagnoses. Others felt that a diagnosis would be difficult without the “touch and feel” aspect of a care visit.
Perhaps not surprisingly, respondents in the 55+ age group were less likely to have used telehealth or expressed concerns about its effectiveness. Because many in the upper level of this age group are likely Medicare beneficiaries, and because coverage by Medicare has been restricted to specific conditions, geographic regions and care settings, this is not surprising. Recent decisions by the federal government to relax restrictions for Medicare coverage of telehealth as a result of the novel coronavirus pandemic may help to close the gap in utilization represented in our survey.
If there is any outcome of the current pandemic as it relates to telehealth, it may be that it will encourage more people to consider using it. Nearly 60 percent of respondents indicated that COVID-19 has made them more likely to consider using a telehealth service in the future. Almost 25 percent of our respondents had not linked COVID-19 to their opinion of using telehealth. However, those numbers will surely change as the health system in the United States continues to utilize all means necessary to care for the health of people in ways that prevent further spread of the disease.