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.
The Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange, announced the release of its findings from its February 2015 ICD-10 Industry Readiness Survey. In its March 31 letter to the HHS Secretary, WEDI reported concern with the current level of industry preparedness noting that many organizations did not take full advantage of the additional time afforded by the one-year delay.
“Unless all industry segments take the initiative to make a dedicated effort and move forward with their implementation work, there will be significant disruption on Oct. 1, 2015,” said Devin Jopp, Ed.D, president and CEO of WEDI.
Highlights from the latest survey findings include:
Compliance date uncertainty: Uncertainty around further delays was listed as a primary obstacle to implementation, appearing on more than 50 percent of all responses for vendors, health plans and providers.
Health plan testing: More than 50 percent of health plans have begun external testing, and of these, a few have completed testing. This is a slight improvement from the prior survey.
Vendor product availability: About 60 percent indicated their vendor products were available or they had started customer testing. This is a slight decrease from about two-thirds in the August 2014 survey. However, the number that responded ‘unknown’ decreased from one eighth to just a handful.
Provider testing: Only 25 percent of provider respondents had begun external testing and only a few others had completed this step. This is actually a decrease from the about 35 percent of provider respondents that had begun external testing in the August 2014 survey.
The Workgroup for Electronic Data Interchange (WEDI), a nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange, released the findings from its recent survey on industry awareness and adoption regarding the usage of the “Blue Button” implementation guide for exporting patient healthcare records.
WEDI conducted its first survey on Blue Button in 2013, and as a follow up on the progress of industry adoption since that time, WEDI re-evaluated the industry in 2014. WEDI conducted the survey from Oct. 31, 2014 to Dec. 8, 2014, which included 274 respondents across multiple stakeholders, including providers, health plans, vendors and clearinghouses.
The full survey results can be viewed online and summarized through WEDI’s March 13 letter to the Department of Health and Human Services (HHS). Some key observations WEDI notes from the 2014 survey in comparison to the 2013 findings include:
Relying on integrated electronic health record and medical device data to populate personal health records (PHRs) increased. While provider respondents remained relatively consistent in their use of integrated EHRs, a significant increase occurred for government respondents from 60 percent in 2013 to 100 percent in 2014.
Ensuring awareness of Blue Button as an industry-wide tool remains an opportunity.
Offering the PHR to all patients when implementing a PHR continues to be significant. There is a high percentage (80 percent in 2014) of respondents that are offering the PHR to all patients/members as opposed to only making it available to select subsets of their patients/members.
Enabling the patient/member to retain control over who has access to their PHR data through privacy controls continues to be important.
Transmitting data to patients, providers or authorized third parties appears to occur through DIRECT. Health plan and provider respondents both showed an increase in use of DIRECT for transmitting data, while government and technology developer respondents showed a decrease in use of DIRECT.
Providing patients with a better overall experience continues to show traditional communication methods as top priorities.
The Louis W. Sullivan Institute for Healthcare Innovation, which is dedicated to distribute health information technology innovation to transform quality and efficiency of healthcare delivery worldwide, announced the release of “A Year in Review: An Update on the 2013 WEDI Report & Roadmap for the Future of Healthcare Exchange.” The industry report evaluated public and private stakeholder progress in critical areas of focus.
The 2013 WEDI Report, the first roadmap for healthcare information exchange produced by WEDI since 1993, provided a framework for the next generation of healthcare information exchange designed to lower healthcare costs, improve healthcare delivery, and achieve better healthcare outcomes. In the past year, the Louis W. Sullivan Institute for Healthcare Innovation has monitored those stakeholder efforts to drive improvements through technology and data exchange, and has produced a progress report on those initiatives, which can be found here.
The initial report identified four key areas of focus and 10 related recommendations that would advance healthcare information exchange. Summarized below are assessments of how industry has performed in each of the core focus areas:
Progress rating = Green
Although the industry has lagged in driving improvements in health IT literacy, there has been continued momentum in patient information capture and patient identification. Private sector efforts, combined with a new federal vision and roadmap for health IT, are deemed to be on pace in meeting WEDI recommendations.
Progress rating = Yellow
Over the past several years, new payment models have leveraged technological advances to rapidly iterate, evolve, and scale across the country. However, models such as ACOs have yet to fully mature, and their success and sustainability remain uncertain – particularly in light of the mixed performance seen in 2014. A framework of core attributes and technological functionalities has yet to be developed and the industry needs further directed efforts to achieve the recommendations outlined in the initial report.