{"id":26471,"date":"2020-03-07T20:25:27","date_gmt":"2020-03-07T20:25:27","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=26471"},"modified":"2020-03-07T20:25:27","modified_gmt":"2020-03-07T20:25:27","slug":"telehealth-beyond-the-hospital","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/telehealth-beyond-the-hospital\/","title":{"rendered":"Telehealth Beyond The Hospital"},"content":{"rendered":"\n

The industry of telehealth is expanding for many reasons,\nincluding increased access to technology, a demand for more affordable health\nservices and the desire for convenient care. Research findings projected a\ncompound annual growth rate between 2014 and 2020 of 18.4%<\/a> for\ntelehealth services.<\/p>\n\n\n\n

Telehealth can reduce<\/a> initial hospital admissions,\nreadmissions, length of stay<\/a> and mortality rates. By\nexpanding telehealth services to the outpatient industry, emergency department\nvisits are reduced, patient engagement and health management are encouraged,\nand the overall cost of chronic disease management is lowered.<\/p>\n\n\n\n

Policy\u2019s Impact On Telehealth For Outpatient Care<\/strong><\/p>\n\n\n\n

While telehealth has been primarily limited to hospitals\nin the past, that\u2019s changing with the expansion of telecommunications and the\nintroduction of new policies. Both the Medicare Access and CHIP Reauthorization\nAct (MACRA) of 2015 and the CMS\u2019s Patient-Driven Groupings\nModel<\/a> are prompting outpatient healthcare clinicians to\nincreasingly adopt telehealth.<\/p>\n\n\n\n

The CMS\u2019s final rule<\/a> is\nalso expanding Medicare Advantage telehealth benefits as of the 2020 health\nplan year. With increased access to preventative and medical care outside a\nhospital setting, we can expect to see decreased costs for both providers and\npatients along with more positive patient outcomes. Virtual physician-patient\nvisits may become the norm for senior-aged patients residing in rural areas and\/or\nthose who have a history of noncompliance with prescribed medication. That\nsaid, Medicare coverage is still limited in terms of home healthcare and tends\nto be directed toward rehabilitation centers and nursing homes.<\/p>\n\n\n\n

MACRA\u2019s Impact On Telehealth Utilization<\/strong><\/p>\n\n\n\n

MACRA is a CMS value-based payment model that provides\nfinancial incentives to healthcare providers with high-quality ratings through\nits merit-based incentive payment system (MIPS)<\/a>. The\nMIPS-calculated quality score is derived from the following four categories:\nquality reporting (50% of score), promoting interoperability (25% of score),\nimprovement activities (15% of score) and cost\/resource use (10% of score). The\naddition of the 2018 CMS Quality Payment Program (QPP) Final Rule promotes\nthe increased adoption<\/a> of\nremote patient monitoring by physicians nationwide. The inclusion of telehealth\nutilization as a factor in calculating incentives for healthcare providers\nfurthers the widespread use of telemedicine practices.<\/p>\n\n\n\n

Telehealth And In-Home Patient Health Education<\/strong><\/p>\n\n\n\n

While patient education is widely recognized as critical\nfor hospitalized patients preparing to return home, home-based clinical care is\nnot usually reimbursable by Medicare and most commercial insurers for more than\na short time period. Therefore, patient education (such as medication\nmanagement) can lack the reinforcement necessary for optimal patient\nunderstanding and retention.<\/p>\n\n\n\n

Telehealth allows patients access to doctors and nurses\nfor follow-up care without requiring an in-person at-home visit. This can\nreduce the number of hospital readmissions and improve the health of\noutpatients. Telehealth\u2019s ability to improve the health status<\/a> of outpatients\nhas been shown in the case of diabetes management via remote glucose monitoring\nalong with virtual diabetes education.<\/p>\n\n\n\n

In its 2016 report<\/a> to Congress,\nthe Department of Health and Human Services (DHHS) noted remote patient\nmonitoring (RPM) has been used primarily for the management of chronic illness\nand the use of devices such as Holter monitors tracking blood pressure to\nconvey health-related data to patients\u2019 physicians. This type of communication\nbetween doctors and patients allows for early detection of symptoms and\nintervention as well as increased patient education. The following four\ntelehealth modalities are described in the report as the most commonly used:<\/p>\n\n\n\n

Live video:<\/strong> Two-way real-time telehealth\nutilization.<\/p>\n\n\n\n

Store-and-forward (SFT):<\/strong> Transmission of video and digital images.<\/p>\n\n\n\n

RPM:<\/strong> Personal health and medical data\ncollection, either real-time or SFT.<\/p>\n\n\n\n

Mobile health:<\/strong> Use of an app for\nclinician-patient communication, RPM, education and\/or appointment reminders.<\/p>\n\n\n\n

Chronic And Preventable Disease Management And\nTelehealth<\/strong><\/p>\n\n\n\n

By properly managing chronic conditions, emergency\ndepartment visits can be avoided and costs lowered. Telehealth provides a\nconvenient and affordable outlet for those with chronic conditions to\nconsistently manage their health.<\/p>\n\n\n\n

Asthma, for example, is the most prevalent chronic\nchildhood disease, and 2.3%<\/a> of all emergency department visits\namong children in the U.S. are due to an acute asthmatic episode. Additionally,\npoorly managed asthma can turn into COPD in adulthood. Meanwhile, Type 2\ndiabetes, a preventable condition, is considered to be at epidemic levels in\nthe U.S. by the Centers for Disease Control (CDC)<\/a>,\nand clinical depression, a treatable condition, affects 6.7%<\/a> of adults in\nthe U.S.<\/p>\n\n\n\n

The telehealth industry is working to stop the\nprogression of preventable and treatable diseases such as diabetes and\ndepression by identifying those at risk and providing ongoing treatment.\nTelehealth offers a way to monitor high-risk patients and provide more frequent\ninterpersonal interactions in order to intervene quickly if a complication\noccurs or nonadherence to the care plan is suspected. In this way, the\nskyrocketing healthcare costs associated with chronic disease management may be\ncontained.<\/p>\n\n\n\n

Telehealth\u2019s ability to track daily food intake and vital\nsigns, symptoms and self-care, accountability, and data acquisition and\nsharing, for both providers and patients, prevents needless chronic disorders\nand emergencies and reduces the cost burden associated with a lack of ongoing\ncare. For these reasons, we can expect to see more policy changes enabling the\nextension of telehealth to an outpatient setting and more people turning to\ntelehealth to help manage their chronic conditions.<\/p>\n\n\n\n

Telehealth Adoption For Outpatient Providers<\/strong><\/p>\n\n\n\n

The adoption rates of telehealth services by outpatient\ncare providers remained flat from 2018 to 2019. Thus, key barriers to increase\nthe use of telehealth must be overcome. For one, many outpatient providers\nsimply do not want to take on the expense<\/a> of\nintegrating new technologies and methods into their care.<\/p>\n\n\n\n

Another major concern is reimbursement from insurance\ncompanies for telehealth services. That being said, roughly 90%<\/a> of outpatient\nproviders already practicing telehealth plan to further invest in their remote\nservices in the next 18 months.<\/p>\n\n\n\n

Despite a slow start, the telehealth industry will\nultimately merge with outpatient providers. To make this transition as seamless\nas possible, both telehealth providers and outpatient providers will need to\ncollaborate to not only implement the necessary technology, but ensure patient\nsatisfaction and positive patient outcomes are maintained.<\/p>\n","protected":false},"excerpt":{"rendered":"

The industry of telehealth is expanding for many reasons, including increased access to technology, a […]<\/p>\n","protected":false},"author":3,"featured_media":26472,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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