Tag Archives: remote patient monitoring

Why Telemedicine Has Failed

telemedicine consult

Telemedicine, the use of technology for remote patient monitoring and medical consultations, is experiencing growing pains in the U.S. It’s a logical response to ballooning healthcare expenditures and an ever-increasing physician availability shortage. Integrated with patient portals, patient engagement mobile apps, remote patient monitoring software and health tracking apps, telemedicine is also part of a growing market for patient engagement solutions.

However, going virtual with healthcare has not been straightforward, and has taken longer than anyone would have expected. For telemedicine to reach its potential, we need to address lags in adoption, privacy concerns, and health policy barriers.

Adoption: Generating Physician Buy-In

There are many private companies that specialize in telemedicine, such as virtual care applications or 24-hour “ask a doctor” services. The other option is a physician who has regular appointments also checking in with patients remotely via a telemedicine portal or a similar application. In this case, many physicians don’t want to change how they do medicine. For a successful transition to a hybrid format, first and foremost, the reimbursement must be there. Reasonable reimbursement for telemedicine is still mostly limited to certain states and is simply not enticing enough to drive telemedicine. A perfect example of this would be the use of chronic care management solutions for CPT code 99490 – which has seen unexpectedly low utilization. The evidence that telemedicine and patient engagement improves outcomes is still lacking as well.

Adoption: Developing Accessible Patient Engagement Solutions

Patients with chronic conditions that require frequent check-ins has a tremendous amount of potential to benefit from telemedicine. Older and typically less tech-savvy seniors are now surprisingly proficient with technology. For example, it may be hard for them to connect or use remote patient monitoring devices between office visits. On-screen interaction may not be easy for those with limited vision. This makes it difficult to engage patients. These obstacles can be overcome with accessible technologies, and health IT professionals should focus on this.

Privacy: HIPAA Compliant Remote Patient Monitoring and Consultation

In telemedicine, personal health information is sent in several ways, including text, audio, video, images, and real-time remote patient data from sensors. This worries healthcare providers, who need to comply with HIPAA privacy rules. While the tools we use daily may not meet standards (video, email, SMS) there are specialized platforms out there that do, the Bridge Patient Portal platform being one of them. These are essential to best practices in telemedicine.

Policy: Taking Advantage of in Interstate Licensing

States have different requirements about where a physician needs to be licensed to provide telemedicine services: In some cases, it’s the state where the practice is located. In others, it’s the state where the patient is located. Over twenty-six states have now introduced or enacted Interstate Medical Licensure Compact legislation, which will make it easier for physicians to practice in several states. As more states join, medical practices may need to be guided on how to get their healthcare teams licensed.

Policy: Addressing Different Reimbursement Rules Across States

Reimbursement is another area of inconsistency: Rules about which telemedicine services need to be covered by Medicare, Medicaid, and private insurance vary from state to state. This is being considered at the federal level. In the meantime, healthcare providers need easy access to centralized, up-to-date information on relevant policies.

By harnessing our society’s tech habits to engage patients and help physicians do their jobs better, telemedicine has lots of potential. At this stage, it faces roadblocks like privacy concerns and policy red tape. It’s important to equip healthcare providers with resources for navigating these issues. On the product end, we need to develop technologies that make telemedicine accessible and effective for both physicians and patients.

5 Things to Consider Before Implementing e-Prescribing

e-prescribeOffering important advantages like fewer errors, decision support, improved adherence, and reduced adverse drug events, e-prescribing has skyrocketed in the past several years. In April 2014, 70% of physicians were issuing Surescripts network e-prescriptions and 96% of community pharmacies were enabled to accept them.

If your practice is not on board yet, a few key points can help you optimize e-prescriptions for better care management.

1. Determine how your physicians can use e-prescribing as a care management solution.

Any system change faces challenges in adoption. Ideally, the e-prescribing option you go with will fit and build on your practice’s current workflow. Examine the prescription process and assess your practice’s medication management needs. Asking physicians what tools would help them do their jobs better generates buy-in and yields the best results.

2. Consider your patient population and take time to teach them about the new system.

Younger, tech-savvy patients are likely to welcome the switch to e-prescriptions. This population will be eager to take advantage of new opportunities like reminders to take meds, e-requests for refills, and access to drug information through patient portals.

Meanwhile, older patients will need more orientation on these tools. Build in appointment time for explaining the new process. For patients who are not comfortable going virtual, consider coupling e-prescriptions with printed ones or providing medication fact sheets. An effective care management solution should take into account patient as well as physician needs.

3. Select priority functionalities like remote patient monitoring or HIPAA-compliant patient portal integration.

While automated checks on duplicates, dosage, allergies, and drug interactions are fairly standard decision support features, think about other functionalities you want to prioritize in your choice of an e-prescribing system. If your physicians are on board with remotely monitoring medication adherence, you may want a system that offers a mobile phone app. Patients can track when they take their meds and record any symptoms, and physicians can feed this data back into treatment plans.

4. Opt for a format that fits your budget and timeline.

A stand-alone e-prescribing system will have a lower annual cost than a full EHR solution. It will also be easier to train your team on and will lead to enhanced efficiency faster. Meanwhile, the more expensive EHR-integrated system will take longer to implement.

The obvious advantage of the latter is that, once in place, it will serve as a one-stop shop. On an EHR-integrated system, physicians can access not only medication histories, but also diagnosis history, test results, and insurance information as they make prescription decisions. A comprehensive option with a remote patient monitoring aspect or HIPAA-compliant patient portal integration also translates to more training time up front.

5. Factor in direct costs, indirect costs, and opportunities for cost-saving.

In addition to annual software licensing fees, you may need to buy and maintain new hardware. You will also have to invest time for staff training, while the transition requires substantial work on the part of management staff. Short-term lost productivity is unavoidable, and you should account for this cost. On the flip side, there are opportunities to obtain free systems or financial aid through private, state, or federal sources, including Meaningful Use EHR Incentive Programs.

An analysis of the challenges and opportunities of switching over to e-prescriptions at your practice is essential to a successful transition.

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