Topic of the Week Telemedicine

  Discussion paper of the article I (Nephrology. Please go by the rubics provided HealthIT Topic of Week Assignment Purpose This assignment is designed to help students • Develop an appreciation for informatics, basic skills and knowledge required in practice settings. Students will select a “hot” or popular topic of particular interest to their practice to discuss. The topic will be selected from the website using the link provided in the course Assignments section. Due Date: Sunday 11:59 p.m. MT at the end of Week 5. Total Points Possible: 175 Requirements Students will login to FierceEMR and FierceHealthIT using the link provided in the reading assignment module for Week 5 and select a “current/popular” topic of the week that may impact their practice. Students, in a professionally developed paper, will discuss the rationale for choosing the topic, how it will impact practice in a positive or negative manner, citing pros and cons. Include a discussion of how informatics skills and knowledge were used in the process relevance to developing the assignment. In the conclusion, provide recommendations for the future. Submit completed FierceHealthIT Topic paper for Wk. 5 to dropbox by end of Week 5. PREPARING THE PAPER 1. The FierceEMR and FierceHealthIT Current/Popular Topic of the Week assignment must be a professional, scholarly prepared paper. See the guidelines for writing a professional, scholarly paper in the Course Resources. The professional paper will have an introduction, body of paper to explain what you are doing, summary/conclusion, and at least three scholarly references. 2. Required texts may be used as references, but a minimum of three sources must be from outside of course readings. 3. All aspects of the paper must be in APA format as expressed in the 6th edition. 4. The paper (excluding the title page, introduction and reference page) is 4-6 pages in length. 5. Ideas and information from professional sources must be cited correctly. 6. Grammar, spelling, punctuation, and citations are consistent with formal academic writing. Category Points % Description Introduction 20 11.4 Introduction presents a brief overview of the parts of the paper. Selects relevant HealthIT Topic to discuss; provides rationale for selecting topic 30 17 Provides convincing rationale for topic selection Convincing arguments of how topic will impact practice in a positive or negative manner citing pros and cons. 40 23 Convincing arguments of how topic impacts practice in a positive or negative manner; pros and cons are presented Discussion of how informatics skills and knowledge were used in the process relevance to developing the assignment 30 17 Provides a discussion of how informatics skills and knowledge were used in the process to develop the assignment Conclusion 20 11.4 Concluding statements summarize insights about the key elements of the paper gained during the assignment. Recommendations for the future are provided APA Style 20 11.4 Text, title page, body of paper, summary and reference page(s) are completely consistent with APA format. Citations 7 4 Ideas and information from sources are cited correctly. There are a minimum of three scholarly, current (5 years or less) references. Writing Mechanics 8 4.5 Rules of grammar, spelling, word usage, and punctuation are consistent with formal written work, Total 175 100% A quality assignment will meet or exceed all of the above requirements. GRADING RUBRIC Assignment Criteria Exceptional Outstanding or highest level of performance Exceeds Very good or high level of performance Meets Competent or satisfactory level of performance Needs Improvement Poor or failing level of performance Developing Unsatisfactory level of performance Content Possible Points = 140 Points What’s the status of telemedicine? A primer for providers and patients by Steven Findlay, Kaiser Health News | May 9, 2018 1:49pm Access to e-visits is increasing rapidly. (shironosov/Getty) ShareFacebook Twitter LinkedIn Email Print Tucked into the federal budget law Congress passed in February was a provision that significantly expands the use of telemedicine—long a hyped healthcare reform and now poised to go mainstream within five to 10 years. “There’s much broader recognition of the benefits,” said Mei Wa Kwong, executive director of the Center for Connected Health Policy, a research group in Sacramento, California, that promotes telemedicine. “The law is the latest to make telemedicine more accessible. But we still have a ways to go before most consumers are aware of the option.” The new law allows Medicare to cover telemedicine services for people who have had a stroke and those who get kidney dialysis, either at home or at a dialysis facility. It also permits Medicare Advantage Plans—private plans that enroll a third of Medicare beneficiaries—to offer telemedicine as a covered benefit. FREE DAILY NEWSLETTER Like this story? Subscribe to FierceHealthcare! The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go. SUBSCRIBE NOW Separately, as of Jan. 1, Medicare began allowing doctors to bill the government for monitoring certain patients remotely using telemedicine tools: for example, tracking heartbeat and rhythm, blood pressure and blood glucose levels. Telemedicine, also referred to as telehealth, uses computers—and their display monitors, software and capacity for data analysis—to deliver virtual health services. In the easiest-to-understand example, a patient is in one location and has an e-visit with the doctor in another location. They are connected via a secure video link. Proponents say that more sophisticated monitoring is on the horizon and that virtual encounters will become more commonplace. As acceptance and adoption of telemedicine expands, so does coverage. All private health plans, Medicare, state Medicaid programs and the Department of Veterans Affairs now cover some e-visits—albeit with restrictions. More health centers and hospitals are launching virtual health centers. And websites offering virtual “doctor-on-demand” services are proliferating. Concerns exist, however. Doctors worry that they may get paid less if insurance reimbursement is lower for e-visits than in-person appointments, or that e-visits could undermine the doctor-patient relationship by reducing valuable face time. They point out that for some ailments, like strep throat, it’s best if doctors or other health providers see the patient. Health economists, meanwhile, are concerned that e-visits could add to costs rather than constrain them—if, for example, doctors and patients abuse e-visits by scheduling them unnecessarily because they are quick and easy. Also, insurers may be motivated to push doctors to do more e-visits instead of in-person visits to save money. And for some people, access to proper equipment or internet access can be difficult. “The potential for abuse is there,” says Robert Berenson, M.D., a Medicare expert at the Urban Institute. “We will need to prevent gaming and misuse of the system. But, generally, helping people avoid unnecessary doctor’s office and hospital visits is a good thing, if we do it right.” Here’s a briefing on telemedicine basics: Q: Are e-visits available from most hospitals and doctors? Not yet. But access is increasing. Ask your doctor, clinic or hospital. In some cities, medical centers are setting up telehealth “hubs” to handle patients. For example, Penn Medicine in Philadelphia launched its Connected Care center in February with 50 full-time employees, 24/7 access to care and a program to treat chronically ill patients at home. Some of the center’s e-visit services are open only to Penn Medicine employees, but other services are available to anyone, with a focus on residents of Pennsylvania, New Jersey, Delaware and Maryland, said Bill Hanson, M.D., vice president and chief medical information officer at Penn Medicine. Similarly, Mercy Virtual in Chesterfield, Missouri, a St. Louis suburb, serves patients throughout the Midwest, and those treated at Mercy Health’s network of 44 hospitals in five states. Launched in 2015, Mercy Virtual provided care to 750,000 people in 2017 with a team of 700 doctors, nurses and support staff. Other medical centers with virtual health programs include Avera Health based in South Dakota; Cleveland Clinic in Ohio; Dignity Health in San Francisco; Intermountain Healthcare in Utah; and Kaiser Permanente, a managed-care health system in California and elsewhere. Kaiser Permanente reported last year that 21% of its 110 million patient interactions in 2015 were e-visits. Officials there predict that by 2020, e-visits will exceed in-person visits. (Kaiser Permanente is not affiliated with Kaiser Health News, which is an editorially independent program of the Kaiser Family Foundation.) Q: What restrictions do health plans, Medicare and Medicaid put on e-visits? Health plan coverage varies, but most private insurers cover e-visits, and 34 states and the District of Columbia require that they do. A few states still require that a patient relationship be established with an in-person visit before the provider can bill for an e-visit. Check with your insurer about its policies. Medicare’s coverage of e-visits is more restrictive. First, e-visits must take the place of an in-person visit. Second, with exceptions allowed under February’s budget law, Medicare largely restricts e-visits to those that occur in rural areas that have a shortage of doctors and/or hospitals. And third, most e-visits can’t occur when the patient is at home. They can be done from a variety of other locations, such as a rural health clinic, a dialysis center or skilled nursing facility. A bill in Congress would loosen that restriction. In contrast, almost all state Medicaid programs cover e-visits in the home. But restrictions still apply. For example, only 22 states cover remote patient monitoring for Medicaid enrollees. The Telehealth Resource Centers, a federally funded organization promoting telemedicine and providing consumer information, has detailed explanations of e-visit restrictions and limitations. Q: Do I need special computer equipment? No. E-visits and other forms of telemedicine are done over commonly available computers, laptops, tablets and smartphones—and are typically encrypted to protect privacy. Specialized equipment is usually needed for remote monitoring, such as blood pressure or heart rate. One vexing barrier: broadband availability in rural areas. Also, millions of low-income and older Americans still lack Wi-Fi in their homes. Q: What services can I get through telemedicine? Most e-visits are for primary care or follow-up services, such as assessing symptoms or checking on people who have had a medical procedure. But a growing number—no one keeps national statistics—cater to people with chronic conditions who are being monitored at home, said Kwong. Dermatology e-visits are becoming especially common. You can send a close-up photo of a skin rash, mole or other problem for an immediate assessment. Psychotherapy by e-visit is also expanding. Sometimes an e-visit may provide an initial medical assessment for an injury, wound or illness that is clearly not life-threatening. Some cities are testing ambulance services that use telemedicine to triage whether people need a trip to the hospital. Q: Will I save money if I do an e-visit instead of going into the doctor’s office? E-visits are generally less expensive than a trip to the doctor, but you may not see the difference if your insurance covers both with only a small copay or no copay. If you have a large deductible, however, an e-visit may mean you pay less out-of-pocket for that encounter. Some states require insurers to make equal reimbursements for in-office and telemedicine consultations on simple matters. Q: Are there downsides or risks with telemedicine and e-visits? There’s no evidence so far that your risk of being diagnosed wrongly or treated inappropriately is any greater with an e-visit compared to an in-person visit. Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente. Read more on Telehealth Physician Practice Patient Engagement Congress Mei Wa Kwong Center for Connected Health Policy Robert Berenson Urban Institute Mercy Virtual Care Center Mercy Health Avera McKennan Hospital & University Health Center Cleveland Clinic Dignity Health Intermountain Healthcare Kaiser Permanente Bill Hanson Penn Medicine The Telehealth Resource Centers