#himss19

Staff from InTouch Health attended the HIMSS19 (Healthcare Information and Management Systems Society) conference earlier this month, gaining valuable insight to many facets of the telehealth industry, from growth opportunities and advances to challenges and issues. HIMSS is a global non-profit organization that focuses on better health by optimizing care outcomes and health engagements through technology and information. So, what did our staff find most valuable from the conference this year?

The real challenges of adopting telehealth:

Technology is not as much of a barrier as it used to be, thanks to the advanced options of today. Funding is also less of a hurdle due to the availability of NIH funding, government funding, and philanthropic organizations’ funding. If you have an idea for the telemedicine industry, present the value of it to those types of funders!

The real challenges of telehealth adoption include a need to align with leadership to understand the goals of institutions. In addition, programs must be effective and efficient, and this depends on people and process systems. Provider engagement is crucial, as they still are healthcare’s driving force. They’ve been trained for years to follow evidence-based medicine, so they now need to see evidence to help get those providers to buy in and get past the early adopter phase. Finally, telehealth programs must be well-designed to ensure they improve provider engagement and efficiency, as well as provider and patient satisfaction. Any new telehealth program has to fit within existing workflows, demonstrate benefit, be easy to use, and offer robust training and education for users.

The path to incorporating a new telehealth program:

Choosing and implementing a new telemedicine program should follow a five-step plan of action in order to ensure the best program for each institution is engaged:

Assess: This step requires an assessment of the needs of clinical and administrative services, technology infrastructure and equipment inventory, leadership support, potential relationships with specialty providers, and clinical provider buy-in.

Establish: As part of the new telemedicine software integration, several components of the institution must be established or re-established, including the actual telehealth team, partnerships, a revenue cycle management program, and a technology infrastructure.

Define: Specifics of the system and institution must be clearly defined for a new telehealth program to be successful, including staff roles like a clinician chairperson, tech support and a coordinator and policies and procedures, including scheduling, insurance billing, credentialing, patient flow, and more.

Implement: Launching the telehealth program encompasses several key points, including technology, staff training, provider orientation, patient education, and going live with patient visits.

Improve: Finally, once the telehealth software has had the chance to run for a while within an institution, it must be analyzed for identifying strong points as well as weaknesses. Provider satisfaction, revenue cycles, and identifying any culture barriers that may be present should be addressed, analyzed, and rectified.

The value of virtual care doesn’t necessarily lead directly to more revenue; however, value in eliciting convenience to patients, and to employers who don’t need to have employees leave work for a few hours does result in more revenue. Improvement on accurately measuring this value is needed to gain more buy-in from stakeholders.

Telehealth reimbursement continues to dramatically improve. Not so long ago, reimbursement was limited to about 1% of care, delivered in rural sites. Recently, telehealth reimbursement has expanded to more locations and CPT codes, but still must be a rural site. Now, the rural requirement has been removed – and this is just the beginning of recent groundbreaking legislation for telehealth reimbursement!

In 2018, federal health bills that passed included improvements like enabling nationwide reimbursement for many conditions, adding mobile stroke units, allowing flexibility to use telehealth in homes and non-rural areas, and more. In addition, a major funding increase for telehealth grants was passed at the federal level, in addition to several improvements for veteran services.

While CMS creates payment for new virtual care services, the change in physician payment from 2018 to 2019 is substantial. In 2018, the number of urban encounters for telestroke was about 60% of cases, for which there was no reimbursement. However, by the end of 2019, approximately 1,000 video encounters are expected – along with $150,000 in professional fees annually.

Tele-ICU is a strategy that delivers! It improves quality via improved leveraging the technology in various care settings, through best practices in population management and disease management, with nurse mentoring, resident eRounds, and support of individual units and their specific needs.

Tele-ICU care adds extra care for patients and improves the quality of it, too. In 2018, 507 ICU lives were saved as the mortality ratio went from 0.42 to 0.22. There was an average decrease of 259 ICU days with a cost avoidance of $959k, which means that the ICU LOS ratio went from 0.63 to 0.61. In addition, 2018 saw a decrease of 441 ICU vent days, with a cost avoidance of $287k (vent ratio went from 0.77 to 0.76).

From recognizing the challenges of telemedicine implementation and incorporating a new telehealth program to reaping the benefits of tele-ICU and improving reimbursements, the information presented at this year’s HIMMS19 conference was invaluable. Essential, relevant, and workable strategies regarding the advancement of telemedicine were delivered each day that will prove to be indispensable to the industry as it advances.

Interviews Live From HIMSS 2019

This week I am talking to several guests live at HIMSS 2019

Rasu Shrestha, MD EVP & Chief Strategy Officer Atrium Health (@RasuShrestha), R. Hal Baker, MD SVP, CIO Wellspan, and Aneesh Chopra, President, CareJourney (@aneeshchopra)

Listen in to hear their thoughts on the latest innovations at HIMSS, what’s coming, the importance of shared values, bringing the humanity back to healthcare and the…