Maybe You Can get Reimbursed for That…

Treasure In Paper

Last week I posted a press release from the ATA about expanded Medicare coverage for Telemedicine.  Well, I decided to actually read the 1200 page rulemaking from the Centers for Medicare and Medicaid Services (CMS).  You can guess why it’s taken a week to write a follow up article…

Actually, no.  I didn’t read the entire rulemaking, only the pages relevant to all things “tele” in medicine and healthcare.  In doing so, I was reminded of something interesting:

There are a number of procedures already covered by Medicare without specific telemedicine codes.  In fact, of the seven bullet points listing the 22 codes rejected or deleted from inclusion, five noted the affected codes were largely unnecessary due to either an existing telehealth code or because Medicare does not distinguish whether the procedure is tele or not.

Here are a few examples:

Regarding electrocardiograms and echocardiograms: “By definition, Read more

ATA Celebrates Halloween Telemedicine Treats for Medicare Beneficiaries

WASHINGTON – Saturday, Nov. 1, 2014 — Yesterday, the Centers for Medicare and Medicaid Services (CMS) issued a rulemaking that includes significant additional coverage for telemedicine services.

“This Halloween, Medicare beneficiaries got an important treat for home care of chronic care management, remote patient monitoring of chronic conditions, and other services when provided via telehealth,” said Jonathan Linkous, CEO of the American Telemedicine Association. The association has been asking CMS for such coverage for over five years.

Buried in an almost 1200-page rulemaking about 2015 Medicare payments to physicians and practitioners were provisions paying for remote chronic care management using a new current procedural terminology (CPT) code, 99490, with a monthly unadjusted, non-facility fee of $42.60. Also, Medicare will pay for remote-patient monitoring of chronic conditions with a monthly unadjusted, non-facility fee of $56.92 using CPT code 99091. Prior to this, Medicare did not pay separately for such services, requiring that such billing be bundled with an “evaluation and management” code.

Also in the rulemaking were seven new covered procedure codes for telehealth including annual wellness visits, psychotherapy services, and prolonged services in the office.

“It has been a long time coming, but this rulemaking signals a clear and bold step in the right direction for Medicare,” added Linkous. “This allows providers to use telemedicine technology to improve the cost and quality of healthcare delivery.”

Read the full document here: http://www.regulations.gov/#!documentDetail;D=CMS-2014-0094-2363. To learn more about telemedicine and public policy, visit http://www.americantelemed.org/policy/overview-news.

About the American Telemedicine Association

The American Telemedicine Association is the leading international resource and advocate promoting the use of advanced remote medical technologies. ATA and its diverse membership work to fully integrate telemedicine into healthcare systems to improve quality, equity and affordability of healthcare throughout the world. Established in 1993, ATA is headquartered in Washington, DC. For more information visit www.americantelemed.org.

Media Contact:
Mimi Hubbard
mhubbard@americantelemed.org
202-659-7616

relaxed to get because 30s
miranda lambert weight lossRalph Lauren Frames Are A Great Choice

7 Things We Learned from the 2014 Connected Health Symposium

Last week we participated at the Connected Health Symposium hosted by Partners Healthcare in Boston.  Jeff Urdan, our COO, gave a presentation on swyMed for the fourth annual Innovators Challenge, a symposium event to draw attention to, as they say on their website, “products that are genuinely new and potentially game-changing for connected health.”  He also had a chance to report back on his key takeaways from the event.

1)     Wearables May Take Over the World

Lots of companies are doing cool things with wearable sensors sending data to smart phones.  At the Innovators Challenge alone there were:

  • Basis – a fitness and sleep tracker watch conceptually similar to the iWatch and Samsung (but better of course!)
  • FeverSmart – a temperature monitor for tracking fever.  It is intended for babies so parents can know both how the child is trending and can give actual data to their pediatrician rather than guesstimates…but imagine the Ebola applications for monitoring people who might have been exposed and need to be monitored for the 21 day incubation period!
  • GoodLux Technology – measures light exposure which has been shown to impact both seasonal affective disorder and depression.

Read more

An Open Letter and Call To Action to the Telemedicine Industry

 

reimbursement boulder in road crop

“Is your cucumber bitter? Throw it away. Are there briars in your path? Turn aside. That is enough.”
Marcus Aurelius, Meditations.

For an industry full of innovators, there’s a distinct lack of innovation in overcoming the reimbursement issue.  I believe this is largely because we’ve trained ourselves to continue focusing on reimbursement, rather than discovering how to make the lack of reimbursement work for us or on creating a new model of telemedicine that makes reimbursement an afterthought.

If you believe telemedicine won’t expand until reimbursement is solved, why are any of us involved in Telemedicine?  (I assume it’s to improve healthcare, which means we shouldn’t let reimbursement stop us.)

This is not to say that reimbursement is not impo Read more

swyMe selected to present at the Innovators Challenge

Dateline Boston: Sept 11, 2014

swyMe, a leader in delivering secure, mobile, high quality video for connected health, mHealth and telehealth through their swyMed product, announced that it has been selected as one of 10 organizations in the Partners Healthcare Innovators Challenge (http://symposium.connected-health.org/innovators-challenge). swyMe will be presenting at the Partner’s Connected Health Symposium 2014 (http://symposium.connected-health.org/) in Boston on October 23rd and 24th, 2014 at the Seaport Hotel and World Trade Center.

“Partners HealthCare was Read more

Prioritize Patients

prioritize patients

I attended a webinar last week where the speaker, Jeff Robbins, Director of Neurodiagnostics and Telehealth at Tift Regional Medical Center, recounted the following (paraphrased) story:

Eight years ago Tift had purchased their first batch of telemedicine equipment.  For the first year or so they mostly stared at it, with no idea how to go about using it.

They wondered whether they could be reimbursed for anything they used it for and whether they could figure out how to use it and wondered what it could do.  They weren’t using their equipment.  They weren’t using telemedicine.

Then Jeff said they decided to “put the patients first.”  They purposefully forgot about reimbursement, coverage regulations, computer abilities of the doctors, or whether the possible uses fit into the business plan of the hospital.  They focused on finding out, through actually doing it, if telemedicine could help their patients.  When that happened…

All those things took care of themselves.

Or, as Jeff put Read more

swyMe – Expanding Telehealth, Mobile, Cloud

reprinted with permission by Mobile Cloud Era


Photo: By Tim Evanson, [CC BY-SA 2.0], at Flickr

In a merger of telehealth, mobile and cloud, Massachusetts-based swyMe is offering video conferencing in ambulances. The basic system includes three cameras in the vehicle: a standard “fish eye” 360º camera mounted high on the ambulance wall; a webcam attached to a touch screen monitor; and a handheld HDTV 720p IP camera.

The combination of the three affords a remote physician a view of the overall situation in the ambulance, the ability to communicate face-to-face with attending EMS workers and capability to zero in to close-up views of the patient. The system is HIPAA compliant and uses AES256 security.

swyMe COO Jeff Urdan explained that Read more

Hackers and Telemedicine Security – Thoughts?

hacked

Today’s reporting (and here, here, and many other places) that Community Health Systems hospital network was hacked for personal information is alarming.  Although no credit card–and NO CARE INFORMATION–was taken, social security, birthdays, and addresses all were.  That is, everything necessary to open bank accounts, sign up for credit cards, and nearly anything else that counts as identity theft.

As potentially bad for the patients as this is, it’s equally bad for Community Health Systems.  Apparently their stock took only a brief hit (CYH), although it wouldn’t be shocking if it moves lower again assuming the news becomes more widespread and if they are sued.  This scenario is possible because although–and I would like to emphasize this yet again–NO CARE INFORMATION WAS TAKEN (medical histories, treatments, etc.) the information was still covered under HIPAA.  (They do have insurance to cover cyber liability, but even so…)

I do not know how the data was kept or encrypted.  It’s interesting…and somewhat heartening…to know that the care information was not accessed by the hackers.  However, I believe it helps us remember that no system is completely safe, and that the highest available level of security should always be used.  Currently, regarding encryption, that would be AES 256-bit encryption.  It also means use of secure one-time-use keys for communication software endpoints and conscientious use of regularly changed passwords by users.  It means keeping devices used within networks either on VPNs (vitual private networks) or, again, using 256-bit encrypted, password-secured communication over non-VPN networks (and why not do it on the VPNs anyway?).

So, now the question is: Does this security breach have any implications for telemedicine and mHealth?  My guess is that mHealth is probably at the greater risk.  I think there’s less of a general use for cybercriminals for care data than simply personal data, and that certain types of personal data, such as location data combined with the pedometer on (could indicate you’re out jogging 10 miles from your house…might be a good time to break in), make mHealth a little more nerve-wracking.  Just a guess.  There may be very creative ways to make use of mass medical histories and treatment information that just hasn’t been discovered yet.  Thoughts?

how to establish a a stack of clothing level
quick weight lossSuggestion to Nike and Jordan Shoes

Bikers and Teddy Bears: 9th Annual Teddy Bear Ride

biketeddys

photo credit: Jeff Schrier | MLive.com

Starting at 2 p.m. this Saturday, children in the pediatric center of Covenant Healthcare in Saginaw, MI, which is a customer using HitCast, an earlier release of what has become our swyMed solution, will be receiving between 200 and 400 teddy bears courtesy of the Great Lakes Harley Davidson and Tri-County Michigan Hogs.

This is a fantastic tradition that’s been as wonderful for the kids in the hospital as for the bikers giving of their time and resources.  However, the children generally are not able to go outside the hospital to see the bikers arriving with teddy bears often attached to the bikes, or to see them dismounting and coming in.  Covenant has, in the past, utilized some of the telemedicine capability to stream video of the bikers arriving into the pediatric center.

Please follow these links for more of the story, and be inspired to do something similar in your area if you can:
http://www.abc12.com/story/26164728/ninth-annual-teddy-bear-ride-to-take-place-this-saturday
http://www.minbcnews.com/news/story.aspx?id=929540#.U-TSmvm-2-0

It has a forward P
quick weight lossWhen to wear a vest

5 Things I Learned on ATA’s This Month in Telemedicine Webinar

As with last month, this is largely geared to updates about legislation along with reminders about the upcoming Fall Forum conference in Palm Springs, CA, which I’ll have to consider as I live out Orange County.

This month’s takeaways are a little more subdued than last month which had some pretty big news (see here).  The ATA had just done a survey on online consultations and had over 500 respondents.

1)  45% of respondents are using telemedicine TODAY.  This is fantastic news and, in my mind, is possibly underreported because, as Mr. Linkous and Mr. Capistrant pointed out on the last call (and pointed out in our 3 Things from last month), nearly every institution is already using some form of telemedicine and the boards don’t realize it.

2)  Specialty Care and Behavioral Health were the leading segments.  Not terribly surprising, as specialty care often needs to use leading edge tools to leverage resources for special care, and behavioral health lends itself well to an old-school videoconferencing set up (patient and doctor meet via video), leading to less push-back on its use while providing maximum benefit to both patients and providers.  The industry will have to really work, I think, to make sure providers and CDOs are aware of the more specialized applications and the benefits to be had.  Telemedice will not yield a large harvest if we only pick the low-hanging fruit.  As if to prove that point:

3)  77% use video, 57% use audio and 28% use medical peripherals.  Just over a quarter are using peripherals, while three times that are using video.  Being at a video-primary solution provider: Yay!  Being a proponent of telemedicine as a whole: We can do better.  Even the video-primary medical solutions offer a lot of specialized or integrated offerings that provide more than just adding a visual element to distance care.  Again, the question is, how do we get this to the doctors and CDOs?

4) Of the 55% of respondents that replied they are not using telemedicine today, 75% plan to implement it very soon.  I present that as Exhibit A to the tipping point naysayers…although I concede that if you responded to a survey about telemedicine from the American Telemedicine Association, you’re probably already predisposed to an interest in telemedicine.  Having said that, interest in telemedicine has been on the rise, and 75% of that growing crowd being interested in giving it a shot can only be a good thing.

4)  Mr. Linkous pointed out something toward the end that I assumed would be a primary driver (or at least remove an obstacle) but assumed would take several more years:  Private insurance is increasingly taking the lead in pushing telemedicine.  I’ve been noting that the reduced cost/better outcome/reduced readmissions scenario HAS to eventually turn private insurance into champions of telemedicine.  Amongst the names he mentioned were Kaiser Permanente, Aetna, WellPoint, and others.

your hands bigger
miranda lambert weight lossMad Fashion of the Past