By Tarun Kothari MD, FACG, FACP
Medical Director, Rochester RHIO
Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. New York State describes telehealth, for purposes of commercial products, as the use of electronic information and communication technologies by a health care provider to deliver health care services to an insured individual while such individual is located at a different site than where the health care provider is located.
While “telemedicine” has been more commonly used in the past, “telehealth” is a more universal term for the current broad array of applications in the field. Its use crosses most health service disciplines, including dentistry, counseling, physical therapy, and home health, and many other domains. Further, telehealth practice has expanded beyond traditional diagnostic and monitoring activities to include consumer and professional education. A connection exists between health information technology (HIT), health information exchange (HIE), and telehealth.
As the country responds to the unprecedented coronavirus pandemic, Centers for Medicare & Medicaid Services (CMS) is working rapidly to change the way it practices medicine to keep people safe. One critical innovation is the use of telehealth, which allows patients to use smartphones, laptops, and other widely available technologies to connect with your healthcare team. For the duration of the pandemic, Medicare beneficiaries may now stay at home and use a commonly available interactive form of technology like FaceTime or Skype to have a telehealth office visit. Some hospitals and practices have online portals available as well, but patients can also simply use their telephone. These developments are a game-changer for new and established patients, as well as their trusted clinicians.
Medicare has added more than 80 new services that can be provided via telehealth, such as physical therapy, speech or hearing therapy, radiation treatment management, group psychotherapy, inpatient neonatal and pediatric critical care, and end-stage renal disease services. During this pandemic, the option for telehealth has now been extended to home health, nursing home visits, and hospice as well. You can even make a “visit” to the emergency room through your phone. Crucially, Medicare copayments can be waived during this national crisis for all these telehealth services.
Telehealth helps doctors and other clinicians as well. It enables healthcare workers to safely work during this pandemic by greatly reducing their risk of exposure to COVID-19. And if they are quarantined, it opens the option of working from home. Telehealth allows them to continue to practice medicine, albeit in a different way, and remain available to their patients.
Moreover, this now-virtual workforce can be deployed to assess and treat patients at a distance, extending a lifeline to millions and providing convenient, continuous management of common chronic conditions like diabetes, hypertension, and more. These clinicians and therapists are helping their patients monitor illness and stay healthy during the COVID-19 pandemic. The same is true for most of the commercial insurances including BCBS.
Providers will be paid Medicare level fees for telemedicine services even for Medicaid or uninsured patients. Commercial Insurances have already been paying for these services.
Rochester RHIO is committed to providing its services to 14 counties and the 1.5 million residents it serves. Providers can log on to the Explore clinical query portal from their home while providing telehealth services in these trying times. Federal and state have relaxed HIPPA guidelines for telehealth services during the COVID-19 pandemic. Rochester RHIO and other HIEs in the state of New York can now accept verbal consent documented in the encounter note as patient consent if provider is not sure that patient consent for RHIO services preexists.
This has simplified the patient-provider connection from their respective homes for diagnosis and treatment at the same time maintaining safe, physical distancing. Telehealth is here to stay as patients and providers gain valuable experience. Technology will keep improving and fees paid for the services will be further enhanced. CMS came through for their Medicare and Medicaid patients to allow access to telehealth and providers are getting paid for it. The speed of decision and implementation of this program during this Pandemic was astounding.
Rochester RHIO's patient query portal Explore is available 24/7 for authorized users from wherever providers are accessing PHI.