Tag Archives: Healthcare

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National task force encourages Congress to maintain telehealth support, but many doctors are leery

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During the COVID-19 pandemic few subjects in healthcare have gained more attention than the heroics of healthcare workers on the front lines; the overwhelming administrative and financial challenges faced by health systems; and the meteoric rise in the use of telehealth.

Doctors of all stripes turned to telehealth to keep their heads above water. Hospitals and health systems, too, implemented the technology in much the same manner: anything to keep revenue coming in and the lights on like nearly everyone else in the United States.

An April 2020 survey of 20 accountable care organizations (ACOs) raced “to implement telehealth and remote patient monitoring to coordinate care and stay afloat financially during the COVID-19 outbreak.”

“For some companies, that has meant moving telehealth business segments from the sidelines and putting them front and center,” the Los Angeles Business Journal reported in April.

It’s no overstatement to suggest that thousands of doctors used virtual consultations to provide care to their patients at the peak of the pandemic economic shutdown. But for many, theirs wasn’t a love affair with the technology.

Nearly 60% of physicians interviewed as part of another survey said they remain leery about the quality of care they can provide remotely. According to Decision Resources Groups’ two-part survey of 4,855 practicing U.S. physicians, four out of five physicians used telehealth during the pandemic.

For 20% of physicians that didn’t use the technology, the primary reason for not doing so was the possibility of diminished quality of care.

For others surveyed in June and July who said they had conducted virtual consultations in the past three months, about half (52%) said they would likely continue to do so after COVID-19 mitigation ends.

On Sept. 15, 23 of the nation’s top healthcare experts released a report identifying challenges and opportunities for telehealth post-COVID-19 pandemic.

The Taskforce on Telehealth Policy, convened by the National Committee for Quality Assurance, theAlliance for Connected Care, and the American Telemedicine Association, spent months “building consensus among its members on a comprehensive set of findings and recommendations,” these organizations said in a joint media release.

Taskforce members — representing a swath of health plans, providers, consumer advocates, and health quality experts from the public, private and nonprofit sectors — said the report is a blueprint for how policymakers can harness the expansion of telehealth and create lasting healthcare improvements that prioritize patient safety, quality, and equitable access to care.

“These recommendations were developed through broad consensus and seek to establish telehealth as a permanent modality,” said Ann Mond Johnson, CEO of the American Telemedicine Association, in the statement. “We heard loud and clear from a range of stakeholders that virtual care must remain an option for patients and providers after the public health emergency is over. Our recommendations provide guidance on aligning standards, quality, payment, and program integrity to make telehealth available to all, including those in underserved and rural communities and our most vulnerable patient populations.”

The Taskforce on Telehealth Policy posted the full report online for public review. Highlights include:

  • Telehealth is evolving healthcare for the digital age, setting up a modality of care.
  • Telehealth is a good substitute for in-person care without increasing overall costs.
  • Policymakers should lift geographic restrictions and limitations on originating sites, allow telehealth for various types of clinicians and conditions, and acknowledge that telehealth visits generally meet requirements for establishing a clinician/patient relationship.

The task force also recommends lifting restrictions on telehealth across state lines.

Additionally, full enforcement of the privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA) should resume when the current public health emergency ends.

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How COVID-19 is changing the exercise industry

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COVID-19 has accelerated the adoption of digital fitness solutions, pushing the exercise industry toward a hybrid model. People will still attend brick-and-mortar gyms when the pandemic is over, but digital fitness classes will have increased their foothold in the market.

Digital Fitness Trends

More people turned to digital fitness solutions when quarantine orders closed fitness centers in March. Companies that had previously made a stir in the digital fitness space experienced a surge of interest at the onset of COVID-19, and businesses that had offered passes to brick-and-mortar fitness studios before COVID-19 shifted to provide access to virtual, pre-recorded, and live studio classes.

For example, according to Evercore ISI analyst Lee Horowitz, Peloton app downloads were five times higher in March than February. Peloton also reported a 77% increase in quarterly revenue at the end of December.

Likewise, Mindbody, a tech platform that connects people to exercise, health, and wellness solutions, launched a proprietary solution to allow users streaming fitness classes to bypass Zoom. According to their research, 46% of survey participants plan to keep taking virtual classes after gyms reopen.

Just as COVID-19 accelerated and forced the adoption of telemedicine in healthcare; it seems that it will also accelerate the adoption of at-home digital fitness.

Of course, the adoption of digital fitness solutions is not surprising. Many experts believed that the future of fitness was headed this way anyway, with pioneering companies like Peloton, MIRROR, Mindbody, Tonal, and NordicTrack paving the way.

The Aftermath of COVID-19 for Brick-and-Mortar Gyms

Not all fitness centers weathered the pandemic well. Likely, anyone who has a YMCA membership received several emails asking them to donate their membership payments throughout the epidemic.

The YMCA lost $800 million in revenue between April and May. Several branches have shut down, with at least two closures planned for Baton Rouge, Louisiana, and more likely to follow.

COVID-19’s impact on the YMCA is a major one, as many parents rely on the Y for child care. The YMCA is an essential provider of preschool and before-and-after school child care programs, and a program that offers child care during school breaks.

But, the Y wasn’t the only fitness center to take a hit during the quarantine.

Gold’s Gym and 24-Hour Fitness suffered severe blows. Both companies filed Chapter 11 bankruptcy between May and June and cited COVID-19 as the reason for their filings. Gold’s Gym is likely to close 50% of its nonfranchise locations, and 24-Hour Fitness plans to close about 30% of its studios permanently.

New York Sports Club and other companies also ushered financial concerns during the quarantine.

Post-COVID Predictions

COVID-19 led to an increase in digital fitness classes. It pushed much of the health and wellness space online, with health coaches, personal trainers, and doctors offering more virtual consultations than before. But, now that gyms have the green light to reopen, what’s in store for fitness?

The forced break for gym-goers prompted a variety of responses. Some claim they’ll never go back to the gym, and others are delighted to be back now that gyms are open again.

Chances are the future will remain a hybrid of digital and in-person fitness solutions.

Digital classes have made exercise more accessible for many. Yet, there are still certain aspects of in-person fitness that digital fitness has yet to replicate. For instance, despite many strategies to replicate community in online fitness classes, there’s still something special about meeting people in-person for a workout, and some things, such as swimming laps, will always be challenging for most people to do at home.

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How biometrics can help your patients during COVID-19 and beyond

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As a healthcare administrator or physician, you know that your patients are dealing with heightened anxiety during COVID-19. Concerns about face-to-face treatment, financial worries, and a strong need for convenience and ease in interactions are just a few of the issues your patients are wrestling with.

One powerful way you can help pacify their fears and make their treatment easier than ever is by implementing key biometric technology within your organization, facilities and clinician practices.

How can you accomplish this? Use the basic principles of biometrics marketing. According to Hitsearch, biometrics marketing is defined as the science of tracking a person’s biometric attributes, using it to improve their customer experience.

This is done using physical data from that person — such as analyzing eye movement to determine what someone is looking at during a given time frame. Of course, it’s crucial to obtain your patients’ consent before you begin the process of integrating biometrics into their care experience — you always want to proceed in a way that’s faultless, both ethically and legally. Biometrics are often used for security purposes and can also be tailored to offer the precise needs and conveniences that make your patients much more comfortable with their care.

Speaking of security, that’s an additional benefit that biometrics can provide your patients: you can use the technology to protect patient medical records and payment information and use it to secure your patient portals and sensitive website info. Customer Think finds that security and convenience are the two key factors you need to focus on, and the specific features that biometrics address offer easy, instantaneous ways to accomplish this.

What are these features, specifically?

KYC (Know Your Customer) technology.

According to Thales, a KYC check is a cornerstone of biometrics — it’s the mandatory process of verifying the identity of your patients. Simple facial recognition applications your customers can choose to use on their phones are a convenient example of this, and one they’ll find easy to utilize as part of their check-in process prior to telehealth appointments or accessing their online records.

Eye tracking.

This technology measures what information a patient is searching for visually or is reading of your digital content. If your patients consent to you using this, you can delve into the concerns they’re reading up on via your health conditions website content. Then, you can address a patient’s questions more quickly, easily and comprehensively.

Skin sensitivity analysis.

A quick in-person check in the ER can help staff address a patient’s emotional needs on the spot — and calm the fears of a patient about to have a COVID-19 test, for example. This technology can be useful in any care situation where stress is a significant factor.

Facial expression analysis.

This is a remote tool that can help doctors during telemedicine visits “read” a patient’s understanding of his/her treatment options and recommendations. Again, with patient consent, this can be a great communication facilitator.

Technological transparency.

Biometrics offers you and your patients flexibility regarding how much information they want to provide to their clinicians. If a patient feels the technology is too invasive at any point, their experience can be scaled back quickly so it’s tailored to their personal comfort level and needs.

Do biometrics sound like a great fit for your organization? Use this information as a jumping-off point, both of in terms of operations and cost-efficiency. You might just revolutionize the care you offer — and ease your patients’ minds now and beyond the scope of the pandemic.

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How colleges are spreading COVID-19

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Most of the attention and controversy over school attendance in the midst of the COVID-19 pandemic these past couple of months has focused on K-12 classrooms. Less attention has been paid to college policies.

That’s too bad, because it’s now becoming clear those same policies are likely to spread COVID-19 back into many of those students’ home communities.

The CDC Steps Up to the Plate — and Strikes Out

In late May, the Centers for Disease Control and Prevention (CDC) issued another of its less-than-optimal position papers related to COVID-19: “Considerations for Institutions of Higher Education,” which laid out the risks involved in college students returning to fall classrooms in the midst of a pandemic, along with “considerations” to lessen that risk. By early fall 2020, they are familiar:

  • frequent hand-washing
  • use of masks “as feasible”
  • ”signs and messages” describing recommended protective measures

A number of CDC recommendations for “healthy operations” follow. Dealing with them all is beyond the scope of this article and, I suspect, readers’ patience, but I’ll focus on two of particular relevance to the problem of COVID-19 transmission:

  • modified physical layouts to maintain a minimum of 6 feet between persons (the CDC again adds the not particularly helpful caution “when feasible.”
  • promotion of “social distancing” at group events, including “sporting events and…sports activities.”

When you’re 19, how are you likely to interpret “when feasible?” With these earnest suggestions, what could possibly go wrong?

Decision-Making and the Adolescent Brain

What can — and already is — going wrong is the CDC’s naive belief that putting out a position paper that relies on college students to maintain safe practices in the midst of a health crisis solves the problem.

Abundant 21st century research (which nearly every college teacher and this former college teacher would confirm) shows that adolescent brains work differently from adults “when they make decisions or solve problems.”

This isn’t a correctable issue because it’s a function of the frontal cortex. Brain development in this area completes by age 25, not before. This is the area where mature decision-making takes place.

What the research shows is that there are a number of ways this development can be slowed down (by drugs, sex, diet and lack of sleep), but that there’s no way of bringing adolescents to maturity any faster. Young adults are biologically determined to act impulsively. Any directive that counts on adolescents behaving otherwise is either cynical or uninformed.

This Is Your Brain (No Drugs Needed)

Keeping the adolescent brain in mind, what has happened as colleges have reopened for the fall was entirely predictable and should have been accounted for. Unfortunately, it wasn’t and so-called “adult” decisions have only made a bad situation worse.

College students all across the country, from Pennsylvania and Ohio to Florida, Georgia and UC Berkeley have celebrated the return to school by partying. At most parties, no social distancing was observed (how can you maintain social distance and hug at the same time — it’s unreasonable!) and masks were generally scarce and more often completely absent.

As noted, all the research strongly suggests that even the best handling of this problem would have been inadequate. But the handling by the CDC and by the majority of college officials has made the situation demonstrably worse.

If you’re 19 years old and told to socially distance, how seriously should you take that when your beloved football team is already getting ready for a full-contact fall season? When local police don’t enforce public health orders on masks and social distancing? When, as Greta Anderson put in in a recent Inside Higher Ed article, students are “Partying Like it’s 2019” with uneven or nonexistent enforcement of the rulings against it.

Now Let’s Spread This Around a Bit!

The worst decision however, and the one that prompted my writing this article, is what seems to me to be the completely nutty one many colleges have made when students contract COVID, namely, to send them back home again where they can spread the disease to one more community. At East Carolina University, for example, where, as of the end of August, there were already 125 COVID cases among students and staff, and where the school made the typically belated decision to send infected students back home again and, as of Sept. 30, to conduct all classes online.

Similar decisions after COVID-19 has begun to spread have been made widely among colleges across the country as administrators find themselves unable to keep college students from, well, behaving like adolescents. The wisdom and necessity of the decision to have begun the fall semester with remote learning seems obvious. But it would have been a decision that carried its own financial and intellectual downsides, although none in my opinion as acute as the decision to return infected students back to their home communities.

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Telemedicine: Gains, losses, and debates

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Telemedicine and telehealth are apparently here to stay, galvanized into intensive service amidst the COVID-19 pandemic. With approximately 20% of all medical visits in the United States estimated to be conducted via telemedicine in the course of 2020, and $29.3 billion in global revenue, we can see that this form of medical practice has truly taken hold.

What are we gaining, who is losing out, and what might we be missing when more healthcare is delivered without patient and provider being in the same room?

The Numbers Speak

According to a July 2019 study on telemedicine conducted by Doximity months prior to the emergence of the now globally ubiquitous SARS-CoV2 novel coronavirus, the market share growth for telemedicine was estimated to increase from $38.3 billion in 2018 to $130 billion in 2025.

Doximity also concluded that the number of physicians claiming telemedicine as a skill had doubled between 2015 and 2018, alongside the number of telemedicine visits ballooning by over 25%.

That same report found that 15% of all physicians were employed in settings utilizing telemedicine to some extent. Meanwhile, in the presence of younger providers apparently being more willing to utilize telemedicine, an increase in the willingness of older physicians to do so also strengthened.

At the time of the Doximity report, the top 10 medical specialties “most engaged with telemedicine job postings” were radiology, psychiatry, internal medicine, neurology, family practice, dermatology, pediatrics, emergency medicine, geriatrics, and allergy & immunology. On the other side of the calculation, the 10 least engaged were anesthesiology, general surgery, orthopedic surgery, obstetrics & gynecology, oncology, physical medicine/rehab, gastroenterology, otolaryngology (ENT), cardiology, and plastic surgery. From the standpoint of practicality, the specialties with the least engagement with telehealth most readily require hands-on care.

What is Being Lost?

Many gains can be cited vis-à-vis the rise of telemedicine, and some losses are also to be found. In an August 2020 article on the JAMA Internal Medicine website, Dr. Paul Hyman of Mid Coast-Parkview Health in Brunswick, Maine, opined that the loss of the ritual of the physical examination was multifaceted and disturbing for him as a practicing physician. To wit:

As our primary care practice has pivoted to telehealth and the physical examination has been ripped away from me, I find myself reflecting on what value the examination has. It is clearly needed at times to make a diagnosis. But I now realize the other ways I use the examination to advance care and its significance to my own well-being. It is a means through which I pause and physically connect with patients, I demonstrate my knowledge and authority, and is a tool I use to persuade patients and reevaluate their narratives.

Aside from the ability to persuade patients to “reevaluate their narratives,” Dr. Hyman has also found other losses tied to a lack of physical examination:

Many physicians would say that some diagnoses cannot be made without examining a patient in person. I am not sure how I am supposed to distinguish central vs peripheral vertigo, diagnose otitis media, or determine if someone has orthostatic hypotension without examining a person in front of me. In addition, many of us have cases where an unanticipated finding on examination feels as though it saved a patient’s life. A discovery of an irregular mole, a soft tissue mass, or a new murmur—I do not forget these cases, and I do not think the patients do either.

What was less apparent to me before the pandemic was how a thorough physical examination provides a measure of objectivity that can help me rethink a patient’s narrative. I work in Maine, which has its share of stoics. A patient recently came in feeling a bit tired but felt it was nothing, likely as a result of working too hard. His examination suggested he was in heart failure. If I had not been able to listen to his heart and lungs, and examine his jugular vein and lower extremities, I may have put too much weight on the patient’s lack of concern and missed the diagnosis.

In Wired magazine, a September 2020 article warned that many of the patients who most need telemedicine are the ones least likely to have access.

Nationwide, 41 percent of people covered by Medicare don’t have an internet-capable computer or smartphone at home, according to a recent paper coauthored by Eric L. Roberts, who teaches health policy at University of Pittsburgh, and Ateev Mehrotra, a health policy professor at Harvard Medical School. Black and Latinx elderly people were less likely to have internet access than white people, the authors reported, and people who have lower incomes, are enrolled in Medicaid, or have a disability were also less likely to have access to the internet.

Tentative Steps Forward

Numerous articles extoll the virtues of telemedicine, while a seemingly equal number elucidate the drawbacks and limitations. Treatment of substance use disorders with MAT (Medication-Assisted Treatment) can be enhanced in some locations with telehealth, yet, as the aforementioned Wired article contended, access to the internet and an appropriate device is a hindrance in rural and urban areas alike.

Telemedicine is now an endemic aspect of healthcare delivery, and we can expect continued exponential growth into 2021 and beyond, even after the COVID-19 pandemic subsides.

As insurance companies offer more reimbursement and healthcare organizations embrace lower costs in the absence of in-person patient visits, the utility and relative equity of an increased telehealth market share will continue to be debated in legislative sessions, medical journals, and in healthcare facilities the world over.

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Be kind to yourself — you’ll be healthier for it

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You forgot your mom’s birthday, you blew the presentation at work and you haven’t worked out in a month — so you beat yourself up. If your best friend called and told you they had done any of these things, you would spend an hour or more talking them through it and making them feel better.

Why is it so easy to be kind to your friends and even strangers, but so difficult to give yourself a break?

The voice inside your head can build you up or tear you down, stiffen your resolve or break you. Being kind to yourself, mentally and physically, can make you healthier and happier.

A study published by Clinical Psychological Science shows that people who talked to themselves in a positive tone had lower heart rates and lower sweat response, which switches off the body’s threat response and can lower the risk of disease.

People with recurrent depression especially can benefit from talking to themselves and treating themselves kindly, the researchers said.

What does being kind to yourself look like? The same as it looks when you are kind to others — showing patience, acceptance and caring. Talk to yourself the way that you talk to people you love. Think of the nicest person you know, a parent, grandparent, favorite teacher or mentor who was kind to you. How did they treat you? How did they talk to you?

Make time for yourself every day to do something that you enjoy. Whether it’s reading, gardening, playing music, sports or games, this should be something that is just for you.

Give yourself some credit when you do a good job, do something nice or accomplish a goal. You would congratulate a co-worker or your youngster, so why not treat yourself as kindly? Be kind to others. When you start to be kind to yourself, it’s easier to be kind to others. When you are kind to others, it’s easier to be kind to yourself. Being kind to others can make a huge difference in their lives and make you feel good about yourself.

When you’ve had a rough day (or week), recharge with some self-soothing like a hot bath, long walk or snuggling with your pet.

Forgive yourself for past mistakes. Nobody is perfect and dwelling on things you have done wrong doesn’t make them go away.

Take care of yourself. Get enough sleep, eat nutritious food, get regular exercise, drink water to stay hydrated and look after your appearance. You will feel better physically, and you will feel better about yourself.

Make healthy friendships. Friends who support you and your dreams can add quality to your life.

Respect yourself. You have value, respect yourself. Keep your promises to yourself.

Don’t dwell on failure. So, you didn’t succeed the first time, but you tried. Give yourself a pep talk and try again. Think of all that you have learned from the experience.

Stand up for yourself. When your inner voice starts to put you down, defend yourself like you would a friend.

Acknowledge your flaws. We all have flaws. You can’t parallel park, you are not good at math and you always forget to make up your bed. If your best friend had these flaws, you would work around them. If they are serious issues, get help — just like you would for your best buddy.

Seek help if you need it. For really big issues, like depression, mental health, drug or alcohol problems, get professional therapy. If you had a broken leg, you would get help. Take care of yourself!

Stop trying for perfection. You won’t reach it and it will just frustrate you. Just try to be better every day. Besides, perfection is boring.

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Research paper: Small businesses lose big in COVID-19 closures

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Social-distancing restrictions have been nothing nice for mom-and-pop shops during the pandemic. In the Journal of Economic Management and Strategy, professor Robert Fairlie takes a deep dive into the harm that COVID-19 unleashed on U.S. small-business owners.

“These findings of early-stage losses to small businesses have important policy implications and may portend longer-term ramifications for job losses and economic inequality,” he wrote.

The initial closing of enterprises, goods producing and services to slow the pandemic’s spread was severe. According to Fairlie: “This study provides the first estimates of the early‐stage effects of COVID‐19 on small business owners from April 2020 Current Population Survey microdata.

“I find that the number of working business owners plummeted from 15.0 million in February 2020 to 11.7 million in April 2020 because of COVID‐19 mandates and health‐ and economic‐driven demand shifts. The loss of 3.3 million active business owners (or 22%) was the largest drop on record.”

By contrast, business activity fell 5% during the Great Recession, according to Fairlie. It is worth noting that small businesses paved the path in terms of hiring to end the Great Recession in mid-2009.

The microdata Fairlie marshals on 2020 coronavirus-related business closures suggests that many may be permanent. Loss of cash flow is a big reason why those enterprises that closed temporarily might not reopen. Fairlie, a professor of economics at the University of California, Santa Cruz, has testified to Congress on minority businesses’ struggles during the pandemic.

In his paper, he found a small business bounce-back from April numbers in May and June of 7%. However, the fate of small businesses temporarily closed remains unclear.

What is clear is that federal policy is underserving small businesses and their employees. For instance, the GOP-controlled Senate has not approved a new COVID-19 aid package to help constituents including small business owners. The CARES Act, Uncle Sam’s initial economic relief bill, lasted through the summer.

Renee Johnson is a senior advisor with Small Business for America’s Future, an advocacy group based in Washington, D.C. “It’s been five months since the Senate passed any relief programs for small business owners,” she told MultiBriefs in an email. “Many of them are now feeling the impact of trying to figure out how to apply for forgiveness for their Paycheck Protection Program loans and make ends meet without further aid and dwindling consumer demand since enhanced unemployment benefits have expired.”

The $600 per week pandemic unemployment aid ended nine weeks ago. The politics for more federal aid to small businesses, such as 80% of independent restaurants that face closing without additional help from Washington, are dicey.

Why? The focus on a replacement for late Supreme Court Justice Ruth Bader Ginsburg is front and center in the nation’s capital now. Meanwhile, Paycheck Protection Program loans to small businesses through the CARES Act are just about depleted.

In the meantime, Small Business for America’s Future is calling on Congress to craft a COVID-19 recovery plan for mom-and-pop shops across the country. To this end, the group is holding a tele-town hall at 7:15 p.m. EST on September 24. For more information, visit https://www.smallbusinessforamericasfuture.org/.

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Has telehealth had its day? It depends on who you ask

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According to some new studies, telehealth use has plummeted from its COVID-19 peak in April and May when the pandemic was in full swing and much of the economy was shuttered. However, some reports suggest that its use continues to soar.

Per Doximity, estimates are that more than 20% of all medical visits will be conducted via telemedicine in by the close of 2020. This would represent more than $29 billion worth of medical services. Such a growth trajectory could see telehealth reach upwards of $106 billion of the U.S. healthcare market by 2023.

Despite the possible carving out of virtual care from the traditional face-to-face models, significant issues remain. Primary among them is reimbursement for virtual services.

Will the federal government move to enact longer term reform that was adopted as part of the amplified response from the nation’s healthcare leaders during the height of the COVID-19 spread?

Time will tell. Some efforts from lawmakers and lobbyists have taken place.

In August, the Federal Communications Commission (FCC) unanimously approved $200 million in telehealth funding and, within the same month, the Centers for Medicare & Medicaid Services (CMS) announced proposed changes to expand telehealth permanently, suggesting that telemedicine has come into its own.

To better understand the evolving role of telemedicine, Doximity researchers examined three important aspects of its use as a clinical tool. First, they conducted a comprehensive inventory of patients’ changing attitudes towards, and their experience with, telemedicine as a replacement for in-person visits to the doctor’s office.

In mid-September, a new bill was introduced that would mandate payers to ensure that all telehealth services be covered if those services are also furnished in person. H.R. 8308 was introduced by U.S. Rep. Dean Phillips (D-Minn.) and attempts to determine how healthcare providers are reimbursed for their telehealth services.

Payers want to set reimbursement rates for telehealth services. Some states have pushed back on this and enacted legislation allowing payers to negotiate reimbursement rates with providers.

In Florida, the state committed $2 million to expanding telehealth services in schools. The money comes from CARES Act funding and will expand telehealth access to mental health services in schools in 18 counties where access to specialists is limited and broadband connectivity is low.

Tennessee lawmakers passed legislation that expands coverage for telehealth services earlier this summer, requiring payers to cover telehealth services as they would cover in-person care, and also requiring payers to cover remote patient monitoring services if that service is covered by Medicare, with payer and provider negotiating the amount of reimbursement.

The new law mandates reimbursement parity for telehealth services up until April 2022. It also allows licensed alcohol and drug abuse counselors and veterinarians to use telehealth to meet patient-provider relationship and standard of care guidelines — also up until April 2022.

It also relaxes the definition of an originating site for telehealth delivery, by characterizing it as “the location where a patient is located for telehealth services and that originates telehealth service to another qualified site, such as the office of a healthcare services provider, a hospital, a rural health clinic, or any other location deemed acceptable by the health insurance entity.”

Researchers and users of the technology say the benefits of the technology are obvious: ease-of-use, more flexibility, and reduction in cost of delivery.

Doximity also reviewed how physicians are using virtual care tools, and analyzed adoption data from its telemedicine feature set, which has grown in the first half of 2020 to more than 100,000 regular physician users.

It found high adoption of telemedicine among patients and physicians alike, “with strong evidence indicating that this shift represents a true change in how medicine is delivered in the U.S. Moreover, we anticipate that demand for telehealth service options will continue to grow quickly, and care providers may even find themselves competing to provide the best telemedicine experience.”

However, according to data from Epic, telemedicine visits made up just 21% of total encounters by mid-July, down from 69% in April. In other words, a significant drop in use occurred despite rosy pontifications from others.

CMS proposed making nine new telehealth codes permanent in its physician fee rule for 2021, along with 13 on a trial basis. But greenlighting the most meaningful changes requires congressional action.

Will patients continue to use the service? After COVID-19 settles, they may ditch virtual visits for in-person and human-connected visits. Vendors say the biggest hump was getting patients to try the service, and now that many have, they won’t go back as telehealth becomes normalized.

Twenty-three percent of respondents in Doximity’s survey said they planned to use telehealth again once the pandemic ends. Only 28% of people said they thought virtual visits were the same or better quality to an in-office exam.

That is a problem for the technology until a tipping point is reached, or the pandemic forces people to continue using such services for their healthcare needs.

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How to setup your telemedicine workspace

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Despite having been around since the 1970s, many healthcare providers have yet to embrace telemedicine. Fortunately, if you’re reading this article, you’ve taken a step in the right direction.

The COVID-19 global pandemic has made telemedicine more important than ever. People are stuck in a paradox. They are more aware and concerned about their health, but less willing and comfortable to visit their doctor for fear of catching coronavirus. Telemedicine solves this issue perfectly.

Setting up your telemedicine workspace

While implementing telemedicine should be a fairly smooth process, you may need to make some changes to your current setup. We’ve put together some key steps to help you on your way. Read on to find out how to set up your telemedicine workspace.

Upgrade your phone system

Pretty much all of your patients will have access to a phone. This makes phone calls one of the main ways you can provide telemedicine appointments. Take a look at your current phone system. Is it up to scratch?

Currently, your inbound calls probably go directly to your receptionist. This is fine when people are just trying to book appointments, but it doesn’t quite cut it for telemedicine.

Investing in multi-line VoIP phone systems will ensure your patients can always reach the right person. Each physician can have their own dedicated line, meaning your patients won’t wait on hold just to end up speaking to the wrong doctor. However, you’ll probably also need a cloud PBX system. This can assist with call routing — and also forward your calls to a receptionist or voicemail when you’re in another appointment.

These tools will also help you in the future should you need to scale your business. You can easily add new lines whenever a new physician joins your practice, or if you want to add a new department.

Setup your ‘studio’

Telephone appointments are great, but what is world-class customer service without a friendly face?

Investing in video conferencing software is a great way to offer virtual appointments. Businesses have been using video calling for virtual project management for some time now, so there are plenty of options out there.

When your patients are video calling with you, they should feel like they are with you in the doctor’s office. Invest in a high-quality webcam and microphone so that your patient can see and hear you clearly. Make sure your broadband is up to scratch so that you have a clear picture without lagging and freezing.

You also need to think about where you’ll be sitting and what’s behind you. It might sound silly, but move some furniture around to give the best possible impression. Pretend that you’re dressing a set for a TV show. Ensure that your background is neat and tidy, have any relevant certifications on the wall, and make sure your shoulders and head are comfortably in frame. If you’re really struggling, remember that a blank wall is better than a messy apartment!

Use visual aids

Visual aids are important for telemedicine, as they can help both the patient and the physician gain a better understanding of the issue. You probably already have several visual aids that you use for physical appointments. Whether it’s a pain scale, a BMI chart, or a diagram of the body, these can help the appointment run smoothly.

Make sure to tailor these aids for use on a video call. A small, detailed diagram may be fine for people visiting your office, but will it be clear on screen? Aim for large, simple diagrams that are easy to see. You may want to have digital files available so that you can screen share, rather than trying to hold it up to a webcam.

Visual aids like this will also help patients feel more comfortable using telemedicine. Familiar charts and diagrams will remind them that this is no different than visiting you in person.

Don’t forget about privacy

When conducting a virtual appointment, it’s easy to forget that you’re dealing with sensitive and private information. You need to make sure your standards don’t slip. Treat a video or phone appointment in the same way you would treat a physical appointment. Ensure you are somewhere private where you cannot be overheard, and advise your patient to do the same. You need to remember that you will still have patients coming in for physical appointments, so conducting a video call on the receptionist’s computer won’t do!

It’s important to note that your video software should be HIPPA-compliant. This will ensure that your video appointments are secure and private.

There’s a chance that you and your patients may also need to securely share PDFs online, especially if they’re signing consent forms. Remember that emails are not secure. Either use specialist software, use a fax machine, or post it.

Give your patients options

The whole point of telemedicine is to make things easier for patients. If you restrict the ways patients can get in touch, then you’ve defeated the purpose of telemedicine.

The best call center software is packed with features that can streamline the process for you. As well as phone and video calls, they offer text, fax and email options. Many also let you manage social media accounts, but you’re not going to need that for appointments.

Telemedicine also means you can offer services outside of your normal working hours. Patients can leave voice or video messages to be securely stored until you’re able to respond. This can help patients who work long shifts or unsociable hours.

Don’t be afraid to adapt

If telemedicine is new to you and your patients, don’t be afraid to adapt. Listen to feedback, ask whether patients would help with anonymised surveys, or get a friend to do a test call. This way, you can set up a telemedicine workspace that works for you and them.

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Want to fly and stay safe? Here’s what you need to know

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Since the COVID-19 pandemic spread around the world, people have figured out ways to conduct business and family reunions without getting on an airplane. But sometimes you have to go. So how do you stay safe on a plane?

First, make sure you really want to go. Some states and countries require people who travel out of state to quarantine for two weeks after arriving or coming home. And some countries aren’t allowing Americans in at all. Check your state’s requirements and those of the destination you are headed. If you don’t have two weeks to be secluded, you probably should stay home.

The Centers for Disease Control says there isn’t much likelihood of getting COVID-19 on a plane because of the way air is filtered and circulates, but airplane seating makes social distancing difficult, so flying could increase the chance of catching the virus.

Still need to go? If you are clear for takeoff, make sure you pack correctly.

Get a mask, in fact, get more than one. You don’t want your mask to fall out of your bag or get left in an airline bathroom, because you are going to have a hard time getting on a plane without one. Your airline might be willing to give you one, or they might not. Put one mask in your carry-on, another in your bag and have one in your pocket or purse to put on when you get to the airport.

When you go through screening, the Transportation Security Administration (TSA) officer is probably going to ask you to adjust your mask so they can see your face. But instead of handing them your boarding pass or cellphone, place it on the scanner yourself to eliminate extra contact. Put your keys, wallet and phone in your carry-on instead of dropping them into the bin when you go through screening, too. If they make you take your cellphone out, ask if you can hold it.

Washing your hands with soap and water for 20 seconds is important in limiting the spread of COVID-19, according to the CDC. Wash your hands before and after going through TSA screening, and after touching kiosks, handrails, elevators or escalators (but try to avoid touching these if you can).

If you cannot wash your hands with soap and water, use hand sanitizer that is at least 60 percent alcohol. The TSA now allows people to carry on a 12-ounce bottle of hand sanitizer, unlike the limit of 3.4 ounces for all other liquids and gels. They are probably going to screen it separately, though, so be sure you have some extra time.

Many airports have spots 6 feet apart marked on the floor at airline and rental car counters and for the lines at the TSA checkpoints. Look for the spots on the floor, and keep your distance in restrooms, seating and food counters, too.

When you get on the plane, it’s probably going to get more difficult to stay 6 feet apart, especially once you take your seat. Keep your mask on when you are boarding and while in your seat, except for eating. Some airlines have done away with food service, so that might not be an issue. Passengers can bring on their own food (put in a plastic bag during screening) and buy drinks once they are through the TSA checkpoint.

You also need to do all the things during travel that you do at home – stay away from people who are sick, don’t touch your nose and mouth and cover your nose and mouth when you cough or sneeze, preferably not with your hands, but with your elbow or a tissue.

And if you don’t feel good, stay home!

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