Patient satisfaction rates provide a measure of the healthcare system’s ability to meet patients’ expectations. In traditional healthcare, patients feel the biggest factors impacting their satisfaction rates are long wait times and staffing shortages. Remote patient management uses patient education and accessible communication to ultimately extend the reach of healthcare workers’ capabilities.

Looking specifically at remote patient management practices, it can be noted that the practice has a patient satisfaction rate of 91% among Canadians.

Improving Patient Care Remotely

Remote patient management leverages patient education and remote communication tools to allow providers to work with a greater volume of people. By giving patients the tools they need to take proactive care of their health, remote patient management reduces the long-term involvement on the provider’s end. 

The transition to remote patient management can take some adjustment for both patient and provider. Using the communication tools available, providers can make this process much easier for both parties. 

Communicate Effectively

When patients begin remote care, the transition may bring a level of discomfort with the new lines of communication. To mitigate these effects, the patient must be aware of how they can connect with their care team and the channels they can use to communicate.

Virtual communication skills also promote increased patient satisfaction. For example, using empathetic responses and engaging with body language can show your patient that you hear and understand their concerns. When conducting a virtual care appointment, setting an agenda at the beginning of the session ensures your patient that you will address all of their concerns.

Take your remote patient management a step further by staying in touch with them outside of scheduled appointments using telehealth messaging systems, file sharing, or resource sharing. 

Make sure your patient is aware of the lines of communication available to them and how they can contact a member of their circle should they need to.

Educate Patients & Encourage Learning

1 in 3 patients feel they’re inadequately educated on their medical care needs when they leave a hospital. As a provider, you can use resources in telemedicine platforms to educate patients on how they can take care of their individual health needs. Sending your patients articles or videos on how they can help themselves with their condition will increase their satisfaction with remote care by assuring them they have solutions at any time.

With remote patient management care, patients learn what factors influence their health and what management tools help prevent any negative impacts. When patients get a head start on preventative healthcare, they reduce the risk of needing emergency interventions later on.

Be Accessible

Many people in remote areas of Canada don’t have accessible healthcare, with some people travelling 200km to attend routine checkups. The solution is telemedicine, which allows people in remote areas to access healthcare right from their living rooms. When people can take proactive steps in their healthcare like regular checkups, the risk of emergency intervention later on decreases. 

Telemedicine is also less involved on the provider end, which frees more time to take on more patients. As patients can treat themselves independently they require even less involvement from the provider and are healthier.

Continuing to Improve Patient Satisfaction

Providers can significantly improve patient satisfaction through remote care with open lines of communication. When providers use the education resources at their disposal, patients can become more proactive with taking care of themselves. Remote patient management lets people in remote areas get easy access to healthcare, so everyone in Canada has a fair opportunity to be safer and healthier. 

The post How To Increase Patient Satisfaction Levels In Canada Through Remote Patient Management appeared first on mTelehealth.

OTTAWA, ON, June 2, 2022 /CNW/ – Aetonix Systems, the leading platform for virtual care and remote patient management, announced today that it has completed its SOC2 Type 2 audit of the aTouchAway™ System. SOC2 Type 2 indicates confidence from auditors that controls are being applied consistently and on an ongoing basis to all aspects of its business with a commitment to maintaining stringent and effective operation controls and processes for the security of its customer services and systems. The independent audit of Aetonix Systems was conducted by Richter LLP, one of the largest and most recognized independent consulting firms in Canada.

“Ensuring data security and confidentiality for our clients is of highest priority” said Michel Paquet, CEO at Aetonix Systems. “With our SOC2 Type 2 certification, we can continue to demonstrate to our customers our commitment to the highest level of security practices, often surpassing the exacting standards of the various national hospital and healthcare organizations we serve.”

SOC2 Type 2 audit consists of a rigorous examination by an independent accounting and auditing firm of the Aetonix Systems internal control policies, practices, procedures, and operations over a period of time.

“At Aetonix Systems, we work with many of the world’s leading healthcare providers to enable virtual care and remote patient management, an area that continues to accelerate following the pandemic. Data security and confidentiality has always underpinned everything we do and attaining SOC2 Type 2 certification formally recognizes this achievement,” said Michel Paquet.

About Aetonix: 

Aetonix is changing lives daily with its virtual care platform, aTouchAway®, which provides telehealth, care pathways and remote patient management to optimize connected health. Its face-to-face communication platform is revolutionizing the way families, healthcare professionals and patients receive care. Over 250 hospitals and tens of thousands of patients use Aetonix globally.

SOURCE Aetonix Systems

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Canada is a leader in providing high-quality healthcare services to patients nationwide. While there is no doubt that healthcare in Canada is advanced when compared with lesser-developed nations, there is always room for improvements and innovation in the sector. In recent years, Canadian healthcare has experienced a few hardships, such as a shortage of healthcare professionals. This both limits access to healthcare services for patients, and puts increased pressure on healthcare workers. To overcome challenges such as these and ensure healthcare professionals are able to adequately provide care for patients, many organizations are seeking new ways to enhance their healthcare processes. 

Here, we’ll highlight a few of the ways telehealth is helping Canadian healthcare professionals through the use of remote patient management:

Enhancing Healthcare Processes With Telehealth

A common solution that organizations have turned to in order to provide ease of work to healthcare professionals is telehealth. Through virtual care platforms, healthcare professionals can access a variety of useful tools that can enhance the way they deliver care, and even lessen their workload. With the advancement in these technology-based solutions in the healthcare sector, organizations such as primary care clinics, hospitals, specialty clinics, and care homes can all benefit from improved efficiency. 

When looking to implement a telehealth platform, healthcare providers should ensure it is able to meet all of their needs, and their patient’s needs. Many of these solutions are focused on enhancing one or few healthcare processes, such as virtual appointments or patient screening. With fully integrated telehealth platforms that offer remote patient management, these organizations can utilize features that improve efficiency in most patient care processes. This can include managing patients every step of the way, whether they have a chronic illness and require continuous care, are preparing for a surgical procedure, recovering from an operation, or simply wish to continue regular check-ups with their primary care physician.  

Benefits of Remote Patient Management For Canadian Healthcare Providers

Improves Diagnosis & Decision Making

With traditional healthcare visits within Canada, patients and healthcare providers are limited to how often they can communicate with one another and share health-related data. Even with remote monitoring equipment, if the proper telehealth platform is not being used, patients will still need to wait until their next visit before discussing any changes in their condition. With remote patient management however, patients are encouraged to log their health data regularly, and can instantly share it with their care circle. In doing so, healthcare professionals and their patients can be on the same page about the status of the patient’s health, and what steps must be taken next to maintain or improve their condition. 

This is important for reducing healthcare professionals’ workload, as collecting, interpreting, and storing patients’ data manually requires a considerable amount of time and resources. Telehealth visits can also allow healthcare providers to enhance the methods they use for diagnosing a patient’s illness. In an article written by Jeff Brady, M.D, he analyses the findings of an issue brief related to “Telediagnosis”. The findings he discusses show that through virtual visits, patients’ family members are able to give their input about a patient’s condition, and healthcare providers can assess the patient’s living condition and determine whether it may be a factor in their health. In doing so, providers can not only improve the way they are able to care for patients, they can also reduce the amount of time it takes to land on a diagnosis.

Allows For Efficient Patient Management

Healthcare organizations within Canada are typically made up of various types of healthcare professionals who bring their own unique skills and expertise. Most commonly, patients seeking healthcare services will be in contact with registered nurses, physicians, specialists, and other healthcare providers along the way. The involvement of so many parties can sometimes be difficult to keep up with all of their medical history, and needs. 

With remote patient management, multiple healthcare providers can access a telehealth platform to keep in touch with patients and other members of their care circle. For example, with the aTouchAway platform, patients will most commonly be in contact with their primary care physician. Through this platform, healthcare providers can conduct virtual visits, follow-up with patients regularly, send medical resources, and collect health insights. 

In keeping all members of a patient’s care circle connected through the same platform, healthcare organizations can reduce the amount of time their staff must spend piecing together various components of a patient’s requirements and progress. 

Reduces Tedious Labour

One of the leading benefits of telehealth is the convenience it offers patients and healthcare providers. With traditional in-person healthcare visits, it’s common for providers to spend a good portion of the visit using equipment to monitor a patient’s symptoms and record their findings. This can reduce the amount of time the provider is able to spend completing tasks that could be more beneficial to their patients, such as discussing their health concerns in greater detail. 

With remote patient management, providers can shift some of the “work” onto the patient, which both reduces the amount of time they must spend completing this, and can actually provide more accurate results for patient data, among other benefits. In addition to reducing the time providers must spend monitoring patients, remote patient management can also help save time with assigning custom, or already assembled care plans as they can be integrated directly into the platform and assigned to patients. 

Continuing To Provide Ease of Work To Canadian Healthcare Professionals With Remote Patient Management

With the many benefits telehealth offers, it’s clear to see why so many healthcare organizations are implementing these systems to better serve their patients and enhance workplace processes for staff. By utilizing remote patient management systems and all of the features they offer, healthcare providers can continue to improve the ways they diagnose patients, manage their conditions, and perform various care tasks. 

The post How Remote Patient Management Is Providing Ease Of Work To Healthcare Professionals In Canada appeared first on mTelehealth.

Building relationships with patients is essential to providing quality healthcare services. A strong patient-provider relationship can help increase levels of trust and understanding, which can ultimately improve healthcare providers’ ability to meet patients’ individual needs. When it comes to improving these relationships, there are several options providers can utilize, one of which is virtual care pathways. 

With the rise of telehealth, and more patients seeking healthcare services remotely, many providers are turning to these solutions to provide effective services while maintaining or improving their relationships with patients. While building patient relationships virtually may sound challenging, there are several unique features which can make this process seamless for all parties involved. 

Understanding The Importance of Virtual Care Pathways

Prior to utilizing a care platform that facilitates virtual care pathways, it is beneficial for healthcare providers to gain a clear understanding of what these pathways are, and how they differ from traditional in-person ones. Virtual care pathways can be defined as packages that include assessment materials, educational materials, and roadmaps that care providers and patients can follow and be guided by. These pathways can be used for complete management of chronic conditions such as COPD or diabetes, as well as acute management for pre, or post-operative care, patient screening, and more. 

Traditional care pathways are defined as “a complex intervention for the mutual decision-making and organization of care processes for a well-defined group of patients during a well-defined period”. The aim of these pathways is enhanced quality of care, improved patient outcomes, and better overall patient satisfaction and safety. While there are clear benefits to utilizing care pathways, whether in-person or virtually, some processes can be further enhanced when delivered remotely. By offering care pathways virtually, healthcare providers can meet their objectives more efficiently and have more time to improve their relationships with patients. 

Benefits of Virtual Care Pathways For Providers

Collecting Patient Feedback and Data Can Be Done Effortlessly

In order to create strong patient-provider relationships, providers must ensure they are effectively meeting the needs of their patients. More often than not, with traditional in-person care, providers do not have ample time to spend communicating with patients about secondary health concerns or other topics as they must spend a majority of the visit reviewing and interpreting symptoms. This can lead to patients having to return frequently for visits that could have otherwise been avoided had there been time to address their concerns, which can lead to a perceived lack of quality. Furthermore, healthcare providers often do not have the time to communicate directly with patients to gather feedback about the quality of their visits during in-person healthcare appointments. 

With virtual care pathways, these barriers to patient communication and satisfaction can be significantly minimized, which can lead to a better overall patient-provider relationship. Through these pathways, healthcare providers can stay updated on their patients’ health in real-time, whether through remote monitoring equipment, or direct messages from patients. They can also send follow-up messages to patients to see how they are progressing with their health. By creating more efficient means of collecting patient data and feedback, healthcare providers can focus more of their scheduled appointment time connecting with their patients on a more personal level, and gain a deeper understanding of their needs.

Efficiency For Regular Healthcare Processes Can Be Improved

Healthcare processes can be tedious, and often involve more than one healthcare professional. When caring for patients with chronic or acute healthcare needs, physicians, registered nurses, licensed practical nurses, care aides, and other healthcare workers are likely to participate in the care process. With involvement from multiple parties, it is important that care processes are as efficient as possible to minimize confusion and improve patient care. 

By utilizing virtual care pathways, healthcare organizations can enhance a variety of complex duties. For example, the care pathway aTouchAway offers for COPD managementallows for simplified follow up, automated assessment and evaluation forms, and guided patient education sessions. When patients are assigned this care pathway, various members of their care circle can be included and assigned different care tasks through the platform. This allows them to quickly access patient data, and follow up all in the same place. The increased efficiency allows healthcare providers to spend more time building relationships with patients through the simplification of processes.

Benefits of Virtual Care Pathways For Patients

Healthcare Services Can Be Accessed From Anywhere With An Internet Connection

For many patients, access to in-person healthcare services are limited, especially for those who reside in remote communities. In Canada, fewer than 10% of physicians and only 2% of specialists are available in rural areas despite 22% of the population living in these communities. This can cause a number of complex issues for patients, especially when they require care for a chronic condition. Patients may have to travel far distances to visit their primary care provider, and may even put off getting the care they need due to accessibility issues. Patients who do not have regular access to care are also at higher risk of hospitalization for their condition. 

With virtual care pathways, healthcare providers can stay connected with patients regardless of where they are located, granted they have access to a smart device with an internet connection. This can help ensure patients have the continued support they need to further their health progress, and help create a stronger patient-provider relationship.

Communicating With Care Team Members is Straightforward

For those who have complex needs, for example patients living with one or more chronic illness or health ailment, it is common to see multiple healthcare professionals and specialists. Patients may also wish to keep loved ones or caregivers in the loop when it comes to their health. With traditional care practices, it can be difficult for patients to keep all of these members updated on changes in their health, and effectively communicate their health needs. 

When patients are enrolled in a virtual care pathway however, healthcare providers can grant access permission to other parties that have been approved by the patient. With this, patients are able to communicate with various healthcare professionals, or other members of their care circles and keep them updated on the status of their health. This can help patients create stronger bonds with their care providers by allowing them to easily connect through messaging, and video conferencing.

The Future of Telehealth & Patient-Provider Relationships

One of the main outcomes healthcare providers hope to achieve when utilizing virtual care pathways is enhancing the care experience for their patients. When patients’ care needs are met, and they are able to feel comfortable communicating with their care team, it is more likely that they will be able to form stronger connections with their providers. By seamlessly collecting patient’s data and feedback, enhancing efficiency and communication, and creating more accessible care through virtual care pathways, healthcare providers can continue to strengthen patient-provider relationships. 

The post The Effect Of Virtual Care Pathways On Building Patient-Provider Relationships appeared first on mTelehealth.

September 28, 2021 – All those with Chronic Obstructive Pulmonary Disease (COPD) now can have access to the RESPIPLUS™ Living Well with COPD self-care resources through the Aetonix aTouchAway® digital platform.

More than 2 million Canadians aged 35 and older are living with COPD, a debilitating condition that impacts every element of life for its sufferers. COPD is the second most common reason for hospital admissions (after giving birth) and has the highest re-admission rate of any chronic disease in Canada.

The partnership between RESPIPLUS and Aetonix that has officially launched today makes available a process of care combining leading educational resources for people with COPD and a digital platform that can dramatically improve patient outcomes. This is done through virtual communications, remote patient management, and better management of clinical workflows. Patients using this new digital platform will benefit from the highest standard of care regardless of where they are in their journey, starting with a special follow-up post-hospital discharge, followed by in-depth evaluation protocols and proper education and support responding to their needs and priorities.

“Physicians and health care systems require an effective and more efficient platform to provide the best care to this (COPD) population. Aetonix will help us do this” said Dr Jean Bourbeau, a world renown respirologist at the McGill University Health Centre and the founder of RESPIPLUS.

Using the aTouchAway® platform in conjunction with RESPIPLUS Living Well with COPD resources, patients will be able to partner with their care team to obtain optimal care digitally. A 2020 survey by Canada Health Infoway showed 84% of Canadians want to use technology to better manage their health and 90% want technology that gives them more control over their health.

“aTouchAway® is the right solution to deliver the Living Well with COPD program seamlessly and successfully to significantly improve patient outcomes,” says Michel Paquet, CEO and Founder of Aetonix.

The ability to monitor COPD symptoms remotely through a platform such as aTouchAway® can significantly improve both patient satisfaction and outcomes. An analysis of remote patient monitoring studies for chronic conditions including COPD published earlier this year showed this approach can help reduce the need for in-hospital acute care.

Dr. Bourbeau and the team at RESPIPLUS, the non-profit providers of the Living Well with COPD educational resources, have worked successfully over the last 20 years to improve patient care and promote patient self-management. This has been demonstrated with more than 40 research publications showing improvements in patient self-management, reduced hospital admissions and costs.

“This initiative could not have been launched at a more key and pertinent time for our COPD population, who have been underserved in this country for many years”, explains Maria Sedeno, Executive Director at RESPIPLUS.

About Aetonix:
Aetonix is changing lives daily with its virtual care platform, aTouchAway®, which provides telehealth, care pathways and remote patient monitoring to optimize connected health. Its face-to-face communication platform is revolutionizing the way families, healthcare professionals and patients receive care. Over 250 hospitals and tens of thousands of patients use Aetonix globally. For more information on the Living Well with COPD care pathway, please visit: aetonix.com/copd-care-pathway-lwwcopd/

About RESPIPLUS:
The Living Well with COPD self-management program by RESPIPLUS™ was created to help patients affected by the disease learn skills to adopt healthy lifestyle behaviours. The program offers a series of learning modules with interactive tools and videos that explore topics, such as managing stress and anxiety, preventing symptoms and saving energy and being healthy with COPD. Medical experts, in collaboration with patients, created this comprehensive program. For more information, please visit: livingwellwithcopd.com

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Remote healthcare has taken big leaps forward over the past year, spurred on equally by new technologies and the onset of the COVID-19 pandemic. The biggest winners: senior patients, who are now able to benefit from more proactive care and avoid trips to the doctor’s office, clinic or emergency room. They can now use solutions such as remote patient monitoring (RPM) to track their vital statistics around the clock and share that information automatically each day with healthcare providers. Technologies such as RPM are helping to transform senior patient care, ensuring a patient’s safety and well-being while allowing them to live independently.

According to a recent report from the CDC, three-quarters of patients 65+ have two or more chronic conditions that require monitoring. This “Medicare population” makes up 71 percent of total U.S. healthcare spend. When patients are feeling poorly, they often end up at their doctor’s office or an emergency room or clinic. And in a COVID environment, that’s the last place patients with chronic illnesses should be. 

There are other challenges the healthcare industry faces when treating patients with chronic illnesses, and RPM can help eliminate many of them:

• At-risk patients need to be monitored 24/7
• Proactive 24/7 real-time interventions can dramatically improve outcomes, but are difficult to achieve
• Lack of budgets, staff, and experience with new technologies can stymie deployments
• Ease of use is critical; ongoing patient education and support may be required
• Less than 40 percent of chronic patients have basic, in-home infrastructure to support remote monitoring
• Economic/cultural disparity causes a range of care

A Patient’s Perspective

With RPM solutions, a patient’s vital statistics, such as blood pressure, oxygen level, blood glucose, weight, temperature, and other metrics, are consistently monitored and delivered to healthcare providers in real time. Providers can then receive the results and make quicker decisions to what actions should be taken. 

Some RPM solutions can also track data over time and spot abnormalities in readings, such as trends seen in low or high blood pressure, low oxygen levels, or see how new prescriptions are working in real time. It can then connect the patient to the doctor to explore solutions.

This is an important shift in healthcare, as many seniors might struggle with frequent in-person visits. For example, they may not have reliable means of transportation to and from their point of care, they might face an extended time in a waiting room and risk exposure to other illnesses, or—despite going home with paperwork—they might not remember all of the doctor’s orders once they leave the office. 

For RPM solutions to work, above all they must be easy for the patient to use. Studies have shown that when a patient that needs a higher level of care can track their vital statistics and communicate with their doctors from home instead of traveling to a health care professional, they are willing to use technology. In a recent study, 88 percent of Americans over age 40 said they are willing to adopt telemedicine solutions to receive care. Meanwhile, in a recent trial, more than 85 percent of patients that used an RPM solution indicated they would use it again if it was made available.

Patients that receive the most benefit from RPM solutions are those that require consistent monitoring of their vital statistics. When the patient is able to take these vital signs at home and have them delivered to their provider automatically, the paradigm of care is shifted from reactive episodic care to proactive preventative care. This allows providers and patients to work together in new ways to reduce the need for trips to the doctor’s office or hospital.

A Physician’s Perspective

RPM solutions allow doctors to proactively treat patients with chronic illnesses, providing them with the patient’s most current vital statistics. RPM provides more than just data points sent once a day. It also offers context through a set of rich data that allows healthcare providers to:

• Provide a variety of voice reminders to help patients with their care
• Track patients’ vital statistics over time and connect the dots to make diagnoses 
• View the data in context and quickly spot trends and determine a course of action 
• Act proactively to make an assessment allowing them to solve small problems before they become big ones
• Communicate directly with a patient via the RPM device to gain additional information about their condition
• Proactively care for patients so they don’t end up at the emergency room, clinic or doctor’s office
• Intervene in the patient’s care to get their health back to normal

RPM in Action

Two examples of RPM in use show how the technology is providing better care:

One patient experienced a spike in blood glucose levels (>500 mg/dl), triggering an alert. The virtual care team followed provider protocol by increasing medication and tracking the patient’s condition every two hours. The blood sugar level was decreased to 300 mg/dl, and a trip to the emergency room was avoided. 

In another patient, a 2-3+ edema bilateral in the lower extremities was detected. The virtual care team followed protocol, increasing medication and having the patient raise extremities and lower sodium intake. The outcome was the edema decreasing to +1 within 24/hours, and an emergency room visit was not required. 

Technology solutions such as RPM are making a huge difference in patient care. When seniors can be monitored consistently from home rather than a healthcare facility, they have more say in their care. And when their healthcare solutions are easy to use, they’re more likely to have a positive experience—leading to positive outcomes. 

The post How to Improve Patient Care with Remote Patient Monitoring Solutions appeared first on mTelehealth.

HELP IS ONLY A
BUTTON CLICK AWAY

The V.ALRT is a wearable help button that can be carried discreetly in a pocket or a bag, worn on the wrist, or around the neck as a pendant. The V.ALRT uses Bluetooth® SMART technology in association with a mobile application, to initiate calls and text
messages from a smartphone. With the push of the V.ALRT help button, your smartphone sends a personalized text message and GPS location to up to three pre-selected contacts.

WATERPROOF, LIFEPROOF

The V.ALRT Personal Alert Button is IP67 Compliant. This means the V.ALRT can go where ever you go. Whether that is
outdoors, to the pool, or even to the shower or bathtub

ANDROID & IOS COMPATIBLE

The V.ALRT works with iPhone 4S/iOS 7 or newer and any smartphone using Android 4.3 or newer with Bluetooth 4.0.

NO CHARGING NEEDED

The V.ALRT has up to one year of battery life and powered by a standard CR2032 watch battery. The battery is removable and replaceable by the user.

OUT OF RANGE NOTIFICATION

If the V.ALRT device travels out-of-range from the smartphone, both devices will receive an audio notification.

NO MONTHLY FEES

Since the V.ALRT operates through your smartphone, all of the features are available without any monthly service fees.

FALL DETECTION

The user can turn on Fall Detection to enable the alert to be sent automatically after a 60 second countdown.

GPS LOCATION

In addition to the alert text messages and phone calls, the location from your smartphone will be sent to your emergency contacts.

TEXT AND CALL

After pressing the button, the V.ALRT transmits a command to your smartphone to send a text message to your preset  contacts, followed by phone calls. This alert behavior is completely customizable.

WIRELESS RANGE

The V.ALRT must be within range of your smartphone to operate. It has a wireless range of up to 75′ indoor or up to 300′ outdoor using Bluetooth 4.0.

PRODUCT SPECS

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As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access the healthcare services they need in as safe a manner as possible. In order to provide our clients with quick and actionable guidance on the evolving telehealth landscape, Manatt Health has developed a federal and comprehensive 50-state tracker for policy, regulatory and legal changes related to telehealth during the COVID-19 pandemic. This summary of findings is current as of noon ET, Thursday, October 15.

Federal Actions and Legislation:

Select introduced federal legislation:

Federal Flexibilities and Reports:

Flexibilities

On Friday, October 2, the U.S. Department of Health & Human Services (HHS) announced that the Public Health Emergency (PHE) declaration for COVID‑19 will be renewed for another 90 days, beginning on October 23 (the date the PHE was previously scheduled to expire) and extending through January 20, 2021. For more information the renewed PHE, please see our Manatt Newsletter.

Reports:

On October 14, CMS released a Preliminary Medicaid and CHIP Data Snapshot to provide information on telehealth utilization during the PHE. This data shows more than 34.5 million services were delivered to Medicaid and CHIP beneficiaries via telehealth between March and June of this year—an increase of 2,600% when compared to the same period in 2019. Additionally, CMS updated its State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version to help providers and other stakeholders understand which policies are temporary or permanent, and to communicate telehealth access and utilization strategies to providers.

On July 28, HHS released the issue brief Medicare Beneficiary Use of Telehealth Visits: Early Data from the Start of the COVID-19 Pandemic. On July 15, CMS director Seema Verma released Early Impact of CMS Expansion of Medicare Telehealth During COVID-19, a blog on Health Affairs. This article highlights CMS’s efforts to expand telehealth during COVID-19 through the addition of 135 allowable telehealth services and the expanded list of types of health care providers who can offer telehealth, and explores how various mechanisms that have allowed for the increase in telehealth utilization during the PHE may continue.

State Laws, Policy, and Guidance

In Medicaid, states have broad authority to permit coverage for telehealth services. Prior to the COVID-19 emergency, many states had implemented broad coverage for telehealth, and in recent months, all 50 states and Washington D.C. have issued guidance expanding telehealth for their Medicaid populations. Medicaid programs have the broad ability to cover telehealth services and the flexibility to rapidly scale up benefits and adjust normal cost-sharing rules, making Medicaid well positioned to quickly address the needs of its beneficiaries during states of emergency.

Select State Legislation and Executive Orders

Since the COVID-19 public health emergency was declared, states have been moving to pass legislation that would permanently expand access to telehealth. The below chart lists telehealth legislation that has been enacted since March 13, the beginning of the PHE, and executive orders that have made the temporarily waived restrictions around telemedicine permanent.

State Trends

Coordination on Telehealth: Colorado, Nevada, Oregon, and Washington announced they will work together to identify best practices around access, confidentiality, equity, standard of care, stewardship, patient choice, and payment/reimbursement. The overarching goal of this partnership is to “ensure that the nation benefits from our knowledge as changes to federal regulations are contemplated, to support continued application and availability of telehealth in our states, and to ensure that we address the inequities faced in particular by tribal communities and communities of color”.

Commercial Payment Parity: In light of the COVID-19 pandemic, states that previously did not require payment parity for telehealth services in commercial plans have begun to issue temporary guidance requiring payment parity for specific telehealth cases. Prior to COVID-19, 9 states (Arkansas, Delaware, Georgia, Hawaii, Kentucky, Minnesota, Missouri, New Mexico, and Utah) had payment parity laws for commercial payers in 2020. California, Arizona and Washington had also recently passed telehealth payment parity legislation in 2019 and early 2020 that would come into effect in January 2021, bringing the total to 12 states. The Governor of Washington recently issued an Executive Order in March which required immediate implementation of its payment parity law.

Appendix K Telehealth Flexibilities: As of October 15, CMS has approved Section 1915(c) Waiver Appendix K (Appendix K) from 47 states and Washington, D.C. Appendix K is a long-standing federal authority that helps states streamline and expedite changes to their 1915(c) home and community-based services (HCBS) waivers to prepare for and respond to emergencies. As of October 15, at least 44 of the approved Appendix K waivers included telehealth flexibilities for states. Some of these flexibilities include adding electronic methods of delivery for case management; permitting personal care services that require only verbal cueing, in-home habilitation, or monthly monitoring; temporarily modifying provider qualifications; temporarily modifying processes for level of care evaluations and re-evaluations; and temporarily modifying medication management.

Audio-Only Telehealth Services: Many state Medicaid agencies are following Medicare’s lead to expand telehealth coverage to audio-only. This includes states that are either adding coverage for telephonic evaluation and management codes or allowing providers to bill the usual service codes when the services are delivered via telephone. As of October 15, all 50 state Medicaid agencies and Washington D.C. have issued guidance to allow for a form of audio-only telehealth services.

Child Well-care and Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Visits: EPSDT is a mandated benefit that provides comprehensive and preventive healthcare services for children under age 21 who are enrolled in Medicaid. Each state is responsible to provide EPSDT services to children and adolescents enrolled in its Medicaid program. The American Academy of Pediatrics has issued guidance recommending all children still receive EPSDT visits. As of October 15, only 19 states and Washington D.C. have issued telehealth guidance for Child Well-care and EPSDT visits.

Early Intervention Services: As of October 15, 16 states have issued guidance to providers to allow for telehealth or remote care delivery for early childhood intervention services. On April 5, Illinois’ Chief Bureau of Early Intervention cleared all previous Illinois Department of Healthcare and Family Services requisites in order to implement and practice Illinois’ first-ever Early Intervention Teletherapy. On April 6, the Illinois Early Intervention Program (IEIP) instituted use of Live Video Visits as a temporary measure until the Illinois state of emergency is lifted. The IEIP is now working on tip sheets for families in English and Spanish and developing resources to help families with internet fees and costs for a computer, camera, and microphone. On April 7, North Carolina (NC) Medicaid released new telehealth guidance expanding the services and provider types eligible to deliver telehealth during the COVID-19 pandemic. Special Bulletin COVID-19 #34 expands telehealth codes and guidance to services delivered through local education and children’s developmental service agencies, and services pertaining to dietary evaluation and counseling, medical lactation, research-based behavioral health treatment for autism spectrum disorder, and diabetes self-management education. NC Medicaid also published an accompanying billing code summary to equip providers with the new codes pertaining to telehealth.

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As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access the healthcare services they need in as safe a manner as possible. In order to provide our clients with quick and actionable guidance on the evolving telehealth landscape, Manatt Health has developed a federal and comprehensive 50-state tracker for policy, regulatory and legal changes related to telehealth during the COVID-19 pandemic. This summary of findings is current as of noon ET, Thursday, September 17.

Federal Actions and Legislation:

On September 4, 14 U.S. Senators sent a letter to the Secretary of the Department of Veteran Affairs (VA) encouraging the VA to provide coverage of comprehensive telehealth services, including audio-only and text messaging services, to Civilian Health and Medical Program of Department of Veterans Affairs (CHAMPVA) beneficiaries. CHAMPVA currently covers real-time audio-visual telehealth, but as this letter notes, many beneficiaries reside in rural areas where internet access is limited.

On August 3^rd, CMS released a proposed Physician Fee Schedule Rule which would make certain Medicare telehealth flexibilities permanent and extend others for the remainder of the year in which the public health emergency (PHE) ends. Additionally, CMS released a list of services they are seeking comment on to decide whether they should be added on a permanent or temporary basis. For a complete list of services impacted by this rule, please see the table below.

Summary of CY 2021 Proposals for Addition of Services to the Medicare Telehealth Services List

On the same day, the President issued an executive order (EO) requiring that within 60 days, the Secretary of HHS shall propose regulation to extend temporary telehealth flexibilities put in place during the PHE. The practical impact of this EO is limited given the statutory restrictions on coverage and payment for telehealth in the Medicare program and that CMS is already in the process of proposing telehealth coverage and payment changes through its typical policymaking process. It is important to note that CMS has consistently stated that extending many of the temporarily waived telehealth restrictions will require Congressional action.

Select federal legislation currently being considered includes:

Federal Flexibilities:

State Laws, Policy, and Guidance

In Medicaid, states have broad authority to permit coverage for telehealth services. Prior to the COVID-19 emergency, many states had implemented broad coverage for telehealth, and in recent months, all 50 states and Washington D.C. have issued guidance expanding telehealth for their Medicaid populations. Medicaid programs have the broad ability to cover telehealth services and the flexibility to rapidly scale up benefits and adjust normal cost-sharing rules, making Medicaid well positioned to quickly address the needs of its beneficiaries during states of emergency.

State Legislation and Executive Orders

Since the COVID-19 public health emergency was declared, states have been moving to pass legislation that would permanently expand access to telehealth. The below chart lists telehealth legislation that has been enacted since March 13, the beginning of the PHE, and executive orders that have made the temporarily waived restrictions around telemedicine permanent.

State Trends

Coordination on Telehealth: Colorado, Nevada, Oregon, and Washington announced they will work together to identify best practices around access, confidentiality, equity, standard of care, stewardship, patient choice, and payment/reimbursement. The overarching goal of this partnership is to “ensure that the nation benefits from our knowledge as changes to federal regulations are contemplated, to support continued application and availability of telehealth in our states, and to ensure that we address the inequities faced in particular by tribal communities and communities of color.”

Commercial Payment Parity: In light of the COVID-19 pandemic, states that previously did not require payment parity for telehealth services in commercial plans have begun to issue temporary guidance requiring payment parity for specific telehealth cases. Prior to COVID-19, 9 states (Arkansas, Delaware, Georgia, Hawaii, Kentucky, Minnesota, Missouri, New Mexico, and Utah) had payment parity laws for commercial payers in 2020. California, Arizona and Washington had also recently passed telehealth payment parity legislation in 2019 and early 2020 that would come into effect in January 2021, bringing the total to 12 states. The Governor of Washington recently issued an Executive Order in March which required immediate implementation of its payment parity law.

Appendix K Telehealth Flexibilities: As of July 23, CMS has approved Section 1915(c) Waiver Appendix K (Appendix K) from 47 states and Washington, D.C. Appendix K is a long-standing federal authority that helps states streamline and expedite changes to their 1915(c) home and community-based services (HCBS) waivers to prepare for and respond to emergencies. As of July 23, at least 44 of the approved Appendix K waivers included telehealth flexibilities for states. Some of these flexibilities include adding electronic methods of delivery for case management; permitting personal care services that require only verbal cueing, in-home habilitation, or monthly monitoring; temporarily modifying provider qualifications; temporarily modifying processes for level of care evaluations and re-evaluations; and temporarily modifying medication management.

Audio-Only Telehealth Services: Many state Medicaid agencies are following Medicare’s lead to expand telehealth coverage to audio-only. This includes states that are either adding coverage for telephonic evaluation and management codes or allowing providers to bill the usual service codes when the services are delivered via telephone. As of July 23, all 50 state Medicaid agencies and Washington D.C. have issued guidance to allow for a form of audio-only telehealth services.

Child Well-care and Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Visits:

EPSDT is a mandated benefit that provides comprehensive and preventive healthcare services for children under age 21 who are enrolled in Medicaid. Each state is responsible to provide EPSDT services to children and adolescents enrolled in its Medicaid program. The American Academy of Pediatrics has issued guidance recommending all children still receive EPSDT visits. As of July 23, only 15 states have issued telehealth guidance for Child Well-care and EPSDT visits.

Early Intervention Services: As of July 23, 16 states have issued guidance to providers to allow for telehealth or remote care delivery for early childhood intervention services. On April 5, Illinois’ Chief Bureau of Early Intervention cleared all previous Illinois Department of Healthcare and Family Services requisites in order to implement and practice Illinois’ first-ever Early Intervention Teletherapy. On April 6, the Illinois Early Intervention Program (IEIP) instituted use of Live Video Visits as a temporary measure until the Illinois state of emergency is lifted. The IEIP is now working on tip sheets for families in English and Spanish and developing resources to help families with internet fees and costs for a computer, camera, and microphone. On April 7, North Carolina (NC) Medicaid released new telehealth guidance expanding the services and provider types eligible to deliver telehealth during the COVID-19 pandemic. Special Bulletin COVID-19 #34 expands telehealth codes and guidance to services delivered through local education and children’s developmental service agencies, and services pertaining to dietary evaluation and counseling, medical lactation, research-based behavioral health treatment for autism spectrum disorder, and diabetes self-management education. NC Medicaid also published an accompanying billing code summary to equip providers with the new codes pertaining to telehealth.

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For a person living with a rare disease, it can take five years or longer to receive an accurate diagnosis. With more than 40% of patients initially misdiagnosed, this “diagnostic odyssey” can have serious and long-term health consequences for the 300 million individuals affected by rare diseases and their families. It is also incredibly frustrating.

A key factor contributing to initial misdiagnoses is the shortage of clinical geneticists. Despite an estimated three-quarters of rare diseases being genetic in origin, there are significant barriers in accessing appropriate genetic counseling.

Telehealth can help break down these barriers.

One of the ripple effects of Covid-19 is increased adoption of telehealth. In the U.S., health care providers are seeing 50 to 175 times the number of telehealth visits they saw before the pandemic, according to a recent McKinsey study, and more than half of providers now view telehealth more favorably. For patients, telehealth can improve access and eliminate added costs and burdens on families. The informal setting can also encourage more honest conversations with physicians.

Although the rare disease field has been striving for innovation in patient care long before the global pandemic struck, the broad acceptance and evolution of telehealth has the potential to change the diagnostic journey for patients through the adoption of telegenetic consultations.

Children’s National Hospital in Washington, D.C., has been working with Microsoft to pioneer the use of telegenetic consultations for patients and, more specifically, for those who are searching for a diagnosis, potentially for a rare disease. Since the inception of this pilot program in 2019, the average time a patient waits to see a clinical geneticist has decreased from three to four months to just six to eight days.

This pilot is supported by the Global Commission to End the Diagnostic Odyssey for Children with a Rare Disease, which was formed in 2018 to bring the rare disease and technology communities together to overcome the barriers to diagnosing these diseases, of which there may be as many as 8,000, faster and more accurately.

This innovative pilot uses virtual tools such as facial recognition, video appointments, and a triage system to deliver genetic assessments and counseling remotely to patients and their primary care physicians. Of the 30,000 patients who have been seen remotely by Children’s National since the start of the pandemic in March, more than 1,500 have been seen by the hospital’s rare disease team.

“There is a unique opportunity in the use of telemedicine to do some transformative things for the diagnosis and care of patients with rare diseases,” the director of the pilot, Dr. Marshall Summar, told us. Like us, he is a member of the Global Commission to End the Diagnostic Odyssey for Children with a Rare Disease. “We are evaluating ways to depart from the traditional model based on a brick and mortar visit and see what is truly in the patients’ best interest,” said Summar, who is also the director of the Rare Disease Institute and chief of genetics and metabolism at Children’s National Hospital.

The pilot is also tackling other common challenges in delivering health care, including potential language barriers among global health care providers and patients. Children’s National is working with Microsoft to use technology for real-time translations, allowing specialists in various countries to discuss the same patient who may have a rare disease. By connecting patients to rare disease specialists more quickly and enabling those specialists to partner with local providers to deliver care, the time to diagnosis can be accelerated.

Here are five things we have learned so far from the pilot:

“Intelligent triaging” allows for more appropriate use of specialty genetic services. The triage app allows primary care physicians to collect and enter patient information by using technology to streamline the process to make a referral to a rare disease specialist. By using the app, clinicians can solicit guidance from specialists and geneticists, including testing that might be needed before a patient’s first consult. That helps filter out patients who don’t have a rare disease, reducing unnecessary testing and ensuring effective use of resources.

Telegenetic consultation strengthens communication across the health team. Specialists can communicate with primary care physicians and other health care providers, sharing patient information to make more informed decisions regarding diagnosis and care. By expanding communication and adding structure to the consultation process, the team can impart information more efficiently, which can lead to faster diagnoses.

Telegenetic visits can enhance the current model of care. By providing initial insights into a patient’s condition, potential diagnosis, and care plan, virtual visits help providers streamline subsequent in-person visits. Virtual visits are especially important during the Covid-19 pandemic, when only patients with the most critical conditions should go to doctors’ offices or medical centers for in-person consultations.

Telehealth helps reduce costs, improve access, and increase efficiency. Transportation costs, missed work, and frequent in-person visits are common challenges for patients seeking care from clinical geneticists. In addition, the relatively few specialists are typically located in urban areas, making it difficult for patients outside those geographies to seek care. Remote care makes it easier to access these specialists and eliminates added costs and burdens on families. The pilot has shown that virtual visits are shorter and more focused, yet still rate high in patient satisfaction.

Virtual visits provide a window into patients’ lives, helping improve patient/provider communication. When health care providers are able to see patients in their home environments, it opens the door for more personal and honest discussions around their day-to-day struggles. Providers are able to form better connections with families by observing them at home, noticing behaviors that may not occur in a clinical setting, and recommending changes that can lead to more positive health outcomes.

Those working on the pilot will continue integrating feedback from physicians to further shorten the path to diagnosis for those living with rare diseases. We expect to expand pilot testing beyond Washington, D.C., to other U.S. sites in 2021, including three to five regional pediatric societies and centers with genetic expertise or capabilities to treat rare disease, before expanding to national pediatric centers and societies and other countries in the future.

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