Telehealth Care: An Innovation in Waiting

I often ask my informatics and innovation students to take a guess as to when telehealth was first conceptualized for use. They are often surprised to hear me say that the concept emerged in the 1960’s (60 years ago). Now while we did not have the capabilities for such operationalization of telehealth care at that time, we did have that capability long before March 2020.

The tipping point to integrate telehealth technology services into care delivery was the Covid-19 pandemic and the need to be able to provide care to patients in a safe way that would not put people at risk for contracting Covid (to the extent possible – not all appointments could be televisits).

Prior to March 6th. 2020, telehealth services were not a service that was reimbursable for most visits. The Centers for Medicare and Medicaid Services (CMS), the largest payer of healthcare services in the United States, granted the ability for providers to be reimbursed for telehealth services (temporarily) across the US. This provision opened the opportunity to leverage the technology available, develop new processes and support people with their healthcare needs.

“Prior to this announcement, Medicare was only allowed to pay clinicians for telehealth services such as routine visits in certain circumstances. For example, the beneficiary receiving the services must live in a rural area and travel to a local medical facility to get telehealth services from a doctor in a remote location. In addition, the beneficiary would generally not be allowed to receive telehealth services in their home.” (CMS.gov)

I’ve long advocated for the opportunity of telehealth to address visit types that may lead to missed appointments or access to care issues. Just this week I had a telehealth follow up visit. I scheduled it at the end of the day and was able to log off of my meeting to log on to my appointment without any need for travel, parking, rearranging my schedule and more. The visit did not require any labs, tests, auscultation or vitals. Therefore, this was an optimal use of telehealth.

Other use cases I often think about

  • individuals who perhaps do not have an effective and/or efficient transportation means for follow up or consult visits,
  • individuals who do not have the funds for parking, or cannot take an afternoon off for such a visit,
  • individuals seeking mental health services who may be too depressed to leave their home and make an in person appointment.
  • individuals in areas where the specialist is in network but not local to the patient

These are just a few use cases where telehealth has likely eased some pressures of patients seeking to access care where being in person was not a necessity. Access to care is essential for optimal outcomes. As we navigate forward toward a post-pandemic healthcare environment, the initial unmet need faced in March 2020 will have changed but this does not mean that there will not be a need to continue to offer such services.

Providing quality care requires patient-centered approaches. Why not continue to make it accessible to receive care?

 

 

The Opportunity to Use Technology to Effectively Engage Family & Friends

Promoting patient-provider relationships and patient engagement in one’s own health care delivery are two topics that often come up for current discussion. I believe both are necessary for quality patient health outcomes. However, establishing a patient-provider relationship and engaging the patient are both areas that require continuous efforts from the providers and the patients. We as health care professionals are responsible for educating patients and their families about the patient’s health condition. Yet, the patient (and family) is also responsible for ensuring an understanding of his or her health condition, as well as asking questions to clarify the disseminated information. Read more

“Where’s my sheet?!”
Introducing Know My Patient™

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“Where’s my sheet?!”

Nurses, you know the sheet I’m referring to…you also know the feeling of panic that rushes over you when you can’t find it. “Where did I leave it? I need that to know my patients!” This sheet is a piece of paper that is the nurses’ daily lifeline to knowing their patients.

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I have an idea.

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Hopefully that sentence resonates with you. Everyone has ideas that come to us – all of a sudden – and usually when we are faced with a challenge. Ideas are important because they are the currency for innovating – for developing new solutions to existing problems. Without ideas we would be limited in creativity, change, and improvements in our lives. In health care, ideas have led to new solutions that transform the way we collect, communicate, exchange, analyze, and evaluate information. Yet, we need more ideas that lead to new solutions that can even further improve the structure, process, and outcomes of quality health care delivery.

A few months ago, I was invited to guest lecture to graduate nursing students at Northeastern University about innovation. I asked each student to formulate a problem that they see each day while working and bring it to class. During class we identified each problem and then I asked each nursing student to formulate a potential solution. Every student had a very real problem they are faced with each day at work – some were more complex than others – but we were able to form solutions that were reasonable and achievable with the right support, enthusiasm, and guidance. The nursing students felt empowered to work to address the identified problems. I hope that they did follow up and begin the process toward improving the desired outcomes.

I offer this scenario to encourage others to develop their ideas and foster further innovation in health care. Each day I see new problems that need to be solved. This blog, Know My Voice™ started as an idea. I wanted a way to share my informatics perspective, or voice, with a larger and broader audience than I could physically reach in the same amount of time. I look forward to seeing the future developments and impact of Know My Voice™ over time.