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?

 

 

Acknowledging Personal Growth through Public Speaking

Last week I had some major flashbacks this afternoon as I approached the Northeastern campus. I was invited to speak on innovation in nursing and healthcare to graduate nursing students. I’ve done this annually for the last several years.

As I approached the classroom, I had memories of rushing to class two nights a week for 4 years after being at work all day. I used to park in this garage as I would rush to make it to class on time.

Northeastern

I then spoke for 2 1/2 hours straight tonight 😳🤣.

As I left, I remembered how much I greatly disliked speaking in front of a class 10+ years ago.

I’d stress about it all day.

My knee caps would shake while I tried to remember what I wrote on my notecards.

I wouldn’t think about anything else but the fact I needed to do that for about 5 minutes, 10 at most.

Now I enjoy it and find it one of the fun parts of my job.

While I’m talking, I don’t think about anything else going on in my day. I make fun of myself and laugh about it. Most importantly, I hope the students think differently as they leave about the opportunities that might catch them by surprise at some point in their career.

 

**If you are interested in having me come to speak at your event, school, conference etc., please do reach out at tiffany.kelley@nightingaleapps.com and I’d be happy to discuss further**

Workarounds and their power for finding Innovative Solutions

If you are anything like me, you see ways to make improvements wherever you go and wonder why something is the way it is…

As nurses and healthcare professionals we need to make improvements often through workarounds to get our work done.

In this piece, I describe those innovative behaviors through workarounds in the context of neonatal nurse environments.

Workarounds are clues that something could be done better, often at a system (and not individual) level. “Do you consider yourself to be an innovative nurse? The concept of innovation is frequently permeating conversations around the future of nursing. Many may hear the term innovation, and wonder “what does it really mean to me as a nurse?” and others may think “innovation does not really apply to me.” Yet, you may be surprised to learn that you are innovating in your role as a nurse every day in your work..”

To read the full article, Workarounds as the Catalyst to Drive a Culture of Innovation, click here.

February 11th was National Inventor’s Day!

Last Monday was National Inventor’s Day!

To celebrate the day, I attended an event held on behalf of UCONN at the Mark Twain House in Hartford CT.

I learned quite a bit…

February 11th is National Inventor’s Day because it is Thomas Edison’s birthday (inventor of the 💡). The first patent issued from the USPTO was in 1790.

The first patent was issued to Samuel Langhorne Clemens (aka Mark Twain). A total of 3 patents were issued that year. Today, there are approximately 320K patents issued each year.

Dr. Eric Hintz, a historian from the Smithsonian’s Lemelson Center for Innovation and Invention spoke to us tonight on several historical ecosystems and their foundational areas of invention influence.

UCONN_NationalInventorDay_2019

One thing I found quite interesting is that Henry Ford wasn’t the first one to create cars. They were first called ‘horseless carriages’ by Hiram Percy Maxim in 1896. He invented them in Connecticut nearly 20 years before Ford due to market saturation of the bicycle.

If you ever get the chance to go to the Mark Twain house, I encourage it. The same is true for the Smithsonian’s Lemelson Center for Innovation and Invention. I had the pleasure of speaking there two years ago next month and it was a fabulous experience. Below is a memory of that event in their 2017 Annual Report.

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The fax machine still exists… in healthcare

Sometimes I am a new patient and it often goes something like this:

“If you can fax us the forms back that’ll be great.”

“I don’t have a fax. Can I email?”

“No. You’ll have to fax or bring in with you for your appt.” 🤦‍♀️.

Bidirectional secure portals do help and cut down on the #fax issue in my experience.

Read on to learn more about fax machines in this article by CNBC:

Health tech is so old-fashioned that Google has to adapt its cloud service to work with fax machines. 

What do you think? Any of your own stories to share?

Have a great day,

Tiffany

Who else enjoys a good book?

Article Thumbnail
Who else is a reader?
I try to read 6-12 new non-fiction books per year.
These 3 came today:
books
Have you read any of them yet? Do you have a recommendation for me to add to my list this year? 
Let me know,
Kind regards,
Tiffany