Medi Oasis Health Services
Telehealth ushering in a new future of Medicine.
WHAT IS TELEHEALTH? It is a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies
As state and federal policymakers, private payers, practitioners, and consumers realize telehealth’s potential benefits, there is a growing need to create a consistent framework for understanding what is meant by “telehealth,” and how the term is accurately applied. First and foremost, telehealth is a collection of means or methods, not a specific clinical service, to enhance care delivery and education. Ideally, there should not be any regulatory distinction between a service delivered via telehealth and a service delivered in person. Both should be held to the same quality and practice standards. The “tell-“ descriptor should ultimately fade from use as these technologies seamlessly integrate into health care delivery systems.
While “telemedicine” has been more commonly used in the past, “telehealth” is a universal term for the current broad array of applications in the field. Its use crosses most health service disciplines, including dentistry, counseling, physical therapy, and home health, and many other domains. Further, telehealth practice has expanded beyond traditional diagnostic and monitoring activities to include consumer and professional education. Note that while a connection exists between health information technology (HIT), health information exchange (HIE), and telehealth, neither HIE nor HIT is considered to be telehealth.
Today, telehealth encompasses four distinct domains of applications. Note, however, that each state Medicaid program and private insurer varies in its use and reimbursement of these applications. These are commonly known as:
• Live Videoconferencing (Synchronous): Live, two-way interaction between a person and a provider using audiovisual telecommunications technology.
• Store-and-Forward (Asynchronous): Transmission of recorded health history through an electronic communications system to a practitioner, usually a specialist, who uses the information to evaluate the case or render a service outside of a real-time or live interaction.
• Remote Patient Monitoring (RPM): Personal health and medical data collection from an individual in one location via electronic communication technologies, which is transmitted to a provider in a different location for use in care and related support.
• Mobile Health (mHealth): Healthcare and public health practice and education supported by mobile communication devices such as cell phones, tablet computers, and PDAs. Applications can range from targeted text messages that promote healthy behavior to wide-scale alerts about disease outbreaks, to name a few examples.
These telehealth services will include both emergency and non-emergency services:
- Non -emergency services
- Infectious Disease
- Emergency services
- Neurology / Stroke
- Patient Visits
Telehealth technology for broadband services and video-conferencing was originally obtained through grant funding from Generous Organization of America.
- Financial ROI
- Patient engagement
- Patient clinical improvements
- Increase access to care for vulnerable patients
- Identify benchmarks and strategies that match stakeholder’s goals and the goals of the organization.
Our Measures for success of a RPM program include:
- Provider satisfaction
- Patient satisfaction
- Population health clinical outcomes
- Individual clinical outcomes
- Meeting the program budget
The Provider understand the Inclusion Criteria for RPM and CCM and how to make a referral. Referrals to RPM and CCM can be organizational policy administrated by other staff.
Determine the frequency that providers will receive patient data reports (we recommend every two weeks). Ideally, providers will receive biweekly summary reports, including subjective and objective Information gathered during the monitoring period to see the patient’s trends over a period of two weeks, to obtain reading averages and review the patient’s plan of care. (An interface between the RPM device vendor and EHR helps with communication between the RPM program and the providers.) Providing trending reports to the provider prior to the clinic visit will allow for more efficient visits and more engaged patients. Determine how much trending data the providers prefer. Determine where providers want the results/reports
- Useful actionable data.
- Enhanced patient engagement.
- Patients who haven’t gotten engaged are now actively engaged.
- See value of using RPM to enhance/obtain patient engagement.
- Clinic visits are more efficient and effective.
- See real-time information that they can rely on to make clinical decisions, make a medication adjustment and watch the trends immediately with impact and further refine based on the biometric data.
RN will meet with RPM patients in the patient home or in the clinic to enroll and educate the patient and check that the devices are working properly. Identify barriers to a patient taking readings or to the successful transmission of RPM data. The RPM nurse performs frequent virtual outreach with the patients to help patients continually learn about their disease management/decision-making. Review patient medications. The RN enrollment visit may also be conducted at a clinic office visit if the patient is not agreeable to a home visit, if RPM staffing time is limited, or if concerns over staff safety at a home visit. Enrolling a patient into RPM requires assessment and education within the RN Scope of Practice to make sure a patient takes accurate readings and that patients understand the readings and monitoring parameters. Provide Patient Education.
Our Technician will set-up equipment needed for a patient, control the inventory and prepare the monitoring devices for re-use.
A Technician does not necessarily need a technical background. They just need to know the equipment well and facilitate any set up needed for a patient, control the inventory and prepare the monitoring devices for re-use. Each organization may have their own way of operationalizing this role. It is best to start a RPM program with new equipment to ensure it is warrantied and working properly. Provide device management Inventory, tag and store devices. Keep devices in a central location.
Pull devices for installation. Utilize device vendors inventory management tools. Receive devices after use. Clean and refurbish devices after de-installation.