Taking stock of the sudden evolution of telemedicine

Photo: Teleperformance

Telehealth continues to grow as a crucial part of patient care, especially when supporting patients who live in remote areas and senior citizens. Research firm Frost & Sullivan forecasts a sevenfold growth in telehealth by 2025 – a five-year compound annual growth rate of 38%.

The bottom line is that people want to have access to healthcare anytime, anywhere, across multiple devices and in the language of their choice. In fact, many new areas of telehealth – such as tele-oncology and tele-stroke – have become part of the mainstream healthcare system.

The idea of triaging patient issues and prescribing medication or assigning tasks such as physical therapy is just a part of the picture. There also has been an uptick in the use of telepsychiatry, especially for patients who are suffering from anxiety, depression and isolation.

For healthcare providers, telehealth presents an opportunity to address patient care needs, improve the customer experience and reduce costs. Healthcare IT News sat down with Linda Comp-Noto, division president for healthcare enterprise operations at telemedicine technology and services vendor Teleperformance, to discuss the evolution of telehealth, unique aspects of supporting remote customers and senior citizens, approval of more than 80 new medical services that can be delivered via telehealth and the creation of new diagnostic codes, and tackling privacy issues related to HIPPA.

Q. How has telehealth evolved over the past few years?

A. Telehealth is defined as the provision of healthcare virtually by use of digital information and communication technologies. According to Mayo Clinic, telehealth is used to access healthcare services remotely to manage one's healthcare. These may be technologies used from the home or that a doctor uses to improve or support healthcare services.

Over the years, while digital technology was quickly advancing, telehealth had a relatively low adoption rate due to poor reimbursement rates and regulatory challenges when it came to patient privacy and HIPAA compliance.

Telehealth providers saw a rapid rise in the need for remote services with the initial spread of the COVID-19 pandemic in early 2020. Healthcare providers needed to find an immediate solution to care for their patients while keeping them home and maintaining the safety of the community. The Centers for Medicare and Medicaid Services (CMS) began to allow for reimbursement for videoconferencing between healthcare provider and patient.

According to HHS.gov, CMS created a provisional policy during the coronavirus pandemic to help support the use of telehealth. CMS issued temporary measures to make it easier for people enrolled in Medicare, Medicaid and the Children's Health Insurance Program (CHIP) to receive medical care through telehealth services during the COVID-19 public health emergency. This trend in remote access to care has expanded widely and is expected to continue.

Q. What are some of the unique aspects of supporting patients remotely?

A. Going beyond a global pandemic with a critical need to support patients remotely, there are many other situations where telehealth plays an important role in a person's healthcare.

It can be critical in helping people who don't have physical access to care due to their geography, lack of transportation or socioeconomic situation. Telehealth also can be extremely helpful in care coordination between primary healthcare providers and specialists by enhancing communication on a real-time basis, allowing faster response time and access to life-changing treatment.

Now more than ever, patients need to be their own advocates and engage in proper self-care techniques for treating and preventing diseases. Telehealth allows access to online portals to track symptoms and progress in a person's quest for wellness.

Portals can contain information from a patient's electronic health records from various providers – test results, digital device results such as heart rate, weight, oxygen levels, blood pressure and activity level, just to name a few. This is an exciting time for the future of telehealth for all people to lead longer and healthier lives.

Q. Please discuss the importance of the approval of more than 80 new medical services that can be delivered via telehealth and the creation of new diagnostic codes.

A. Last year, Congress eliminated barriers to patient care by approving a bill called the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020. This allowed telehealth to be used to prevent the spread of COVID-19. Since then, CMS has now expanded coverage for telehealth and telemedicine. Eighty services can now be offered at the same reimbursement rates as traditional in-person office care.

According to CMS.gov, CMS is expanding access to telehealth services with Medicare. This means patients can receive care wherever they are – at home, nursing home, assisted living, etc. If they have COVID-19, they can continue in isolation and prevent the spread of the illness. If they are not infected, they can get care without risking exposure to others who may be ill.

The 80 services that have now been approved include emergency department visits, initial nursing facility and discharge visits, and at-home visits that must be provided by a clinician who is allowed to provide telehealth.

This is important for the future of healthcare because it is helping remove the restrictions on access to care for many people. The new rules allow for some audio-only options that can help people who do not have access to computer equipment or video phones. There also are new provisions allowing telehealth use for ambulatory surgery, mental health centers and other healthcare settings that were restricted in the past. Further updates can be found at Coronavirus.gov.

Q. How can healthcare provider organizations tackle privacy issues related to HIPPA when it comes to telemedicine?

A. Patient privacy and data security are paramount when it comes to a successful telehealth operation. It is imperative that provider organizations ensure patient information is fully protected, as patients are trusting them to do so. There are many ways to effectively ensure privacy and security.

According to HIMSS, there are four best practices for data privacy and telehealth: strong authentication, end-to-end encryption, clean machines, and, when in doubt, throw it out. When addressing authentication, the telehealth platform should provide a strong authentication method. This means both parties need to be authenticated prior to the sharing of access to any confidential information.

This often involves platforms that require individuals to log in with unique usernames and passwords. Passwords need to be strong and contain a complex combination of uppercase and lowercase letters, numbers, and symbols. Biometrics can be implemented, along with multifactor authentication when required.

Second, end-to-end encryption is important for ensuring that only the people intended to be part of the conversation are able to access any part of communication and no one can break through.

Third, keeping a clean machine ensures that all operating systems and applications are fully up to date and working properly. This includes, but is not limited to, antivirus and appropriate firewalls. WiFi should be secure and not open to the public whenever personal or proprietary information is exchanged.

Lastly, when in doubt, throw it out. If any electronic communication appears to be suspicious, it's best to delete it and avoid clicking on any links.

Phishing is used to infect users' machines with malware and viruses. Both patients and providers can receive phishing emails, and they should always be disregarded. Privacy and data security go hand in hand and should involve technology combined with solid standard operating procedures that are audited and adhered to.

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.

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