Industry Organizations Praise Senate Passage of VA Mission Act | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Industry Organizations Praise Senate Passage of VA Mission Act

May 24, 2018
by Heather Landi
| Reprints

The U.S. Senate on Wednesday passed, by a vote of 92-5, a major Veterans Affairs (VA) reform bill that includes health IT-related provisions to improve health data exchange between VA healthcare providers and community care providers.

The VA Maintaining Internal Systems and Strengthening Integrated Outside Networks, or VA MISSION Act (S. 2372) is a $52 billion reform bill that will overhaul medical care options for veterans, including giving them more access to private doctors and hospital. The bill also extends the VA’s Choice program for one year.

A companion bill passed the House last week, and the legislation now moves to President Donald Trump’s desk, and he is expected to sign it. With regard to health IT, the bill aims to improve health data exchange between VA healthcare providers and community care providers, including a provision to ensure community healthcare providers have access to relevant patient medication prescription information to ensure safe opioid prescribing practices. The legislation clarifies that VA could share medical information with non-department entities for the purpose of providing health care to patients or performing other healthcare -related activities.

In a section focused on establishing processes to ensure safe opioid prescribing practices by non-VA healthcare providers, the bill mandates that the VA implement a process “to make certain that community care providers have access to available and relevant medical history of the patient, including a list of all mediation prescribed to the veteran as known by VA.”

The bill also clarifies that a covered health care professional may practice at any location in any state, regardless of where the covered health care professional or the patient is located, if the covered health care professional is using telemedicine to provide treatment to a VA patient.

A number of health IT associations and organizations have praised the VA Mission Act. In a statement, eHealth Exchange Vice President Jay Nakashima said, “Since its inception, the eHealth Exchange network has worked closely with the Department of Veteran Affairs to support health IT interoperability between the department and partner providers but our success was limited by an outdated congressional mandate - until now. With the passage of VA Mission Act, we hope to see exponential improvements in health data sharing between community providers and the Veterans Health Administration, with the resulting benefits of patient satisfaction and health outcomes.”

The Sequoia Project CEO Mariann Yeager said in a statement, “For many years, we’ve seen veterans and their providers frustrated because veteran health records were not accessible to private sector providers due to an administrative issue. The VA Mission Act provides an important fix that will unlock veteran health records to enable the providers who care for veterans to make better informed decisions and coordinate care regardless of whether they are treated at a VA medical facility or in the private sector.”

Health IT Now, a broad-based coalition of patient groups, provider organizations, employers, and payers supporting health information technology to improve patient outcomes, also applauded the Senate passage of the bill, particularly the provisions around expanding telehealth access to VA patients.

Health IT Now Executive Director Joel White said in a statement, “With the president's signature, our nation's heroes can, at long last, more easily access the care they need, when they need it, without fear of Washington standing in the way. For too long, veterans have dealt with inflexible laws requiring them to travel long distances to federal facilities in order to receive care from a VA provider located in another state. The VETS Act will propel VA health services into the 21st century, breaking down geographic barriers to care and spurring better outcomes for the 20 million patriots who receive care through the Department of Veterans Affairs today.”

White concluded, "It is our strong hope that the VETS Act is not the end of this Congress' support of technology-enabled healthcare reforms, but simply the latest in a continued series of measures to expand coverage and reimbursement of innovative care delivery models and knock down regulatory barriers to virtual treatment.”

Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association, also said of the VA Mission Act, “With passage of the bipartisan, bicameral VA Mission Act of 2018, Congress made notable improvements to the VA Choice Program that will assist medical group practices in meeting the growing health care needs of our military veterans. The bill aims to lessen the administrative burden on practices that care for veterans outside the traditional VA system. It addresses barriers to care and ensures physicians receive timely payments from the VA so they may continue to provide high-quality care to our nation’s deserving veterans.”

 

The Health IT Summits gather 250+ healthcare leaders in cities across the U.S. to present important new insights, collaborate on ideas, and to have a little fun - Find a Summit Near You!


/news-item/telemedicine/industry-organizations-praise-senate-passage-va-mission-act
/blogs/david-raths/telehealth/key-questions-partnering-telehealth-specialty-providers

Key Questions Before Partnering With Telehealth Specialty Providers

| Reprints
Click To View Gallery

For primary care clinics, especially those in rural areas, establishing solid relationships with organizations that provide specialty telehealth services can vastly improve the number of services they can offer their patients. But building and maintaining those relationships so that they make sense financially and in terms of quality and patient satisfaction takes a lot of work.

I hadn’t realized how complex that relationship-building could be until yesterday, when I got a chance to hear an online presentation by the California Telehealth Resource Center (CTRC) detailing 20 questions clinics should ask specialty telehealth providers when vetting different offerings. The speaker was Kathy Chorba, CTRC’s executive director, who has 20 years of telehealth program development experience, beginning with establishing and growing the UC Davis Telemedicine program, incorporating 80 sites and 35 specialties, and directing the Telemedicine Learning Center. 

Chorba began by noting that the work of assessing these partnerships should begin only after you have done a needs assessment, identified the kinds of specialties you want to engage (dermatology, psychiatry, etc.), and the volume you expect to generate. You should also have established physician buy-in and identified your telehealth team. Once you have done these things, then you are ready to start establishing partner relationships, she said.

I won’t go through all the questions Chorba suggested clinics ask of specialty provider groups, but just the following sampling of them might help those of us who are not in the telehealth trenches everyday better understand some of the logistical issues involved.

• What specialties are available through this provider group? Chorba noted that some specialty provider groups offer one specialty only (such as behavioral health) while others offer a wide variety of specialties.  She added that some clinics prefer the “one-stop shop” for all their specialty needs, because it simplifies the contracting, credentialing, referral process and workflow, while other clinics prefer to shop around and find the best price for each specialty.

• Does the provider group contract with your payer(s), bill you by the hour or block of time or patient seen? Specialty provider groups use different payment mechanisms, and you have to find one that is mutually beneficial. Chorba added that before you negotiate, you should know how many referrals you think you will have for each specialty and how soon you will be able start. “This will help determine the financial model that fits your program,” she said.  The speciality provider will know if they have capacity.”

• What are the rates for live video and store and forward and are they the same for adult and pediatric? Rates will vary depending on the specialty services needed, as well as volume and modality. Rates for store-and-forward specialties such as dermatology will typically be lower than live video specialties, and new patient appointments may be more expensive than follow-up appointments, Chorba said. Also, rates may vary according to the volume of patient referrals you anticipate sending to the specialty group. Each specialty also tends to have a different timeframe for visits. Dermatology visits may take 20 minutes, while psychiatric visits take an hour. “One rule of thumb is 40 minutes for new visits and 20 minutes for followup visits,” she said. Clinics have to structure their appointment strategy to afford the specialists’ time. “When does a $250-per-hour specialist cost less than a $200-per-hour specialist? When the $250 specialist can fit more patient visits into that hour,” she said.

CTRC offers clinics a sustainability worksheet to help them understand all their costs involved in purchasing blocks of time from telehealth specialists. Initially they may expect to lose some money because all the patients are new and the visits are longer, but as you move into the growth phase, and the specialists are seeing more follow-up patients, you can fit more patients into an 8-hour day. “The bottom line is you are not losing money anymore,” Chorba said. About seven months into the program, you should hit the maintenance phase, where you are keeping your patient no-show rate down and overall costs down.  

• Does the specialty provider group have referral guidelines for each specialty? Besides specifying the time required for new and follow-up patients, these guidelines also state what information or tests are needed prior to the consult (labs, chart notes, etc.). Chorba added that the tests required could be unavailable or too expensive for your patients or not covered by their health plan. “Just knowing the referral guidelines and tests rquired prior to a consult,” she said, “may help you decide that is a provider you don’t want to work with.”

• What level of technical support will the specialty provider group provide? While most primary-care clinic sites have some technical support staff available, few clinics have staff that are able to troubleshoot telemedicine video and peripheral equipment and/or broadband connectivity issues. Some specialty provider groups provide a basic level of technical support or troubleshooting assistance in order to make sure services are provided as scheduled. Chorba said clinics should make clear what type of support it can provide.

This is just a subset of all the questions Chorba raised with webinar attendees. It helps explain why Federally Qualified Health Centers and other small clinics need consulting help to get their telehealth programs up and running. In closing she mentioned that the CTRC is now working on its next set of guidance on how to keep that relationship with specialty providers healthy once you have chosen a group to work with. With so much emphasis on the potential for telehealth these days, it is important for all of us to remember that the transition to telehealth and the hand-offs between providers involves a lot of complexity!

 

 

 

More From Healthcare Informatics

/news-item/telehealth/amia-supports-nist-efforts-secure-telehealth-rpm-ecosystem

AMIA Supports NIST Efforts to Secure Telehealth RPM Ecosystem

January 9, 2019
by Heather Landi, Associate Editor
| Reprints

Back in November, the National Cybersecurity Center of Excellence at NIST, the National Institute of Standards and Technology, issued a draft paper outlining a project it plans to undertake to provide a reference architecture addressing the security and privacy risks for healthcare delivery organizations leveraging telehealth capabilities, such as remote patient monitoring.

Traditionally, patient monitoring systems have been deployed in healthcare facilities, in controlled environments. Remote patient monitoring (RPM), however, is different in that monitoring equipment is deployed in the patient’s home, according to NIST’s NCCoE. NIST is housed within the Department of Commerce.

These new capabilities, which can involve third-party platform providers utilizing videoconferencing capabilities, and leveraging cloud and internet technologies coupled with RPM devices, are used to treat numerous conditions, such as patients battling chronic illness or requiring post-operative monitoring. As the use of these capabilities continues to grow, it is important to ensure the infrastructure supporting them can maintain the confidentiality, integrity, and availability of patient data, as well as ensure the safety of patients, according to NCCoE.

To address these security, privacy and safety concerns, NCCoE aims to provide a practical solution for securing the telehealth RPM ecosystem. The NCCoE project team will perform a risk assessment on a representative RPM ecosystem in the laboratory environment, apply the NIST Cybersecurity Framework and guidance based on medical device standards, and collaborate with industry and public partners. The project team will also create a reference design and a detailed description of the practical steps needed to implement a secure solution based on standards and best practices, according to the organization.

This project will result in a publicly available National Institute of Standards and Technology (NIST) Cybersecurity Practice Guide, a detailed implementation guide of the practical steps needed to implement a cybersecurity reference design that addresses this challenge.

The NCCoE sought public feedback on the project, which was detailed in a draft released in November called “Securing Telehealth Remote Patient Monitoring Ecosystem.”

The American Medical Informatics Association (AMIA) is one industry organization that has voiced support for the NCCoE project to develop guidance around security and privacy risks associated with remote patient monitoring.

In written comments about the project, AMIA president and CEO Doug Fridsma says he “foresees a future of care delivery and disease management that will rely heavily on RPM,” due to a “confluence of shifting and/or diminished reimbursement, aging and chronically ill population growth, and continued depopulation of rural areas.”

Securing these systems and ensuring trust in the data generated by these systems is an utmost priority, and is at the heart of consumers’ ability to obtain care and manage their health, Fridsma noted in the written comments.

Among its recommendations, AMIA advises the NCCoE to leverage existing mobile infrastructure and health IT standards.

“The ultimate spread, scale, and usage of these RPM tools will likely depend more on the commercial marketplace than the short-and long-term plans of healthcare institutions. Further, patients/consumers will use the tools that they are familiar and fits best into their individual ‘workflows.’ Securing the existing mobile infrastructure where individuals perform most of their day-to-day living will improve the likelihood that healthcare specific tasks will succeed,” Fridsma noted.

Fridsma also noted that AMIA recommends NIST focus on data security and integrity that provides data provenance and supports consistent semantic meaning of the data across RPM manufacturers.

 

Related Insights For: Telehealth

/news-item/telehealth/michigan-becomes-25th-state-join-interstate-medical-licensure-compact

Michigan Becomes 25th State to Join Interstate Medical Licensure Compact

January 9, 2019
by Rajiv Leventhal, Managing Editor
| Reprints

Michigan Governor Rick Snyder signed two bills into law on the last day of December, making Michigan the 25th state to enact the Interstate Medical Licensure Compact (IMLC), an initiative that offers an expedited pathway to licensure for physicians wishing to practice in multiple states.

In 2017, the Interstate Medical Licensure Compact officially began accepting applications from qualified physicians who wished to obtain multiple licenses from participating states. The Compact has been expected to expand access to healthcare, especially to those in rural and underserved areas of the country, and facilitate the use of telemedicine technologies in the delivery of healthcare.

Licensing providers across state lines has long been a challenge, as clinicians who want to treat patients in another state have historically had to apply for and pay for licenses in those states—a costly and time-consuming process. Some state boards have also sought to prevent or limit the expansion of telehealth, citing patient safety concerns.

But under this agreement, licensed physicians can qualify to practice medicine across state lines within the Compact if they meet the agreed upon eligibility requirements. As of December 31, 4,511 medical licenses have been issued and 2,400 applications processed through the IMLC.

The Compact legislation was supported in Michigan by Ascension Michigan, Trinity Health, Michigan Health & Hospital Association, American Society for Dermatologic Surgery Association, and AARP Michigan, among others.

“Ascension Michigan applauds the passage of legislation providing for the state of Michigan to join the Interstate Medical Licensure Compact,” Sean Gehle, chief advocacy officer, Ascension Michigan, said in a statement. “We believe that not only will the Compact facilitate increased access to healthcare for patients in underserved areas of our state, allowing them to more easily connect to medical experts through the use of telemedicine, but also provide for a more streamlined and expeditious process for recruitment of physicians to these same underserved areas.”

Michigan joins 24 states, Guam and the District of Columbia in enacting legislation to join the Compact. These states include Alabama, Arizona, Colorado, Idaho, Illinois, Iowa, Kansas, Maine, Maryland, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, Pennsylvania, South Dakota, Tennessee, Utah, Vermont, Washington, West Virginia, Wisconsin and Wyoming.

The initiative remains under consideration in Kentucky, New Mexico and South Carolina.

See more on Telehealth

agario agario---betebet sohbet hattı betebet bahis siteleringsbahis