Monthly Archives: June 2015

Breaking Through the Telemedicine Payment Barrier

dr A and BA tale of two doctors. 

Doctor A and Doctor B see two patients simultaneously.  Both patients have come in for a follow up visit on their recent knee surgeries.  Both doctors speak with their patients for 15 minutes, asking about the recovery, if the patient has any abnormal pain, and observing the leg for any visible redness or abnormal swelling.  Both patients are recovering well, are pain free, and look to be avoiding infection.  The doctors both advise their patients to continue on as they have been, and to come back in another month for another follow up appointment.  The patient outcome is the same in both scenarios.  Doctor A gets a check from the insurance company as usual.  Doctor B submits for payment to the insurance company as well and is denied payment.  Doctor A gets paid and Doctor B is left holding the bag saying, “Show me the money.”  The difference?  Doctor A sees his patient in person, while Doctor B sees her patient through the use of a video conferencing system.

It’s amazing to think that telemedicine has been around for nearly 40 years.  Of course, the technology used back then was markedly different than today’s high definition audio video teleconferencing systems.  Yet despite these innovative leaps in technology, one thing has remained rather constant.  The insurance companies have not paid telemedicine claims in the same way as in person visits, and sometimes, haven’t agreed to pay for them at all.  This lack of payment has been a major problem in the adoption and proliferation of telemedicine systems in general.

Today however, all that is changing at a quicker pace than ever before.

There are two main reasons that the tide is shifting in favor of telemedicine, creating what Forbes called a “perfect storm” for the rapid adoption of telemedicine as a viable way to reduce health care costs and better leverage the limited resources of our physicians’ time.

Federal Regulation

To start, the Affordable Care Act, or ACA, is redefining the way we evaluate medical care.  It is moving our insurance payer model from a “fee for service model” to one based on patient outcomes.  According to Shahid Shah, CEO of Netspective, also known as “The Healthcare IT Guy”, the idea is not the services that the provider performs and gets fees paid for; instead it is the outcome that the services provide that is of significance.” It is this focus on outcomes that means “Physicians will get paid for emails and phone visits in the same way they get paid for in-person visits…”

Besides the ACA, the Medicaid program is also creating opportunities for telemedicine to proliferate as well by defining care standards for “the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment.” They in turn are encouraging states “to use the flexibility inherent in federal law to create innovative payment methodologies for services that incorporate telemedicine technology.”

State Legislation

Given the efficiencies of telemedicine, the need for health care reform, and the directives of federal programs like Medicaid above, the states have indeed been leveraging their power as well to change the way insurance companies are approaching payments.

In fact, currently 27 states now have laws in place to assure that telehealth is treated similarly to in person visits from a payment perspective.  The three latest states to pass this legislation were Indiana, Minnesota, and Nevada.  There are currently 8 other states in the process of this type of legislation as well.  Given those bills are passed with equal fervor, it seems 35 states and Washington DC will all have some type of telemedicine legislation in effect by the end of the year.  Of course not all states are implementing this equally, so the American Telemedicine Association has created a resource center to help educate us on the differences.

It has been shown through several studies that Americans are ready and willing to start to leverage telemedicine to take control of their health.  Unfortunately, despite the patient’s desire to take advantage of these services and their innate cost efficiencies, Telehealth has been undervalued for many years…because the reimbursement climate for telehealth was not favourable.” However today, through the exercise of governmental reforms on the state and federal levels, we have finally broken through the telemedicine payment barrier.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

 

Resources:

#1: http://www.handsontelehealth.com/past-issues/139-healthcare-reform-how-telehealth-and-telemedicine-fit-in

#2: http://www.forbes.com/sites/brucejapsen/2014/12/09/with-aca-telemedicine-in-perfect-storm-for-coverage/#3

#3: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Delivery-Systems/Telemedicine.html

#4: http://www.americantelemed.org/news-landing/2015/05/27/milestone-most-states-now-have-telehealth-parity-laws#.VXfD3PlVikq

#5: http://www.americantelemed.org/policy/state-policy-resource-center/#.VXfD2PlVikr

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Babies with Hearing Impairments? We’ve got an “app” for that.

young girl with tabletAs parents, we try to find that edge; the advantages that will help our children grow and mature faster, stronger, better than we did when we were young.  We strive to make their paths to learning easier, to help them avoid the “school of hard knocks”, and for them to be smarter than we are and achieve more than we did.  Our parents wanted the same for us, and their parents the same for them.

Technology is a great way to stimulate the brain and get the creative juices flowing. With the visual nature of most people, video is naturally helping kick-start that learning curve quicker than ever before.  Avidex has played a role in finding these paths to learning and breaking down boundaries through everything from simple apps on your phone to complex distance education solutions used in the office or the home in corporate and medical environments.  One of our customers has found a way to help babies and parents with unique challenges through an innovative communication method…enjoy and get thinking!

15 month old Jenny sits playing on the floor. Like any new mother, her mommy watches her with wonder as she explores the world around her. Jenny looks up at her mother, pauses slightly, and then says “mamma”. Her mother stops in her tracks and starts crying with joy. In the life of an average 15 month old, this would not be a life shattering event. However, Jenny was born deaf. She received cochlear implants 3 months ago and this was her first word.

As of 2012, over 38,000 U.S. children with hearing impairments had received cochlear implants to assist them in hearing. The stories of their amazing turnarounds are being told every day, and many are not unlike the story above.

However, according to cochlear implant surgeon Nikolas Blevins, MD,

“Getting an implant is the easy part. The question is, what are you going to do with it once you’ve got it? Without follow-up education and therapy, it’s not a useful device. The patient will not develop speech.”

Patients that receive cochlear implants need speech therapy in order for the implants to create a meaningful difference. The problem is that not everyone has access to this type of resource. Stanford Medicine has an answer to that problem.

Baby Talk

Baby Talk is a speech therapy “app” developed by Stanford medicine that leverages the iPad to teach babies with cochlear implants how to talk.

With the help of Stanford and eager parents, BabyTalk is exploring the practicality of telemedicine, especially for high-risk, low-income families who live far from specialized medical professionals.”

Stanford has partnered with Weingarten Children’s Center on the project, and according to executive director Kathy Sussman,

“Our whole program is based on the notion that we can intervene with technology, developing listening and cognitive skills.”

The Baby Talk app leverages the iPad and Apple FaceTime and has been received well by both therapists and patients for several reasons.

  1. HIPPA Regulations- Doctor-patient relationships and patient medical records are deemed confidential and protected. FaceTime is an encrypted application for video conferencing and as such it is HIPPA compliant.
  2.  Audio and Video- FaceTime leverages both audio and video in the speech learning process. Video capability is extremely important as for babies it’s just as important to read lips as it is to hear the language. New research suggests that babies learn to speak while watching other’s lips.” 
  3. Curriculum- There is more to the Baby Talk app than just video conferencing. The iPad provides a platform for parent lesson plans that allow parents to continue speech therapy with their children using objects in their own home. We really are in the business of empowering parents to be effective language teachers for the children,” says Sussman.

The program is currently funded by a grant and can serve up to 30 children at a time. It is highly scalable and Stanford is optimistic that it will grow to reach many more babies between the critical ages of 0 and 3 years old. Given all this, it is no wonder that Kathy Sussman describes Baby Talk as “the future”.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

 Resources:

#1: http://www.cochlear.com/wps/wcm/connect/au/home/understand/my-child-was-born-deaf/hearing-stories-from-recipients/natalies-story/natalies-story

#2: http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx

#3: https://med.stanford.edu/news/all-news/2013/12/therapy-via-ipad-aims-to-help-children-with-cochlear-implants-.html

#4: https://hearinglosscure.stanford.edu/2015/02/babytalk/

#5: http://money.cnn.com/2015/02/09/technology/ipads-deaf-kids-therapy/index.html

#6: http://www.weingartenchildrenscenter.org/assets/babytalk_flyer_v1web.pdf

#7: http://www.speechbuddy.com/blog/language-development/read-my-lips-how-babies-learn-to-speak-by-watching-you/

 

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Avidex Awarded PAMF Los Gatos Center Project, Opening June 22

The project was a TEECOM AV design/bid that Avidex submitted on and was awarded the job. Avidex was subcontracted by Redwood Electric (the electrical contractor) to provide the audiovisual equipment and installation.

The audiovisual portion of the project included a Divisible Conference Room and the installation of twelve flat panel displays for signage and patient information.The Divisible Conference Room consists of ceiling recessed video projectors in motorized lifts and motorized projection screens. In each of the rooms, an audiovisual input wall plate at the front of the room provides connectivity for a VGA input, 3.5mm audio input, and  HDMI laptops or other AV sources. A wall-mounted, push-button control interface at the front of each room allows users to turn the AV systems ON and OFF, RAISE and LOWER the Volume and SELECT input Sources. Audio is reproduced via ceiling recessed loudspeakers. A small AV equipment rack is located in the credenza in the rear of one of the rooms and houses all of the audiovisual equipment.

Avidex supplied all of the audiovisual equipment, the installation of the equipment as well as the programming of the control system and audio and video switching.

The new Palo Alto Medical Foundation (PAMF) Los Gatos Center is scheduled to open for patient care on Monday, June 22, 2015.

Services at the new 40,000-square-foot medical building, located at 15400 Los Gatos Blvd., will provide primary care – Pediatrics, Family Medicine and Internal Medicine – as well as digital imaging services, a laboratory, and an urgent care center that will be open 365 days a year. The new building includes 51 exam rooms, four treatment rooms, one anti-coagulation room, two observation rooms and one radiology room.

Anthony Paoletti

About Anthony Paoletti

Anthony brings over 23 years of audiovisual experience and has worn nearly every "hat" in the industry; from Consultant to End User; Account Representative to Install Technician; Project Manager to Systems Engineer. Contact Anthony at apaoletti@avidexav.com

Are you getting your part of the $19 million dollar giveaway?

$1M Dollar BillYou heard that right, the USDA has just approved $19,000,000 in grant money specifically for telemedicine and distance learning.  The even better part is, you still have until July 6, 2015 to apply for your share of these funds!
Rural should never mean low-tech. In fact, remote locations have the potential to realize even better efficiencies and higher ROI on investments in telemedicine and education due to reduced costs of transport and travel.
These grants will give geographically isolated areas convenient and easy access to the same level medical specialists and educational resources that their big city counterparts enjoy, all through deploying innovative technology.
Are you getting your piece of the 19 million dollar pie?  To learn more about the program, visit the USDA site and learn more about the RUS-DLT Grant.
Do you want some tips and tricks on how to make sure you take advantage of this program to improve your healthcare facilities and schools?  There is a helpful guide here to assure you don’t miss out.
Again, the deadline is July 6th, so you still have a few weeks to ensure that your healthcare facility or school benefits from this unique grant opportunity.
Don’t miss it!
Please feel free to email me at bhigginbotham@avidexav.com or call 800.798.0330 if you need some assistance with any system and pricing information for telemedicine and educational AV solutions. 
Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Beyond Dial a Doc: 3 Tips for Next Level Telemedicine Systems

doctor on cell phone screenThe field of medicine is ever evolving. The first doctors walked from village to village to see their patients. In the old west, doctors dropped everything to saddle their horse, rode the range and got to their patient’s home as fast as they could. The invention of the buggy and then eventually the automobile allowed them to travel safer, faster, and farther. Today distance and time are no longer even factors. Doctors will appear on our TVs, phones, tablets and even our watches…just another step toward “quick and convenient” medicine. But simple and easy is not always the best medicine. Convenience is good…but quality is better.

In 2014, Dr. Phil McGraw and his son Jay raised over $21 million to help start Doctor on Demand, an online healthcare platform where “consumers can access in under three minutes a physician from a smartphone or a desktop.” It’s no surprise that with their combined audience of millions from The Dr. Phil Show and The Doctors, which Jay produces, that their “dial a doc” platform has generated a lot of buzz in the past several months.

It’s important to first acknowledge that the idea is not a bad one.  The Doctor on Demand system touts over 1400 physicians available to consult with patients and drastically reduces the cost of care.  With 64% of the population receptive to online medical care, it would be alarming if no one was making a mass market play for these dollars.

But can a large system like this offer the value that patients expect?  What is a medical clinic or hospital system to do in the face of this online competition?

There is hope, as the type of systems Doctor on Demand and others like it have put together, leave quite a bit of room for improvement.  According to Dr. Daniel Carlin, president of a health concierge service called World Clinic,

“Many of the big telemedicine companies are not care providers. They are marketing companies with big marketing budgets that have built a network of subcontracted physicians willing to receive a patient phone call. There is a broad range of quality among these doctors. This is not surprising given that the doctor earns, on average, $20 per call.”

Given all this, where are the opportunities for improvement?  What would a next level telemedicine practice look like?  To start it should focus on three main components.

Doctor Choice

Dive deeper into Doctor on Demand and you’ll notice that they tout “more than 1,000 doctors available for video consultants one or two days a week.” Of the 1000 plus physicians in the Doctor on Demand system, the website profiles 18 of them. Physician choice is not a part of the equation in these systems and a recent Harris Poll relates that 88% of consumers want to select their doctor and only 12% are willing to be randomly assigned one.

Personalized Care

Developing a system that has the ability to personalize care to the individual has innate advantages. The random “dial a doc” process is hardly an equation for a consistent doctor patient relationship. Even if the patient is cared for by a small team when 24/7/365 access to a single physician is just not feasible, the practice should be able to leverage electronic health records to deliver care with a broad/holistic understanding of each client/patient.”

Consistent Technology Experiences

Imagine a network of over 1000 doctors answering randomized calls forwarded to them by a system like Doctor on Demand.  Depending on where the physician is at and what device they pick up the call from, there is the potential for a wide swing in the quality of that consultation.  Everything from bad WiFi, poor cell service, or even differences in the quality of cameras on their devices can all adversely affect the calls.

Creating a system that utilizes high quality microphones and HD cameras in quiet, dedicated spaces with reliable high speed internet connections assures that the patient experience is consistent.  Developing a policy and set of standards for devices used by the doctors in remote locations can also help mitigate differences in the quality of care form call to call and patient to patient.

It is apparent that the future of healthcare includes the continued adoption of telemedicine in one form or another.  The opportunity for medical practices and healthcare systems is in developing systems that offer more value than their mass market counterparts.  Building a system that incorporates physician choice, that is patient centered, and delivers a consistent, high quality audio visual experience can make the difference between offering a random doctor on demand and offering a service and a doctor that is in demand.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes.  Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

 

Resources:

#1: http://www.doctorondemand.com/

#2: http://www.forbes.com/sites/zinamoukheiber/2014/08/06/dr-phils-doctor-on-demand-raises-21-million-as-telemedicine-heats-up/

#3: http://www.fiercehealthit.com/story/patients-increasingly-open-video-doctor-visits/2015-01-23

#4: http://www.forbes.com/sites/russalanprince/2015/03/30/the-limitations-of-dial-a-doc-telemedicine/

#5: http://healthland.time.com/2013/12/10/dr-phil-startup-brings-check-ups-online/

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com