On April 19^th, President Joe Biden announced that every adult became eligible for their vaccination shots, the most recent sign that we are that much closer to returning to normalcy in our everyday lives. That same day, Chicago Public High Schools reopened for the first time in over a year. As other industries have recently begun to utilize telehealth in their fields, it is time for school systems across the country to do the same.

Obviously, the cost of implementation would be too much for most school systems, so partnerships with outside organizations is key. For example, the Center for Psychiatric Health is partnering with the Southwestern District Health Unit in North Dakota, giving students the ability to speak with physicians located more than three hours away. Partnerships like this help those students in rural areas better access to healthcare, resulting in better attendance rates.

Mental health has become a major area of concern in our youth, especially over the last year of this pandemic, as they are more isolated than ever before. Giving a school nurse the ability to connect a student to trained counselor over video, will not only open the nurse up for other issues that may arise, but more importantly will give the student the professional help they need, that they may not have gotten otherwise.

“School nurses are more effective at triaging who really has the greatest needs for telehealth services,” says Laurie Combe, president of the National Association of School Nurses (NASN). “School nurses have expertise in care coordination for students with chronic health conditions. For rural communities and for impoverished communities, telehealth facilitated by school nurses has great promise to increase access to care.”

Essentially, with the help of telehealth programs, school nurses and teachers will more clearly be able to define whether a student should go home if they are feeling sick. A physician could provide the best advice through telemedicine regarding whether a child needs to stay home and not attend school. All the guesswork is taken out of the equation when a telehealth program is implemented.

The Children’s Health organization in Dallas, Texas implemented a school-based telemedicine program, giving schools various equipment, such as digital scopes, and HD real time videoconferencing, connecting them to a partnering physician. Both parents and teachers have enjoyed the program, as the parents don’t need to miss work for a doctor’s appointment, and the kids are back in the classroom learning sooner.

Since school funding is based on average daily attendance among students, schools benefit financially when telehealth systems are implemented. Additionally, school nurses state that approximately two out of three students who use telehealth would have otherwise ended up at emergency departments or urgent care centers. As such, telemedicine programs save both families and the healthcare industry money. School nurses also report greater professional satisfaction due to the benefits of telehealth.

Telehealth in schools help everyone involved, especially the young students, who are our future.

One year ago, this month, everyone had their world flipped upside down, as we entered the “two weeks to slow the spread” shutdown. Obviously as we learned more about COVID-19, the shutdown lasted longer than those two weeks, and we were forced to adapt the way we went about our daily lives.

As companies and organizations worked swiftly to adjust, many in the medical field turned to Telehealth. According to the American Journal of Preventive Medicine, more than a 20-fold increase in the incidence of telemedicine utilization following March 13, 2020. Conversely, office-based encounters declined almost 50%.

As a result, both patients and providers have now experienced the benefits that telehealth has to offer over traditional care:

• When a patient and their family need to discuss test results or post-op care with a physician, a videoconference replaces an in-person visit, saving patients time and money related to travel.
• When a patient needs to manage a chronic condition like diabetes or COPD, Remote Patient Monitoring (RPM) replaces routine office visits and even prevents ER visits when the disease is mismanaged. And since RPM creates more frequent contact with the doctor’s office, patients experience less fragmentation of care when they forget to monitor their condition. As a result, patients have greater engagement and ownership of their health.
• Providers can significantly expand their potential patient base and improve the quality of care with no additional travel and minimal increase in overhead.
• Providers are at lower risk for burnout because they can interact with patients more frequently and manage patients more efficiently.
• Providers can more easily participate in training and education without traveling to out-of-state multi-day events.
• No-shows go down because patients are more engaged with their care team.
• Readmissions go down because RPM and remote consultations help patients manage health conditions more effectively. One innovative hospital invites the patient’s offsite family members to a video conference where they can ask questions of doctors, nurses, and other care team members, and also receive after-care instructions. This type of family and patient engagement can improve compliance with after-care instructions, which then reduces readmissions.
• Costs go down because online visits are less expensive than urgent care and ER encounters.

Even with the success of the past year in the industry, there are questions about the future of Telehealth. When COVID overtook the country, temporary policies were put into place to support telehealth. These policies have been extended and will likely be made permanent.

In an interview with the American Medical Association, John Halamka, MD and president of the Mayo Clinic Platform, recently echoed this sentiment saying, “The hashtags that were trending with the American Telehealth Association were #DontRollBack and #RetainTheGain. I will tell you the feeling that I get when I chat with people at CMS [Centers for Medicare & Medicaid Services] and HHS [Department of Health and Human Services] is that these are not going to be rolled back. These are changes that are going to persist. Obviously, we’ll see with a new administration what regulation and regulatory guidance they put forward. But if the issue is reaching more patients with more expertise and a better value, that’s certainly consistent with what we need in health care in this country—and it’s not partisan.”

Telehealth visits have skyrocketed in urban areas blanketed by broadband internet service, but when coverage is scarce, as it is in many rural areas, telehealth isn’t an option. Dr. Halamka encountered this situation when rolling out Mayo’s advanced care at home. Thirty miles out from an urban area you may get into not only not having a broadband connection, but not even having a good cellular connection. “The two answers are: On one hand, you need good connectivity, but also it needs a public that’s aware of the potential of telehealth. And in those rural areas, without a guiding organization providing access to telehealth care, people just may not know about the options.”  Hopefully, efforts from the Mayo Clinic, ATA, and AMA will help increase the awareness and the reach of telehealth sooner rather than later. CareXM is helping lead the charge as well, by making telehealth services easier to adopt for providers, clinicians, and patients.

CareXM’s integrated communication platform is designed to help providers care for patients at home through remote patient monitoring (RPM), communication, education, and patient engagement across various reimbursement models offers both low cost patient outreach and engagement options via video chat, text, IVR and email as well as more robust fully loaded RPM kits for automated readings via Bluetooth enabled devices. Combined with CareXM’s clinical and non-clinical answering services, intelligent call routing, and robust data analytics, providers are positioned to truly transform the patient care experience right when we all need it most.

And who knows? Maybe in another year we’ll be able to look back and think less of what this pandemic has cost us and see more good – like advances in telehealth – that has come from it.

Why Remote Patient Monitoring (RPM)?

Caring for patients with chronic diseases has become more challenging during the COVID-19 pandemic, as agencies, nursing staff and patients are seeking to avoid virus exposure by minimizing human contact.  Now more than ever, remote patient monitoring holds the promise to leverage digital technologies to collect health data from home care patients and electronically transmit information securely to home health care providers.  But lacking reimbursement for costly Bluetooth- enabled home monitoring devices deters many agencies.

 

The Solution:  Device free RPM by TouchPoint Care (TPC)

Device free RPM uses the patient’s phone or tablet to transmit health data to the home care agency.  This eliminates the need for costly Bluetooth -ended scales, blood pressure monitors, and the like, and avoids the IT support and patient training of deployment.

 

Instead, patients answer a series of questions about their vital signs and key health measures, and share these answers using their tablet, cell phone or landline with the home health agency.  TouchPointCare’s platform stores real-time patient data in the dashboard and triggers when patient data is out of normal range for follow-up by nursing staff.  Using this platform, the home health agency can greatly scale the number of patients in its care and at the same time, deploy nursing staff more efficiently by freeing up more time for nurses to provide in-home care for higher risk patients.  This achieves better care with less cost, and keeps patients engaged in their own care.

 

How TouchPointCare Works

TPC offers low cost and flexible approach to gather signs and symptoms while delivering encouragement and education to patients.  The agency uses the turnkey TPC program to create custom question scripts specific to the diagnosis, plus creating follow-up questions based on patients’ responses. The script is created within minutes and includes options for triggering alerts for immediate notification to nursing staff for follow-up.  Based on patient preferences, the script is automatically deployed via IVR call, text message, email, or live phone call.

 

Example

The agency is caring for a recently discharged patient following complications from heart failure as seen in figure 1.  The patient has a history of heart conditions and is overweight.  Using the hospital discharge instructions, the agency creates a call script that reaches out so the patient daily with questions surrounding her weight, swelling in abdomen or ankles and if she’s taking her medications as in Figure 2.

 

Figure 1:                   Figure 2:

 

The agency receives automated daily data from the patient and immediate alerts should any of the data trigger action.  Additionally the agency can use the TPC platform to send education and health tips to encourage the patient’s engagement.

 

If the agency decides to pursue Bluetooth-enabled devices such as a scale, TPC works seamlessly to integrate any brand of equipment.

 

For more information on how to use the low cost deviceless RPM from TPC, set up a time for your demo.

TouchPointCare (TPC) introduces a new mobile technology with which to engage patients, making TPC the most robust communication platform in the telehealth marketplace.

TouchPointCare’s BYOD offering allows patients to use their own smart devices and the app store to pair with an array of blue-tooth biometric devices, directly input health data and interact with their care providers virtually.  Patients are more likely to participate in their care because of the familiarity of their own device, and payors save because the connectivity comes from the patient’s device.

Patients can download our app on their phones to stay connected.  The new BYOD app features the ability to manually input readings or pair with blue-tooth automated devices, includes live virtual or video visits, the ability to respond to customized questions and view personalized educational videos, the ability to request a call from the care provider, notifications, secure messaging, full access to health content resource library, trending data and more.

Clinicians benefit with another tool to manage care for home based patients with costly chronic illnesses, and manage a wider range of risk populations.   It also enables them to use the TPC platform to help patients remain independent and leads to better outcomes and higher patient satisfaction.

The Centers for Medicare & Medicaid Services (CMS) has proposed a new rule that would make certain COVID-19-related telehealth flexibilities introduced over the past few months permanent for Medicare beneficiaries.

CMS: True Telehealth Change Will Require Congressional Action

Today, the Administration announced new flexibilities from multiple agencies intended to expand access to telehealth under COVID-19 emergency authorities.

Medicare and Medicaid

The Centers for Medicare and Medicaid Services (CMS) is using Section 1135 waiver authority to waive originating site restrictions for telehealth during this emergency. They will reimburse for telehealth visits to Medicare patients starting March 6, whether the patient is in a health care facility or in their home. CMS also notes that Medicaid programs have the flexibility to allow for telehealth reimbursement and do not need the federal government’s permission to do so.

• CMS Press Release: https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak
• CMS Fact Sheet: https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak
• CMS FAQs: https://edit.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf