Author Archives: Lindsey Ingram

This Month in Telemedicine – mHealth

November 11th, 2013 | Posted by Lindsey Ingram in Healthcare | Video Conferencing - (0 Comments)

American Telemedicine Association’s policy duo Jonathan Linkous, CEO and Gary Capistrant, Senior Director of Public Policy, return with updates and new information regarding telemedicine.

Mobile Health
Mobile Health is making much more than a dent in the telemedicine industry; $161 Million has been dedicated to mobile health from 43 different companies in the last quarter. This is a drastic increase compared to earlier in the quarter when only $42 Million was dedicated to mobile health.

Currently the guidelines that involve mental health correspond with mobile health. ATA is currently in the process of doing an accreditation of mobile health care services online, and hopes to have it ready by early next year. This is a major step for ATA and for telemedicine. A Special Interest Group on mobile health is hosting a webinar on privacy and international applications in mobile health.

Telehealth Opportunities
A component of the Affordable Care Act, which is currently being implemented, says that those in the health insurance exchanges have to support essential health benefits. However, there is no basis in the regulation to not pay for a telehealth claim. It is all supposed to be provided and covered on the same basis as in-person care.

The CMMI, or Center for Medicare and Medicaid Innovation, continue to create funding opportunities either directly for projects or through the states. There is managed care within Medicare and Medicaid populations, most of the managed care plans have had the flexibility to use mobile health or other telehealth aspects. Hospitals have grown interested in home monitoring of people, and other aspects dealing with readmissions problems. Since Medicare cuts funding for hospitals not reducing their readmissions enough, many have grown more receptive of using difference health technologies such as mobile health.

Medicare Physician Fee Schedule
A major change that is expected in the new fee schedule for telehealth is CMS will use a much more open definition of rural health shortage areas that will allow telehealth to be provided on the fringes of rural areas.

Legislation
Harper Bill, H.R. 3306 is a very notable bill for mHealth and has many bipartisan sponsors. Telehealth for Medicare ACO’s, or Accountable Care Organizations, currently don’t have coverage for telehealth in metropolitan areas, where most of the ACO’s are. The goal is for ACO’s to have full flexibility of telehealth.

It will also have shared savings for reducing Medicare readmissions. This proposal gives hospitals the incentive to do better than their own benchmark, in hopes of saving money for Medicare. It is an opportunity for hospitals to have some sort of income, and it will ultimately be a positive thing for patients. It will also target home dialysis, hospice, and homebound patients. Mobile Heath can cover these kinds of patients at home, and have the same kind of in person physician assistance.

There are also several other bills that are pending and being discussed. The Step Act (H.R. 1832) was enacted in December 2011. This act expanded the authority for the defense department to require only one state license for health professionals to operate in any state. This model is also being expanded to apply to two others, the VA: VETS Act, H.R. 2001, or Vets affairs facilities and TELE-MED Act, H.R. 3077, or the Medicare population.

Finally there is also the SOFTWARE Act, H.R. 3303, which is Sensible Oversight for Technology Which Advances Regulatory Efficiency and has been proposed by Congresswoman Marsha Blackburn. This bill deals with the volume of applications that have flooded FDA for mobile applications.

Young Executives Depend More on Video

September 5th, 2013 | Posted by Lindsey Ingram in Cisco | Industry News | Video Conferencing - (0 Comments)

With the next generation of executives taking control over established companies, new changes are bound to arise. The 2013 Cisco Global Young Executives’ Video Attitudes Survey shows that many of these new managers are interested in video collaboration and plan on incorporating it into their business or company. Many new managers understand the benefits video can provide for their company, and some will not even consider working with other companies unless they use it as a tool.

The convenience of video conferencing is something that many young executives and managers are taking advantage of because it allows participants to read visual cues, “be there” without traveling, and have the ability to share content instantly. Constantly traveling in order to meet with clients or other people is time consuming and costly, not to mention frustrating when flights get delayed or cancelled. More organizations are shifting to visual collaboration as the technology continues to advance and creates interoperable and scalable solutions.

The data from the survey shows that many young executives plan on relying heavily on video conferencing to manage their business. Three out of five young executives say they will rely more heavily on video within the next 5 to10 years and 87% believe video has a significant and positive impact on an organization. These executives cite benefits ranging from enhancing the experience of telecommuters to saving money on travel costs and even attracting top talent.

Video collaboration is also an effective method of transferring information and connecting geographically dispersed people. It not only allows those within the states to contact one another, but it also opens up the global marketplace. Of the organizations surveyed that have less than 400 employees, 94% said they utilize video in order to break down language barriers in the increasingly global marketplace.

Telecommunication is a major appeal to prospective employees as well. In fact, 87% of respondents say they would choose to work for a video-enabled organization over a company that has not invested in business-class video communications. This is because organizations that invest in visual collaboration embrace the increase in technological advancement and are considered to be more innovative.

While video conferencing is a great tool for many companies, people are still wary of it. Survey respondents showed that their top five fears about video conferencing were: a messy office, personal appearance concerns, the inability to multi-task, the need to eat and some are not comfortable on video in general. However, as people utilize the technology more often, they will eventually become more comfortable with it.

The advancement of technology is rapidly increasing, and it is up to these companies and businesses to keep up. The new executives plan to do what they can to run successful companies, and telecommunication is a tool that will allow these companies to be successful.

Take a look at the slides below for more survey data.

An Audio Visual Prescription for Health

August 19th, 2013 | Posted by Lindsey Ingram in Audio Visual Integration | Healthcare | IVCi - (0 Comments)

The Cohen Children’s Medical Center, a part of North Shore LIJ, strongly believes that art is a crucial aspect of children’s hospitals, as it creates an optimistic and constructive environment. This kind of environment allows children to open up their imagination and begin the healing process. As a result, they implemented an interactive virtual aquarium to entertain the children who are in the pediatric emergency waiting room.

The inspiration of this theme came from Long Island’s very own ocean and shoreline to create a familiar setting for young children, making them feel more at home rather than in a hospital. A hospital environment can be scary for young children and having interactive technology that makes them more comfortable can make their stay much more enjoyable and entertaining. By interacting with the technology and creating their own underwater world within the digital aquarium, children can gain a sense of control, something they may have lost by being in a hospital.

Rather than sitting in an intimidating waiting room, children can now be entertained with the virtual aquarium, and interactive “fish tank” that allows children to create their own fish, and then launch it into the tank to swim among the other fish other children have created. The fish are virtually fed, and swim among other sea creatures, such as turtles, larger fish and live among sea coral. Fish and shells decorate the floors and walls, and the CT scan also has fish painted on it. The renovations have made the hospital more appealing to children, making them less fearful of their environment. “Years of planning went into making the new facility child-friendly. Kids almost want to be here,” said Dr. Charles Schleien, Chairman of Pediatrics, in an interview with Newsday.

IVCi was contracted by North Shore LIJ and The Rockwell Group to install the system which is made up of six LCD panels, each about 55 inches wide, creating a fifteen foot screen. Six iPads are used to control what happens on the panels and allow the children to create the fish they want. The main audio comes from two speakers located on either side of the LCD mounting frame, creating as real of an experience as possible.

See for yourself with the demonstration below!

Digital Aquarium at Cohens Childrens Medical Center – Emergency Waiting Room from labatrockwell on Vimeo.

Video is Most Useful Tool to Oil & Gas Industry

August 12th, 2013 | Posted by Lindsey Ingram in Collaboration | Video Conferencing - (0 Comments)

As the need for collaboration grows, the video conferencing industry provides. Microsoft and Accenture have published survey results showing that the oil and gas industry has looked to video conferencing as a solution for major problems within the industry. Accessing information at anytime from anywhere is a key factor in business success, and having the ability to share data and communicate in real time provides major benefits.  As a result, the need for video collaboration in this industry is steadily increasing as workplace dynamics continue to change.

Approximately 200 oil and gas industry professionals including engineers, mid-level and executive management, business unit heads and staff, project managers and geoscientists, were candidates for completing Microsoft and Accenture’s online survey in order to determine how video conferencing has affected the gas and oil industry. Results show that the percentage of oil and gas professionals that are collaborating is increasing, and 35% have spent more time collaborating. Social networking has also become a major business collaboration tool as well, and is growing each year. Results of the survey also show that instant messaging and social networks are the most popular social media tools for business collaboration, and the usage of internal company social networks has increased.

Video conferencing has been a definite solution for the problems that this industry faces. Problems, such as a lack of skills and an aging work force, make it difficult for this industry to stay modern and keep up. Younger generations don’t have the skills and experience needed to maintain the industry. There are also issues with breaking workflow and challenges involving knowledge sharing. Video conferencing has allowed these issues to dissolve, as collaboration allows users to share information in real time and creates an outlet for easy communication.

While many companies find that video conferencing is a solution, about 30% of the companies surveyed are still hesitant about the technology and restrict its usage, leading employees to be weary of using social tools in the workplace. However, 40% of employees surveyed feel that there is not enough teamwork among employees and social tools drive collaboration. The survey has also shown that there are distinct differences between counties, sectors and genders relating to productivity.

Every company utilizes their tools in different ways. Some feel that video collaboration will make them more successful, while others may not. However, the majority of companies that participated in this survey have realized the benefits of video conferencing and are integrating it into their daily business routines, thus improving collaboration, speeding up customer response and assistance, and creating a new competitive advantage.

This Month in Telemedicine – July 2013

July 29th, 2013 | Posted by Lindsey Ingram in Healthcare | Video Conferencing - (0 Comments)

American Telemedicine Association’s policy duo, Jonathan Linkous, CEO, and Gary Capistrant, Senior Director of Public Policy, return with updates and new information regarding telemedicine.

Medicare
Several weeks ago Medicare created its proposed rulemaking for the physician fee schedule, set to begin on January 1st, 2014. There have also been two major improvements proposed for telehealth. One is the expansion of the definition of a rural health shortage area. The purpose of this is to increase coverage of telehealth by allowing more areas to be considered metropolitan counties. This proposal will help the 104 counties that lost their telehealth coverage due to their lost status as a metropolitan county.

The second proposal would provide telehealth coverage for CPT codes for transitional care management services. With this process however, there are some difficulties. While there will be a website people can visit to find out if they are covered, it does not have direct yes or no answers, making it hard to determine coverage. Another issue is that eligibility for coverage is renewed yearly, meaning one year a person may be eligible and the next they are not.

Congress
In last month’s installment of This Month in Telemedicine, Linkous and Capistrant mentioned legislation that Congressman Greg Harper was working on. His bill is moving forward, and some changes were made in the process of finalizing it. “The effort is to really deal with the Congressional Budget Office and what they will end up saying about telehealth provisions” explained Capistrant. There have also been several proposals to get a savings estimate from the CBO.

  • To have a Medicaid option for high risk pregnancies. Two years ago ATA got an estimate that it would save Medicaid 168 million over 10 years.
  • Giving hospitals an incentive for doing a better job in reducing their number of readmissions. It would allow the hospitals to share in the savings and will pay for home monitoring and video.
  • Have Accountable Care Organizations currently under Medicare (which serve about 4 million beneficiaries) use telehealth the same way Medicare’s managed care plan does. Medicare has started an effort to experiment with bundling with hospital payments with post-acute payments. There has participation in almost 400 hospitals all over the country. The goal is to have those hospitals be able to use telehealth to deal with that post-acute care and not have the restrictions that are in Medicare’s statute continue to apply.
  • Allow home video to people who are doing dialysis at home. This will empower more home dialysis and yield savings.

Other Harper package provisions that have been added include: restoring coverage for 104 counties, provision to go for coverage for telestroke diagnosis country wide, as well as some provisions dealing with critical access hospitals that are in metropolitan areas. These hospitals will not be included in the health shortage area because it is a hospital.

States
There has been a lot of progress among the states with telemedicine. The Governor of Missouri has signed a bill that will allow a parody law for private insurance covering telehealth. Missouri is now the 19th state that has this law. The ATA is finalizing three of the state best practices for Medicaid uses of telehealth, as well as a final report of major gaps in each state about telehealth

The ATA Board just recently approved online, web-based mental health services. It is also interested in developing practice guidelines for teleICU, web based or online primary and urgent care services that are starting to be developed, and remote health date management on wounds and burns, according to Linkous. Telepathology guidelines are also being rewritten.

Fall Forum in Toronto
The focus of the Fall Forum in Toronto is to examine some of the problems that have recently been discussed involving telemedicine. A major focus will be reducing readmission rates in hospitals. “A big topic in every hospital, in not only this country but around the world, is how do you reduce the readmission rate within the hospital and there’s a lot of work that’s been done on this using telemedicine as part of the answer. Not as the answer, but part of it,” explained Linkous. They will also be covering issues such as Telehealth networks, and how you can make those networks sustainable, as well as how to engage customers. They will also be covering topics such as mainstreaming in health applications, or “apps” to be integrated into the healthcare system. Other topics include virtual care and provider services.