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.

The federal government has experienced the benefits of video conferencing and now new legislation is being introduced to demand it. Congressman Mike Fitzpatrick of Pennsylvania has introduced a new bill, the Stay in Place, Cut the Waste Act of 2013, into the House of Representatives that encourages the usage of collaborative solutions, such as video conferencing, to reduce the amount spent on travel by federal agencies. If this bill passes, at least 50% of federal travel expenditures will be cut, saving taxpayer dollars.

Many of the benefits of video conferencing have been mentioned in the bill. While it will not only save money, it will also cut down carbon emissions as there will be less of a need for travel. It will also help in facilitating staff training, meetings, and enhance employee productivity.

The bill cites previous legislation, like the Telework Enhancement Act of 2010, which required every federal agency to establish policies that enable remote working and greater flexibility in management of the federal government’s work force through the usage of telework programs. Combining the intentions of these two bills will ultimately create a beneficial system.

Other governments worldwide have already discovered the benefits of using video conferencing. The UK government put Operation StepChange into effect in order to plan for the chaos of the 2012 London Olympics. This plan encouraged business professionals to change their working practices and utilize video conferencing, particularly with the excess amount of tourism in London. There is also discussion of making this change permanent, depending on the plan’s success, “Depending on the success of Operation StepChange, there are those who advocate making these reforms permanent. This could transform the civil service as we know it – and that is getting the interest of some of Britain’s political classes,” says Max Smolaks.

The introduction of this bill indicates that video conferencing has become a priority for the political system in the United States. Hopefully, the United States will pursue this need as other countries have and encourage the use of video conferencing in order to gain greater sustainability and create a more efficient workforce.

Video conferencing has quickly become a major tool that many companies utilize. Cory Johnson of Bloomberg Television’s “Bloomberg West” talked with Cisco Senior Vice President Collaboration Technology Group, Rowan Trollope, via video about the adoption rate of video conferencing.

Trollope gave some insight into Cisco saying that about 38% of Cisco’s employees do not work at the same site as their managers; however,  it’s not really an issue  thanks to video conferencing. Video collaboration technology has allowed managers and employees to stay in touch with one another and chat about certain projects or simply to keep one another updated. Connecting via high video quality is just as productive, if not more productive, than in person interaction because video conferencing forces participants to sit down, discuss the issue at hand, and then find a solution.

Video conferencing has not only advanced the companies that utilize it, but the technology itself has also advanced, allowing users to collaborate on the go on devices such as cell phones, laptops or tablets. Rather than being limited to a conference room, users can participate in a conference via mobile devices due to the advancement in equipping such devices with cameras. Now, it is possible to make a video conference call just about anywhere.

According to Trollope, about 89% of Cisco employees work at home once a week, and are able to communicate with other employees and participate in meetings through telecommuting. It is very difficult to follow along on a conference call when there is no face to put to a voice. The quality of an audio call is simply not the same as a video call. When you use high definition video, it is much easier to follow the conversation and participants can focus on the task at hand as opposed to trying to figure out who is speaking.

While it seems that only large corporations would find a need for video conferencing, smaller companies and even individuals can utilize the benefits of video conferencing. Companies of all shapes and sizes currently use video conferencing as a key tool and are pulling for quality and reliable video conferencing devices to benefit their own business.

To see Cory Johnson’s interview with Rowan Trollope, check out the video below and see how Cisco has grown because of video conferencing!

 

When thinking about movie production, video conferencing and collaboration is not usually the first thing that comes to mind. However, producer Jerry Bruckheimer agrees that thanks to video conferencing, producing films is much more successful and efficient. Rather than spending excess amounts of money on travel costs so directors, producers, and actors can be in the same location, video collaboration has allowed the flow of communication to be unaffected by the lack of physical presence. Bruckheimer certainly utilizes his Cisco TelePresence set up, and is in constant communication with everyone on his production team.

When making a movie, it is nearly impossible to have every member of the production team in the same location. As a result, video collaboration equipment is becoming the newest member of every production team. Directors and producers can work with their cast from across the globe, and work out final touches with editors in an instant. There is a large amount of data that is transferred throughout the film-making process, and Cisco TelePresence makes it easier to move around. The way that technology has changed the way films are produced is remarkable; pretty soon even movie theaters will be digital, and physical film will no longer be needed.

With this drastic change in technology, many people question whether it’s the best option, particularly in Hollywood when the director/actor relationship is key. Losing that in-person interaction is a difficult thing to replace, however the face to face interaction provided by video collaboration is helpful in establishing that relationship. Video conferencing has not only helped producers keep in touch with their teams, it has also helped choreographers teach their dance students, and even inmates going through arraignment.

The benefits of video conferencing are well known in the enterprise world; now they are making their way into other career fields as the technology continues to grow. Soon we will see the impact of video conferencing and collaboration in everyday life.

Check out the video below to watch Cisco’s interview with award winning film producer Jerry Bruckheimer, and see for yourself how much of a difference video conferencing has already made in the film industry!

Polycom has recently announced its latest addition to its video collaboration family, the Polycom CX5500 and CX 5100 Unified Conference Station, a 360 degree panoramic 1080p HD video collaboration solution custom-built for Microsoft Lync 2013 and the first ever in the video conferencing industry. These stations are designed to create an around-the-table experience with a 360 degree camera panoramic view of the room, allowing all participants to engage.

Polycom has also announced that it has received Lync 2013 qualification for its Polycom VVX Business Media Phones, strengthening the partnership between the two companies by expanding Polycom solutions that are compatible with Lync products.

Why is this great for customers?

  • Easy to use. With Polycom CX5500 and CX1500, the operator has options that allows for easy usage. A new user interface and design system allows easy access to launch or join a call directly from a Lync user environment. Users can directly connect the CX5500 or the CX5100 via USB to a Lync-run computer. These two solutions can also be used with the Lync Room System, combining a 360-degree camera experience with touchscreen monitors and tabletop touch controllers.
  • Better productivity. The Polycom CX5500 and the CX5100 are placed in the center of the table, and therefore allow a natural conversation by engaging all participants simultaneously, with not only those sitting around the table, but other participants who are not. Both systems include 1080p active speaker video while displaying 30 frames per second at a 360-degree panoramic view. Conversations are clear with Polycom HD voice.
  • Financially beneficial. The Polycom CX5500 is both an HD video collaboration environment and a fully featured SIP conference phone, which ultimately reduces capital costs for organizations that require both systems. Since it is so easy to use, the company can also save on training and IT costs.

While desktop video has many advantages, it can become cluttered when connecting multiple groups of people. These solutions are great for organizations looking to extend their Lync application into a conference room environment. Contact us if you have any questions or would like more information on designing or installing collaboration room environments.