This month’s telemedicine videocast from the American Telemedicine Association focused on a major change in the population tabulation that directly affects telemedicine reimbursement, as discussed by ATA’s CEO Jonathan Linkous and Gary Capistrant, senior director of public policy.

Federal Policy Changes & Activity
The hot topic was the re-designation of many counties from rural to metropolitan, which resulted in the loss of Medicare telehealth reimbursement. Due to a change to the Standard Metropolitan Statistical Areas, 97 counties newly designated as “urban” will lose reimbursement privileges because Medicare reimbursement for telehealth services is not available to populations in metropolitan areas. On the other hand, 28 counties will gain coverage because they are now designated rural.

While this is a setback for telemedicine and Linkous proposed two ways to deal with the situation: the first, to grandfather in counties that have been redefined as metropolitan; the second is to expand Medicare reimbursement for urban populations. “This really shows the need to do that,” said Linkous.

Also mentioned was the F.I.T.T bill (Fostering Independence Through Technology), which is sponsored by South Dakota Democratic Senator John Thune and Minnesota Democratic Senator Amy Klobuchar. The bill aims to establish a pilot program for home health agencies serving rural communities to use remote patient monitoring.

Capistrant and Linkous also discussed FDA regulations about medical devices, licensure and interstate health commerce, and the need to coordinate the various roles that the federal government plays in healthcare. Linkous points out the very real potential for backlogs—the FDA, Linkous says, has received 100 or so applications but can only process 20 a year.

“The good thing is there’s a lot of innovation in mobile health. The bad is it’s taking a long time to get through regulation, and, number two, you can’t get paid for it.” - Jonathan Linkous, CEO American Telemedicine Association

State Activity
They also discussed the ongoing issue of licensure, and the burden acquiring multiple state licenses places on telehealth providers. The Federation of State Medical Boards is proposing a form of state reciprocity but, Linkous points out, getting all the states on board could take a long time—a decade or more. He offered the example of the nursing compact, which was started 15 years ago and less than half the states have signed on to date. (The ATA has not endorsed any one approach).

Big Med Developments
Larger healthcare systems are seeing the potential business benefits of telehealth, and are looking to expand their footprint and brand by providing more services to a larger population. Linkous gave the example of the Mayo Clinic Care Network, an affiliation program. They have a goal of reaching 200 million patients by 2020, through both their own hospitals and the affiliation network by using “e-consults”, i.e. telemedicine. Cleveland Clinic also has an affiliate program. “It’s an interesting contest,” says Linkous, noting this is a business decision and cost-reduction tool. Mercy Healthcare is using telehealth for a broad range of services, including stroke, autism, and cardiac care, and they’ll soon be breaking ground for a virtual healthcare center which will house subspecialists and a teaching facility at their headquarters outside of St. Louis.

New Online Education
ATA will be launching an education service on their website with webinars, videocasts, and online courses, with many continuing medical education accredited. The organization is looking to develop a major educational center—online, of course—for telemedicine providers.

Annual Meeting
ATA’s annual meeting will be held in Austin, Texas, from May 5 to 7. For a free exhibit hall pass, click here to register and enter  the code VIPcomp13.

The next This Month in Telemedicine videocast is on April 23.

The ABA TECHSHOW is taking place April 4-6, 2013 in the Windy City (Chicago, IL). Visit us at booth #614!

IVCi is partnering with Blue Jeans Network to showcase how video collaboration solutions can help law firms meet today’s legal challenges, such as geographically dispersed clients and timely access to subject matter experts, while helping minimize expenses.

In a previous article, we discussed how firms can use video to build client relationships, as well as, manage their ever growing case load by keeping in touch with traveling clients effortlessly through video enabled smartphones or tablets. Additionally, firms can use video conferencing to depose remote witnesses or interview difficult to reach subject matter experts without the time and cost associated with business travel.

Firms can also use video conferencing solutions to attract and retain top associates. Partners can interview potential candidates remotely so that only the most qualified candidates are brought in for further discussion. Plus, law firms can help differentiate themselves by utilizing the latest technology and making the firm more attractive to new recruits.

Additionally, partners and associates can attend meetings with remote offices and confer on any range of topics that would typically be discussed in a face-to-face environment.  Plus, attorneys can attend classes and seminars over video as part of distance learning courses to satisfy CLE requirements. This frees up valuable time and resources by avoiding travel to various firm or seminar locations.

Stop by our booth at ABA TECHSHOW for a demonstration and learn how video collaboration solutions can help your firm. Click here for registration information.

Additional Resources:
Video Conferencing Hits Legal Age

I attended a recent community meeting to hear about a proposed 600-home development to be built on what is now one large open space parcel. One of the concerns raised was the fact the developer had only one entrance to the proposed neighborhood, which would connect to a two-lane road. With a normal ratio of homes to cars, that translates to a lot of cars trying to squeeze into a small space during rush hour.

The meeting quickly devolved into a gripe session about the overall state of traffic in the area. My neighborhood has three separate entrances, and it seems the most difficult part of any commute is to get out onto the main thoroughfare at 8:00 a.m. on a weekday morning. Not to mention at the end of the two-lane road, the City is planning to install a roundabout to alter a dangerous intersection. I suggested that training ought to be provided for roundabouts, since I have yet to see anyone use them as anything other than a four-way stop. Polite Southerners mixing with more aggressive drivers from other regions (you know who you are) is an interesting combination.

I am fortunate that I am able to work from my home office when I am not travelling or meeting with customers. By using the calculator found on the Georgia Clean Air Campaign’s website, a daily commute of 20 miles (which is far below the average daily commute of most Atlantans), would cost me approximately $2,500 annually as opposed to working from home; calculated by gas usage, gas price, wear and tear, repairs, etc. Even being able to telecommute just one day per week would provide a savings of over $500 annually, based on the same averages.

Unified Communications solutions, with or without video conferencing capabilities, have become commonplace, and allow employees to collaborate with a co-worker at a moment’s notice. Despite recent news headlines suggesting otherwise, you can be seen and heard working remotely. Why not take full advantage of those capabilities from your home office? You might also be far more productive without having to sit in all that traffic.

You probably already have a high-speed Internet connection at home so your kids can play interactive games and download movies, so why not use that for business purposes? If more people took advantage of working from home even once per week, chances are traffic in your neighborhood would look a lot better, and we might need to build fewer roundabouts.

 

Enterprise Connect 2013 has come to a close and what an event it was. This was IVCi’s first year attending and exhibiting at the show and it was a fantastic experience that provided many opportunities for us to connect with our current customers as well as future prospects. In addition, the opportunity to see the latest technology and offerings from our partners was great. The event was jam-packed with great sessions, keynotes, exhibitors, attendees and more. Here is an overview of some of the key takeaways and messages from the event.

WebRTC
WebRTC (as previously covered here on Collaboration Insight) is a new browser based protocol that allows for real-time voice and video communication to occur right inside a web browser. WebRTC has gotten to be so big; the conference dedicated an entire track to the topic and every session was full. The reality of WebRTC is that not all browsers currently support it (only Google Chrome and the developer builds of Firefox) but the potential for it is endless.

At the end of the day, WebRTC will enable any browser to be a video client or endpoint on a communications network. In Cisco’s keynote, the example of a shopper on a website was used. They were looking for accessories and information on a his store  purchases. They simply clicked a link and a video session was initiated with an expert back in a video call center. No wait to download a client and no security issues with the install; it simply happened in the browser. When the standard is ratified and included in all browsers, the potential will be limitless! Cisco demoed a Jabber client built entirely in the browser, contact center agents could access their voice services right within the browser and more. It has to the potential to breakdown interoperability issues and extend enterprise collaboration to an organization’s customers.

Unified Communications
Frost and Sullivan presented a session at the conference in which they defined unified communications as “an integrated set of voice, data and video communications applications, all of which leverage PC- and telephony-based presence information.” UC was in full force at the conference with all major players showing their latest innovations. Both Cisco and Microsoft came with their entire vision. Microsoft presented their total solution from mobile devices (Android, iOS, Windows Phone) to tablets (Surface, iPad) to desktops and even room systems. The solution was elegant and worked as advertised. Microsoft has been pitching this vision for a while and it was great to see it fully realized. At the same time, Cisco showcased their Jabber solution which offers interoperability across all platforms and seamlessly integrates voice, video, data sharing, and more.

The key takeaway about UC is that the technology is very real and organizations are definitely implementing or looking to implement it in their current short term roadmap. Voice, video, and everything in between have converged!

The Cloud and Mobility
There was not a session that didn’t include a discussion around how cloud delivery and mobile devices would influence employees and technology. Even sitting in the sessions themselves one could see dozens of attendees taking notes on their iPads, checking email, and ultimately staying connected. The discussion of cloud, however, must be secondary. The user of the technology, how it can impact user productivity must be first. How it is delivered (on-premise, cloud, etc) is a decision that comes after.

Business Case
Perhaps the most exciting trend seen at Enterprise Connect was a focus on making the business case for the technology being presented. Certainly there was a large amount of discussion around the technology itself, the features, etc. But in many of the sessions, the business case for collaboration technology was continually presented. Some of the key messaging was around how these technologies can help move a business forward and help fulfill strategic goals. Additionally, simply deploying technology does not equal success. Organizations must see widespread adoption and employee satisfaction to really judge if the technology implementation was a success.

A couple of weeks ago I had the opportunity to sit in on a NASA Digital Learning Network program with a fourth grade class that ironically was located about fifteen minutes away from me.  Scott Anderson, a DLN Coordinator at NASA Marshall Space Flight Center, taught a module about Toys in Space. The program focuses on forces and motion and consists of an investigation of what toys will work in a microgravity environment (such as space).

Did you know that a boomerang actually works in space? It’s because the looping path a boomerang follows is actually the result of the uneven forces exerted by the air they travel through and not the influence of gravity.

For each segment, a short video of an astronaut using a toy, such as a jump rope, is shown to the class. After the video, the instructor gave a brief explanation as to why the toy did or did not work in space. In the jump rope’s case it is because of the law of motion; an object in motion will stay in motion until something (usually gravity) causes it to stop.

The instructor then poses the question to the class, what could be done to modify the toy to perform better in space? After a flurry of raised hands, the teacher selects a few students to answer the question. My favorite answer for the jump rope was magnet boots. When you jump up the magnets pull you back down similar to gravity (smart fourth grader!).

After the lesson is completed, the students have the opportunity to ask questions about the lesson or NASA programs.  For example, what animal has gone into space the most? The answer is the squirrel monkey although France did send a cat into space one time.

Overall, the program was extremely interesting and the kids were well behaved and actively engaged.  I learned a lot of interesting tidbits so I imagine the children learned a lot from the class as well.  It’s great to take a break from typical lessons and learning channels (or work day) and learn something new!

Watch the below video for a sample of one of NASA’s DLN programs where they connect Mission Control with students in Georgia.