Issue link: http://accesshealth.uberflip.com/i/105922
"I think you have to ease people into it so they understand that they will see a face and hear a voice," Tindle explained. "But to my knowledge, no one has been resistant to it. I am sure it is a little uncomfortable at the very beginning, but as soon as you start hearing that voice and asking questions, you realize there is in fact a practitioner at the other end." As CCMH makes moves to expand its telehealth services, CCMH: Standing left, Jennifer Hostetter, RN, BSN, Director of it hasn't come without a few Outpatient Services; standing right, Kim Benedict, RN; seated, hiccups. One of the biggest Kristie Summers, Outpatient Services Reception. is physician with teleradiology services. challenges reimbursement. Teledermatology is slated for Increasingly, telehealth is implementation early this year. Telehealth reimbursement becoming the new normal for many primary care and High-tech yet high-touch— "The federal government will psychiatric facilities in West helping patients warm up pay for a neurologist to travel to Carrollton, see patients and Central Missouri. to telehealth Getting patients acclimated to bill customary fees," Tindle One aspect of telehealth is telehealth and creating a said, "but they are not willing real-time interactive services comfort level for this mode of to pay for a less expensive that allow a patient to visit a health care delivery has been modality like telehealth." health care facility close to a challenge and learning curve home while receiving care from for both practitioner and Tindle added that health care a provider or specialist in patient. CCMH is just one case reform looks to health care practitioners to increase another city or state. The in point. access to care while reducing remote doctor can examine and diagnose the patient via a "It is crystal clear to me that costs. high-definition television there are distinctive screen, equipped with special advantages of telehealth," "Telehealth will do that, but devices to aid in the Tindle said. "It strikes me as they are not willing to pay for examination. A health care strange that for certain people it," he said. "I worry that until practitioner is present with the this seems like something from physicians can sit in their office patient during the telehealth outer space when you start in Kansas City and get paid the same or reasonably close to consultation or exam. talking about it. But it is very the rate they get when they easy and very simple when you Because rural areas lack break it down to its basic come to rural America, they won't be willing to come to the specialty care services and in components," he said. table." some instances have a shortage of health care CCMH used geriatric psychiatry providers, telehealth is used to to break the telehealth ice. According to the Center for help bridge the access gaps. "Geriatric psychiatry did it Telehealth and e-Health Law Several area providers, along right," said Shannon Jordan, (CTEL), a Washington D.C.,– with a rural health care CCMH's COO. "The first based organization that tackles network, have launched active interaction with the the legal and regulatory telehealth programs. Among psychiatrist has not been via barriers impacting telehealth them are Health Care telehealth, it's been in person. utilization, there are 15 states Collaborative of Rural Missouri, Those initial intakes are face (California, Colorado, Georgia, Pathways Community Health, to face. Subsequent follow-ups Hawaii, Kentucky, Louisiana, I-70 Community Hospital and are done via telehealth. The Maine, Maryland, Michigan, clinics, and Lafayette Regional doctor leads them into that New Hampshire, Oklahoma, Health Center and clinics. initial conversation about Oregon, Texas, Vermont and that currently telehealth during their face-to- Virginia) Carroll County Memorial face visit so the rapport with mandate coverage for Hospital (CCMH) in Carrollton, telehealth is already being telehealth services for private MO, also provides telehealth established. It's important to payers. for emergency room, provide them a transition and outpatient and geriatric give them an intermediate Greg Billings, CTEL's executive outpatient services. Jeff Tindle, step. We like to push the director, said that although the hospital's CEO, said they high-tech, without losing the these states finagle telehealth began implementation of high-touch aspect of delivering differently, they've managed telehealth over 15 years ago to work with private insurance quality health care." carriers to reimburse for services traditionally reimbursed for but done through telemedicine. "If you are an insurance company in one of these states and you cover a certain encounter for an in-person visit, and the health care practitioner believes that same encounter can be done through telehealth—while upholding the same standard of care— the insurance company cannot deny coverage just because it was done through telemedicine," Billings said. Telehealth providers and insurance companies in Missouri aren't there yet. "Telehealth is all about access and keeping patients from traveling distances to receive consultative services," Tindle said, "and it's all being held back because of some silliness about the way the federal government is willing to pay for it." till optimistic Even with reimbursement challenges, there is optimism for telehealth's future. "I am very hopeful for positive change in the future," said David Lee, government affairs and policy manager for the National Rural Health Association. "Insurance companies and some state Medicaid programs have taken great strides in removing payment and delivery barriers in the field of telehealth. Furthermore, some rural health facilities have developed partnership agreements with large urban systems that allow for the use, if not full reimbursement, of the technology so folks can stay in their local communities. Positioning for the future CCMH recently developed a comprehensive master facilities plan to chart the next steps for telehealth expansion. "What's next for us is preparing for the expansion of telehealth and making sure our patients want these services, know that they are available, understand how it works and most importantly that they are comfortable with it," Tindle said.