telehealth triage: how to use telehealth during covid-19...share family, patient and provider...
TRANSCRIPT
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Telehealth Triage: How To Use Telehealth During COVID-19
April 23, 2020
© California Telehealth Policy Coalition 1Today’s webinar
supported by
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Welcome and Introduction to the Webinar
© California Telehealth Policy Coalition 2
Mei Wa Kwong, JDExecutive DirectorCenter for Connected Health Policy
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About the California Telehealth Policy Coalition
© California Telehealth Policy Coalition 3
Please visit our website for more information or if you are interested in joining.
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Educate stakeholders on telehealth basics and how it can be used for triage and treatment during and beyond COVID-19
• Share family, patient and provider perspectives on how telehealth can facilitate care delivery, particularly during the COVID-19 pandemic
• Increase attendee interest in using telehealth to meet patient, health plan member and other constituent needs
• Enhance attendee knowledge of telehealth modalities, use cases, and key considerations during COVID-19
4
Purpose and key objectives of today’s webinar
© California Telehealth Policy Coalition
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Agenda and preliminary announcements
Introduction to telehealth, moderator• Mei Wa Kwong, JD, Executive Director, CCHP
Family and patient perspectives• Ginger Moyles• Julie Bates, MS, Gerontologist, Associate State Director, AARP of
California
Provider perspectives• Sean Johnson, MHA, BSN, RN, Vice President of Applications and
Analytics, Sansum Clinic• Kate Williamson, MD, Pediatrician and Primary Care Informaticist
Children’s Hospital of Orange County; President, AAP Chapter of Orange County
• Misty D. Humphries, MD, MAS, RPVI, FACS, Associate Professor, Vascular and Endovascular Surgery, UC Davis Health
Facilitated question and answer• Timi Leslie, Founder and President, BluePath Health
Attendees will remain muted during the webinar.
Please submit any questions you have during the webinar in the Q&A box, not the chat box.
5© California Telehealth Policy Coalition
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New Coalition fact sheets on telehealth
© California Telehealth Policy Coalition 6
Fact sheets will be sent out with a copy of today’s materials and are available on our website.
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Many thanks to the sponsors of today’s webinar
© California Telehealth Policy Coalition 7
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What telehealth is, and how it can improve care
© California Telehealth Policy Coalition 8
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9© California Telehealth Policy Coalition
Ginger Moyles, Parent from Siskiyou County
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10© California Telehealth Policy Coalition
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Julie Bates MSGerontologist
Associate State Director
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The Centers for Medicare & Medicaid Services (CMS) broadened access to telehealth services in response to the coronavirus public health emergency.
Medicare pays health providers to offer many telehealth services to Medicare beneficiaries for evaluating and managing your health, including mental health counseling, common office visits, and preventative health screenings.
For private insurance, most insurance providers are expanding coverage for telehealth services during the coronavirus pandemic and waiving cost-sharing like copays, deductibles and coinsurance.
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Health insurance companies across the country have taken action to remove cost barriers to getting care through telehealth services.
For those with Medicare, beginning March 6, 2020, and for the duration of this public health emergency, Medicare can pay for office, hospital and other visits via telehealth for all beneficiaries. Generally, beneficiaries will pay the same out-of-pock costs for telehealth as they would for an in-person visit.
The Department of Health and Human Services has offered flexibility for health care providers to reduce or waive cost-sharing for telehealth visits paid by Medicare.
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Provide clear instructions on how to access the visit, at what time and what to do if they need to wait.
Make sure they are tech-ready. They will need a decent smartphone, tablet or PC for a remote consultation, along with a reliable broadband or cellular connection to the internet, especially for video.
Let them know if they need to visit the practice's patient portal. Do they need download an app? Will you email or text10 minutes before your designated appointment time.
Remember this is new for most of your older patients!
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https://www.aarp.org/health/conditions-treatments/info-2020/telehealth-faq.html?intcmp=AE-HP-BB-LL3https://www.aarp.org/health/conditions-treatments/info-2020/how-telemedicine-works.html?intcmp=AE-HP-BB-LL1https://www.aarp.org/health/conditions-treatments/info-2020/telehealth-benefits-for-patients.html?intcmp=AE-HP-BB-LL2c
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Telehealth
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3/13/2020 • Communicated Cancellation of Clinics
3/15/2020• Built Basic Telehealth Encounter• Enrolled All Providers with Zoom Basic Accounts (we already have licensed HIPAA version
for administrative purposes
3/17/2020 • Went Live with Telehealth 1.0 (Encounter in EHR and Separate Scheduling in Zoom)• Licensed from Zoom Epic MyChart Integration Functionality (App Orchard)
3/31/2020 • Went Live with Full MyChart Zoom Integration• Non-MyChart visits Occur with Separate Zoom Schedule
4/13/2020 • Revamped Patient Text Reminder System to help with patient prep (links to Zoom Test, links to support sites)
4/28/2020 • Going Live with Non-MyChart Zoom Integration (can SMS or Email Patient Zoom URL directly from Epic)
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683
1737
2943
3459 3413
0
500
1000
1500
2000
2500
3000
3500
4000
Total
3/16/20 - 3/22/20 3/23/20 - 3/29/20 3/30/20 - 4/5/20 4/6/20 - 4/12/20 4/13/20 - 4/18/20
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110 138 175 187 184
6.7
13.5
18.2
19.8 19.8
0.0
5.0
10.0
15.0
20.0
25.0
0
50
100
150
200
250
Mar 21 Mar 28 Apr 4 Apr 11 Apr 18
Unique Providers Avg Visits/Provider
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17%
36%
47%
28%
21%
15%
55%
43%38%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Apr 4 Apr 11 Apr 18
MyChart Zoom Standalone Zoom Other (phone, etc)
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102,176
95,000
96,000
97,000
98,000
99,000
100,000
101,000
102,000
103,000
104,000
105,000
January February March April
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12,044 11,633 12,704
11,894 11,536
5,541
2,306 2,394 2,605 2,483
729
1,870 3,185
3,702 3,660
-
2,000
4,000
6,000
8,000
10,000
12,000
14,000
2/9-2/15 2/16-2/22 2/23-2/29 3/1-3/7 3/8-3/14 3/15-3/21 3/22-3/28 3/29-4/4 4/5-4/11 4/12-4/18
Face to Face Telemedicine Average 50% Avg
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26Telehealth 101
-Questions?
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27L O N G L I V E C H I L D H O O D
Kate Williamson, MDPresident, AAP-OC Chapter & Governing Board of AAP-CAPrimary Care Informaticist, CHOC Children’sPediatrician
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28L O N G L I V E C H I L D H O O D
CHOC: Guidance For Providers On How To Have A Successful Visit
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29Telehealth 101
Telemedicine for Specialty Services and Triage of Urgent Issues
Misty D. Humphries, MD, MAS, RPVI, FACS
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30Telehealth 101
Why Expand Telemedicine
Minimize Patient Risk of Exposure But Still Take Care of Them– Postoperative Patients– Surveillance Patients– Chronic Patients with New Complaints– New Patients Triage
Keep You and Your Staff Working Maintain A Revenue Stream Bring Quality Care to Everywhere
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31Telehealth 101
Access to Specialty Care
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32Telehealth 101
Who to See When
Triage– Patients with nonurgent needs, but with high concerns (fear
of life-threatening complications)• Schedule Procedure after Phase 3 reopening
– Patients with urgent needs, and physician concerns• Schedule Procedure NOW, COVID testing prior
– Patients with intermediate needs, but can likely wait until Phase 2 reopening
Call and schedule in 4-6 weeks
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33Telehealth 101
Pick Your Platforms: Integrate EMR and Billing
Doxy.me, Google G Suite Hangouts Meet, GoToMeeting, InTouch Health,
Mend, Mundaii Skype for Business, swyMed, Teladoc, Updox, Vsee, Zoom for
Healthcare iPhone, Android
Coordinate with Billing/Back Office
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34Telehealth 101
Specialty Needs to do Telemedicine Long Term
Improved image sharing between facilities– All radiographic images able to be shared through cloud-
based software Increased provider willingness to do telemedicine in rural
primary care setting– Either by the Provider– Or as a hub for patients to come for good Internet Access
Improved Electronic Medical Record sharing – Ability to speak to each other seamlessly
Better broadband access in rural areas
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Facilitated question and answer
© California Telehealth Policy Coalition 35
Timi LeslieFounder and PresidentBluePath Health
Please submit your questions in the Q&A box.
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Thank you again to today’s sponsors
© California Telehealth Policy Coalition 36
Please visit our website for more information: https://www.cchpca.org/about/projects/california-telehealth-policy-coalition.