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POSTS BY TAG | COVID19

Physicians


You’ve made your way to the physician’s corner of the pMD blog, welcome! Here you’ll find information written for physicians, by physicians. 

This post is written by Richard E. Lehman, MD, Pediatric Critical Care Medicine.

Last year, the world was rocked in ways that no one could have predicted or even imagined. With 2020 and more than half of 2021 behind us, and as the world adapts to a new normal, what does this post-COVID environment look like for physicians, practices, and patients? In this blog post, we’ll take a look at the good, the bad, and the interesting in relation to the impacts of the pandemic on medical practices and their patients, as well as what to expect moving forward.

THE GOOD


Prior to the start of the pandemic, the use of telemedicine was somewhat of a novelty. Some practices began tinkering with this technology for their chronically ill or remote patient populations. As the spread of the virus started gaining speed, practices soon found themselves deep in the throes of figuring out how to integrate video visits into their daily routine and how to help patients through one of the worst global medical crises in recent history. The increased use of telemedicine brought to light the benefits of incorporating technology into patient care, providing flexibility and accessibility to patients who need it most. It also showed us that its success and continued use are largely dependent on an appropriate reimbursement model. Without it, practices may be less incentivized to adopt telemedicine or are likely to face financial challenges. I would hope to see and anticipate seeing some practices adapt to a hybrid model that incorporates both telehealth and in-person visits, barring any reimbursement policy changes. There are still some aspects of medicine that require face-to-face care with a provider but for those less complex scenarios, why not give the patient (and practice) a choice?

THE BAD


In an era where data is more accessible than ever, misinformation is simultaneously on the rise and finding its way into the general public. As a result, we saw more and more hesitation around believing the data and science presented about COVID-19 and mitigating its spread. People tend to forget that science evolves and adjusts as more data is collected. However, the public is constantly being bombarded with quick one-liners and sensational headlines in the media, many of which are inaccurate statements. This mistrust permeated throughout the country and, in my opinion, has been devastating to the medical community. With the rapid vaccine deployment, it's understandable that patients have questions regarding the effectiveness and potential unknown side effects. Over time, with more data, we’ll be able to paint a better and more clear picture to patients surrounding the vaccine. It's our job as physicians to answer questions and help them make informed decisions based on their medical history. 

So, what does this mean for health care moving forward? It means that medicine is now even more having to compete with the media and navigate that influence on their patients. Providers are not only health care professionals but are also now having to manage public health and society concerns. However, while we all have differing opinions about what to do and how to cope in certain situations, I believe providers need to elevate their approach towards a more open and transparent environment with patients, allowing for more engagement and helping prevent patients from finding other, less reliable sources of information surrounding their care. We should embrace the questions and not shut people down when questioning what they believe to be fact. The COVID crisis is under the microscope, so being open to conversation and providing thoughtful explanations can provide a stable foundation with patients. 

Health care is changing as rapidly as the world and we should take away from this recent pandemic lessons in not only handling future outbreaks but also handling patient trust where trust has been lost. The bottom line is that how we collect data and release that information needs to improve. For example, how many people test positive for COVID-19 doesn’t tell the same story as to how many of those patients are severely ill, hospitalized, and/or need a ventilator. The foreseeable future holds residual pandemic effects, and providers will be expected to work even harder to regain patient trust.

THE INTERESTING


While many of the impacts of the pandemic are fairly obvious or have been discussed at length for the past year and a half, there are also plenty of areas of medicine that have seen a ripple effect and are likely to change moving forward. As a pediatric physician, an interesting event that resulted from 2020’s lockdowns was the decrease in child immunizations. According to a recent article in the Morbidity and Mortality Weekly Report, infants and toddlers up to age 2 years in Michigan have been falling behind on their immunizations, showing a decline in January 2020 through April 2020 compared to 2018 and 2019. Only the hepatitis B vaccine dose given at birth, typically in the hospital, did not decrease. This is just one example of the many impacts a pandemic can have on ancillary health care, which is just as important to recognize. Since many ancillary services in health care require in-person visits and render telehealth a suboptimal solution, providers are looking towards new strategies to maintain essential services.

It’s hard to imagine that the first half of 2021 sped by so quickly, considering everything we’d been through in 2020. As we navigate the good, the bad, and the interesting in relation to this pandemic, we can’t forget that COVID-19 will still continue to have a presence moving forward. A practice’s ability to adapt in the face of sudden change is essential for successful patient care and its survival as a business. We should continue to learn from one another and work through challenges together despite our differences in hopes to quickly combat any future outbreaks. 

Dr. Rick Lehman is a veteran critical care physician, providing care to pediatric patients across the country. He’s “grown-up” with the changes in health care over the last 20 years related software and has been directly involved with implementing new EMR systems at multiple hospitals, often transitioning them from paper to digital systems. His frustrations surrounding inefficient EMRs while managing his critical care patients have driven his passion for changing these health care systems to create better provider workflows.

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To find out more about pMD's suite of products, which includes our charge capture and MIPS registrybilling servicestelehealthsecure messagingclinical communication, and care navigation software and services, please contact pMD.

Being more than just a public health issue, the pandemic has drastically changed our way of life - the way we work, learn, socially interact, and especially how health care is practiced and delivered. For most health care organizations, this event has been a shock, not to mention an unexpected spike in demand for virtual care.  With the massive response to the pandemic, of the groups who weren't already utilizing this technology, many had to rush to incorporate services to keep up with the growing demand of patients needing care from afar.  It has forced telehealth to the forefront, now proven to provide quality care virtually. Whether it’s a phone call, video, or messaging, telehealth can come in many forms that can cover a variety of mediums.

In a new survey conducted in October of 2020, the COVID-19 Healthcare Coalition Telehealth Workgroup found that more than 75% of the almost 1600 physicians polled said that “ telehealth has allowed them to provide quality care for a variety of specialties, from COVID-19-related care to behavioral health.”

Importance of Accurately Measuring Impact & Success of Telehealth

Unsurprisingly, telehealth has become a lifeline for both patients and providers alike. But with any new service or technology, it’s extremely important to measure both effectiveness and satisfaction, all the while making it accessible, time and cost-efficient, and compliant under federal regulations relating to patient care during COVID-19. A practice also needs to evaluate the impact telehealth might have. They need to understand the nature of these services, assess the needs of patients, and collect and analyze measures relevant to accurately measure the success of telehealth medicine. 

Measuring, Tracking & Reporting on Telehealth Services

If a practice can optimize their systems to expand both the use of telehealth and their ability to measure, track, and report on the quality of telehealth, it could change the outcome of care for many patients. So how would a patient or a provider make sure they are using telehealth correctly and efficiently? These questions can be sought through a framework of measurable data identifying the level of accessibility, financial impacts, user experience, and effectiveness of a system. 

How to Measure the Quality of Telehealth Services

A great way to collect metrics is through the use of pre- and post-telehealth visit surveys for both patient and provider, and also Electronic Clinical Quality Measures (eCQM).  eCQMs are measures specified in a standard electronic format that use data exported from electronic health records (EHR) and/or health (IT) systems to measure the quality of health care provided. The Center for Medicare and Medicaid Services (CMS) use eCQMs in a variety of quality reporting and value-based purchasing programs. Each eCQM is documented in a special way defining its intent, populations included, logic, data elements, and value set identifiers. 

CMS, required by federal law,  provides a quality incentive program, rewarding providers one of two ways, one being a merit-based incentive payment system (MIPS) and another through Advanced Alternative Payment Models (APMs).

pMD Platform Provides the Perfect Solution

In light of this year’s unparalleled events, telehealth is being pushed more now than ever, but with so many variables and deterrents, how does one solve problems and address barriers relating to virtual care? The pMD platform offers a great solution to meet CMS MIPS requirements with our point-of-care data capture which provides a robust dashboard to monitor performance metrics and offers real-time data for reporting purposes. Having the ability to enter these eCQMs at the point of care can help providers focus more on patients. Rather than spending hours on paperwork, providers can save time, improve on and assess the quality of treatment, and foster a goal of access-driven real-time data to help decrease medical errors.  When a provider seeks out a telehealth solution, it’s a no-brainer that pMD is a perfect solution, not just for now but for the future of patient care.


Related articles:
Telehealth Workflow: Best Practices for Building a Long-Term Workflow
MIPS 2020: What’s New
Investing in Partnerships Pays Dividends

 

To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.






Telehealth is not a new concept, but amid the recent public health concerns surrounding the COVID-19 coronavirus outbreak, it has catapulted to the top of most practices’ priority list. During this pandemic, it is essential to stay informed and know what free resources are available to your practice to help slow the spread of the virus while continuing to provide patients with a high level of care and reassurance. “The use of telemedicine is going to be critical for management of this pandemic,” said Dr. Stephen Parodi, an infectious disease specialist and executive with The Permanente Medical Group, the doctors’ group associated with Kaiser Permanente. 

Telemedicine a Good, Safe Option for COVID-19 Screening & Patient Care

When possible, using virtual visits provides a safe option for care, while helping contain the spread of the infection at hospitals, clinics, and medical offices. Implementing or expanding an existing telehealth strategy will enable health care organizations to safely screen and treat patients for coronavirus. If patients can receive virtual guidance to help know when they need to be seen or tested, we can limit the number of people who show up unannounced at the emergency room or doctor’s office as well as avoid crowded waiting rooms and potential infection. Good communication with patients is key to keeping the worried as calm as possible and away from clinical care so that practices can steer the most at risk to the proper treatment.

Updates To Telehealth Billing for Services During Pandemic

As part of an $8.3 billion emergency funding measure, the government has granted the Department of Human Health and Services (HHS) the ability to loosen restrictions on the use of telemedicine by broadening the originating requirements and providing a nationwide waiver during this emergency. CMS, state Medicaid agencies, and commercial insurers are taking steps to expand telehealth coverage and reimbursement. To improve access to care, CMS announced that during this crisis, Medicare will pay for telehealth services (conducted via video) regardless of the originating site. Private health insurers, including Aetna, Cigna, Humana, and United Healthcare, have also agreed to cover telehealth visits for the next 90 days in some states. Reimbursement policies vary from state to state, so practices are encouraged to confirm local guidelines. 

For more information, please see CMS’s frequently asked questions for health care providers and fact sheet for telehealth services. You can also find additional information regarding new telehealth rules and procedure codes for testing on the American Academy of Family Physicians website. 

pMD’s Free Telehealth Tools

pMD® Secure Messaging™ provides a secure, HIPAA compliant free telemedicine platform solution that allows practices to connect, triage, and follow up with patients through secure, HIPAA-compliant text, video, and voice calling. You can easily invite patients to download the application at no cost to facilitate timely communication when it matters most:

          * provide health safety guidelines and recommendations
          * share important practice updates and announcements
          * outreach to your most vulnerable patient population
          * perform telehealth visits with patients advised not to leave their homes

For help setting up patient communication or to contact pMD customer support, please give us a call at 800-587-4989 x1 or email support@pmd.com. 

Stay safe, everyone!


To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.