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POSTS BY TAG | telehealth



By now most people have at least heard the term 5G floating around. But many are still left with more questions than answers: What is 5G? How does it work? What makes it different than 4G? When will we see it? How will it impact the healthcare industry? Have no fear, we are here to provide some clarity!

How did we get to 5G?

Before we dive into what 5G is and what it means for the health care industry, let’s explore how we got here. "G" stands for generation, so 5G is the fifth generation of wireless technology. The graphic below does a good job of explaining the evolution of wireless.

 

Source: System One


 

When not connected to WiFi, a 4G LTE connection is what most of us currently use for anything that requires an internet connection on our mobile devices - calls, texts, email, etc.

What is 5G?

5G is a new software-defined wireless network that operates largely in the cloud. The result is more than 100x more capacity that 4G networks. In a nutshell, it means much faster speeds with far lower latency. 

For example, if you want to download a 2-hour movie on 3G it would take a whopping 26 hours. With 4G, you are down to 6 minutes. But with 5G, you are only looking at just 3.6 seconds.

For a world that has become reliant on the internet to function, the reduction in time delay is critical. While 4G network sees command responses in just under 50 milliseconds, that jumps down to only 1 millisecond with 5G, which is 400x faster than the blink of an eye! This reduction in latency will challenge what we consider possible and is expected to be the catalyst that brings data-intensive applications, like autonomous vehicles, into the mainstream.

When will 5G be here?

The first two 5G-compatible mobile phones, the Moto Z3 and Samsung Galaxy S10, were released earlier this year. Meanwhile, AT&T and other carriers have been quietly running trials of 5G hotspots with businesses in various cities across the country, preparing for broader commercial availability. Realistically, expect the big 5G applications to crop up around 2021 or 2022, but analysts predict that by 2025 nearly half of mobile connections in the U.S. will be via 5G.

What will 5G mean for health care?

Now on to the million-dollar question. Just as it promises to increase speeds and reduce latency for consumers, 5G technology also has the potential to transform how health care is delivered. Especially as the use of Internet of Things (IoT) technologies continue to grow, the amount of data on networks is also expected to continue to skyrocket.

Expanding Telemedicine

Telemedicine requires a network that can support real-time high-quality video, which today is limited to wired networks. Video lag is not only frustrating for those using it but the poor quality can delay patient care, hurting outcomes in the long run.

With faster service also comes the ability to provide new value-add to the conversation. Take real-time language translation, for example. This could mean a doctor in Indiana can take care of patients in foriegn countries, regardless of language barriers.

With 5G, health care systems can enable mobile networks to handle telemedicine appointments, which can greatly increase the reach of these programs. Patients can often be treated sooner and gain access to specialists otherwise not available. It also enables doctors and other staff members to collaborate more efficiently and effectively.

Reliable, Real-Time Remote Monitoring

By using IoT devices, health care providers can monitor patients and gather data that can be used to improve personalized and preventive care. Slow network speeds and unreliable connections could mean doctors are unable to get the real-time data they need to make quick health care decisions. 

5G networks will enable the transfer of more complicated and robust patient data from remote locations. The extremely low latency can facilitate reliable home care, such as home ICUs or hospitals-as-a-home settings. In other words, the more reliable remote monitoring becomes, the more patient care can be moved out of the hospital. For example, a doctor can be alerted in real-time if a patient's blood pressure spikes while they are at home. Providers can be confident they will receive the data they need in real-time and are able to intervene before serious complications arise.

Quicker File Transfer

MRI machines and other imaging equipment typically produce very large files that must be shared with various specialists. When the network is low on bandwidth, the transmission can take a long time or not send successfully. This means the patient waits even longer for treatment and providers can see fewer patients in the same amount of time. With 5G, files could become instantly available via mobile devices. This opens up opportunities for providers to easily share large imaging files without taxing their network, furthering the ability to collaborate about patients in order to provide better and quicker care. 

Ultimately, 5G is a catalyst that will support a decentralized health care ecosystem by making operations more reliable and accessible, further accelerating the industry trend toward providing care outside of the hospital.

 

Find out more about pMD's suite of products, which includes our, charge capturesecure messagingclinical communication, and care navigation software and services, please contact pMD.



Earlier this year the Centers for Medicare and Medicaid Services (CMS) made the biggest change to telehealth policy in decades. In one abrupt, little-advertised bulletin, it announced that it would begin paying for five entirely new “Category 2” telehealth services on January 1, 2019. In that instant, tens of millions of Medicare beneficiaries became eligible for new remote services. However, nine months later very few of their physicians know about the change, and even fewer have the tools to offer or bill for these services.

Most physicians and practice administrators still think of telehealth as largely unfunded. This is understandable because until 2019 Medicare still only reimbursed provider-to-patient video visits, and only for patients located in rural areas, and only when the patient was physically located at a medical facility such as a clinic or hospital. In effect, CMS only used telehealth to supplement specialist staffing at medical facilities in rural areas. It didn’t want to introduce competition against the traditional office visit.

So until this year, telehealth was progressing mainly in the private sector. Because of successful direct-to-consumer telehealth companies, we associate telehealth with several major benefits: convenience and time savings for patients, increased access to care, work-life balance for physicians, and lower costs. CMS took a big step towards these additional benefits in the public sector with its new Category 2 telehealth funding.

Category 2 Telehealth Services and Charge Codes


Here are the new Category 2 services that can be billed today for Medicare patients:

Interprofessional Internet Consultation
CPT® codes 99446, 99447, 99448, and 99449

This is a physician-to-physician service billed by a consulting specialist. The specialist uses phone or video to give treatment guidance to the referring physician, along with a written report. The specialist never has any contact with the patient. The reimbursement is small, but many specialists already offer phone advice to other physicians without always seeing the patient. Now they can be reimbursed for these calls - it removes a perverse financial incentive for them to always do an in-person consult when that might not be necessary and could be an extra expense and inconvenience for the patient.

Interprofessional Written Internet Consultation
CPT® code 99451

This is similar to the Interprofessional Internet Consultation above, but removes the voice or video requirement. The specialist’s treatment guidance is purely written in this scenario.

Interprofessional Referral Services
CPT® code 99452

This pays the referring physician (typically a primary care physician, family medicine doctor, or hospitalist) for their end of the interprofessional internet consultation described above. The billing is based on time spent preparing materials, reviewing documentation, and speaking with the specialist. It’s nice that both parties can now get reimbursed for something that they were already doing in many cases.

Remote Evaluation of Pre-Recorded Patient Information
HCPCS code G2010

Consumer wearable medical devices got ahead of reimbursement models, leaving physicians to wonder “how am I going to get reimbursed for interpreting this flood of patient-generated data?” Apparently by billing G2010. When a physician gets a medical recording or image directly from a patient, this code pays them to send their interpretation back. No voice or video involved, just text chat. The reimbursement is low, but then again, it’s a simple transaction and it could be high-volume with the right marketing and tools.

Virtual Check-in
HCPCS code G2012

This code pays a physician to talk with an established patient for 5-10 minutes, as long as it’s unrelated to any scheduled in-office visits from the past 7 days and doesn’t lead to an immediate office visit or procedure. Typically this would be used after the patient calls the practice with a complaint or question, and the call gets escalated to a physician. It can be proactive on the part of the practice as well. Many practices traditionally provide this service for free for their established patients - now there’s reimbursement available.

How to Get Reimbursed for Category 2 Telehealth Services


If you’re already meeting the requirements to bill for one of these services, then the remaining challenge is charge capture. Because of the time requirements and the coding complexity, it’s prohibitively time-consuming to capture the billing charges for these services unless you can do the charge capture in the same clinical communication software where the service itself took place.

In order to fully capitalize on these codes, health care organizations should invest in integrated charge capture and clinical communication software. This software can be used for interprofessional and provider-patient text chat, voice, and video. The same software then can guide the physician to bill the appropriate Category 2 charge code based on the type of service (provider-provider or provider-patient), type of communication (text, phone, or video), and the duration of the call. It has to be mobile because who is in front of a computer every time they talk on the phone? And it has to be easy and integrated so that the time spent on charge capture doesn’t exceed the time spent on the actual encounter!

Why miss out on telehealth reimbursement? Contact pMD to find out how our easy-to-use, integrated charge capture and clinical communication software can streamline your telehealth services!

Further Reading
https://www.aappublications.org/news/2019/01/04/coding010419
https://practice.asco.org/sites/default/files/drupalfiles/2018-12/Final-Rule-2019-Resource-FINAL-12-5-18.pdf
https://acpinternist.org/archives/2014/01/coding.htm

 

Find out more about pMD's suite of products, which includes our MIPS registrycharge capturesecure messagingclinical communication, and care navigation software and services, please contact pMD.


Recipe for Success


pMD recently implemented a big performance boost that brings enhanced video chat performance to its iOS and Android apps, facilitating lower latency and higher resolution video calls. What does that mean for you? Clearer, faster video communication!

Video chatting is becoming a more common type of communication between providers and their patients. It’s a convenient way for physicians to consult with patients about non-urgent issues and an effective way to connect specialists with dispersed patient populations and rural communities. Not to mention, certain types of telemedicine video consultations are billable services. 

With more and more of the Millennial generation requesting telehealth over office visits, the demand will only increase with this growing demographic. But even in older patient populations, reducing the amount of travel from home to the doctor’s office can make a world of difference. A HIPAA-compliant video conferencing platform like pMD’s allows care teams to collaborate more efficiently to provide the best patient experience possible with little-to-no operating costs.

Gone are the days of choppy or unflattering frozen stills of your face. Say hello to telehealth from your local corner cafe, on your morning walk with the dog, while finishing up paperwork in the office, or from the comfort of your living room couch. Whether you’re the provider or the patient, pMD’s free video chat allows you the freedom to connect face-to-face at your convenience. Communication in health care should never be a hurdle to providing or receiving the best possible care.

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.


Secure video chat


Last year we were excited to announce the launch of our free Secure Messaging product, which is now enabling thousands of health care providers across the United States to communicate in a way that’s convenient and secure. As that offering has gained adoption, we’ve been actively soliciting feedback from our user base in order to understand how we can continue to make the product better for them. One of our biggest takeaways has been that, while secure text messaging has indeed addressed a major pain point, there are additional scenarios where a richer form of communication would be helpful.

That’s why we’re excited to announce the upcoming release of secure video chat capability.  This new feature will enable providers to utilize pMD to quickly get a second opinion from another clinician, connect with a nurse at a remote clinic, or even chat directly with a patient who may not be able to leave his or her home. Best of all, video chat will be built into our free Secure Messaging product.

Secure Video Chat Added to Free App for Bigger Impact on Health Care


We know that often, vendors dangle new features behind a paywall, or an upgrade requirement, rather than shipping them directly to their customers. However, our philosophy at pMD has always been, first and foremost, to help clinicians provide better patient care.  The cutting edge design agency, Chagency, sums up this approach well in a recent blog post, suggesting, “Help [your users] grow so you can grow together.” To accomplish this, we push down as much value into our free offering as we possibly can, knowing that the more people who benefit from pMD, the bigger the impact we’re able to have on health care in this country.

pMD Product Suite Growing to Improve Health Care Communication


We’re extremely excited about this upcoming enhancement to pMD’s product suite. We look forward to continuing to gather feedback from our customers as they leverage this new tool to improve their care delivery. Most importantly, we’re not done innovating. In fact, we’re just at the beginning of a compelling roadmap of new features to empower richer communications in health care.

 
App with secure video chat capability

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.






Artificial intelligence (AI) is a term we have been hearing a lot lately. Most of the time it concerns the variety of problems AI is solving along with future solutions to those problems. In recent years, health care has adopted AI technology in a number of areas including disease diagnosis, imaging analytics, virtual telehealth services, and most recently, EMR integration. The possibilities for the application of AI are endless, especially when it comes to optimizing common processes in the health care industry, such as medical billing and coding.

What exactly is AI?

Robots and flashbacks to Terminator might ring a bell for some, but AI is actually a very broad term with many branches of application. According to the National Institute of Standards and Technology, or NIST, “Artificial Intelligence (AI) refers to computer systems that think and act like humans, and think and act rationally.” Simply, AI is the capability to learn and problem solve by machines, in contrast to how humans display these behaviors naturally. For machines, the ability to learn and make decisions require lots and lots of data. An algorithm is needed to then test this data, until eventually the machine learns how to tell a bee from a flower, or better yet, identify enlarged lymph nodes in a CT scan of the chest while simultaneously scanning the patient’s medical record to determine if they have lung cancer. These current applications work to make physicians’ workflow more efficient. What if there were a way for AI to similarly improve the efficiency of medical billing?

What problems are the medical billing and coding space facing today?

It depends on who you ask, but the error rates in medical billing are reportedly pretty high. According to a study conducted by the American Medical Association in 2013, the error rate for medical billing was at 7.1 percent, while a study by Nerdwallet in 2014 put the error rate for Medicare claims at a whopping 49 percent. This can be due to many factors such as upcoding, duplicate billing, and even the digit transposing of ICD and CPT codes. Most of this is at the hands of human error, but certainly not without reason. With the transition change from ICD-9 to ICD-10 codes in 2015, the amount of codes increased by five times the original amount. Now having roughly 68,000 ICD and 8,000 CPT codes to work with, medical billers and coders have had to learn and process tons of new information. In this period of getting used to a new system, there was a 50% loss in productivity at first, but the industry has since adapted. The system will surely change again, and I can’t help but wonder if machine learning might be able to work a little bit of its magic in the medical billing and coding space.

Using AI to assist with medical billing and coding

By using machine learning techniques to process data, it may be possible to deploy an application that can process medical codes and billing codes, identifying errors and making appropriate corrections. AI could be integrated as an assistant and allow for medical billers and coders to work more efficiently and accurately by flagging mistakes and suggesting possible fixes. Having an automated process where computers take care of the more tedious and common clerical tasks, will allow for medical billers and coders to spend their time on the more difficult and comprehensive issues, such as insurance appeals and the claims process. The end result of introducing AI to medical billing and coding: less errors, more money, and more time!

What’s on the horizon for AI in health care?

It took nearly a decade to develop ICD-10 codes and another decade to implement. Innovations in health care can sometimes be referred to as “slow moving giants”, so it’s possible we won’t see AI completely taking over right away, but we can expect to see the adoption of machine learning more frequently. According to Healthcare IT News’ reporting on HIMSS18 “Allscripts, Athenahealth, Cerner, eClinicalWorks and Epic revealed big plans for adding AI into the workflow in forthcoming iterations of their electronic health records platforms.” As you can see, AI is no longer this untouchable, sci-fi enigma, but now is something that is actually being utilized in our day-to-day. There’s much more on the horizon for AI’s role in health care, so we'll just have to stay tuned!

 If you'd like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, care navigation, and clinically integrated network software and services, please contact pMD.