ehealth

University of CA-Merced launches six telemedicine centers

Mon, 09 Jun 2008 06:59:54 -0400

Last week the University of California-Merced announced that it would be opening six telemedicine centers in underserved cities in the state's San Joaquin Valley. Right now, these sites are among the area's most rural and underserved communities, with one of the worst ratios of doctors to patients in the state at just one licensed physician for every 686 residents, compared with one physician for every 379 residents elsewhere.

However, the new project should help. The centers will now have access to specialists at UC-Merced via teleconferencing and other technology, which will be used to sustain remote consultations. Specialties represented will first include dermatology, psychiatry, pediatric specialties, endocrinology and gastroenterology, but more are to come.

To fund the project, UC Merced has received almost $1 million in grants, including $500,000 from AT&T, $200,000 from the California Emerging Technology Fund and $250,000 from the California Partnership for the San Joaquin Valley. The funds are no being managed by a new organization called the Valley Telehealth Partnership.

To learn more about the project:
- read this piece from the Stockton Record

Related Articles:
Despite benefits, telemedicine barriers remain high
Telemedicine project scores success
Report: Gov't should remove telemedicine barriers
Study: Telemedicine offers clinical, cost benefits for chronic disease care

Health IT unlikely to generate big cost savings, CBO says

Tue, 27 May 2008 06:59:57 -0400

For years, researchers have argued over whether EMRs actually save money, with studies reaching different results depending on whether they looked at inpatient or outpatient care, small, mid-sized or large medical practices, and rural or big-city health systems.

Government researchers have been perhaps a tad more optimistic, though late last year, a report from the Congressional Budget Office suggested that without large charges in the healthcare delivery system, EMRs wouldn't generated many cost reductions. Now, the CBO has gotten tougher. In a follow-up report issued last week, the it strongly challenged an estimate issued by RAND Corp., holding that health IT could save $77 billion a year. "By itself, it's generally not sufficient" to cut costs at all, CBO Director Peter Orszag said.

The question, now, is whether the CBO's challenges to savings estimates will derail current health IT initiatives on the Hill. Apparently, Hill watchers are still likely to push ahead with measures integrating e-prescribing into Medicare, but other efforts could be thrown into question.

To learn more about the effort of the CBO's report:
- read this Wall Street Journal article (sub. req.)

Related Articles:
Research finds EMR benefits, savings unclear
Case study: EMR paid for itself in 16 months
CBO says EMRs won't save as much as hoped

Primary care group wants pay for online work

Tue, 27 May 2008 06:59:56 -0400

The American College of Physicians has taken a position that shouldn't be much of a surprise. It's suggesting that payers should reimburse physicians for added work needed to take part in new digital relationships, including using and analyzing PHRs, and conducting online communications with patients.

In a new report, the internal medicine group argues that physicians should be reimbursed for time spent accepting, reviewing, validating and analyzing PHR data, as well as responding to or modifying the records' contents. The group would also like to see payers reimburse doctors for reviewing websites to select for accurate sources of consumer health information.

Along with seeking pay for physicians conducting e-health activities, the ACP is also recommending the use of secure web messaging infrastructure (rather than standard email) for use in communications between doctors and patients.

To learn more about the ACP's proposals:
- read this report (.pdf)
- read this Modern Healthcare piece (reg. req.)

Related Articles:
Trend: Health plans begin reimbursing for 'virtual visits'
Insurers keep getting on Web visit bandwagon
Physicians offer "e-care"
Study: MD e-mails could drain physician income

E-prescribing advocates harness patient pressure

Mon, 05 May 2008 06:59:59 -0400

If vendor SureScripts gets its way, e-prescribing should develop a much higher profile among consumers, doctors and pharmacies over the next few weeks. Last Tuesday, the company kicked off what looks like a very comprehensive campaign promoting the use of e-prescribing, including virtually all of the nation's pharmacy chains and thousands of independents.

The campaign, interestingly, doesn't deluge physicians directly with pitches. Instead, it urges patients to sell their doctors on e-prescribing, helpfully providing them with a physician-oriented website (www.GetRxConnected.com) to help close the deal.

While SureScripts doesn't say as much in its announcement on the campaign (naturally), to me this suggests that the company has all but thrown its hand up in the air when it comes to recruiting physicians directly. As the company notes, only 4 percent of physicians' offices are prepared to e-prescribe, despite the fact that more than 40,000 pharmacies can accept such prescriptions.

Will patient pressure have an impact? I think so. This kind of "push" strategy can work very well in retail--even though retailers are as loathe to change their buying patterns as doctors are their practice style. While doctors aren't going to change their habits overnight, repeated patient requests will get through. After all, not only are doctors concerned about keeping patients, they're certainly capable of learning something new from them.

Besides, what else can SureScripts do? Many proven physician marketing tactics don't apply here. For example, put friendly, attractive young men and women in suits and send them to pitch doctors directly, as pharmas do with new drugs, and it'd be a big bust. E-prescribing reps would have no educational updates or samples to offer.

Now, the question is whether efforts like this can move the needle enough to make a difference. Let's see, folks! - Anne

Trend: Few US doctors respond to patient email

Mon, 28 Apr 2008 06:59:54 -0400

Not only are physicians struggling with implementing EMRs, few are even exchanging email with their patients, it seems. While many patients say that they'd love to use email to handle routine chores such as scheduling a visit, getting lab results or requesting medication refills, only 31 percent of physicians were emailing back and forth with patients as of first quarter 2007, when Manhattan Research conducted a survey on this subject. Even fewer have begun offering "e-visits" via email and web, though insurers seem increasingly inclined to reimburse them for such care.

Physicians who don't use email say that they can't afford to invest the time to write email, an activity for which they aren't paid, and also fear that patients will abuse the medium. Others--particularly those whose institutions have built portals that simplify the process of communication--say that email is no different than responding to phone calls, and moreover, that it makes them more efficient. However, it seems that it will be quite some time before they're in the majority.

To learn more about this trend:
- read this Associated Press article

Related Articles:
Duke launches doctor-patient portal
Hospital portal helps doctor-patient communication
Insurers keep getting on web visit bandwagon
Trend: Health plans begin reimbursing for 'virtual visits'

Insurers keep getting on web visit bandwagon

Mon, 07 Apr 2008 06:59:55 -0400

A growing number of health plans have begun to pay for patients to participate in online visits with their doctor. In recent months Aetna and Cigna have started paying for some doctors' visits on the web, and given their industry status as being influential, others are sure to follow soon. In both cases, patients have to pay a co-pay to have an e-visit, just as they would if they saw the doctor in person. Meanwhile, players like McKesson-owned Relay Health is slowly but surely gathering subscribers for its secure web site tailored to delivering e-visits, signing up 16,000 physician subscribers to date. Aetna and Cigna both contract with Relay Health.

All that being said, one major player remains on the sidelines to date. Things will get really interesting when Medicare pays for online visits. However, there's currently no word as to how soon that might happen, if at all, though it is experimenting with other telemedicine options.

To learn more about this trend:
- read this Philadelphia Inquirer piece

Related Articles:
Health plans begin reimbursing for 'virtual visits.' Report
Study: MD e-mails could drain physician income. Report
Physicians offer 'e-care.' Report

TennCare and Blue plans launch e-prescribing test

Mon, 24 Mar 2008 07:59:57 -0400

Tennessee's Medicaid program and one of its Medicaid managed care providers have announced that they plan to kick off an e-prescribing pilot program in 13 of the state's rural counties. The Bureau of TennCare plans to work with SharedHealth, a subsidiary of Blue Cross and Blue Shield of Tennessee. The partners have recruited 50 physicians to join the program who will get free software, training, support and Internet access. The pilot, which began in early March, will run through June 30. Shared Health, for its part, is still developing a "patient-centered community health record," which it will roll out to TennCare members.

To learn more about the pilot:
- read this Modern Healthcare (reg. req.)

Related Articles:
Study: E-prescribing boosts safety, quality. Report
Groups launch campaign to promote e-prescribing. Article
E-prescribing: What's holding it back? Editor's Corner
Mississippi Medicaid saves $14M with e-prescribing. Article

MN offers $2.3M in EMR loans

Mon, 24 Mar 2008 07:59:55 -0400

The state of Minnesota is offering a total of more than $2.3 million in state loans to help a pair of hospitals complete their EMR rollout. Swift County-Benson Hospital and Mille Lacs Health System are getting loans from the Electronic Health Record System Revolving Account and Loan Program, which is providing a total of $6.3 million to rural hospitals, small-town physician practices, nursing homes and other community providers. The money is intended to help facilities meet the state's Jan. 1, 2015, deadline for all states to have implemented EMR systems. Under the terms of the program, facilities can get up to $1.5 million, on a first-come, first-served basis. To succeed in their loan applications, providers must have completed their own needs assessment, chosen a vendor and planned the implementation process.

To learn more about this program:
- read this Modern Healthcare article (reg. req.)

Related Articles:
USDA offers $128M for rural telemedicine. Report
Consumer, biz groups push pro-EMR legislation. Report
Bill would pay for physician health IT costs. Report
MD group asks for federal help with EMRs. Report

MN offers $2.3M in EMR loans

Mon, 24 Mar 2008 07:59:55 -0400

Despite benefits, telemedicine barriers remain high

Mon, 10 Mar 2008 07:59:59 -0400

Despite benefits, telemedicine barriers remain high

Increasingly, it's become obvious that telemedicine has a place in the healthcare system, not only to improve care but also to conserve resources. Consider some of the useful applications we've described just in this publication:

* A cellphone-based solution which monitors blood sugar levels and transmits them to monitoring physicians.

* Cellphone-based disease management services that provide patients with a diary, reminders and reports on their condition.

* eICUs, allowing scarce intensivist physicians to monitor several units or even several hospitals' worth of critically-ill patients from one location.

* Technology allowing one healthcare provider to remotely monitor blood pressure levels for its own employees.

Research continues to mount suggesting that telemedicine applications both are clinically useful and cost-effective, particularly for chronically-ill patients who otherwise consume large amounts of resources.

The problem is, at present healthcare organizations face a huge up-front risk if they invest in telemedicine. For one thing, payers aren't reimbursing for most services delivered this way. Then if you add the time and money involved in integrating telemedical data with existing in- and outpatient data, the problem looks far too daunting to approach for all but the best-funded institutions.

Heck, yes, Newt Gingrich and the Center for Health Transformation are onto something when they say government should help along the process of telemedicine adoption. Let's start by seeing Medicare offer some meaningful payment for such services (not just pilot projects).

Turning loose tons of grant money to organizations that upgrade to create a telemedicine infrastructure, or giving them big tax breaks, would be a fine idea too.

The bottom line is that until something gives, telemedicine will remain one of the most effective technologies not being used in the healthcare system. Let's hope that changes over the next year or two. - Anne