Telemedicine Introduction (07:41)
Dr. Paul Langlois reads a disclaimer and outlines the webinar agenda. He defines the terms telemedicine, telehealth, and information technologies, He explains synchronous and asynchronous telemedicine and provides a history.
Telemedicine Structure (04:01)
Hub-and-spoke uses a remote center in a fixed location to provide critical care services to multiples locations simultaneously. In a decentralized program, the provider virtually reviews one patient at a time at a local location. A hybrid structure is a central structure that uses an oversight model.
Telemedicine Use and Healthcare Providers (04:42)
Telemedicine is not appropriate for emergency situations but is useful for simple issues. Telemedicine is convenient for patients and has several competitive advantages.
Telemedicine Trends and Benefits (05:09)
Learn trends that will influence the growth of telehealth care delivery. Benefits include emergency visit reduction and lower costs; insurances are starting to offer coverage. Langlois discusses tools and services for clinician to clinician, clinician to patient, and patient to mobile health technology use.
Telemedicine Misconceptions (03:34)
Misconceptions include patients not having the technology, harming continuity of care, shortening visits, using a "plug in and start" model, appropriate for any patient, and reducing no-shows.
Ways to Use Telemedicine (06:20)
Uses include electronic intensive care unit monitoring, patient care when staff are quarantined, treating minor injuries and ailments, behavioral health, pediatrics, dermatology, patients with chronic conditions, cardiac patients, cancer care, elderly patients, obstetrics and gynecology, and surgery.
Evolving Applications and Trends (03:10)
Telemedicine applications include improving sepsis care, increasing function of telemedicine centers, and facilitation for end-of-life care planning. A survey reveals that telemedicine engagement is consistent across all age groups.
Setting Up Telemedicine (06:27)
Identify what you want to accomplish, select a form of telemedicine, understand the regulations, inform patients that telemedicine is available, choose the software, begin with simple services, integrate with scheduling, setup your space, and perform trial runs.
Equipment, Space, and Technology (04:57)
Have the camera at eye level, remove clutter, wear headphones, and ensure adequate lighting. Some providers use basic videoconferencing tools; HIPAA requires patient data to be secure. Technology issues include patient identity verification, internet speed, point-of-care devices, and remote patient monitoring.
Patient Interview and Legal Information (05:02)
Prior to the interview, read the patient's complaint and have the chart ready. Questions will be similar to in office visits; you may have to direct a self-examination. Langlois discusses the Final Rule in connection with Medicare Advantage and obtaining licensure in other states.
Informed Consent (02:58)
Informed consent explains provider services and the risks and benefits associated with that treatment. Langlois cites a list of discussion points and provides a link to a state-by-state breakdown.
Medicare Reimbursement and Telehealth Rules (04:39)
Traditional Medicare only pays for synchronous visits and payment is limited to underserved rural areas. Medicare reimburses telestroke services to specific populations; virtual check-ins are available anywhere in the country. CMS loosens scope-of-practice rules during the COVID-19 crisis.
Telemedicine, long essential in rural areas, is gaining traction in urban areas. Practitioners use telemedicine for minor ailments and monitoring chronic conditions. Fully understand all regulations and investigate telemedicine platforms.
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