New CPT Codes Approved for Telehealth

In Medicare’s 2014 physician fee schedule, the Centers for Medicare and Medicaid Services outlined several new telehealth services and service regions that will be reimbursed by the federal government starting 2014.  These changes include new services for mental health providers. …More

8 Notes About Changes to EHR Stage 2/Stage 3

CMS and ONC recently extended Stage 2 of the EHR meaningful use program, delayed the start of Stage 3 by a year until 2017, and tweaked the EHR certification program. But the actions aren’t as much of a reprieve to providers as they might appear; there are tradeoffs. Here’s a look at the changes. HDM Resources
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Care Beyond Walls and Wires: Telemedicine Home-Health Monitoring Program is Changing Patient Lives

Care Beyond Walls and Wires - Telemedicine Home-Health Monitoring ProgramCare Beyond Walls and Wires, it’s a telemedicine-based, home-health monitoring program that has significantly improved the health of most participating patients, while reducing emergency room visits and hospital admissions and readmissions, and decreasing the length of stay for those who still require hospitalization.

Qualcomm funded the Care Beyond Walls pilot study. When it ended on April 1, 2013, Northern Arizona Healthcare took on the costs of continuing Care Beyond Walls and Wires.  More


FDA Regulation of Mobile Health 2013

FDA Brad ThompsonFDA at last has published its final guidance on mobile medical apps. Further, the mHealth industry has morphed several times over the last couple years. Consequently, in this second edition, more than 80 percent of the content is new. Download here Not only have I updated the regulatory analysis, but I’m also covering a few new topics like FDA regulation of pharmaceutical apps.  More

Home telehealth helps specialists reach Parkinson’s patients

Vidyo Samsung Galaxy TabIn a study published this month as an open-access article in the journal Neurology: Clinical Practice, 100 percent of the 55 patients who participated in a virtual house call with a neurologist said they were likely to recommend telemedicine to a friend. The researchers, from Johns Hopkins University in Baltimore and the University of Rochester (N.Y.), found patient satisfaction levels topping 90 percent for most aspects of remote consultations.  More

Meaningful Use Portal Updates in USHIK

The Meaningful Use Portal in the AHRQ-funded United States Health Information Knowledgebase (USHIK) has been updated with new functionality. The portal is a one-stop shop for Meaningful Use Stage 1 and Stage 2 Clinical Quality Measures, their computation logic, their data elements, and the vocabularies and codes the data elements may take on.

What is USHIK?

The United States Health Information Knowledgebase (USHIK) is an on-line, publicly accessible registry and repository of healthcare-related data, metadata and standards. USHIK is funded and directed by the Agency for Healthcare Research and Quality (AHRQ) with management support in partnership with the Centers for Medicare & Medicaid Services (CMS)More

Text message interventions work best when they’re tailored

Text messages have been proven several times to be a positive medium for improving health outcomes. Text message intervention studies for smoking cessationmedication adherence and weight loss have all come back with positive results.

While all of the studies focused on tailoring messages, the researchers agreed that a good next step for texting studies is a three-way texting system, which is helpful to adding an even more human element to the intervention.

“In other studies that we’ve done we’ve created three-way messages, send out, come back in and receive a tailored message based on your response,” .... “And we found that patients sometimes think that it’s their doctor texting back. So we’ve used it as a communication tool, to really think that they’re being cared about.”  More 

6 regulatory and procedural hurdles for multistate telemedicine

For the most part, the laws that govern the practice of medicine in the United States are state laws. One of the few things Federal law does say is that jurisdiction of those laws is based on the patient’s location, not the doctor’s. That’s tough news for a mobile health company that wants to establish any sort of multi-state telemedicine practice, whether it’s evaluating moles and blemishes via store-and-forward dermatology or doing virtual video consultations on an iPad. More

EHR Use Boosts Diabetes Care, Federally Funded Project Finds

A study by the Western New York Beacon Community finds that the use of electronic health records and other health IT helped improve the care of patients with diabetes and reduce costs. The study was funded through a $16.1 million Office of the National Coordinator for Health IT grant. Buffalo News, FierceHealthIT. More

The Transparency Tipping Point


thumbnailPatients are engaged and participate in their care when they can view their medical records. 

The Issue:
With the increasing use of electronic health records (EHRs), patients have more access to their lab and medical records. What is less often seen by patients, however, are the notes doctors enter in the medical record. The Robert Wood Johnson Foundation-funded OpenNotes initiative sought to find out how patients would use and feel about open access to doctors’ notes. Others now are experimenting with OpenNotes and exploring how they might change doctors’ practices.  More

AHRQ’s Innovations Exchange Focuses on Mental Health Care in Rural Settings

AHRQ Health Care Innovations Exchange: Innovations and tools to improve quality and reduce disparitiesThe latest issue of the AHRQ Health Care Innovations Exchange features three innovation profiles describing programs that increased access and improved mental health care for individuals living in rural areas. One of the featured profiles describes a program at the University of Virginia Health System in Charlottesville, in which psychiatric fellows and residents use videoconferencing to serve children and adults with mental illness who live in rural parts of the state. More

Mayo’s iPad study had 98 percent engagement among seniors

mayo clinic mycare“Patient participation is completely dependent on usability,” Cook said at a session at the mHealth Summit near Washington, DC. “Healthcare technology and tools are not meaningful unless they’re integrated with care plans and expectations, and that’s dependent on delivering knowledge to patients. Once you have a usable tool, you can help self-assessment and reporting, data acquisition and aggregation is meaningful, and clinically meaningful algorithms can impact patient outcomes.”  More

Home Runs in Telemedicine and Telehealth: The Season is Always Right!

The First Telemedicine Service Home Run

MGH in the late 1960s and early 1970s: The first telemedicine service home run was teleradiology, a component of the MGH-Logan Airport telemedicine program.
Teleradiology had been deployed in Canada, around 1959, and then adopted by the MGH program in 1968.
Home run status was achieved decades later.
Today, teleradiology is quite ubiquitous, sustainable, cost effective, and is regarded by many to be mainstream medicine. Thus, a home run!   More

Want to Improve Diabetes Management? Send Texts


Researchers study the effects of text messaging on glycemic control in patients with diabetes in a new study.  Text messaging is a practical, cost-effective way to engage and motivate low-income patients with type 2 diabetes to improve their long-term management of the disease... Research has shown that even in poor communities, where costly smart phones are inaccessible, most patients have and use text messaging as a means of communication, making it the ideal platform on which to deliver an effective and automated diabetes management solution.

Source: “Trial to Examine Text Message–Based mHealth in Emergency Department Patients With Diabetes (TExT-MED): A Randomized Controlled Trial” Article in press in Annals of Emergency Medicine http://bit.ly/HScCV

Medicare Physician Fee Schedule Expands Telehealth Coverage

The final Medicare Physician Fee Schedule for 2014 recently released by CMS expands Medicare coverage for telehealth services to rural areas defined by the Office of Rural Health Policy. The American Telemedicine Association called the telehealth provisions included in the fee schedule "good news." MedPage Today et al.
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Telehealth Innovations & Spotlight

AHRQ :
Videoconferencing Enhances Access to Psychiatric Care for Children and Adults With Mental Illness in Rural Settings 12/4/2013
Psychiatric fellows and residents at the University of Virginia Health System in Charlottesville provide care via videoconferencing to patients in rural parts of the state who otherwise would likely not have had access to such care. 
 
New Expert Commentary
Academic Telepsychiatry Programs Enhance Access for Rural Populations
by Ana Maria Lopez, MD, MPH, FACP, Medical Director, Arizona Telemedicine Program and Professor of Medicine and Pathology, University of Arizona http://www.innovations.ahrq.gov/content.aspx?id=3945&tab=2

Changing Behaviors to Improve Health

Do you want to change your behavior to improve your health? According to the Fogg Behavior Model, behavior change happens when three factors—motivation, ability, and triggers—come together at the same moment.  http://rwjf.ws/IGk6eLDo you want to change your behavior to improve your health? According to the Fogg Behavior Model, behavior change happens when three factors—motivation, ability, and triggers—come together at the same moment. http://rwjf.ws/IGk6e

High-tech home care for children

Children who need complex care can receive it at home
Home & Community Programs have experienced an increase in home care volume as medical advances have allowed premature and other medically needy children to survive longer with a better quality of life. Bringing the child home despite needing complex care reduces the risk of nosocomial infection and often is easier on the family than continued hospitalization.  Nurse.com
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Other Nursing Informatics & HIT Blogs of Interest

Nursing Informatics & Technology: A Blog for All Levels of Users

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mobihealthnews

iHealthBeat

Health information technology improves care and saves lives

AHRQ Research about: * Telemedicine * School Health * Health Maintenance

Ethics and HIT

Challenges...
http://jamia.bmj.com/site/icons/amiajnl8946.pdf
  • patient safety should trump all other values; corporate concerns about liability and intellectual property ownership may be valid but should not over-ride all other considerations;
  • transparency and a commitment to patient safety should govern vendor contracts;
  • institutions are duty-bound to provide ethics education to purchasers and users, and should commit publicly to standards of corporate conduct; and
  • vendors, system purchasers, and users should encourage and assist in each others’ efforts to adopt best practices.

e-Behaviorial Health


Benefit from new technologies... enable people to have remote access to CBT

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