Thursday, December 1, 2016

Bipartisan Legislation Proposes Telehealth Solutions for Effective Chronic Disease Management | The National Law Review

Collaborative efforts between federal congressional offices and various health care stakeholders, as well as the feedback provided in response to the Bipartisan CHRONIC Care Working Group Policy Options Document released in December of 2015, have driven the Senate Finance Committee to introduce a draft of bipartisan legislation known as the CHRONIC Care Act, which seeks to modernize Medicare payment policies to improve the management and treatment of chronic diseases using telehealth.


in response to the Bipartisan CHRONIC Care Working Group Policy Options Document released in December of 2015, the Senate Finance Committee recently introduced a draft of bipartisan legislation known as the Creating High-Quality Results and Outcomes necessary to Improve CHRONIC Care Act of 2016 (the CHRONIC Care Act). The CHRONIC Care Act seeks to modernize Medicare payment policies to improve the management and treatment of chronic diseases using telehealth.



 Below is a summary of the key telehealth provisions under the CHRONIC Care Act that aim to expand access to home dialysis therapy and timely stroke care, increase convenience for Medical Advantage enrollees, and improve care coordination by accountable care organizations (ACO).



Expanding Access to Home Dialysis



 Increasing Convenience for Medicare Advantage Enrollees through Telehealth



Medicare pays for a limited number of Part B services furnished by a physician or practitioner to an eligible beneficiary via a telecommunications system (i.e., interactive audio and video telecommunications system that permits real-time communication between the practitioner at the distant site and the Medicare beneficiary at the originating site). Reimbursement for these telehealth services includes payments to physicians or other professionals (at the distant site) for the telehealth consultation, and to the facility where the patient is located (the originating site). A Medicare Advantage plan may provide telehealth services to its beneficiaries, including, but not limited to, using telemonitoring and web-based and phone technologies, and providing medication therapy management via telehealth; however, any telehealth services beyond what is covered under Medicare must be paid for through the Medicare Advantage plan’s rebate dollars as a supplemental benefit.

The report seems to indicate that these benefits apply only to those patients in a Medicare Advantage Program, or ACO. It made not reference to fee for service Medicare.  This specific exclusion is prejudical to those beneficiaries. It also makes no mention of Medicaid benefits.

Whle this proposed legislation is a step in the right direction it ignores paymenets for telehealth for postoperative care, and acute medicine contnuing care at home. 

The bill is in the Finance Commitee at the present time.  Interested parties should contact their Congressional Representatives regarding these shortcomings.




Bipartisan Legislation Proposes Telehealth Solutions for Effective Chronic Disease Management | The National Law Review

Wednesday, November 23, 2016

Holiday Season



HAPPY  THANKSGIVING

TO ALL THOSE ON THE HEALTH TRAIN EXPRESS

Wednesday, October 26, 2016

The Anatomy of an Internet Hack: Denial of Service

Do you really want your data in the Cloud ? Digital Health Space receives daily updates in regard to internet security and the reliablity of the internet.

Many of my subscribers have switched to cloud based electronic health records, and many health information exchanges use general internet sources using VPN or tunneling platforms.

Are you at risk ?  My philosophy is if your system is connected to a broadband internet service you are at risk if you are even plugged into an ISP.

What are the trade-offs of a cloud based vs a client-server electronic health record?

Advantages and Disadvantages of Cloud Computing





A network ISP server rack hosting multiple applications.  Often these are leased by EHR vendors to serve their clients.  Your data could share  space with Amazon, Best Buy or many others.

Or have your own hardware and data stored in house. Secure, but much more labor intensive with updates, patches, and  local maintenance delays.

Many vendors offer both types.

The difference in cost, and licensing are important issues.to consnider.

And don't forget HIPAA.  Not all cloud servers are HIPAA compliant. Even if the EHR is HIPAA compliant, Cloud vendors/servers may not be HIPAA compliant.







Dyn Analysis Summary Of Friday October 21 Attack | Dyn Blog

Monday, October 24, 2016

5 digital characteristics of office-based vs. hospital-based doctors | Articles | Main

Study finds hospital-based doctors lean more toward digital technology than their office-based counterparts.

 When looking at the digital habits of physicians who work for hospitals and those working in offices, there are important variances. Here are five points to know about how these groups differ:
1. Hospital-based doctors place a higher value on both drug reference and diagnostic tool mobile apps as important digital information sources.
2. About 81 percent of hospital-based doctors say they use their smartphones for professional reasons. Only 73 percent of office-based doctors responded the same.
3. Hospital-based doctors are only slightly more likely than office-based doctors to use tablets for professional reasons: 44 percent vs. 42 percent. Interestingly, 16 percent of office-based doctors use tablets for personal reasons only compared to 8 percent of hospital-based doctors, demonstrating that more of the latter use tablets overall but mostly for personal use solely.
4. More office-based doctors (29 percent) say that they use email as a way to communicate with patients compared with hospital-based doctors (23 percent).
5. Office-based doctors (45 percent) are more likely to use professional social networks for professional purposes compared to hospital-based doctors (33 percent). These could include QuantiaMD, Sermo or Epocrates.
Chances are good that doctors using hsopital electronic health records use a totally different EHR at home in their offices. This may not be true in the huge systems such as Kaiser Permanente, MayoClinic, Cleveland Cllinic and University Health Systems.   The level of complexity for patient illness is higher than for office visits, which is why hospital physicians use online references for diagnostic and therapeutic guidelines. These are subtle but important differences.



5 digital characteristics of office-based vs. hospital-based doctors | Articles | Main