Saturday, May 30, 2020

Large Tennessee insurer makes telehealth coverage permanent

As Digital Health Space predicted there will be many permanent changes in standard operating procedures as Covid-19 pandemic fades.  The stumbling blocks which at times seemed insurmountable are falling away. No one could have predicted this change which took less than two months.

 After most commercial insurers moved to expand their coverage of telehealth during the Covid-19 pandemic, health systems are watching to see if the changes will become permanent. BlueCross BlueShield of Tennessee was one of the first to make the move, saying it would keep its expanded telehealth coverage.



Tennessee’s largest commercial insurer was one of the first to signal its continued coverage of telehealth. Last week, it updated its plans to permanently keep expanded telehealth coverage.

“This recent period has proven virtual care can work for preventive, routine and maintenance care, and we’re making this decision because the added convenience can bring better health,” BlueCross BlueShield of Tennessee President and CEO JD Hickey said in a news release.

To start, the insurer just expanded its telehealth coverage to primary care providers, behavioral health providers and other specialists. Later, it began covering occupational therapy, speech therapy and applied behavioral analysis (ABA) therapy. The company will reimburse for both phone calls and video visits.

As health plans began to cover more telehealth visits, adoption soared. Between March 16 and April 14, BlueCross BlueShield of Tennessee saw 71,000 telehealth claims, 18 times more than it saw during the same period last year.

Telehealth startups and healthcare providers have similarly reported a sharp increase in telehealth visits, though overall patient volumes are still down since the start of the pandemic.  Tennessee’s largest commercial insurer was one of the first to signal its continued coverage of telehealth. Last week, it updated its plans to permanently keep expanded telehealth coverage.

“This recent period has proven virtual care can work for preventive, routine and maintenance care, and we’re making this decision because the added convenience can bring better health,” BlueCross BlueShield of Tennessee President and CEO JD Hickey said in a news release.

To start, the insurer just expanded its telehealth coverage to primary care providers, behavioral health providers and other specialists. Later, it began covering occupational therapy, speech therapy and applied behavioral analysis (ABA) therapy. The company will reimburse for both phone calls and video visits.


As health plans began to cover more telehealth visits, adoption soared. Between March 16 and April 14, BlueCross BlueShield of Tennessee saw 71,000 telehealth claims, 18 times more than it saw during the same period last year. 

CMS shares specifics on sweeping Medicare telehealth expansion

The Centers for Medicare and Medicaid Services provided guidance on new telehealth regulations that would allow Medicare to reimburse for more telehealth visits. While Medicare previously limited reimbursement to patients living in rural areas, HHS Secretary Alex Azar recently expanded it in light of the Covid-19 pandemic.

 Centers for Medicare and Medicaid Services Administrator Seema Verma has hinted that the agency might keep some of the changes made to its telehealth coverage during the Covid-19 pandemic, though CMS hasn’t yet announced any specific plans.  The sweeping changes could play an important role in the trajectory of the disease, letting older patients who face a higher risk from the disease receive care at home.

Prior to the changes, Medicare would only pay for telehealth visits when the patient was in a rural area and if they went to a clinic, hospital, or another medical facility to receive care. Now, Medicare will cover in-home visits, and for patients in any location. A broader range of providers will also be able to deliver telehealth services, including doctors, nurse practitioners and clinical psychologists, the Centers for Medicare and Medicaid Services explained.

If other insurers make similar moves, it could be a sign of things to come.





Thursday, May 28, 2020

A new artificial eye mimics and may outperform human eyes | Science News

A new artificial eye mimics and may outperform human eyes
The high-tech device boasts a field of view and reaction time similar to that of real eyes



The 'bionic eye' required several major innovations:

1.  The sensors were placed in a. manner identical to the human eye, giving it the ability to have a wide angle field of view, unlike flat sensors.  The human eye owes its wide field of view and high-resolution eyesight to the dome-shaped retina — an area at the back of the eyeball covered in light-detecting cells. Fan and colleagues used a curved aluminum oxide membrane, studded with nanosize sensors made of a light-sensitive material called a perovskite (SN: 7/26/17), to mimic that architecture in their synthetic eyeball. Wires attached to the artificial retina send readouts from those sensors to external circuitry for processing, just as nerve fibers relay signals from a real eyeball to the brain.2..

Crystals of perovskite on matrix



 Researchers are betting on a class of sunlight-absorbing materials called perovskites to improve today’s solar cells. A perovskite’s cagelike crystal structure (right) surrounds a chunky ion such as methyl­ammonium. The red, purple and orange balls are ions that can be varied so the material absorbs different wavelengths of light in its 3-D form (left).



Several unique manufacturing processes were necessary since the retinal light sensors (rods and cones) are intricately related to nerve fibers which connect to the brain.  Attaching the electrodes required a unique microapplication connection.


Sunday, May 17, 2020

Urologic Telehealth: Substitution or Expansion? Covid-19 and Beyond ?


Providers have had to adapt to using telehealth during a crisis, to. allow for distancing and improving office efficiency.   Most health insurers adapted quickly to the emergency needs.  I have not seen any reports regarding the rates of denials for telehealth as yet.  Will this carry forward after the emergency orders for distancing ?

Health insurers in the past have been reticent to offer telehealth visits as it has not been established whether telehealth increased health spending, or if it was offset by fewer in person visit. 



In a poster by 

Juan Andino, MD 

Michigan Medicine Department of Urology Ann Arbor, MI 

 While insurance companies are increasingly providing coverage for telehealth services, such as video visits, and healthcare providers are increasingly utilizing these modes of healthcare delivery, the impact of video visits on cost and quality is largely unknown. One important question is whether a video visit can serve as a substitute for in-person care or whether the use of video visits will lead to additional downstream in-person visits (i.e., expansion of healthcare utilization). 

Methods: We reviewed 141 consecutive, established patient video visits completed with four urologists at our institution. We then randomly sampled 141 established patient clinic visits to serve as our comparison group. After evaluating baseline demographics of the patients in the two groups, we determined whether video visits served as a substitute for in-person care or as an expansion of healthcare services, by comparing the number of additional visits (i.e., revisits) that occurred within 30 days of each type of encounter. 

Results: There was no difference in revisit rates after video visits (4%, n=6) compared to clinic visits (6%, n=9; p=0.42). Patients that were seen via video visits tended to be younger (54.9 vs 62.7 years, p<0.001). Differences in the distance from the hospital (72 vs 64.5 miles, p=0.65) and median income ($51,402 vs $53,239, p=0.46) were not statistically significant. The most common diagnoses evaluated through video visit encounters were urolithiasis (38%), kidney or upper tract malignancy (18%), followed by elevated PSA (10%), prostate cancer (7%), and voiding issues (7%). 

Conclusions: Video visits served as a substitute for traditional clinic visits and were used by patients with a broad range of urologic conditions. These findings suggest that the expansion of synchronous telemedicine coverage by private payers may not necessarily increase the utilization of healthcare services. 



This study was in a very limited cohort for one specialty, and may not reflect the overall effect of telehealth visits.  It was also performed during an acute crisis of a pandemic outbreak of a novel coronavirus.











































Monday, May 11, 2020

Guidance to HIPAA Compliant Communication



We all use messaging, SMS, Facebook messenger, Chat rooms and more.  Some even use video conferencing.  During the Covid-19 pandemic it became an essential means for education, telehealth for medical as well as remote work from home to insure social distancing to 'flatten the curve"




How patient-centered communication can help deliver better personalized care

Research increasingly shows that patient satisfaction is strongly linked to communication between healthcare providers and their patients. A global study conducted by FICO found that 80% of people would like to use their mobile phones to interact with healthcare providers. Doctors, nurses and administrators also see the clear benefits of asynchronous communication from their smartphones: It’s easy, convenient and effective.

But for healthcare organizations to give both patients and providers the communication channel they want, they need a messaging and chat solution that is both easy to use and HIPAA compliant. Therefore, it’s essential that healthcare organizations find a communication solution that is already HIPAA compliant to prevent these PHI breaches before they occur.

In this guide you will learn:

  • How to balance the risks and benefits of HIPAA compliant SMS

  • The role of HITECH in patient communication

  • How to choose a HIPAA-compliant communication channel that best fits your needs