New Telemedicine Bill; Results of Remote COVID Care; Next: Telesurgery?

Welcome to the Telehealth Roundup. Introducing news and features about telemedicine and emerging trends in telemedicine.

Telemedicine method introduced

Members of the House Telehealth Caucus recently introduced bipartisan legislation to permanently extend the telehealth waiver of Medicare patients, HealthLeaders Media report.

of Protecting access to telemedicine after COVID-19 COVID-19 You can continue to use telemedicine beyond public health emergencies, make telemedicine more flexible, remove geographic restrictions, and make your home your originating site.

so Health problems Blogs, Seema Verma, and MPH, who maintain the Medicare and Medicaid Service Center, said: You will get the best possible results only through telemedicine, not directly. “

During COVID-19, Medicare refunded the provider the same telemedicine fee as the face-to-face consultation, although it is unclear if this will continue, HealthLeaders Media OK. The regime has just Expanding the emergency This allowed a waiver that expires in October. Politico.

By April, Medicare beneficiaries had 1.7 million telemedicine visits. “Now that’s enough CBO data. [Congressional Budget Office] To really understand the impact…and potential cost savings or cost drivers.” Said Tom Leary, vice president of government at the Medical Information and Management Systems Association.

This bill includes Letter to Congress Signed last month by the American Telemedicine Association and 340 national and regional organizations. This includes federal-qualified health centers and rural medical clinics continuing to provide virtual visits after COVID-19 public health emergencies and authorizing the Department of Health and Human Services (HHS ) Waive restrictions in future pandemics and disasters.

Case Study: Remote COVID Care

A program that integrates a dedicated team of 24×7 telemedicine clinicians with automated text message check-in was able to monitor COVID-19 patients at home and quickly support those with worsening symptoms. .. Case Study NEJM catalyst Indicated.

Results of the first 3,000 patients invited to join the University of Pennsylvania Health System COVID watch The program showed that 83% of confirmed or suspected patients with COVID-19 are managed by an automated program. Anna Morgan MD, MSc, and colleagues at the University of Pennsylvania’s Perellman School of Medicine escalated the need for clinical care to only 17%.

COVID Watch included text messages twice a day, and telephony clinicians called when needed.

On any given day, approximately 2% of patients were escalated to telemedicine nurses. The largest participation at any one time was about 1,000 patients. At that point, the COVID watch generated about 20 escalations a day.

“When combined with human care in the form of escalation or exception management, automated systems for patient care are more effective and likely to have more use cases,” Morgan and coauthors write. ing. “The initiation of these programs requires careful evaluation, as not only new diseases like COVID-19, but also patient response to clinical automation is not always expected.”

Access to an aging population

Many older patients cannot attend telemedicine, Kaiser Health News (KHN) Although reported, a solution is emerging.

SCAN Health Plan, a California-based Medicare Advantage HMO, surveyed the most vulnerable members and found that one-third lacked access to the technology needed for telehealth. Nearly 40% had visual impairments that prevented them from using digital devices and 28% had clinically significant hearing loss. Language barriers are also a problem, said Eve Gelb, senior vice president of healthcare services at SCAN.

Similarly, home care company Landmark Health has found that less than 25% of patients use the appropriate remote technology and know how to use it. KHN OK. “Telehealth is not a panacea, especially for this group,” said Landmark CEO Nick Lopolcaro.

One solution is the GrandPad, a tablet with apps designed for people over 75. KHN OK. These devices have been “significantly successful” in facilitating video streaming interactions and helping nurses and social workers address the needs of patients, and have said that they will support operational and innovation in the PACE South East Michigan Program for seniors. Said Roger Anderson, director.

“We need to target interventions to help these people,” Guerb said. SCAN is considering sending a community health worker to the patient’s home to conduct a virtual visit. The landmark is paying attention to what Ropolcaro calls “easy telemedicine.” Non-medical personnel bring the device to the patient’s home to manage telemedicine appointments.

“As if you were in the operating room”

According to an Italian surgeon, using robotic technology and 5G networks, successfully performed a delicate vocal cord procedure on a corpse 15 km away. Internal medicine annual report To report.

5G is a “significant enabling technology” for telesurgery, said Dr. Leonard Matos of Istituto Italiano di Technologia of Genoa, and co-author. Telesurgery is not new, but they pointed out that its growth has been hampered by the limited availability of surgical robots and the lack of fast and reliable network connections.

During the experiment, a specialist otolaryngologist exposed the cadaver’s vocal cords using a remote-controlled surgical robotic system, then performed a type I colectomy on the left vocal cord, followed by a type IV on the right vocal cord. I had a colectomy.

The surgeon was able to effectively control the robot, forceps, and laser to perform the procedure with confidence, Matos and colleagues said. The experience “allowed the surgeon to manipulate the corpse’s vocal cords as if they were in the operating room where the patient was operating directly,” they observed.

With the rapid evolution of technology and medicine, they added that 5G is set to play an important role not only in remote surgery but also in remote support and distance learning.