# data[].attributes.body
Recently, telemedicine was used to provide free medical services to people affected by Hurricane Irma

Article: http://www.reuters.com/article/us-money-healthcare-telehealth/u-s-employers-make-big-push-for-telehealth-idUSKBN1C92EP

# data[].attributes.attachment_link.keywords[]
using telemedicine while fleeing hurricane irma

# data[].attributes.attachment_link.title
Using telemedicine while fleeing Hurricane Irma

# data[].attributes.attachment_link.description
While there has been a mass exodus of Florida residents fleeing the approaching Hurricane Irma, many remain in its path. Aside from immediate safety concerns, there's the issue of health care during and after the storm hits. CBS News medical contributor Dr. David Agus joins "CBS This Morning: Saturday" to discuss how telemedicine services can be used in emergency situations.

# data[].attributes.body
https://www.proprofs.com/quiz-school/story.php?title=telehealth

# data[].attributes.body
http://ahca.myflorida.com/SCHS/telehealth/docs/Telehealth_Report_Final.pdf

# data[].attributes.body
Currently, there are no parity laws.

Florida`s Medicaid program allows providers to deliver behavioral, dental, physician E & M, and diagnostics health services via telemedicine.

To bill for telemedicine, Florida providers should use consultation codes 99241 through 99255.

A valid physician-patient relationship may be established through telemedicine.

The regulations expressly prohibit controlled substances from being prescribed through telemedicine, except for hospitalized patients.

The regulations explicitly recognize that telemedicine may be performed not only by a licensed Florida physician, but also by a physician assistant.

For each telemedicine visit, the provider needs to document a brief explanation of why the services were not provided face to face. They also need to record the service and result of medical assessment, and signed patient consent.

(Florida AHCA, 2016)

# data[].attributes.body
In the U.S., 29 states have telemedicine parity laws for private insurance.

In the U.S., 23 states and the District of Columbia have enacted full telemedicine parity laws.

In the U.S., 48 state Medicaid agencies offer some type of coverage for telemedicine services.

In the U.S., 24 states offer some telemedicine coverage under their state employee health plans.

(Adler-Milstein, Kvedar, & Bates, 2014)

# data[].attributes.body
Definitions and Terms

Telemedicine: the use of medical information exchange from one site to another via electronic communications to improve a patient's clinical health status, including the use of telecommunications and information technology to provide access to health assessment, diagnosis, interventions, consultation, supervision and information across distance

Other similar concepts and terms include: telehealth, mobile health, mHealth, telenursing, e-Health

Telemedicine is an umbrella term encompassing many different forms of remote health care services utilizing technology.

(Kvedar, Coye, & Everett, 2014)

# data[].attributes.body
Studies demonstrate:

Improved health outcomes, reduced hospital readmissions, and decreased mortality for CHF patients.

Virtual home health programs for Veterans demonstrated high patient satisfaction, reduced hospital admissions, an increased independence.

Dermatologists and ophthalmologists are among the firsts to widely adopt this technology with positive outcomes and increased productivity.

Remote intensivist care in ICUs demonstrating decreased mortality, decreased length-of-stay, and reduced cost.

Technology-enabled medication reminders demonstrated higher medication adherence.

eReferral technology led to shorter wait times, reduced number of in-person speciality visits, strengthened provider collaboration and satisfaction.

Telestroke services connect patients with vascular teleneurologist for tPA evaluation resulting in improved patient outcomes.

While telemedicine offers promising results, the rapidly developing field will require further study to determine long-term outcomes, cost-benefit analysis, etc.

(Kvedar, Coye, & Everett, 2014)

# data[].attributes.body
Cyber security

It is predicted that more than 25 billion connected things will be used by 2020. This massive collection could cause many serious concerns such as more opportunities for hackers to tap into PHI.

Not all connected devices are approved for healthcare use.

Regulation

Barriers with traditional regulatory agencies such as the FDA & FCC.

Quality of Care

Reduced care continuity.

Technical difficulties.

Fewer in-person consultations.

Reimbursements

Medicare does not reimburse very much in fee-for-service system

Reimbursement largely limited to non-metropolitan areas, certain institutions, and certain CPT codes.

(Chen, Hollander, & Doarn, 2015)

# data[].attributes.body
(American Telemedicine Association, 2016)

# data[].attributes.body
Inability to prescribe medications

Many states generally do not allow online prescribing (not to be confused with e-prescribing) without an established relationship between provider and patient.

Physical examination or evaluation may be required before a provider can write a prescription.

Technical training and equipment

Providers need to be trained on how to use telemedicine equipment.

Associated costs of the equipment, such as integrated telemedicine carts and encounter management software.

Startup cost of implementing telemedicine may be taxing on rural facilities.

Licensing issues

Certain states may require providers who practice telemedicine across state lines have a valid license in the state where the patient is located.

Cost

May lead to more encounters overall.

(Ben-arieh, Vimarlund, & Boissy, 2015)

# data[].attributes.body
Per the American Telemedicine Association, nearly 13 million Americans use telemedicine.

The number of patients using telemedicine services will increase to 7 million in 2018, up from less than 350,000 in 2013.

More than half of all U.S. hospitals currently have a telemedicine program.

An estimated 200 existing telemedicine networks in the U.S. provide connectivity to more than 3,000 sites in rural and suburban areas.

The three states with the highest telemedicine adoption rates are Alaska (75%), Arkansas (71%), and South Dakota (70%).

(American Telemedicine Association, 2016)

# data[].attributes.body
https://cvshealth.com/newsroom/press-releases/cvs-health-partner-direct-consumer-telehealth-providers-increase-access

# data[].attributes.attachment_link.title
Telemedicine and Telehealth Services: MinuteClinic Connect™

# data[].attributes.body
Cost effective

Providers: reduces operating costs

Patients: reduced cost of travel, lost work hours, etc.

Payers: reduced reimbursement secondary to reductions in overall utilization

Improving access to care

Rural area care, access to specialists, access for home bound patient or those for whom travel is difficult or frequent follow-up necessary

Improved communication and data sharing

Connecting clinical-to-clinician, clinician-to-patient, and patient-to-patient

More efficient monitoring and timely adjustments of therapies and treatments

(Kahn, 2015)

# data[].attributes.body
How are you seeing telemedicine used in your practice or place of employment?

What advantages and disadvantages can you see to using telemedicine?

What are the implications for nurse practitioners?

Would you be interested in a job as a telemedicine provider?

# data[].attributes.headline
Telemedicine in Jacksonville: My Virtual Care

# data[].attributes.subject
Telemedicine in Jacksonville: My Virtual Care

# data[].attributes.body
MyVirtualCare.com is St. Vincent's newest telemedicine development providing 24/7 online diagnosis and treatment.