Tuesday, November 17, 2015

Telemedicine saving revenue for hospitals and allowing doctors to better monitor rural patients

Telemedicine is saving hospitals revenue from readmission penalties, while allowing medical professionals to keep better tabs on rural and remote patients with severe conditions and allow patients to better monitor themselves, Debra Gordon reports for George Washington University.

The Hospital Readmissions Reduction Program, instituted in 2012 by the Centers for Medicare & Medicaid Services (CMS), "is designed to slash the rate of 30-day readmissions of Medicare patients, which hit a high that year of nearly 20 percent," Gordon writes. "The penalties are tough. This year, hospitals stand to lose 3 percent of their entire Medicare reimbursement for excess readmissions of patients who have had heart attacks, pneumonia, heart failure, chronic obstructive pulmonary disease (COPD), and hip and knee replacement. In 2014, 2,610 hospitals were fined through the program, with 39 penalized the entire 3 percent. Overall, CMS estimates that hospitals paid $428 million in penalties that year."

But money isn't the only issue, Gordon writes. Remote monitoring means patients—especially those who have to travel long distances—make fewer trips to the hospital while still getting the extra care they need. Patients can be equipped with devices such as an iPad, a digital scale, a blood pressure monitor and an oximeter to determine the oxygen levels in her blood and a handheld EKG device to measure heart rates. Hospitals can also monitor the weight of a person with congestive heart failure to provide an early warning signal that the patient's heart is having trouble pumping enough blood. "Ensuring that patients with chronic obstructive pulmonary disease (COPD) use their maintenance medications every day can prevent problems that lead to hospital readmission."

There are still some challenges to using telemedicine, Gordon writes. "State medical boards regulate the practice of medicine in each state, often with differing requirements. What happens when a doctor or nurse licensed in one state delivers telemedicine services to a patient living in another?" Other concerns are whether or not insurers will pay for telemedicine, how treating virtual patients affects malpractice rates, privacy and confidentiality concerns and whether or not technicians who help set up the equipment understand HIPAA policies. (Read more)

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