Doctors cite ease of use in rapid adoption of tablet computers

By Pamela Lewis Dolan, amednews staff. Posted April 18, 2011.

Just one year after Apple launched its first iPad tablet computer, 27% of primary care and specialty physicians own an iPad or similar device -- a rate five times higher than the general population, according to a report by market research firm Knowledge Networks.

The research, released March 31, was based on a poll of 5,490 doctors conducted by the Physicians Consulting Network, a health care research panel that surveys physicians.

The survey did not ask respondents about a preference for tablet computers, but most experts agree the iPad prompted the attention to the mobile devices. In 2011, more than 52 million tablets are expected to be shipped, with iPad models representing 75% of that number, according to research firm Canalys.
Only one year after Apple released its first generation iPad, it has come out with a second-generation edition. Meanwhile, most every major technology company has launched their own versions of the lightweight tablet, many of which are being built on the Android operating platform. That is used by several smartphone devices designed to compete with Apple's iPhone. According to the Knowledge Networks report, 64% of doctors own a smartphone.
Meanwhile, Research in Motion, makers of the BlackBerry smartphone, plans to release it own tablet this year.

60% to 80% of health IT users in hospitals are unhappy with their computer systems.

C. Peter Waegemann, vice president for development at mHealth Initiative, a Boston-based organization that promotes mobile technology in health care, said doctors have adopted tablets quickly because they find them easier to learn and use than other computer systems. In many cases, data on tablets can be accessed by the touch of a finger on a screen, rather than typing or searching.
Waegemann said various studies have found that between 60% and 80% of health information technology users in hospitals are unhappy with their computer systems, finding them too cumbersome or slow to use. Various analysts say tablet computer purchases are starting to cut into desktop computer and laptop sales.
"This is a whole new approach, and people get excited, they like it and they say, 'We want systems like this,' " Waegemann said.
The growing number of iPad competitors, many offering their tablets at a lower price than Apple's range of $500 to $750, will only help speed the development of new technology and make it more accessible, he added.

Few fans of "e-detailing"

The survey found that mobile apps such as drug reference tools are the most popular among physicians. Use of mobile devices to perform tasks such as email, research and taking surveys grew significantly in 2010, Knowledge Networks said.
But one area that has not caught on for physicians is "e-detailing," electronic communication between pharmaceutical sales representatives and doctors.

64% of physicians have smartphones.

Mobile apps from pharmaceutical manufacturers receive minimal use, the survey found. Only 23% of primary care physicians and 28% of specialists prefer computer-based e-detailing. Physicians 55 and older viewed e-detailing only slightly less favorably than younger doctors.
"Our findings also reinforce the important role that sales reps' visits still play in doctor interactions; the transition to digital is still just that, and ignoring either side of the equation is likely to backfire," said Jim Vielee, senior vice president of the Physicians Consulting Network in Roseland, N.J.
A 2009 report by Cutting Edge Information, a Durham, N.C.-based market research firm, estimated that big pharmaceutical firms were investing between $5 million and $10 million in e-detailing solutions as they slashed their numbers of sales reps.
Henry Gazay, CEO of Medimix International, a marketing research firm for pharmaceutical, medical and diagnostic device companies, said that despite the preference for face-to-face meetings, many sales reps believe the return on investment is at stake when they weigh the costs associated with an in-person visit against the number of prescriptions they can expect to gain from that visit. It has become especially difficult when generic drugs make up more filled prescriptions, he said.
The survey also found that 61% of primary care physicians and 50% of specialists have an open-door policy when it comes to visits by sales reps. The remaining physicians either require reps to make appointments or don't meet with them at all.
amednews.com
http://www.ama-assn.org/amednews/2011/04/18/bisc0418.htm

Universal Service Fund Form 465 Window Opening

Each year, the Universal Service Administrative Company (USAC) allows eligible rural healthcare providers to post the FCC Form 465 to apply for telecommunications funding. This year, the window of opportunity to file the form opened on Monday, April 4 at 8:00 AM EST.

By filing the Form 465, rural healthcare providers are able to begin the process of funding their networks for the 2011 funding year, which begins on July 1, 2011 and ends on June 30, 2012. The 465 form serves as a "Description of Services Requested and Certification," describing the type of support for which the applicant is requesting funding. By submitting the form, rural healthcare providers are able to become eligible for funding through the Universal Service fund and are posted on the USAC website. Telecommunications service providers, like TeleQuality Communications, Inc. can then propose services that will help the healthcare provider improve the technology and care offered to their patients.

Why is it important to know about the Universal Service Fund, and apply for support? Because the benefits that USAC provides for rural hospitals and clinics can add incredible value to your organization, both financially and technologically. In today's advanced society, health care facilities have come to rely on fast, secure networks to keep their patients happy and healthy. The Universal Service Fund helps rural healthcare providers implement the same efficient technology used by large, urban hospitals without the large financial burdens associated with long distance service. Here at Rural Health Telecom, we operate under the same belief that every hospital or clinic, no matter the lcoation, deserves the ability to offer the best care possible.

Submitting a Form 465 for funding is incredibly easy. You can visit the USAC website at http://usac.org/rhc, and visit the Health Care Providers link for more information. You can submite a Form 465 at any point during the year, however it is encouraged that you complete the application before June 30 in order to recieve funding for the entire 2011 funding year.
Source: Rural Health Telecom April 2011 Newsletter
http://campaign.r20.constantcontact.com/render?llr=ob8giwbab&v=0019vIjpnfVUZ-sqe9H7C4o-uyaT5SLabVBQ08O-qjhCbE75Ti930qeC2gdjyhROtlLetfFi2zjC-bgmzQm0CmtAwVezhRTBlRG-uXOAJGylDFTYkwU9kszy2vFT_ZBgnyO32SlDWMyM0M%3D

Senator reintroduces bill to push telehealth for rural America

March 18, 2011

WASHINGTON – Sen. John Thune (R-S.D.) has reintroduced the Fostering Independence Through Technology (FITT) Act, which would expand the use of telehealth technology under Medicare in rural and other underserved communities across the nation.

The bill was first introduced in 2009, but never made it out of committee.
According to Thune, the bipartisan FITT Act of 2011, reintroduced March 8, would create a pilot program to provide incentives for home health agencies across the country to use home monitoring and communications technologies.
Thune said under his budget-neutral legislation, home health agencies participating in the pilot program would receive annual incentive payments based on a percentage of the Medicare savings achieved as a result of telehealth services.

"Access to high-quality healthcare in rural areas can be costly and limited," Thune said in a statement released March 8. "Telehealth technology stands to bridge the distance gap between patients and specialized healthcare providers through new and innovative measures and can bring down the cost of healthcare in rural communities. Additionally, non-invasive telehealth technology such as remote monitoring gives seniors the ability to stay in their homes longer, giving their loved ones peace of mind."
Sen. Amy Klobuchar (D-Minn.), lead cosponsor of the bill, said telehealth technology helps ensure that people in rural communities have access to high-quality affordable healthcare. "This is one of many ways that we can increase the efficiency of healthcare and reduce the increasing costs of healthcare for our families," she said.
[See also: USDA awards 44 rural healthcare organizations with telemedicine grants.]
Thune's bipartisan bill has the support of several prominent telehealth and home health advocates in South Dakota and throughout the country.
"Innovative technologies such as telehealth enhance long-term care services, give seniors more options and can reduce healthcare costs for consumers and government entities," said David J. Horazdovsky, president and chief executive officer for The Evangelical Lutheran Good Samaritan Society, the nation's largest not-for-profit provider of senior care and services."In rural areas in particular, the bill offers the ability to dramatically change the way seniors receive healthcare by making greater use of telehealth services and remote monitoring tools."
The National Association for Home Care and Hospice (NAHC) and its affiliated Home Care Technology Association of America (HCTAA) ALSO support the legislation. Rich Brennan, executive director of HCTAA said, the home care and hospice community of providers envisions a future where the widespread use of remote monitoring technologies enables greater access to healthcare professionals in rural and underserved urban areas.
"The FITT Act is a great initial step to ensure that these highly sophisticated health monitoring devices which capture vital clinical information are in use in homes across the country," he said.
The bill has been referred to the Senate Finance Committee for consideration.
Source: Healthcare IT News
http://www.healthcareitnews.com/news/senator-reintroduces-bill-push-telehealth-rural-america

American Medical Association Advocates for Pilot Projects Utilizing Telemedicine

New policy directs the AMA to advocate for pilot projects testing new payment models.

In an era when virtual medicine is becoming more common, physicians deserve separate payment for the care they provide via telephone, e-mail, Web portals and other electronic means, according to the AMA House of Delegates.

"We want insurers and Medicare to recognize this is going to be a true form of health care delivery, not just a convenience," said Barbara L. McAneny, MD, then chair of the AMA Council on Medical Service, whose report the house adopted. "This should be a separately reimbursable and Medicare-payable expense."

All "non-face-to-face electronic visits" should be adequately paid for, according to the newly adopted
policy.

The Association has had policy seeking such payment since 2000, but the new policy also directs the AMA to advocate "pilot projects of innovative payment models be structured to include incentive payments for the use of electronic communications such as Web portals, remote patient monitoring, real-time virtual office visits, and e-mail and telephone communications."

It is unlikely that Congress will approve more money to pay for telemedicine, so the AMA should focus on pressuring states and private health plans to pay, said Donna Sweet, MD, a Wichita, Kan., internist and member of the Council on Medical Service.

Twelve states mandate that health plans cover virtual care, with Virginia in April being the latest to enact such legislation. Meanwhile, telecom firm Cisco Systems Inc., announced in January a $10 million pilot partnership with Long Beach, Calif.-based health plan Molina Healthcare to create 15 telehealth sites across underserved areas of the state.
In reference committee testimony, some delegates said expanding telemedicine could exacerbate existing disparities in access to health care. But Dr. McAneny, an Albuquerque, N.M., oncologist, disagreed.

"I work with a clinic that serves the Navajo Nation, and the patients text me on their cell phones all the time," said Dr. McAneny, who was elected June 15 to the AMA Board of Trustees. "Addressing disparities is important, and I absolutely think electronics will make it easier for patients to access physicians even when they live 100 miles away or more."

Source: AMDnews.com

 http://www.ama-assn.org/amednews/2010/06/28/prsj0628.htm

CMS Announces Additions to Telehealth coverage for 2011

We are very pleased that the Centers for Medicare and Medicaid Services (CMS) have finalized all of their proposed telehealth code additions that were originally published in June 2010. These changes will go into effect January 1, 2011.
CMS finalized their proposals to add the following requested services to the list of Medicare telehealth services for CY 2011:
Individual and group kidney disease education (KDE) services (HCPCS codes G0420 and G0421, respectively);

Individual and group diabetes self-management training (DSMT) services, with a minimum of 1 hour of in-person instruction to be furnished in the year following the initial DSMT service to ensure effective injection training (HCPCS codes G0108 and G0109, respectively);

Group medical nutrition therapy therapy (MNT) and health and behavior assessment and intervention (HBAI) services (CPT codes 97804, and 96153 and 96154, respectively);

Subsequent hospital care services, with the limitation for the patient's admitting practitioner of one telehealth visit every 3 days (CPT codes 99231, 99232, and 99233); and

Subsequent nursing facility care services, with the limitation for the patient's admitting practitioner of one telehealth visit every 30 days (CPT codes 99307, 99308, 99309, and 99310). Furthermore CMS is revising §410.78(b) and §414.65(a)(1) accordingly. Specifically, the agency is adding individual and group KDE services, individual and group DSMT services, group MNT services, group HBAI services, and subsequent hospital care and nursing facility care services to the list of telehealth services for which payment will be made at the applicable PFS payment amount for the service of the practitioner. In addition, CMS reordered thelisting of services in these two sections and removed "initial and follow-up inpatient telehealth consultations furnished to beneficiaries in hosptals and SNFs "in §410.78(b) because these are described by the more general term "professional consultations" that is in the same section. Finally, CMS is continuing to specify that the physician visits required under §483.40(c) may not be furnished as telehealth services.

The telehealth originating site facility fee was raised to $24.10.

The full final rulemaking is available at  http://www.ofr.gov/OFRUpload/OFRData/2010-

27969_PI.pdf  with the major telehealth section from pages 486 to 526. There are other provisions addressing more specific forms of telehealth, such as cardiac event monitoring. This final rule is scheduled to be printed in Federal Register on November 29, 2010.

Source: American Telemedicine Association