Thank you, Cisco for the powerful partnership and for sharing it on Times Square. I am sure I speak for all your Nasdaq Board partners when I say we are thrilled to be working so closely with you and seeing the partnership stated in such an iconic place. It also gave me ‘street cred’ with my 3 daughters. https://lnkd.in/eWrkepMp
The Biden administration has benchmarked more than $19 million in grants to expand telehealth in rural and underserved communities, which have continued to lack access to care during the COVID-19 pandemic.
The investments will provide funding to train primary care providers, bolster groups providing virtual care, pilot new telehealth services and research the efficacy of digitally delivered care in rural geographies.
The $19 million will be distributed to 36 awardees through the HHS Health Resources and Services Administration, the agency said Wednesday.
Welcome to Ethics Consult — an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true, but anonymized, patient care case, and then we provide an expert’s commentary.
And now, bioethicist Jacob M. Appel, MD, JD, weighs in.
COVID-19 has raised many ethical challenges for healthcare providers, including the level of risk they must take when providing patient care. Early in the pandemic, the ability to mitigate these risks was relatively limited, especially when caring for hospitalized patients. Shortages of personal protective equipment rendered mitigation even more challenging.
As a result, it has been reported that 3,607 frontline healthcare workers died of COVID-19 in the U.S. from March 2020 through April 2021.
Health Care Access, Experiences, and Concerns Since the COVID-19 Pandemic
OCTOBER 8, 2020
Jen Joynt, Independent Health Care Consultant
Rebecca Catterson, NORC
Lucy Rabinowitz, NORC
This page provides an overview of Listening to Californians with Low Incomes. The complete report, including 27 figures highlighting key survey findings, as well as detailed data tables, is available under Document Downloads below.
The COVID-19 pandemic has inflicted significant stresses on the physical, emotional, and financial well-being of California’s residents, especially the seven million Californians — approximately 18% of the state’s residents — living in poverty.
CHCF partnered with NORC, a national research organization, to conduct a statewide survey of the health care experiences of California’s residents, age 18 to 64, who had received health care since March 2019. The survey included an oversampling of residents with low incomes.
The survey, conducted in the summer of 2020, asked respondents about their health care concerns, experiences, and access before and during the COVID-19 pandemic, as well as about their experiences with racial discrimination and the impact of the pandemic on employment and insurance coverage. This initial report highlights a collection of key findings from the survey, focusing on health care access, mental health, telehealth experiences, pandemic-related stresses, and experiences with racial discrimination. Findings are presented for respondents with low incomes (defined as below 200% of the federal poverty level) compared to respondents with higher incomes (defined as 200% FPL or higher) whenever sample sizes are sufficient to allow this comparison. In cases where there is an insufficient sample size, overall findings are presented.
The initial report, as well as a zipped file of all of the charts from the report, is available for download below.
The full report, to be released in early 2021, will detail complete findings on respondents’ experiences with health and health care since the pandemic, including analyses of differences by a variety of demographics (including additional analyses by income, race, ethnicity, and insurance coverage and new analyses by region, gender, and language) as well as cross-tabular analysis of the impacts of the COVID-19 pandemic on respondents.
A large portion of all respondents who reported wanting to see a physician or other health care professional since the start of the COVID-19 pandemic did not receive care. Notably, many respondents (31%) did not receive urgent or emergency care for a health problem unrelated to COVID-19.
Even larger shares of respondents did not receive care for a nonurgent physical health problem (45%) or mental health problem (44%).
Deterioration of Mental Health Since Pandemic Among Respondents with Low Incomes
Survey respondents with low incomes were also more likely to report that their mental or emotional health got “worse” (30%) or “a lot worse” (6%) since the start of the pandemic than did respondents with higher incomes (27% “worse,” 1% “a lot worse”). Survey respondents with higher incomes were more likely to report no change in their mental or emotional health (62%) compared to respondents with low incomes (44%).
Telehealth was an important source of care for Californians who received care during the pandemic. Sixty-five percent of survey respondents with low incomes and 62% of respondents overall reported that they had a telehealth (phone or video) visit. Forty-three percent of respondents with low incomes reported having a phone visit, and 34% reporting having a video visit.
Three in four respondents of color (76%) who received care during the pandemic received a telehealth visit compared to less than half of White respondents (48%). Nearly equal percentages of respondents of color received care by video (47%) or by phone (46%).
Among survey respondents overall who received telehealth visits, satisfaction with them compared favorably to in-person visits. Among those who received care by phone, 24% of respondents overall reported they were “more satisfied” with their phone visit than with their last in-person visit, and 48% reported they were “just as satisfied.” Twenty-eight percent reported that they were “less satisfied” with their phone visit.
Among those who received care by video, one-third of respondents overall (33%) reported they were “more satisfied” with their video visit than with their last in-person visit, and one-third (32%) reported they were “just as satisfied.” Thirty percent of respondents overall reported that they were “less satisfied” with their video visit.
Respondents with Low Incomes Report Higher Levels of COVID-19-Related Stress
Concern about the health or well-being of a loved one was the most reported stress for respondents with low incomes and higher incomes, with over half of respondents (53%) experiencing this stress. Respondents with low incomes were more likely to report experiencing stress related to affording basic needs, such as food, rent, and utilities (50%), children out of school or childcare unavailable (38%), and the death of a loved one (10%) than respondents with higher incomes (18% for affording basic needs, 30% for childcare, 4% for death of a loved one).
Experience with Discrimination Common Among Black and Younger Respondents
The survey asked respondents a number of questions about their personal experiences with racial or ethnic discrimination and the impacts of any racial or ethnic discrimination on their health. Nearly 7 in 10 Black respondents (69%) reported ever personally experiencing discrimination or being treated unfairly because of their race or ethnicity. More than 4 in 10 Asian (43%) and Latinx respondents (43%) reported ever personally experiencing discrimination.
Younger respondents, especially those age 18 to 24, were more likely to report experiencing racial or ethnic discrimination (57%) than older age groups (25% to 41%).
About the Authors
This report was written by Jen Joynt, independent health care consultant. Research was conducted by NORC at the University of Chicago (NORC). NORC is an objective nonpartisan research institution that delivers reliable data and rigorous analysis to guide critical programmatic, business, and policy decisions. The survey and data analysis were led by Rebecca Catterson, MPH, senior research director at NORC and Lucy Rabinowitz, MPH, principal research analyst at NORC. For more information, visit www.norc.org.
Treatment and prevention of chronic illness threatens to overwhelm California’s health care safety net — the provider and payer organizations that serve people with low incomes. Long stressed by workforce shortages, the safety net is under increasing strain due to the rising prevalence of chronic conditions such as heart disease and diabetes in the patient population.
Remote patient monitoring is a type of telehealth that involves the secure transfer of personal health and medical data to a provider for remote monitoring, care, and support.
Encouraged by positive experiences with telehealth modalities during the COVID-19 pandemic, providers and payers are interested in additional ways to use technology for greater efficiency and access, including to facilitate chronic condition care and prevention.
To do so, some providers across the health care spectrum have incorporated remote patient monitoring (RPM) into their workflows. RPM is a type of telehealth that involves the secure transfer of personal health and medical data to a provider for remote monitoring, care, and support. Although not yet widely used among California’s safety-net providers — in part because of current Medicaid reimbursement policy — RPM offers potential for mitigating access barriers and facilitating care management for patients who have chronic conditions or who have warning signs of such illnesses.
Providers see the potential for RPM to improve connections with patients outside clinic walls, integrate services across the continuum of care, maximize workforce efficiency, expand access to care, and reduce health inequities.
This report includes a landscape scan of some of the available tools geared to chronic condition management. The research was done between November 2020 and February 2021 in an extremely fast-evolving marketplace, so the information shown is not complete. The report addresses several questions:
What problems can RPM help solve?
What do providers want and need from RPM?
What are patients’ needs and perspectives?
How is RPM currently reimbursed in Medicaid and Medicare?
What should providers know about starting or scaling up a program?
What is the outlook for RPM in the safety net?
What is the landscape of emerging companies focused on RPM?
Rates of avoidable hospitalizations in California are highest among Medi-Cal beneficiaries; nearly 700 hospitalizations per 100,000 people are potentially preventable through effective chronic care management and access to primary care. Such numbers point to unnecessary suffering for people with chronic conditions as well as unnecessary expense for the safety-net system. Providers, payers, and all Californians have an interest in leveraging technologies that can assist in the management of chronic illnesses.
Safety-net providers often weigh the pros and cons of using “connected” or “nonconnected” devices:
Connected RPM devices automatically transmit data through the internet or a cell phone into an analytics platform that providers and patients use to view the data and manage care. Such connected devices lessen the number of manual steps required for patients and providers to collect and deliver data. However, the connected devices are more expensive than nonconnected devices — in some cases twice as expensive — with integration into the provider’s EHR system being yet another expense.
Nonconnected devices require patients to manually report health measures such as blood sugar and blood pressure through a patient web portal, by text message, or during a visit with their provider. Many clinics choose such low-tech RPM methods because of cost factors and limited access to internet or cellular data. However, these solutions require the provider to develop workflows to capture data and may present additional challenges if readings are not accurately reported by patients. Providers and other stakeholders emphasized the need for RPM program operations and workflows to be thoroughly considered before a technology is selected. Cindy Keltner of the California Primary Care Association noted, “Our clinics are very concerned with the workflow implications in terms of monitoring, managing, and acting on data as it streams in electronically.”
Figure 1 illustrates the difference between a connected and nonconnected device for remote patient monitoring.
What Is the Outlook for RPM in the Safety Net?
The limited research that exists indicates that RPM programs can deliver strong clinical outcomes when applied to safety-net populations.
The most valuable information, experts said, would come from rigorous, large-scale evaluations of the clinical impact and cost-effectiveness of RPM programs, conducted by provider organizations with research funding. Such a fiscal impact analysis would support changes in coverage and payment that would in turn facilitate broader market adoption.
About the Authors
Andrew Broderick, MBA, is research program director at the Public Health Institute (PHI); Valerie Steinmetz, MPH, is program director at PHI; and Michael Benzinou, PhD, is founder of Elements Innovation. The Public Health Institute, an independent nonprofit organization, is dedicated to promoting health, well-being, and quality of life for people throughout California, across the nation, and around the world.
Sarah Carroll, MPH, is senior director, and Hanna Helms is senior manager, at the Center for Care Transformation, AVIA. A leading digital transformation partner for health care organizations, AVIA provides unique market intelligence, proven collaborative tools across a network of 50+ leading health systems, and results-based consulting to help solve health care’s biggest strategic challenges.
From FierceHealthCare July 2021 — Teladoc Health is partnering with Microsoft to integrate telehealth into the Teams app for hospitals and health systems.
he combination of communications, collaboration and workflows in Microsoft Teams with Teladoc Health’s virtual care delivery technology will simplify the way care providers work by streamlining the technology and administrative processes associated with providing virtual care, according to the companies.
“We will deliver what hospitals and health systems want: integrated, enterprise solutions that make the full breadth of virtual care available in their daily workflows,” said Joseph DeVivo, president of hospitals and health systems at Teladoc Health, in a statement. “Our collaboration will deliver a more seamless, unified experience for clinicians and patients that makes healthcare better, leveraging leading data, artificial intelligence and machine learning expertise from both companies.”
During the COVID-19 pandemic, many hospitals and health systems adopted Microsoft Teams to connect clinicians and patients on video. Clinicians already have the ability to securely access clinical data included within their electronic health record system using Teladoc Health’s Solo platform and will be able to do so without having to leave the Teams app, according to Teladoc.
OnDemand Visit, a direct-to-consumer telemedicine app, now offers walk-up kiosks for easy, accessible virtual healthcare visits. Although hospitals and clinics have already offered kiosk services for a quicker check-in process onsite, OnDemand Visit is kicking it up a notch by taking the kiosks offsite. Specifically, they are installing these kiosks at various school campuses.
OnDemand Visit’s high-tech healthcare kiosks are built with user-friendly features and high-functioning medical applications. Their seamless telemedicine app has already expanded physicians’ patient reach across geographical locations, but the kiosk expands the reach even further to include those without access to a smart device or computer. Instead of having to commute to the nearest hospital or doctor’s office, a patient can find a close, convenient kiosk instead. Where would such a machine come most in handy? A school campus!
Consider this scenario: A fourth grade boy starts to not feel well during class. He asks to be taken to the school nurse’s office. In the nurse’s office, she examines his symptoms, takes his temperature and vitals, and decides he may be sick enough to see a doctor. Instead of calling the boy’s mother and letting her deal with it, she has an OnDemand Visit kiosk installed right there. She is able to input the boy’s medical information and speak to a pediatrician virtually. The pediatrician performs a virtual exam and writes the boy a prescription for an antibiotic. The nurse can now send the boy home to his mother with the medical visit already taken care of.
Now consider another scenario: A college student is in her dorm room and starts to feel ill. She has a fever, chills, and a slightly upset stomach. She knows she needs to seek medical attention, but the thought of driving all the way to urgent care feeling this way doesn’t sound appealing. However, there is an OnDemand Visit kiosk in her building, so she walks there instead. At the kiosk, she quickly puts in her profile and insurance information and is connected to a healthcare professional who diagnoses her symptoms as Influenza and sends a Tamiflu prescription to her pharmacy down the street.
In both scenarios, there are no downsides. The healthcare kiosks offer multiple benefits such as saving time getting to and from a facility, money for gas and copays, and ultimate patient satisfaction. By installing these kiosks on school campuses, both the school systems and the students reap the benefits. OnDemand Visit is ahead of the curve when it comes to all things telemedicine, and this is just the beginning of the advanced solutions they are sure to continue to provide. For more details visit http://www.ondemandvisit.com
About OnDemand Visit, Inc.
OnDemand Visit, Inc. is an all-in-one direct-to-consumer telehealth platform that enables the highest level of quality and cost-effective healthcare for patients, regardless of where they are located. Technology offers a built-in AI and Machine learning tool to identify patients based on Geo-Location and pair them with the nearest licensed care provider within the network. The secured solution connects patients, employees, and members with doctors in real-time or OnDemand. This enterprise-wide virtual care solution engages more conveniently than in-person office visits. A true clinical telemedicine technology. For more information call, 800-638-5535.
Libraries on the vanguard of transforming healthcare delivery, what is your library going to do in this moment when the federal government is committing over $7 billion to communities making a difference?
This guide lays out how to a) get to the heart of patrons’ healthcare needs, b) create something that’s never been done in your community before, and c) market your telehealth and broadband grant proposal.
More than video chats, telehealth uses intranets and Internet networks to observe, diagnose, initiate or otherwise medically intervene, administer, monitor, record, and/or report on the continuum of care people receive when ill, injured, or wanting to stay well.
I’ll take this definition one step further and differentiate between
1) real-time telehealth,
2) store-and-forward telehealth, and
3) “passive” telehealth.
Real-time telehealth are activities happening “right here and now,” often involving medical or healthcare professionals. In a library setting, a patron is video chatting with a doctor from a study room or other enclosed private space, or a traveling nurse sets up in a room to do hypertension screening with patrons and video conferencing with a doctor in another location should patrons have questions.
Store-and-forward telehealth is collecting medical data and sending it electronically to another site for later evaluation. Patrons who don’t want to go over their data cap (limit) might use a library’s Wi-Fi to send medical records, test results, or digital images. For maximum privacy and security, telehealth applications receive and send using HIPAA-compliant software.
In the context of this guide, “passive” telehealth refers to educational Web content, digital knowledgebases, and software applications that help us understand, prevent, treat, or recover from threats to our physical and mental health. Few entities are as competent as libraries for making knowledge easy to find and sort through.
Telehealth making a difference
There are at least five primary ways to impact healthcare delivery through telehealth at libraries:
1. Reinventing the doctor office visit – video consults for a variety of healthcare practices including observation, screening, gathering body data, data exchange, counseling
2. Marrying chronic healthcare and home care – libraries can check out Wi-Fi hotspots and laptops to patrons, plus add exciting, interactive Web content
3. Aiding emergency response – turning libraries into wireless way-stations to connect ambulance crews en route from rural homes to far-off hospitals
4. Expanding mental health care – in addition to the video consult, there can be interactive content, in-person group sessions, and meetings with social workers
5. Improving senior care and aging in place – another benefit of checking out portable hotspots
“If the overall strategy is to make telehealth a part of 21st-century cities and rural living, if it’s part of our vision that ‘Telehealth is the future of healthcare,’ we’re going to have to come up with lots of different ways to reach lots of different communities,” said Francella Ochillo, Executive Director of Next Century Cities. Libraries supporting telehealth in laundromats, barbershops, and hairdressers is part of that strategy.
This guide lays out a straightforward needs assessment process so you get a representative portrait of how telehealth can benefit the community. Libraries reach out and touch virtually everyone in their communities across the entire economic spectrum, so it’s quite exciting to imagine telehealth capabilities at work.
Healthcare professionals weigh in on how to get the maximum impact from telehealth
technology in your library. The guide also gives you tips and pointers on getting the best from your IT investment. Not only does it address access to broadband but also broadband and telehealth adoption and training.
Ultimately, it takes funding to transform community dreams into reality. The guide offers insights into federal grant programs that fund libraries and telehealth: the FCC’s E-rate program, the Institute for Museums and Library Services (IMLS), and Health & Human Services (HHS), plus links to other valuable resources that help you.
SEAFORD, Del.- An all in one kiosk at the Seaford District Library will hopefully start making a difference soon in the community.
It’s called the Social Service Kiosk.
This Delaware Libraries Telehealth Initiative can fit 2 to 3 people inside.
People can use software-loaded computers to help them access telehealth services, online job interviews, legal appointments, and more.
The kiosks are soundproofed, equipped with HEPA filtration, UV sterilization technology, and hand sanitizer dispensers.
We’re told hopefully this kiosk will remove barriers to access in the community.
“We think that this will bring access, equity especially in digital platforms,” Rachel Wackett, Deputy Executive Director for the, Seaford District Library, said. “Clearly we recognize the need that everything has changed with the new reality, and we made the pivot to access to healthcare for our community.”
The Seaford District Library is one of the first three libraries in the state to offer these kiosk services, the others are in Laurel and Milford libraries.
We’re told several funders helped with this initiative.
Funds also enabled them to hire staff called “Navigators,” who assist in parts of the kiosk process including scheduling appointments, assistance with technology inside the kiosk, the necessary case management and follow up for each patrons specific needs.
Seaford District Library was the first library in the state to re-open after the initial COVID lockdown, because we recognize that the public library is a vital part of the community, especially when it comes to digital and health access.
ST. JOHNS COUNTY, Fla. – The Children’s Home Society of Florida, Flagler Health+, St. Johns County School District and St. Johns River State College are coming together to offer support to students beyond education.
Officials tell News4Jax a call to a parent from a school nurse would typically require the child to be picked up from school, taken home, and then schedule an appointment with a physician. Now, these needs can be addressed more urgently and free of charge, with a visit to the Flagler Health+ Wellness Kiosk.