The AR SAVES stroke program is about one thing; giving equal access in the best possible stroke care to all Arkansans across the state. We currently work with 44 emergency departments all across the state and last year alone had community contacts with over 350,000 Arkansans about the signs and symptoms of stroke. Setting up our “Code Stroke” protocols in all our affiliate sites has given us the ability to treat these patients consistently and safely to ensure better outcomes.

This video was designed to help our healthcare providers understand the code stroke process in a more detailed manner. With the teamwork of Ozark medical center and EMS in Clinton, AirEvac flight services, and the AR SAVES team, I am proud that we can offer this in-depth look into a “Code Stroke” situation. Never in the history of Arkansas have so many stroke patients been taken care of in this short amount of time. We look forward to continuing our care for all Arkansans in the future.

Time is Brain

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Chasing reimbursement for telemedicine is somewhat like pushing the elevator button once it’s lit. It may not get the elevator there any quicker, but it makes you feel like you are at least trying.

Time will tell. It’s the answer that is best given right now when it comes to what is and what isn’t reimbursable with Telemedicine. As Telehealth has grown across the southeast as well as the country, the demand for these services has also placed a demand on payers to reimburse for these innovative services. What we are finding is that the typical fee-for-service structure may not be the best way to cover services which Telehealth can provide.

As healthcare reform changes with coverage and payment schemes, maybe telehealth can fit the new paradigm of reimbursement, instead of telehealth being made to fit the current fee-for-service model. With more of an integrated system payment coming, the efficiency and outcomes will help providers decide the best access for their patients, whether face-to-face or by Telehealth.

One thing you can never forget is that this is about providing the best outcomes that are evidence-based for the patient. Whether this is in person, or now utilizing interactive video, the reimbursement should be no different. But just because a service or intervention is involved with technology, and “looks” to make a difference, it should not be paid for unless it improves or proves there are no differences in patient outcomes.

As champions of telehealth we will keep moving forward and pushing that lit elevator button. The elevator doors are going to open eventually, and we are going to be right there to be the first ones on.

Michael Manley is a registered nurse and the Director of Outreach for the UAMS Centers for Distance Health.

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Eliminating the red tape

By simplifying how hospitals and non-hospital providers privilege doctors who remotely treat patients, CMS has lowered the administrative burden of delivering telehealth and telemedicine services.

The new rule particularly helps small hospitals in rural and isolated areas by making it easier to access remote specialty services via telemedicine. Medicare will now privilege telehealth practices such as teleradiology, teleICU and telestroke, whether they are delivered directly by the hospital or by an outside clinical vendor.

“CMS’ new rules will truly help patients receive the care they need, no matter where they live or where their doctor is located,” said Dale Alverson, MD, President of the American Telemedicine Association.

“By eliminating the overly burdensome credentialing and privileging rules in Medicare, CMS has shown it’s growing support of telemedicine.”

Dale Alverson, MD

Read the final ruling

The final rule was announced May 2, 2011 and will go into effect July 2, 2011. A full copy of the rule is available at: http://www.gpo.gov/fdsys/pkg/FR-2011-05-05/pdf/2011-10875.pdf

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Albert Einstein defined insanity as, “Doing the same thing over and over again, expecting different results”. So goes it with healthcare over the past 20 years. Health Information Exchanges, Health Insurance Exchanges, Telemedicine, Telehealth… I think you see where this is all going.

As others have been debating healthcare reform, some have been making it happen over the last 7 years. Though it’s just now that the rate of acceptance is helping meet the needs. Healthcare is at a defining moment of how we will proceed to the next level. Though the embracement of the technology is ramping up, there are areas of policy that aren’t keeping pace.

There are several initiatives that are working to enhance patient care utilizing a Telehealth Network. I have listed two below:

1. Credentialing – With the success of the ANGELS and AR SAVES programs in over 25 healthcare centers in Arkansas, there has never been a more important time for centralized credentialing. Since the number of doctors who participate in these two specialized programs have been manageable to this point, it’s time to take what we have learned and apply it to the onslaught of other specialties wishing to participate. Coming on quickly will be the Trauma System and need for ED physicians and Specialists to assess and care for critical patients in all Arkansas ED facilities.
2. Reimbursement – Several states have pursued legislatively to have all billing for Telemedicine be equally paid as if the patient were actually onsite. My institution has been lucky enough so far that we haven’t had any issues with the billing  or contractual reimbursements overall with our programs. But we realize this is just the beginning and many steps will have to be taken in order to keep pace with the demand that is coming.

We have had the pleasure of working with the American Telemedicine Association (ATA) as well as the Center for Telehealth and e-Health law (CTeL) in formulating and pushing policy on both of these issues. We  are interested in hearing your story from your perspective, or any other policy areas you find challenging, or even successful! This isn’t a matter of if this happens, but being positioned well when this happens. As I stated before, individuals can continue arguing on the reform to our healthcare system, and we will continue keeping the patient the number one priority. Doing this, we are reforming healthcare while having better outcomes, which ultimately should be everyone’s goal.

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