Pacific Telemedicine Network

Pacific Telemedicine Newsletter #4

June 2019

Welcome to the Pacific Telemedicine Network American Samoa Newsletter. PTN is a Telemedicine and Education Program funded through USDA providing care where and when it is needed.  This month we look at Social Determinants of Health in Telemedicine.


Social Determinants of Health and Telemedicine

What is the role of  Social Determinants of Health in Telemedicine?  Are there specific areas of importance such as with OUD/SUD treatment or Infectious Disease treatment and management? 

CMS now permits Medicare Advantage and Part D plans that offer supplemental benefits that address the social determinants of health (SDOH).  Updates include provisions that would allow Medicare Advantage and Part D plans to care for patients who may be impacted by Opioid Use Disorder. Newly allowed flexibilities include supplemental benefits for patients with opioid use disorder and cost-sharing reductions for patients with chronic pain.  Medicare Part D plans will be encouraged to offer at least one overdose reversal drug on a low cost-sharing tier, improving patient access to these types of medications.  The new CMS rules have the potential to increase the role of telehealth and telepsychiatry in OUD/SUD treatment and recovery programs. 

CMS stated it would allow for telehealth use for prolonged preventive care, patient check-ins using remote patient monitoring tool and treatment in home health settings. Each of these efforts aims to promote more use of remote patient monitoring which can help expand patient care access and treatment outside the four walls of the hospital or clinic.  This rule also innovates and modernizes home health care by allowing remote patient monitoring.

ICD-10 Codes can be used to track many Social Determinants of Health.  The ICD-10-CM Code Category includes: Z55 – Problems related to education and literacy, Z56 – Problems related to employment and unemployment, Z60 – Problems related to social environment, Z62 – Problems related to upbringing, Z63 – Other problems related to primary support group, including family circumstances, Z64 – Problems related to certain psychosocial circumstances, Z65 – Problems related to other psychosocial circumstances.

What other ICD-10 codes or data fields for your EHR are needed for American Samoa?  Send ideas and recommendations to  and we will continue the discussion regarding Social Determinants of Health in Telemedicine. 


Telemedicine and OUD / SUD Treatment

Opioid Use Disorder and Substance Use Disorder are generally behavioral health or mental health issues, and treatment often includes mental health care. Telehealth can play a life-saving role in connecting patients to the resources they need.

Tele-Behavioral Health / Tele-Psychiatry is an important new part of telemedicine. Virtual care through video and remote diagnostics offer mental health specialists, like psychiatrists, psychologists, and behavioral health counselors, a tool for extending care beyond the office or clinic and into the communities where access is limited. For patients dealing with mental health issues, treatment can be accessed at home, through a laptop or tablet, securely and in privacy which can make a tremendous difference in therapy and treatment outcomes.

Along with using telehealth for individual treatment, Specialists can now use secure video conferencing for group therapy sessions, allowing treatment to be provided to more patients in multiple locations without the need for provider or patient to travel.

Along with the use of tele-behavioral health and telepsychiatry tools, we can apply Telemedicine to support front-line Providers who deal with OUD/SUD emergencies, such as community health workers, and EMS Medics.

Update on the Drugs and Alcohol Task Force

 Mr. Motusa Tuileama Nua and the Department of Health Team are an important part of the Drugs and Alcohol Task Force.  The Department of Health role in Testing, Treatment/Counseling and Coordination is central to the success of the Task Force.  The Alcohol and Drug Policy has been approved by the Senate and is now a Law that all Government Departments and Agencies have to follow.  During our June video conference call, we will discuss how the Telemedicine Project can assist.


Telemedicine and Seniors:

For some patients traveling to see a doctor can be a challenge, particularly for older adults who face transportation as well as mobility challenges.  Health care delivered via Telemedicine from a doctor off-site provides a solution for seniors to get the health care when and where they need it.

Seniors are statistically more likely to experience chronic conditions such as heart disease and diabetes which require routine monitoring from healthcare providers. The increased opportunities for communication by video, smartphone, and patient-worn devices which telemedicine allows for permits health care professionals and caregivers alike to assess the status of patients when needed without repeated visits to the doctor’s office or hospital. This can include monitoring everything from medication taking and blood levels to telemonitoring vital signs, interacting with blood pressure cuffs and glucose monitors, and notifying caregivers about changes which may indicate illness.

The “Reducing Unnecessary Senior Hospitalizations (RUSH) Act of 2018 is an effort by Congress aimed at reducing rehospitalizations at qualified SNFs by giving them more incentives to use telemedicine and telehealth to improve patient care.  We will look at this and other Senior Health Care focused telemedicine issues in our next Newsletter.


Project Notes:

 If you would like to take part in the project Advisory Committee send an email to

Do you know a school or library that should also take part in the telemedicine project? Send an email with your suggestion to and we will contact them.

Are there Clinical issues you would like to see the project provide resources for? Send an email with your suggestion to .

To sign up for the Telemedicine Technology Skills Course send email to with your name and email and we will contact you regarding class requirements.

Next video conference call is Thursday, June 27, 9 a.m. .  Invitations will be sent out by email.

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