Pacific Telemedicine Newsletter #5
August 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. Congratulations to the PTN program for a second USDA Telemedicine award which will provide Olympus Digital Microscopes and CellSens Imaging software and Intraoral Dental Cameras for both the LBJ Medical Center and Department of Health. This will allow us to begin integrating Telepathology and Teledentistry into the services PTN can provide in American Samoa. Special thanks to Dr. Akapusi Ledua and Dr. Anaise Uso for their help in planning for the new equipment.
New CMS rules impacting Telemedicine based OUD/SUD treatment:
Medicare is proposing to provide reimbursement for Healthcare providers who use telehealth in substance abuse treatment. CMS has recommended creating new codes for bundled episodes of care for treatment of opioid use disorders, adding connected health services, including a payment option for Medication-Assisted Treatment (MAT) therapy and services for the treatment of OUD including overall management, care coordination, individual and group psychotherapy.
CMS is proposing that the individual psychotherapy, group psychotherapy, and substance use counseling included in these codes could be furnished as Medicare telehealth services using communication technology as clinically appropriate.
CMS is also seeking comment on bundles describing services for other SUDs and on the use of MAT in the emergency department setting, including initiation of MAT and the potential for either referral or follow-up care, as well as the potential for administration of long-acting MAT agents in this setting, to help inform whether they should consider proposing to make separate payment for such services in future rule making.
Infectious Disease Society of America Releases Position Statement in Favor of Telehealth:
The Infectious Disease Society of America (ISDA) has published a position statement on the use of telehealth in infectious disease practice. The statement, published in the journal Clinical Infectious Diseases, is in favor of the appropriate and evidence-based use of telehealth. The ISDA announced its support for telehealth in areas including HIV care, directly observed treatment for tuberculosis management, antimicrobial stewardship programs, and infection prevention and control. The ISDA lists these as established use cases that demonstrate the ability of telehealth to improve access to care, patient satisfaction, outcomes, and reduce costs.
Evidence-based Telemedicine Healthcare:
An Evidence-based approach to telemedicine delivers the best treatment outcomes. Telehealth provides a unique opportunity to provide evidence-based care to patients in the most remote sites and the case of Behavioral Health, allows the patient to remain in a familiar location. Once a patient has entered data such as symptoms and personal health history, use of video conferencing software can bring Doctor and Patient together and help determine a diagnosis that will lead to the creation and delivery of an evidence-based treatment plan that optimizes patient outcomes. As we begin to establish regular diagnostic exchanges between Pago Pago and Dr. Landon’s team of specialists in California, we should look at the opportunity to educate the community about this new resource. Letting community groups, as well as patients, know about the Pacific Telemedicine Network availability to provide Primary Care and Behavioral Health Care assistance working with the LBJ Medical Center and Department of Health Clinics will lead to increased use. Let the community know that telehealth delivers quality, evidence-based care, and the treatment received through telemedicine and telepsychiatry involves the most up-to-date technology.
Telemedicine and Dental Care
Teledentistry can improve access to comprehensive oral health care through community health center oral health care integration. If community clinics have intraoral dental cameras and are connected to a Telemedicine Network Providers can focus on the importance of preventive oral health care during regular clinic visits, and as a result, the community will see a reduction in visits to the emergency department (ED) for dental emergencies. Teledentistry expanded to the schools has the potential to bring oral health education and regular check ups to the most rural communities.
Telemedicine and Asthma Treatment:
For patients with Asthma, access to Specialists is often a problem which telemedicine can solve. Telemedicine is cost-effective, eliminates travel, and provides doctors with the opportunity to bring in Specialist assistance as needed. In many cases, the patient only needs a refill on their rescue inhaler or inhaled corticosteroids. Rather than taking time off from work and traveling to the clinic, telemedicine provides a way for a patient to see their doctor and refill prescriptions.
Telemedicine in Asthma treatment has proven to maintain quality of care, increase access to specialists, and provide patients a way to see their doctor, receive the proper medicine for their symptoms and have reliable follow up. For Asthma treatment, Telemedicine is often classified into five categories: tele-case management, teleconsultation, tele-education, telemonitoring, and tele-reminder services. Utilization of all five categories for asthma follow-up potentially results in improved clinical outcomes such as the Asthma Control Test (ACT) scores, lung function, and medication adherence.
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Project Notes:
Do you know a school that should also take part in the telemedicine project? Send an email with your suggestion to rain@rain.org, and we will contact them.
The Next video conference call is Thursday, Aug. 22, 9 a.m. Invitations will be sent out by email. Dan Kurywchak will provide training in the use of the new General Exam Cameras during this call.
Questions on Clinical Issues? Send an email to the Project Medical Director, Dr. Chris Landon at chris.landon@ventura.org .
