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The New Oklahoma Law about Telemedicine Expands Availability but Raises Questions

With time, telemedicine is increasingly growing in popularity as an excellent option for individuals to receive health care services. It involves an indirect meeting between patients and health caregivers. Recently, the Oklahoma Legislature has passed a new law aiming at making telemedicine more available to individuals across the state.

What is telemedicine?

Oklahoma law defined telemedicine as a means of providing healthcare, diagnosis, treatment, provision of consultation and medical education through real-time interactive communication between the patient and the physician. The services are offered after the doctor has access to and reviews the patient’s essential medical information before the telemedicine visit.

What are the requirements for telemedicine providers in Oklahoma?

The newly initiated law allows telemedicine visits between the physician and a patient in Oklahoma even if it is the first time contact as long as the telemedicine provider fulfills all the requirements of the state. Some of the requirements are;

The provider must be certified and permitted to provide the services in Oklahoma. The provider must show the license document. The provider can be in another state during the telemedicine, but the patient must be in the state of Oklahoma during the encounter.

The telemedicine healthcare providers should provide the patient with their full identity and credentials to prove that they have the required experience. On the other hand, the patients have to submit their identity and location showing that they are in Oklahoma.

The provider must have a system that fulfills all the requirements to conduct telemedicine. A system that only offers means for audio phone calls, texts messages and electronic mail are disqualified.

What restrictions are made by the new law?

The new law has brought up some restriction on telemedicine especially on some drugs such as opiates, synthetic opiates, carisoprodol or benzodiazepine. There has to be a face to face meeting between the patient and the physician for the provider to prescribe such drugs. However, opioid antagonists and partial agonists can be prescribed without a prior face to face encounter between the two parties.

This new law does not specify who else is allowed to provide telemedicine services other than medical or osteopathic doctors. This way, although the law is expanding the availability of telemedicine across Oklahoma, it has left people with some unanswered questions.

Teledoc Drops 2011 Lawsuit as Texas Passes New Telemedicine Bill

Telemedicine, which is the latest medical technology trend, recently got a boost from some of the biggest technology and health firms. Among the companies that have outlined their plans to use this virtual consultation plan in their services are Apple Inc., CVS, and Aetna. With these giant companies on board, telemedicine can now safely take off.

Telemedicine or virtual medicine as it is commonly known consults patients by video or phone, and it has been one of the milestones the industry has achieved. Lack of awareness has been one of the setbacks that this technology has faced over the years. Aetna has merged with CVS to deliver the best in this sector. Aetna’s strategy is not only to enable this technology looks after patients from home, but also to introduce more apps that will help patients when their levels of glucose are low.

Apple, on its part, has great plans for its new heart-health study. In what can be seen as a well-calculated move, this giant electronic company opted to work with American Well, an established telemedicine startup to give access to those who aren’t able to get to the doctor’s office. Apple Inc. through its COO, Jeff Williams had earlier advocated for a virtual medicine when he unveiled their plan for a new heart-health study.

This Apple/Aetna deal has been applauded by various key players in the sector especially the developing crop of venture-driven firms who specialize in home-health monitoring, virtual consultation as well as the creating of digital health apps. This new development has made people aware of a particular technology that has been in existence for quite some time. It provides a cheaper alternative as compared to driving for long hours to reach a health center.

The challenge, however, lies with the adoption. Even though several doctor’s offices and hospitals may begin providing this service, they {services} still remain unknown to quite a number. In addition to that, very few will also find their employers or insurance firms to see if the whole service is a benefit.

Telemedicine is a new concept in the world of internet but it is developing at a very high speed. Doctors running a virtual medical practice is not simple as it encompasses more than just technology. According to Micheal Nochomovits, MD, chief clinical integration and network development officer at NYP the concept of telemedicine is growing and there is need to come up with a sophisticated approach. The execution of the idea is not as simple as it sounds. According to Micheal Nochomovits, telemedicine started out simple handling common diseases such as coughs and colds but it has been rapidly expanding to handle even more serious diseases. This comes with its own set of challenges.

A telemarketing visit is no ordinary video call and should not be taken lightly since it involves serious medical interaction between the patient and the medical practitioner. There are a few standards that have been put in place by different individuals but there has not been an agreement on the basic standards for which to stick to. It telemedicine is successful, there will be people who will solely depend on telemedicine for income. That will be their career. Their typical day at the office will not involve the traditional way of doing things where the patient has to be physically present in the office. However to make this work there is need to have a set of core competences in place. Medical virtualist is the term they have come up with but it is not set since they are still playing around with the name.

Telemedicine idea is new and some fear that this new technology will be disruptive. While the path ahead is unclear, it would not be wrong to say that it is exciting to see the impact that telemedicine will have on the health care system.

OIG’s November Plan on Opioid Prescribing and Telemedicine

Following the previous two work plan publications this year, OIG has come up with another strategy where it will be updating its work plan on a monthly basis. In November, the four plans are;

• OIG will be evaluating the prescriptions for opioids to Medicaid. Their observation was that Medicaid beneficiaries mostly the disabled are more vulnerable to abuse of opioids since they tend to suffer from conditions that require pain relief. OIG will be examining the issue by considering both the prescriber and the beneficiary side. The prescriber may include doctor or pharmacy. The study aims to come up with a baseline of beneficiaries receiving extreme amounts of opioids and identify the prescribers who are giving excessive or too much of opioids to recipients.
• OIG wants to study if Medical payments made for services provided through telecommunication systems fulfilled the requirements of Medicaid. The OIG will determine if all the telehealth services that may be delivered through audios and videos and any services that beneficiaries get through interactive transmissions are all paid for in the required manner.
• The Medicaid Managed Care Organizations (MCOs) will be examined by the OIG to check if it is using Medicaid funds to offer proper care to the Medicaid MCO enrollees. These are funds that MCOs receive inform of capitation payments which come from over 40 percent of federal Medicaid expenditures. The OIG aims to ensure that the capitation rates are set appropriately so that they can provide adequate services to the beneficiaries.
• OIG will be determining the way hospitals are billing for severe malnutrition. The condition is common among the elderly especially those who are seriously ill. Malnutrition can be as a result of inadequate treatment, treatment of a different disease, negligence or general worsening of the patient’s health. Hospitals are expected to bill for the treatment of this condition based on how serious the state is, which can be mild, moderate and severe. Severe malnutrition is a significant complication and increases Medicare reimbursement. OIG will be reviewing the precision of the claims to Medicare for the treatment of acute malnutrition.

There exists a potential to reshape the health system by use of telemedicine. The modern society has allowed consumers to access almost everything online which includes healthcare. Telemedicine is a comprehensive type of healthcare. It can be used to enhance the treatment of emergency care patients through its convenience, increased efficiency, and accessibility.

The various incidents where telemedicine comes in handy, especially to patients requiring urgent care include load balancing, satellite, and hub and spoke models. These services are provided by both the government and non-profit oriented organizations who offer some online healthcare facilities for those seeking to expand their telemedicine program.

Telemedicine is both safe and effective for the evaluation of any manageable conditions in the urgent care environment. Furthermore, there exists growing evidence that affirms the audio and video-based intervention for the different acute conditions that manifest in the pediatric care. For example, using telemedicine can make the diagnosis of common severe illnesses much more comfortable than before. Also, patients with trust issues would feel more comfortable being diagnosed online rather than in-person.

The evaluation and consequent treatment of urinary tract infection and sinusitis have also been enhanced using tele-visits where most physicians purpose to offer prescribed antibiotics to their online patients. These means that telemedicine is not any different from one on one diagnosis. There also exists no difference in the number of patients that may be required to make a follow-up to their treatment either online or in-person. These imply that there is a consistency in patients’ satisfaction with telemedicine attributable to the convenience provided as well as the reduced cost of medication.

The urgent care patients can, however, be given the option to either be treated at home or through telemedicine. Alternatively, patients in need of physical emergency rooms are also given the opportunity to choose from one on one treatment or receiving treatment through telemedicine. Indeed the introduction and use of telemedicine for emergency care have helped reduce the average time and money spent on medication.

Virtual medical consultations, or telemedicine, are soon going to be offered by Aetna and Apple. With CVS joining in as well, telemedicine is facing a large increase in consumer awareness. Although telemedicine has been around for years, getting the information to customers has been difficult. Now that fortune 500 companies are promoting the service, virtual medical consultations are set to become more normal.

The chief executive of Aetna, Mark Bertolini detailed the plan to incorporate glucose level readings. With technology becoming such an intricate part of everyday life, it is no surprise that medical services are being digitalized as well. Patients having the ability to help themselves at their fingertips is a step towards healthier lives for many. With the ability to connect apps to Bluetooth to get instant readings coupled with a lower cost of healthcare.

Along with lowering the cost of healthcare, patients are now able to be more independent. The technology being introduced has the ability to monitor the patient from home. This means that the CVS, Aetna, and Apple medical merger could allow people to go home and not remain stuck in a clinic or hospital. There is no set in stone apps or technological specifics being mentioned thus far, but this is progression in America’s healthcare system.

This plan sets out to ensure the patient has the independence that they want, while also remaining affordable. A large issue with America’s healthcare system is the amount of money it takes to have any medical procedure or test. Doing it remotely, from home, eliminates some of those costs that traditional medicine incurs.

Telemedicine sets to make leaps and bounds within healthcare. Gaining exposure so that patients can utilize the service has been an obstacle, but that is changing quickly. Providing people with a less expensive, easy access way to medical treatment is groundbreaking.

Diabetes is a growing epidemic, brought on by unhealthy choices, and demanding medical care unlike any disease before. Telemedicine, allowing physicians to remotely monitor patients with diabetic retinopathy, can help meet that growing demand.

Noted physician Dr. Zimmer-Galler has stated that the DR telemedicine programs have been quite helpful to treat patients. They are highly effective, but because of the anticipated rise of diabetes cases in the next 15 years, they may not be enough. Her concern is that there will not be appropriate or adequate resources to properly evaluate and treat the rate of diabetic patients.

The lack of resources to properly treat diabetic patients isn’t the only concern Dr. Dimmer-Galler and other physicians have, however. The question of the validity of telemedicine practices is another. Presently, the American Telemedicine Asociation has 4 different levels of standard validity, starting with the presence of limited of minimal DR; presence of vision-threatening DR; the ability for providers to make clim=nical recommendations, and the Early Treatment DR Study photograph star=ndard (the highest level).

This validation is how telemedicine is judged to be a standard of care – currently, DR is determined by an in-person evaluation. Each DR treatment program, including telemedicine, must be evaluated to see how well it works, based on the “gold standard” of ETDRS photographs.

Telemedical treatment of diabetic retinopathy is expected to become more common in clinical practice. This should include primary-care automated image analysis using Nonmydriatic fundus cameras. With these, the images will be able to be transferred to readings centers for viewing, and then returned to the primary care physicians for diagnosis.

There is a concern that the rate of upgradeable images may affect telemedical treatment of DR. Currently, the minimum acceptable value for upgradeable images is 5%. There is no way with the current level of telemedicine, however, to diagnose diabetic macular edema (DME), which will require office visits. As the technology of telehealthcare improves, though, this may also be a viable option for remote diagnosis.

As it stands, telemedicine cannot be fully relied upon to treat DR or DME, although the technological improvement is increasing.

The Centers for Medicare and Medicaid announced on Thursday the final rule for Medicare Physician Fees in 2018. Part of the numerous changes and payment increases is the decision of CMS to pay for a greater number of individual telemedical services. As technological capabilities increase, as well as demands on physician’s time, telehealth is increasingly a viable alternative to traditional office visits. Many of the approved telemedicine codes include instances concerning lung cancer, health risk assessments, psychotherapy, chronic care management and interactive complexity.

According to the press release provided with the document, access to telemedicine for those living in rural areas will strengthen the care available to them. In addition, the changes to Medicare telehealth coverage will make it easier for these providers to bill Medicare.

This is part of the process to modernize Medicare payments and promote innovations that enhance patient care. In addition, changes to patient monitoring via virtual treatment is also in the process of being finalized.

Morgan Reed, the Connected Health Initiative Executive Director, is very supportive of the efforts from CMS to encourage physicians to embrace remote patient treatment and monitoring. He praises the new rules from CMS as an important, yet necessary step forward to a more connected healthcare system in America. With approval for many types of telemedical treatment, connected health technologies are now accessible to those utilizing Medicaid and Medicare services. Until now, participants in those health care plans have been effectively locked out from telehealthcare.

Prior to the 2018 changes, CMS rules essentially discouraged doctors from considering newer technologies to treat Medicare and Medicaid patients. Working in conjunction with the Connected Helth Initiative Adsivory Board, the newly updated rules make telehealth and other new technologies more accessible to both doctors and patients alike.

Speaking for the American Hospital Association, Executive Vice president Tom Nickels confirms support for the CMS agency’s policies. While the support is present, this association encourages a more expansive approach to telehealth coverage available.

Telemedicine is basically the application of technology to provide health care, especially to people in the remote locations. The doctor and the patient can use either a smartphone or a computer to meet outside of the exam room.

Telemedicine seems to be taking over the health sector and improving lives all across the nation. Delaware, for instance, is placed in a better position of becoming the leader in this latest practice in health care. The technology is soon becoming available even to those who cannot afford some of this equipment.

But in reality, telemedicine has been around for quite some time, previously referred to as telehealth. What could be possibly new is the just the fact that doctors now recognize that ordinary patients now have more access to communication devices like computers and smartphones, unlike in the past.

Telemedicine has greatly helped patients with critical health conditions like Parkinson’s, who are impressed by the idea of not having to visit the physicians regularly to have a series of tests. With this new technology, they can now be tracked at home. Autism patients are also not left behind; they can arrange to meet their doctors at a place of their own choosing.

Delaware, under the legislative leadership of Rep. Byron Short and Senator Hall-Long, passed a law in 2015 that created a system seeking to balance the patient’s safety and access. But more importantly, this law created payment congruence for many insurers in Delaware, which implies that there is not a disincentive for medical practitioners to apply it for attending to their patients.

But all is not well, yet. A federal system called Medicare, for instance, is still unable to cover telemedicine in Delaware. A number of employer plans under ERISA, which is another federal law also does not match the law of Delaware by parity paying for the telemedicine services. In fact, quite a number resolve to use direct-to-consumer service, without noticing the gaps they are creating in continuity care.

But despite all that, physicians should continue to embrace telemedicine and not shy away from it.

Washington’s endless and circular debates over health insurance cannot give a true reflection of reforms in health-care. But the recent progress in telemedicine law that New Jersey has made indicates a great progress in this sector.

Washington’s health-care debate is mainly characterized by varying health insurance visions; affordable care going up against Republican repeal-and-replace; all against single payer. This is far from the type of care such systems of insurance should purchase.

This fight of insurance has been denoted by two main factors; who pays how much and for what services, and who is considered first when it comes to claiming bulks of medical resources largely fixed quantities. This, in the end, ensures that each system comes up with losers and winners.

In the last summer, New Jersey Governor Chris Christie signed the Senate Bill 291 into law, and this elevated the state of New Jersey to a more telemedicine-friendly state. In certain instances, patients will have an opportunity to get prescriptions without having to visit the doctor physically. The law has gotten rid of the need of a telepresenter, who is a basically a health-care assistant who stays with the patient as the electronic communications with a physician goes on.

As a way of satisfying the concerns of the providers in terms of efficacy and safety, the law clearly defined telemedicine to exclude emails, simple phone calls, faxes, as well as texts. Relationships must be very substantial including the transfers of the medical records of the patient to the teleproviders and video conferences. According to this new law, the patients should not worry about undergoing an in-person examination before having a consultation with a teleprovider.

There are also certain possibilities that some components of this law by the state of New Jersey could discourage telemedicine. This is because it foists massive reporting requirements as well as record keeping. Teleproviders are also required to review some medical records before they meet their patients. The patient’s gender, age, and ethnicity to the state must also be reported by the providers.

In summary, this law is likely to enable New Jersey to provide valuable services and present a wider variety of choices for the patients.