It’s these reasons that led the incredible team to create SilverCloud Health. The genesis of SilverCloud came from the extreme social and economic need for an effective and clinically validated digital solution demand and the failure of solutions to address these needs – these solutions had three major flaws; low user engagement, high user dropout, and limited clinical improvement – essentially, the solutions did and do not work in real-world settings. Since then, SilverCloud has grown into a global leader in accessible, scalable, digital behavioral healthcare backed by years of clinical research and validation.

In 2021 our hard work was further validated when digital health leader Amwell acquired SilverCloud. This was a defining moment in our journey, by becoming part of the Amwell family, we had an opportunity to accelerate our Mission of Helping people improve their mental health through technology. This was reinforced by our Vision of Effective mental healthcare for all.

Mental health and physical health are intrinsically linked, leading to the expression that there is no health without mental health. As such, mental health care should be incorporated into every part of a patient’s physical healthcare. It’s also important for a patient to have access to that care when, where, and how they need it – providing what works best for them given the context of where they are on their care journey – in a consistent and streamlined way. By combining the power of SilverCloud’s digital mental health tools, courses and support with Amwell’s digital care delivery enablement platform, we can redefine the practice of medicine to include always-on healthcare companionship that makes the balance and transition between interactive, digital and in-person care more fluid across the full spectrum of care. Finally, mental health care is getting an equal seat at the table, bringing the head and the body back together again for truly holistic care.

Fast forward another year, and I am honored to say that SilverCloud has surpassed another major milestone – today, we have over one million users using our platform. That means over one million people, their families, workplaces and communities have felt the positive impact of SilverCloud on their journey to better mental health. These one million people have been able to have access to care that they might not have otherwise had. One million people are getting the help they deserve.

It’s been an incredible journey to get to this point and we’ve only just begun to scratch the surface of what’s possible. As we think about all that lies ahead, let’s take a look back at just how far we’ve come:

• 2012: SilverCloud is born! SilverCloud was spun out from the Technology Enhanced Therapy (TET) project.
• 2017: SilverCloud raises over $8 million in series A funding.
• 2019: Express Scripts, the largest independent manager of pharmacy benefits in the United States, includes SilverCloud on its new digital health formulary. This makes the platform more widely available to people nationwide who are suffering from Anxiety, depression, stress and sleep-related issues, like insomnia.
• 2019/2020: SilverCloud collaborates with Microsoft to conduct research that combines Microsoft’s cutting-edge machine learning and AI technologies with SilverCloud’s expertise in real-world delivery of evidence-based interventions and mental health outcomes. The results were published in JAMA Network Open and serve to show how machine learning can meaningfully assist in the detection, diagnosis, and treatment of mental health problems.
• 2020: SilverCloud raises $16 million in series B funding. Led by MemorialCare Innovation Fund, this round elevated the company’s total funding to more than $30 million.
• 2021: SilverCloud is acquired by Amwell.
• 2022: Amwell announces Comprehensive Behavioral Health offering combining the best of SilverCloud digital care and Amwell therapy delivery and its 50 sate network.
• 2022: SilverCloud surpasses one million users of its digital mental health platform.

Amwell commends FDA on the proposed rule. It is consistent with all that the Agency has shared in prior guidance and industry discussions. It offers flexibility “regarding the types of additional conditions applicants may propose and how those additional conditions can be implemented.”

We stand by our position that the FDA has provided the industry with a roadmap for gaining approval for new nonprescription products. This pathway will unlock growth and value for sponsor companies.

Amwell is poised to support this new era of consumer empowerment and improved health equity.

FDA has placed a clinical hold on an actual use trial designed to evaluate the Rx to OTC switch of CIALIS, a treatment for erectile dysfunction. In the company’s recent press release, Sanofi said the pause is related to concerns about how the trial protocol has been designed, adding that no patients had so far been recruited for the study.

Much of the industry coverage of the announcement has suggested that FDA’s action will have a chilling effect on the ability of Sanofi and others to successfully switch many prescription drugs to over-the-counter status in the future.

We disagree.

As far back as 2012, FDA drew attention to the significant public health benefits that would accompany greater access to many treatments that currently require a prescription. The Agency stated that nonprescription access could help reverse the crisis of undertreatment of many common and some chronic conditions such as high blood pressure, high cholesterol, and asthma and relieve burdens on an already stressed healthcare system. At that time, FDA laid out a vision for using technology to aid consumers in selecting and using nonprescription drugs.

FDA had more to say on this in 2018 when it issued Industry Guidance entitled, “Innovative Approaches for Nonprescription Drug Products.” In its Guidance, FDA outlined “approaches that may be useful to consider for demonstrating safety and effectiveness for a nonprescription drug product in cases where the drug facts labeling (DFL) alone is not sufficient to ensure that the drug product can be used safely and effectively in a nonprescription setting: (1) the development of labeling in addition to the DFL, and (2) the implementation of additional conditions so that consumers appropriately self-select and use the product.”

FDA said that these approaches could lead to the approval of a wider range of drug products that consumers could safely and effectively use without the supervision of a health care practitioner.

Today, we have the technology, data interoperability, and consumer readiness to achieve FDA’s vision. And we can achieve this within the current regulatory framework by automating, connecting, and personalizing the tools of additional labeling and additional conditions for safety and effectiveness.

Our partners at Biograph have followed the FDA’s thinking on this issue since 2012. In response to the Agency’s vision, we submitted a Pre-Request for Designation (Pre-RFD) in 2017 that outlined a process to adapt data-driven safety standards operating in the Rx domain to deliver the same quality process in the OTC setting. This application set off a series of interactions and meetings with the FDA over the past five years as we crafted a technology-enabled approach to digital labeling for the next generation of nonprescription products.

Today, Biograph has partnered with Amwell to create a suite of Life Sciences solutions. The Amwell digital care platform offers sponsors a pathway to properly implementing a wholly new and empowering consumer self-care experience.

We do not know the specific issues that led FDA to their action on the Cialis program. However, Sanofi likely did not propose a comprehensive labeling strategy that included additional labeling and additional conditions sufficient to maintain the same safety provided to the public when purchasing Cialis on a prescription basis.

The FDA’s Innovative Approaches for Nonprescription Drugs Guidance suggests that sponsors leverage data and technology to interact with consumers and enforce label instructions. These additional conditions will improve the performance, reduce risk, and maximize the potential public health benefit.

We propose at least three considerations that a sponsor seeking to switch a prescription drug to nonprescription status should consider.

The first is objective verification of the consumer identity to ensure compliance with labeling regarding age, sex, and other instructions for use.

The second objective is a consumer-driven query of personal health attributes to check against label warnings. This safety process, powered by reliable third party data resources, identifies contraindications or drug interaction warnings for the individual consumer.

A third objective is to map a pathway for real-time access to a physician or pharmacist when label instructions direct the individual to “Ask a doctor before use” or “Ask a pharmacist.” This becomes an opportunity for retail collaboration to offer support in the consumer journey.

There are certainly other considerations that a sponsor and FDA will consider to ensure that nonprescription access carries the same safeguards as prescription access. A comprehensive labeling strategy for each nonprescription drug will reflect and address the risk profile of that product. Sponsors can approach each program with confidence that the vast capabilities and ecosystem connectivity of the Amwell digital care platform will help them address FDA requirements.

Rather than engaging in a “rush to judgment” that the FDA is not serious about enabling greater access to nonprescription treatments, Industry leaders should empower their organizations to evolve programs to meet the requirements outlined in the FDA’s Innovative Approaches for Nonprescription Drugs Guidance.

The FDA has provided the industry with a roadmap to the approval of new nonprescription products; and a pathway to offer consumers greater self-directed access to treatment. The requirements are reasonable, achievable, and within our grasp.

Amwell and its Biograph partnership are committed to helping sponsors act on FDA’s Guidance with innovative and comprehensive digital care capabilities that meet policy objectives and unlock value for consumer health.

In such a tumultuous market, the latest Gartner Market Guide for Virtual Care Solutions is a welcome resource, especially for CIOs looking to better understand the market vendors and industry changes. Amwell is proud to have been identified by Gartner as a Representative Vendor in the report.  

The breadth and scope of the Amwell platform and the virtual care modalities the company natively supports, including scheduled, on-demand and asynchronous virtual visits, digital clinical encounters, remote monitoring, and provider-to-provider virtual consultations set it ahead of the competition. In fact, Amwell is the only vendor to have been identified as having ‘Primary area of focus and well-recognized in the market’ in five of the seven modality categories examined in the Virtual Care Modalities Natively Supported by Vendor Solutions section of the Gartner Market Guide.  

“It’s an honor to be recognized by Gartner as a Representative Vendor in its Market Guide for Virtual Care Solutions. Last year in response to the evolving needs of our clients as a result of the pandemic, we launched our Converge platform to not only support a wide range of digital care use cases but also to enable a seamless care experience across in-person, virtual and automated care visits,” said Roy Schoenberg, President and CEO, Amwell. “Demand for a single platform is something we’re increasingly hearing from clients as they look to replace the point solutions launched during the pandemic in preference of a single system that is more scalable, modular and supportive of the type of experience that patients and providers are after. To us, it’s validating to see what we deem as similar findings in the Gartner Market Guide.” 

The report goes on to share key findings that we believe are very much in line with Amwell’s own industry research, which found that the vast majority of hospitals and health systems want to move toward a single integrated platform for telehealth, and over 80% of providers believe investing in a fully integrated virtual or hybrid care system would have a positive impact on clinical outcomes and patient experiences.  

We believe the Gartner report underscores similar learnings, including: 

• Transformation of the entire care journey: Per our view, the Gartner Market Guide shows that healthcare providers are shifting away from leveraging virtual care as a substitution to in-person care and are now working to find new virtual care business models that can transform the entire clinical care journey. This new care experience “integrates in-person and virtual care services, with care being delivered via the modality that is most appropriate based on individual patient needs.”  
• Integration is key: As we understand it, the Gartner report finds that healthcare providers to scale sustainable virtual care services, enabling technologies must seamlessly integrate into clinical workflows and provide frictionless consumer experiences. The report goes on to predict that the “long-term competitiveness of virtual care vendors will hinge on their ability to achieve seamless integration and data interoperability with core clinical systems, such as EHRs.”
• COVID-19 band-aids aren’t cutting it leading to a consolidation of vendors: It appears that conversations with Gartner clients over the past year have shown a light on the fact that CIOs are re-evaluating their digital capabilities to better align with their evolving virtual care strategy. Specifically, CIOs are prioritizing the consolidation of all of the disparate solutions launched during the pandemic. This represents a shift in the market towards a single enterprise platform that supports many modalities and use cases, rather than niche, solutions that support a single type of interaction.   

With the market changing every day, not to mention the evolving needs of patients and providers. and current demands on our healthcare system, it can be hard for healthcare provider organizations and their leaders to select the right virtual care partner. The latest Gartner Market Guide serves as a guiding light to help healthcare provider CIOs understand the current marketplace and how various vendors have been recognized when it comes to meeting today’s demands, and Amwell is proud to be recognized as a Representative Vendor. Whether you are reevaluating your current strategy or looking to launch a new one, we encourage you to read the full report.   

Download your complimentary 2021 Gartner Market Guide for Virtual Care Solutions report here. To learn more about our Converge platform, click here.  

Attribution and Disclaimers: 

Gartner, Market Guide for Virtual Care Solutions, Sharon Hakkennes, 2 November 2021 

Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose. 

GARTNER is a registered trademark and service mark of Gartner, Inc. and/or its affiliates in the U.S. and internationally, and is used herein with permission. All rights reserved. 

Now that the dust has begun to settle, healthcare providers are taking stock of the wins, losses, and lessons from their experience with telehealth during the first wave of COVID-19. To shine a light on this stocktaking and the future direction of virtual care, Amwell and HIMSS Analytics asked more than 100 senior executives at hospitals and health systems around the country about their postpandemic strategy and their planned investments in telehealth.

Most survey respondents said they expected to expand virtual care at their organization, by adding new telehealth capabilities or by investing in related hardware, equipment, and infrastructure. Even more important, their responses expressed a strong desire to consolidate the numerous platforms and systems now in use for telehealth and digital care into a single, integrated whole.

More than half of all hospital and health system leaders are planning to increase their investment in virtual care.

The average IT budget disclosed in the survey was $6.2 million, with some large health systems topping out above $15 million and smaller stand-alone hospitals reporting budgets of under $1 million.

Overall, 56% of the respondents said they plan to increase their investment in telehealth solutions and virtual care over the next two years. Staff training and support, telehealth for specialty care, and hospital at home capabilities were all among the needs cited by the respondents.

Healthcare providers are using 3 to 4 platforms for digital care, on average — and some are managing far more.

The hospitals and health systems represented in the survey are using an average of 3.45 different systems or platforms for digital care experiences, including telehealth, remote patient monitoring, and patient engagement.

Platform sprawl is especially acute at larger institutions. Roughly 1 in 6 integrated delivery networks and 1 in 5 academic medical centers reported using eight or more platforms for digital care.

For telehealth, the vast majority of organizations want to move in the opposite direction — toward a single integrated platform.

Among the decision-makers and influencers currently using two or more platforms, 77% said moving toward a single, secure telehealth platform that is fully integrated with other systems (such as the EHR and compliance systems) is “very” or “extremely” important for their organization.

Roughly 1 in 6 respondents who supported a single platform flagged potential blockers or concerns, including the feasibility of EHR integration (11%) and cost (5%). But the overhelming majority (85%) — citing benefits such as streamlined implementation, training, vendor management, and data collection — said a single platform would have a large and positive impact on the organization.

As one respondent put it, consolidating platforms “would provide a better, efficient process, as well as a better patient experience.”

A single platform, added another, “would be a game-changer.”

Telehealth and other digital tools have the power to democratize access to care helping to improve care outcomes for all. Together with our partner Google Cloud, we examined five ways telehealth can help account for SDoH and make healthcare more accessible. Specifically, we explore how telehealth can:

• Remove distance as a barrier to care, which is critical as 6 million Americans live more than 30 minutes from their nearest hospital.
• Eliminate the risk of unnecessary exposure, providing patients who may be more susceptible to diseases with access to continuous healthcare without putting them at higher risk for developing more severe symptoms.
• Extend access to specialty care, and with 55% of preventable hospitalization or mortality in rural settings being due to a lack of access to specialty care, specialists are a core part of our healthcare system.
• Save patients time and money, by enabling them to spend less on travel and childcare, limit time taken off work, and save on other costs associated with in-person visits.
• Combat physician shortage and fatigue by improving care delivery and making it more efficient, ensuring more people can still have their healthcare needs addressed.

To learn more, read our full blog co-written with Google Cloud and click here to download the whitepaper “Healthcare’s Virtual Transformation,” written in conjunction with Becker’s Hospital Review.

We are proud to announce that our C500 telemedicine cart has won the “Best Virtual Care Solution” award from MedTech Breakthrough, an independent market intelligence organization that recognizes the top companies, technologies and products in the global health and medical technology market. This is our second MedTech Breakthrough award win, having also won “Best Overall TeleHealth Solution” in 2020, and we continue to be honored by the recognition of the value of our solutions and the impact they are having on healthcare.

“Virtual care is one of the most critical and exciting healthcare technology categories this past year, and Amwell’s C500 cart is delivering a breakthrough virtual care experience in this area, empowering providers to conduct the most efficient, high-quality remote exams possible,” said James Johnson, managing director, MedTech Breakthrough. “The C500 can greatly improve care delivery, whether it’s helping staff stand up tele-isolation room to quickly and effectively triage COVID patients or allowing providers to diagnose and treat stroke patients quicker, the C500 empowers care delivery to patients that health systems might have not otherwise been able to reach. Congratulations to Amwell again this year for a well-deserved MedTech Breakthrough Award win.”

As a company on a mission to connect and enable healthcare’s key stakeholders to deliver greater access to more affordable, higher quality care – our telemedicine carts are instrumental in our ability to democratize healthcare resources, and they have never been more critical. During the pandemic, telemedicine carts were used to keep providers safe, allowing them to monitor and continue seeing highly contagious patients at a safe distance. They were also used to ‘beam’ specialists and other healthcare personnel from one part of the country to another, especially impactful in geographies hardest hit by COVID-19 or in areas without the same access to care.

Specifically, the C500 was recognized for its ability to deliver a big impact with a small footprint. Its cutting-edge technology empowers providers to conduct the most efficient, high-quality remote exams possible. New features like an embedded 4K camera, beamforming microphones that focus on the speaker, and adaptable form factors greatly improve the clinician experience. Some highlights include:

• Ready when you are. With smart cart sensors, you save time spent waiting for technology—the C500 wakes up the moment you approach your workstation.
• Adaptive to your environment. A camera that responds immediately to user commands lets you move at your pace and beamforming microphones focus in on the speaker, so you hear what matters most.
• Simple to use. An intuitive design and sleek interface make using the cart easy and seamless.
• Performance that lasts. Durable glass, protective coverings, and increased battery life keep you running at high performance for the long run.
• Worry-Free Fleet Monitoring. Remote monitoring, auto alerts and over-the-air (OTA) updates ensure your telehealth solution is up and running at all times.

The C500 is versatile and supports every workflow, from patient triage to specialist consults. While the use cases are plentiful, the following are some of the most impactful ones we see across our clients:

• ED Triage: With the C500, you can divert select ED cases to on-site virtual visits to address increasing patient volumes and wait times. With just one touch to start a virtual visit, the C500 simplifies connecting ED staff to remote providers. The care team can then utilize tools like enhanced camera control, integrated peripherals, and an easy stethoscope plug-in to assess patients and enable quicker discharges.
• Telestroke: Utilizing the C500 for telestroke care allows providers to diagnose and treat stroke patients more quickly. New cases can be created with one click to document vital information in the stroke intake form. The cart’s agility and small footprint make it a great solution for busy EDs, giving on-site staff the ability to move it quickly to where it is needed most. An optional pan-tilt-zoom camera add-on capable of 20x zoom enables the remote neurologist to examine the patient quickly and carefully and recommend the best treatment.
• Acute Behavioral Health: The C500 permits staff to bring in a psychiatrist with one touch. The agile cart can be easily moved in and out of treatment rooms to ensure patient safety, and the self-contained system eliminates the chance of patients harming themselves with loose components. Leveraging Amwell’s provider network through the C500, health systems can expand access to psychiatric care, ensure better treatment for patients in mental distress, and reduce length of stay.
• Isolation Rooms: The COVID-19 pandemic and the need to triage and contain the spread of the virus have increased the importance and prevalence of isolation rooms in hospitals. The C500 helps staff stand up teleisolation rooms, allowing clinicians to instantly connect to on-site patients—all while conserving personal protective equipment (PPE) and avoiding unnecessary in-person interaction. With the C500’s enhanced audio and video performance, providers can quickly and effectively triage COVID patients in this manner in order to determine the safest, best next step.

Amwell equips clinicians, patients, and the industry that supports them, with the tools to realize a better healthcare experience by delivering a full end-to-end telemedicine solution. The C500 delivers on this mission by providing high-impact virtual care with the footprint that fits health systems’ needs best.

To learn more about the Amwell C500, click here: https://business.amwell.com/telemedicine-equipment/carts/500-telemedicine-cart/

Congratulations to the winners of the 2020 Amwell Client Awards!

As we do each year, the Amwell team has selected from a highly competitive field of clients those who stand out for their innovation and achievement in telehealth.

Our clients are an endless source of inspiration for us, and we conceived these awards six years ago to share their success stories and spur the entire telehealth ecosystem to new heights.

The effort and dedication these awards represent are especially meaningful to us this year. At a time of tremendous stress and uncertainty for our healthcare system and our nation as a whole, the health plans and health systems recognized in the four categories below have shown exceptional vision and leadership in scaling virtual care and improving health outcomes for individuals and communities.

This year, we’ve added a special fifth category, Pandemic Activation & Acceleration, to recognize the heroic efforts of our clients during COVID-19. Amid the unprecedented challenges brought on by the virus and the need for social distancing, Amwell clients have risen to the occasion — and then some. In their own way, in their own communities, each of the organizations included in this category has gone above and beyond in their response to the pandemic.

Clinical Impact

Cleveland Clinic

Cleveland Clinic continues to be a model of provider engagement. With more than 1,000 providers utilizing its Express Care Online platform in 2019 alone, Cleveland Clinic’s commitment to integrating telehealth into the way it delivers care has served as an example for health systems across the country. During the COVID-19 pandemic, the health system saw an unprecedented surge in virtual care. At the height of the outbreak, virtual visits represented 65% to 75% of ambulatory care, up from just 2% pre-COVID-19. The health system also saw a 10-15x increase in on-demand virtual visits during the pandemic. To meet this surge in demand, Cleveland Clinic leveraged both its providers who were already active on the platform, and also trained more than 350 primary care providers — many of whom were temporarily redeployed due to the virus — on telehealth.  During weeks of peak volume, more than 2,500 Cleveland Clinic providers from primary care and specialty departments provided virtual visits to their patients.

Indiana University Health

Only three of the 17 hospitals in the IU Health system had access to 24/7 psychiatric care at the beginning of 2019. Patients presenting with psychiatric or substance use disorders often needed to be transferred. Similarly, peer recovery coaches were only available at two hospitals. By 2020, IU Health had launched on-demand virtual psychiatry assessments in the ED and a virtual peer recovery program, going live in 14 hospitals in less than 100 days. In the first six months of the program, the system performed more than 1,600 ED psychiatric assessments — resulting in 700 avoided transfers — and more than 700 peer recovery coach visits.

During COVID-19, IU Health launched a Virtual Screening Clinic one day after the first person tested positive in the state.  A comprehensive virtual plan was put in place to offer screening, testing, and monitoring, as well as a plan to help employees safely return to work. Following the initial explosive growth of virtual urgent care visits, IU quickly pivoted to focus on virtual scheduled visits as patient demand shifted. The health system had conducted more than 40,000 COVID-19 virtual screenings through May, adjusting and changing protocols frequently to align with new guidance from the CDC.

M Health Fairview

M Health Fairview (MHF) went live with a telestrokepilot program in 2018. After a successful launch, MHF identified the opportunity to integrate telestroke into the Epic EHR via Context-Aware Linking (CAL), which streamlined the workflow and enabled providers to practice telemedicine from within their standard EHR workflow. After the telestroke program became a standard of care, MHF partnered with Amwell to bring video spotlight capabilities to the clinical platform, allowing the provider to keep the patient as the prominent view even as multiple providers joined the consult. MHF’s telestroke program has expanded to multiple spoke locations and continues to grow.

During COVID-19, Fairview is seeing more than 2,000 patients per day through its CAL integration within the Amwell Patient Portal (this implementation was coined Amwell 1.5). This implementation includes integration with M Health’s patient portal and provider mobile application.  The health system performed both scheduled and on-demand visits, and added Amwell telemedicine hubs at two locations for patients needing mental health and addiction therapy. Planning is underway to expand this service to Catholic Charities, an MHF community partner that serves Downtown St. Paul.

Engagement Excellence

Blue Cross Blue Shield of Michigan

Blue Cross Blue Shield of Michigan (BCBSM) has partnered with Amwell since 2016, expanding to an enterprise platform, Blue Cross Online Visits, in 2018. Since launch, the health plan has seen nearly 17X growth in telehealth registrations and 16X growth in visits. In 2019, 52% of BCBSM virtual visits replaced emergency room and urgent care center visits, equating to promising cost savings. The health plan has developed and executed significant strategies and campaigns to boost adoption and use, including worksite engagement programs, paid search, social, SMS/text, and other targeted direct-to-member campaigns. During COVID-19, BCBSM offered virtual visits at no cost to all members and engaged employers to increase its telehealth-eligible member population to include approximately 300,000 new lives.

Gundersen Health System

With the arrival of COVID-19, Gundersen Health System needed to rapidly ramp up its telehealth platform. In just a few weeks, Gundersen nearly quintupled its typical pre-pandemic visit volume. As the health system continues to operate in the “new normal” of the pandemic, it is focused on expanding into new specialties and programs to build on its already impressive telehealth success. Gundersen is currently on pace to greatly exceed the first-year telehealth utilization benchmark for rural health systems, and is on track to meet the utilization levels typically seen with rural or urban hospitals after two years of telehealth deployment and engagement.

Nemours Children’s Health System

Nemours Children’s Health System, using the Amwell Mobile Software Development Kit (SDK), has developed a robust, parent-friendly mobile experience designed to put the best of Nemours pediatric care at their fingertips. The Nemours app provides useful features tailored to each patient and custom tools for chronic disease management, like the one-of-a-kind asthma tracker. Parents can also use the app to access their child’s health records, view test results, have scheduled or on-demand video visits, and more. Nemours is committed to developing tools that help parents keep their kids healthy and make quality pediatric healthcare accessible to all families. Nemours has also partnered with Amwell’s Engagement Services team to actively promote their telehealth program, Nemours CareConnect.

Verizon

A strong, ongoing partnership between Verizon, Anthem, and the health plan’s telehealth offering, LiveHealth Online (LHO), has resulted in Verizon exceeding its telehealth registration goals two years in a row. The company had nearly 47,000 telehealth registrations by end of May 2020. An effective assisted enrollment campaign, employee-facing webinars, a strong LHO presence at “Be Well, Work Well” live and virtual events, and biannual registration email campaigns all contributed to this registration success. Verizon also authored an “About You” series chronicling the adventures and misadventures of two characters and how their use of LHO “saves the day.” The company has also seen impressive growth in telehealth utilization, with behavioral health visits increasing 83% and breastfeeding support visits increasing 63%.

Verizon further demonstrated its commitment to engagement excellence during the COVID-19 crisis. As the virus began to spread across the United States, Verizon expanded the LiveHealth Online benefit to its associate (union) employees and pre-Medicare retirees. Compared to the same period in 2019, Verizon’s LHO utilization for January to May 2020 increased by 107% for behavioral health visits, 72% for medical visits, and 21% for breastfeeding support visits.

Leadership Alignment

Blue Cross Blue Shield of Arizona

In early 2019, Blue Cross Blue Shield of Arizona (BCBSAZ) launched their enterprise telehealth program, BlueCare Anywhere, by initially offering virtual medical and behavioral health services to 250,000 members.  Since then, the health plan has seen 96% growth in its eligible members, almost doubling the number of members eligible for BlueCare Anywhere.  Not only has BCBSAZ demonstrated impressive growth, they have shown aligned leadership through their vision for a healthy Arizona. The health plan is committed to the inclusion of all its members, which it has demonstrated by offering telehealth to its Medicare Advantage members, launching a Medico (Spanish) practice, and developing a marketing strategy for digital worksite clinics. All these collective efforts are driven by the health plan’s vision of making digital care available to not only its entire membership, but to Arizonans at large. Further demonstrating its leadership, during COVID-19 BCBSAZ offered telehealth for free and made it available to an additional 60,000 Medicare Advantage members and 20,000 ASO group employees, resulting in a 148% increase in telehealth enrollments and a 176 percent increase in visits.

Children’s Health in Dallas

Leadership and key stakeholders of Children’s Health in Dallas quickly and systematically came together in response to the COVID-19 pandemic. From January to March 18, 2020, the health system conducted approximately 1,000 virtual care visits. However, from March 19 to June 22, Children’s Health did nearly 25,000 virtual visits. The health system saw a nearly 6X increase in on-demand visits, and a 16X increase in ambulatory (scheduled) virtual visits. During this time, the health system trained more than 1,200 providers, 900 nurses, and 260 clinical staff on virtual visits. Children’s Health, which has a robust school-based telehealth program leveraging Amwell carepoints, had its partner schools loan hospitals these carepoints to quickly build needed COVID-19 divisions. Through thoughtful leadership, Children’s Health expedited credentialing, created automated training, incorporated telehealth into patient discovery, and implemented virtual rounding for bedside telemedicine.

Penn State Health

Penn State Health enhanced its telehealth program in response to COVID-19, a feat that required leadership alignment at the highest levels of the organization. The commitment from leadership was not simply a response to the pandemic, but rather the latest iteration of a long-term strategy to make virtual care a priority across the organization moving forward.  Clinical, technical, operational, and executive leadership continue to work diligently to ensure the health system is well-positioned to meet the evolving needs of its internal and external stakeholders. This commitment has led to the introduction of several new telehealth initiatives and programs that compliment Penn State Health’s mission of enhancing the quality of life through improved health, the professional preparation of those who will serve the health needs of others, and the discovery of knowledge that will benefit all. Penn State is a shining example of the change that can occur when leadership is aligned and committed to these values in the work they do every day.

Community Innovation and Activation

Centurion Health

Centurion Health works with a large state department of corrections to provide psychiatry services and specialty consults to its incarcerated population across 10 statewide prison complexes. These telehealth visits help supplement in-person visits and increase the availability of healthcare services to an underserved population. Since launching the program in July 2019, Centurion has conducted more than 15,000 virtual visits for in-state patients, with even higher utilization expected in 2020.

NewYork-Presbyterian

NewYork-Presbyterian (NYP), in partnership with Weill Cornell Medicine and ColumbiaDoctors, goes above and beyond to provide excellent care to all the communities and populations in its ecosystem. Through telehealth, NewYork-Presbyterian has been able to launch multiple teleconsults programs across its 10 hospitals and communities. During COVID-19 the system stood up eICU and tele-isolation (where patients in isolation can communicate remotely with their care team). NewYork-Presbyterian has expanded access to high-quality care by pushing the boundaries of how telehealth is used inside and outside hospital walls. As part of its COVID-19 response, NewYork-Presbyterian expanded access to urgent care by offering low cost virtual visits, and expanded access to therapy, follow-up care, and workforce safety through virtual scheduled visits. The health system leveraged C250 carts — mobile telehealth stands with cameras and displays that bring remote physicians to the patient — within its hospitals in isolation rooms and within the ED to reduce the use of personal protective equipment and create nurse-free care models. Through its combined efforts, NewYork-Presbyterian has conducted more than 50,000 virtual visits on Amwell technology this year, and has more than doubled the number of providers using the technology.

Anthem Inc.

While still in the early days of the pandemic, Anthem encouraged the use of LiveHealth Online, Anthem’s telehealth platform, as a safe and effective way for members of its affiliated health plans to access care, and also waived member cost shares for virtual visits on LiveHealth Online as well as from Anthem’s network providers. Working with Amwell, Anthem also doubled provider capacity to significantly reduce wait times. Anthem also accelerated the integration of LiveHealth Online within Sydney Care through the use of Amwell’s Software Development Kit (SDK) and enabled an AI-driven symptom checker to include a COVID-19 assessment. Through this rapid and forward-thinking response, Anthem has surpassed more than a million lifetime virtual visits through LiveHealth Online while also covering more than 14 million virtual health visits between March and June 2020 within Anthem’s own provider network.

Ascension

Ascension successfully enrolled and onboarded thousands of Ascension Medical Group partners in a short amount of time at the beginning of COVID-19. The team quickly created a virtual care training site for Ascension providers, and ran a daily provider support line. During the COVID-19 pandemic, Ascension providers conducted nearly 33,000 visits in a single month.

Augusta University Health

Augusta University Health’s innovative telehealth strategy became a cornerstone of its response to COVID-19. At the onset of the pandemic, AU Health worked diligently to implement and deploy its virtual COVID-19 screening program. The health system also transitioned in-person care into virtual visits, rolling out telehealth at 35 ambulatory clinic sites and training 1,150 providers on its virtual platform. By the end of April, the health system had conducted more than 12,300 virtual care screenings. In addition, AU Health partnered with the Georgia Department of Public Health to schedule COVID-19 tests resulting from virtual screenings.

Baptist Health South Florida

At the onset of COVID-19 in March 2020, Baptist Health South Florida proactively prepared for the pandemic and offered free virtual urgent care visits to the community to ensure community access, limited exposure, and decompressed in-person visits to help flatten the initial curve. To meet the drastic increase in screening visits, Baptist Health ramped up the number of its own providers on the app, with over 415 trained in just two weeks. The health system also added an additional 11 practices to the telehealth app, which now offers patients services ranging from urgent and cancer care to cardiology and neurosurgery consults. Baptist Health implemented several enhancements to improve delivery of care, including leveraging internal pharmacists and redeployed staff to ensure local care was delivered with limited interruption. The added volume generated nearly a 10X increase in total visits from the early weeks of 2020 to the peak week of COVID-19 in April. As evidenced by the large amount of community support and positive feedback, Baptist Health Care On Demand made a significant impact on the community and continues to do so in this time of need.

BayCare Health System

In response to the COVID-19 pandemic, BayCare onboarded over 500 providers to their telehealth platform in a matter of days to help prepare for widespread closures of the brick-and-mortar practices throughout their network. In order to prepare for this, BayCare team members worked tirelessly to train and support providers and staff during this transition. Collectively, BayCare providers have offered over 50,000 virtual visits to patients over the past five months, spanning several specialties and clinical disciplines. In line with their mission to “improve the health of all we serve through community-owned services that set the standard for high-quality, compassionate care,” BayCare continues to position their telehealth service BayCareAnywhere as an access point to patients seeking care during these challenging times.

Dignity Health

The Dignity Health telebehavioral health program is specifically designed to maintain access to assessments and evaluations in a potential COVID-19 environment. Through telemedicine, county mental health workers and hospital social workers were able to conduct behavioral health assessments from home without being physically located in hospitals. This allowed for timely evaluations while saving personal protective equipment (PPE) and reducing exposure. From January to May of 2020, Dignity Health conducted more than 3,740 telebehavioral consultations, and enabled hundreds of additional encounters for off site behavioral health personnel. The health system also extended its telehealth technology to departments and personnel that had otherwise not used the telehealth to help with a surge in COVID patients, thus exposing new healthcare professionals to the benefits of telehealth and promoting the future of the industry.

Hawai’i Medical Service Association (HMSA)

HMSA‘s response to the COVID-19 pandemic exemplifies what it means to make members the highest priority in healthcare. As soon as HMSA noticed that an increase in member demand for its virtual health platform, HMSA’s Online Care, was leading to longer wait times, it immediately began training and onboarding more providers.

HMSA brought an additional 500 medical and behavioral health care providers to HMSA’s Online Care. It also mobilized a local customer service team to provide better support to providers and patients. HMSA updated its website with information about telehealth and used email and other channels to educate members about their benefits. Through its response, HMSA saw a 271% increase in virtual visits from March to May and cut the average wait time for patients by more than half.

Houston Methodist

Based in Houston, Texas (one of the country’s COVID-19 hotspots), Houston Methodist has leveraged its virtual program to meet the clinical needs in the Houston metropolitan area. These needs spanned the care continuum — urgent care, primary care, specialist consults, and care in the ER and ICU environments throughout all system hospitals. Using a mixed model of Houston Methodist and Amwell Medical Group providers, Houston Methodist has seen a steady increase in virtual urgent care visit volume, averaging over 2,300 visits in the last 2 weeks. Importantly, Houston Methodist has experienced a nearly 600% increase in visit growth compared to this time last year. Houston Methodist continues to invest and rapidly scale its virtual care capabilities to support the needs of its community during the pandemic.

Intermountain Healthcare

Very rapidly, Intermountain Healthcare responded to the COVID-19 crisis by shifting nearly all of the health system’s visit volume to virtual care. The health system went from conducting roughly 1,000 virtual on-demand visits per week to nearly 20,000 virtual on-demand and scheduled visits per week. Intermountain also developed a robust strategy to care for potential COVID-19 patients, integrating virtual care into that strategy to triage for testing and conduct at-home monitoring.

MetroPlus Health Plan

MetroPlusHealth launched a new telehealth program to over 500,000 members in the middle of a pandemic while being located in New York City, the epicenter of the country’s COVID-19 crisis.  On March 23rd, the health plan implemented its urgent care telehealth program, followed quickly by the implementation of its therapy and psychiatry programs on April 1st.  MetroPlusHealth launched these programs early to provide critical access to care for their New York City-based membership, which was greatly impacted by the pandemic. The health plan leveraged an innovative multichannel engagement campaign — which included email, direct mail, SMS text, and IVR calls — to quickly inform members of the new benefit and educate them on telehealth.

Midland Health

When COVID-19 began to spread, Midland Health quickly transitioned its telehealth program from solely urgent and primary care visits to all specialties. The health system rapidly converted typical in-person visits to virtual care to prevent the risk of virus exposure. It was important to Midland Health System that all its providers utilized its established telehealth solution instead of adopting non-HIPAA-compliant technology to conduct virtual visits — something that they believe will benefit their long-term telehealth provider engagement. During the pandemic, the health system went from conducting roughly 30 virtual visits per month to more than 2,000.

Naval Hospital Jacksonville

In March 2020, as COVID-19 began to impact the nation, virtual care became a critical part of Naval Hospital Jacksonville‘s response to the pandemic. The health system’s long-standing efforts to encourage virtual care — through a program known as Navy Care — proved to be a valuable asset during COVID-19, leading to a dramatic increase in Navy Care use. In April, Naval Hospital Jacksonville enrolled more than 5,900 patients and conducted more than 3,000 telehealth encounters. In a single day in April, Naval Hospital Jacksonville performed 50% of the virtual visits completed in all of March. Patient enrollment in Navy Care has tripled during the pandemic, to 21,000. While COVID-19 accelerated patient adoption of Navy Care, it also impacted provider use, which increased by 104% between February and April 2020.

Norman Regional Health System

Norman Regional Health System needed to quickly activate telehealth to provide ongoing care to their patient base during the pandemic. In just 72 hours, Norman Regional onboarded nearly 200 providers and 20 practices to its virtual health platform, enabling a dramatic increase in scheduled virtual visits. In April 2020, Norman Regional saw a 4x month-over-month increase in the total visit count, 3x increase in scheduled visits, and more than doubled their daily average of on-demand virtual visits. Virtual health helped Norman Regional Health System adapt to new and uncertain conditions and ultimately continue operations during the pandemic.

Northwell Health

As New York’s largest healthcare provider, Northwell Health found itself at the epicenter of the country’s COVID-19 outbreak. In response, the organization incorporated virtual care into its large-scale pandemic response, integrating more than 65 departments into the scheduled visit workflow and increasing provider adoption by nearly 900%. The health system saw in incredible increase in telehealth visit volumes during the pandemic, going from roughly 150 virtual visits per month to more than 3,000 virtual visits per day.

Nuvance Health

As COVID-19 began to spread across the country, Nuvance Health in Connecticut and New York State recognized the need to quickly and thoughtfully scale up its scheduled virtual visit program to meet patient demand. In a matter of days, the health system grew its program from roughly 10 providers to more than 1,000 across the organization’s newly merged HealthQuest and Western Connecticut Health Network system organizations. Year-to-date scheduled visits are nearly 90,000 and continue to grow at a significant pace.

Ochsner Health

Ochsner Health heavily integrated telehealth into their COVID-19 response. Ochsner quickly converted four urgent care clinics into completely virtual COVID-19 clinics. Utilizing their own provider network in Louisiana and the Gulf South states, Ochsner Health was able to train hundreds of providers on virtual visits so they could leverage Ochsner’s telehealth app, Ochsner Anywhere Care, for patient care. Since March, Ochsner has completed over 150,000 virtual visits. The health system also developed a comprehensive Safe to Return service plan and resource toolkit that empowers employer groups to feel comfortable and confident about transitioning employees back to work and interacting with the community again. More than 70 local employers are already leveraging Ochsner’s virtual employer clinics to create a safe and healthy workplace for both employees and customers. Ochsner’s goal is to continue to support employer groups to help minimize the risk of exposure to COVID-19 and ensure everyone can work safely in the “new normal.”

OU Medicine

Pre-COVID-19, OU Medicine, Oklahoma’s most comprehensive academic health system, had a modest telehealth program in place that consisted of some primary care services, post-op visits, and a virtual pain management clinic. Since COVID-19, the health system’s virtual strategy has seen unprecedented acceleration. OU Medicine has built out its internal telehealth team, onboarded more than 800 providers across all specialties, and conducted more than 25,000 virtual visits since March. Rather than wait for a perfect implementation, OU decided to deploy quickly and iterate — a decision that was key to its success.

Southwest Medical Associates and Health Plan of Nevada

The strong partnership between Health Plan of Nevada (HPN) and Southwest Medical Associates (SMA) and their long-time commitment to telehealth and telehealth expansion set the stage for 50,000 virtual visits to be completed so far in 2020, surpassing the total volume for all of last year. While HPN waived member co-pays and cost shares and initiated significant outreach to drive patients to this innovative platform, SMA enrolled more than 600 providers in a variety of specialties, including primary care, pediatrics, OB-GYN, and rheumatology. SMA leveraged both on-demand and scheduled virtual visits to better care for its patients in Nevada and Utah and supported more than six partner Optum organizations in quickly launching a telehealth program.

Trinity Health

In response to the COVID-19 pandemic, Trinity Health rapidly scaled up provider usage of its telehealth platform, onboarding more than 2,000 providers in a short period of time. These providers leveraged Trinity Health’s direct-to-patient context-aware linking integration to conduct scheduled virtual visits with patients within Trinity’s Epic EHR platform in its Michigan Regional Health Ministry locations. Further expansion of Trinity’s virtual scheduled visit capability within Epic is planned throughout other Regional Health Ministries later this year and throughout 2021.

UAB Medicine

UAB Medicine leveraged its established, unified telehealth platform that spans both ambulatory and inpatient settings to better care for patients during the pandemic. The single sign-on capability allowed the health system to deploy telehealth broadly and rapidly across its provider base, enabling them to train 2,200 providers on telehealth in a very short period. UAB Medicine leveraged Amwell’s Hospital platform to conduct scheduled visits with patients on the ambulatory side, which remains 41% of their total ambulatory volume. Furthermore, UAB delivers inpatient care by using telemedicine carts in emergency departments and inpatient wards for critical care, stroke, infectious diseases, nephrology, and general neurology. Telehealth has allowed UAB to better protect patients and providers, conserve personal protective equipment, and involve remote family in palliative care even as patients remained isolated.

UNC Health

In response to the COVID-19 pandemic, UNC Health quickly expanded it telehealth services by leveraging virtual care for a myriad of ambulatory use cases, including family medicine, occupational therapy, social work, and gastroenterology. The UNC Health telehealth team made this rapid growth possible by training and operationalizing scheduled visit workflows with Epic + Amwell context-aware linking. In a matter of days, the health system went from 200 providers using telehealth to 2,200 providers. This quick expansion translated into a 27,740% growth of virtual visits volumes in 2020.

Wellstar Health System

Wellstar leveraged its existing telehealth technology used for inpatient care and expanded it across the enterprise, broadening inpatient virtual care programs and creating new virtual ambulatory care programs. In just four weeks — a rollout schedule nearly a full year faster than originally planned — the majority of Wellstar’s providers were leveraging telehealth, and within six weeks they had executed 50K visits. The expansion included deploying tablets in each of the health system’s intensive care units (ICUs) and COVID/PUI Units to allow physicians to have virtual face-to-face conversations with patients and their families, and accelerating the use of an on-demand telehealth program, WellstarON. Along with the rapid technology deployment, Wellstar developed a multimedia educational program for all providers and a streamlined billing system to encourage adoption.

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As a geriatric psychiatrist by training, I’ve long been a believer that mental healthcare is one of the most deliverable specialties via telehealth.  I started Aligned Telehealth because I knew there had to be a better way for providers to access consumers who needed care. Today, we can provide a comprehensive psychiatric evaluation to patients 24/7. Our platform has reduced psych evaluation wait times from the national average of about 8-12 hours to 30-40 minutes. This means we’re able to not only take care of mental health patients but can also improve throughput and open up hospital beds for higher acuity patients. During COVID-19 when these beds were in short order, the ability to use telehealth to keep patients out of the ER or at least make their stay their shorter was critical.

Despite my beliefs of the value of telehealth for mental health patients long before the pandemic, COVID-19 has seemingly overnight increased the number of patients and providers who have and are willing to try virtual care. And today, more people than ever consider telehealth to be an acceptable and quicker way to access healthcare. So how will this impact how care is delivered for years to come? Here are my top three takeaways from our discussion during the event:

1. Telehealth must integrate: When it comes to mental health specifically, few EHR systems can be embraced. This makes it difficult for providers to want to use the technology. Previously, we’ve taken a very hospital-centric approach to things like EHR integration, billing and coding but to continue sustaining telehealth growth we must take a more provider-centric approach to ensure it’s easy to use and works with their preferred systems.
2. The mental health toll: The pandemic took a clear toll on the physical health of many Americans, but it’s the mental toll that I’m most worried about. Research shows that the number of individuals reporting symptoms of depression and anxiety are much higher than normal. We also know that those who suffer from mental health issues often have other comorbidities. At the same time, we lack the providers needed to be able to treat all those in need. Thanks to telehealth, mental health treatment can be a more regular part of a person’s healthcare experience, allowing them to access care wherever and whenever they need it.
3. Regulation needs to continue to adapt to the increasing demand for care: There has been much debate regarding which elements of legislation waived during the pandemic will remain waived.  We know that many of these modifications have increased the delivery of quality mental healthcare and we feel strongly that they must remain in effect.  We must maintain the ability for psychiatric providers to deliver care across state lines, regardless of the originating site.  It is also critical for payors to continue to reimburse for care delivered in both rural and urban sites.  We know that lifting these legislative barriers has enabled providers to care for those who desperately need it, and will continue to increase access to mental healthcare in the future.

While hospitals in hotspots struggled to stay afloat amid a surge of patients newly diagnosed with COVID-19, ambulatory providers found themselves upended from their routine patient encounters and had no choice but to adopt or at least consider telehealth.

In recent months, virtual visits have surged and are expected to exceed 200 million this year, much higher than projections.¹ This growth is on pace with the spread of COVID-19, which has infected more than 2.2 million U.S. residents, as of June 2020.²

This shift to telemedicine has forced many providers out of their comfortable office or hospital setting and into an unfamiliar digital world. With more patients using telehealth than ever before, even physicians with telehealth experience are finding it challenging to keep up with the demand brought on by COVID-19.

One thing hasn’t changed: the importance of the patient experience. Whether providing care in person or online, the patient experience and the quality of care delivered needs to be a priority. Yet, providing an optimal experience via telehealth requires different techniques than an in-person visit. Webside manner, the virtual equivalent of bedside manner, is not often taught, especially during times of crisis, yet it can make or break a patient’s virtual healthcare experience.

Click here to read more about what ‘webside manner’ is and tips for how providers can improve their ‘webside manner’ on MGMA.  

The reality is that many individuals are finding themselves feeling scared, confused, angry, and generally unsettled by today’s current events. All of these feelings are completely natural during this historic and highly chaotic time. However, as more people become quarantined or simply isolated from their daily routines, getting mental health treatment becomes even more valuable. Fortunately, thanks to telehealth, even when normal life events get disrupted, mental healthcare can remain consistent.

I recently shared my thoughts on how mental health professionals can help patients cope with COVID-19 with the Behavioral Healthcare Executive. Click here to read the full article for my tips to help patients through this difficult time.

As telehealth proves its value, hospitals and other healthcare organizations that did not have an existing virtual care offering are now scrambling to get one up and running. With good intentions, we’re seeing some organizations move to implement the lowest-cost and easiest-to-implement platform they can find, including free — and non-HIPAA-compliant — web-based videoconferencing tools.

These tools became an option for health systems and other providers when the U.S. Department of Health and Human Services announced in March that it would exercise enforcement discretion for healthcare providers who violated HIPAA while using non-compliant platforms in good faith during the ongoing public health emergency. While this unprecedented step was effective in rapidly expanding access to virtual care, it has also created some hazards for healthcare providers and patients who are experiencing telehealth for the first time.

As we anticipate telehealth usage to remain high even after COVID-19 ceases, it’s important that organizations think about their long-term telehealth strategies when implementing new solutions in the short term. Here are some reasons why a quick fix may not be the best approach.

Safety and Security

Though regulatory security requirements around HIPAA have been relaxed during this public health emergency, patient privacy and other safety measures are still critical. By choosing a platform that is not HIPAA-compliant or HITRUST-certified, healthcare organizations run the risk that it will not be compliant when this emergency is over and HIPAA regulations are reinstated.

Perhaps even more concerning is the risk that patient visits themselves will not be safe and secure. For example, non-compliant platforms create the possibility that another individual could accidentally join the visit unannounced, or that a patient records the visit. Free platforms also can serve up ads, so patients could be receiving advertisements during a medical visit. Furthermore, some options expose provider contact information to patients. Bottom line: Although some regulations have been relaxed, organizations shouldn’t compromise on safety and security.

Community Support

It’s true that many web-based video platforms enable providers to connect with their patients online and perform scheduled visits, but that’s where the capabilities often end. While this may seem sufficient to some healthcare organizations right now, having an enterprise-wide telehealth urgent care offering allows health systems to provide access to their broader community during the public health emergency, and not just to existing patients. At a time when we all need to be working together to support patients and communities, this should be an important consideration.

Provider Support

The support that a more sophisticated telehealth platform offers is especially necessary during times when medical professionals are already feeling the strain. Capabilities including co-pay collection, insurance support, provider training, visit summaries automatically sent to patents, a dashboard providing a view into a provider’s virtual waiting room, and more, all help to make a provider’s job just a little bit easier. Web-based platforms tend to lack sophisticated integrations with EHR systems like Epic, and other services like Surescripts or labs, so providers still have to manually input the necessary information or write a prescription after a visit, again adding more work.

We’re facing times of great uncertainty and we’re all moving as fast as we can to outpace a virus that doesn’t seem to be slowing down. However, we’re running a marathon, not a sprint. In addition to the virus sticking around for longer than expected, there’s no doubt that once we’re on the other side of this pandemic, COVID-19 will have a long-lasting impact on our healthcare system. In fact, it’s safe to say the system will never be the same, including the ways in which patients interact with their doctors.

As patients and providers get comfortable using telehealth for their medical needs, it’s important we not lose sight of the importance of privacy, security, and scalability. As difficult as it may be to think beyond COVID-19, when it comes to telehealth a long-term approach will pay dividends.

Part two features Tim Lovell, Director of Operations for Intermountain Connect Care, and Bryan Wang, Connect Care Product Manager, as they talk about Intermountain’s EMR integrations.

Did you launch Connect Care with any type of electronic medical record (EMR) integration in place?

Tim Lovell: We launched Connect Care in 2016 without any type of integration. At the time, we were in the process of rolling out Cerner to all our clinics and so we started that independently. Our direct-to-consumer telehealth program consists of three workflows: on-demand, provider scheduled, and staff scheduled. On the on-demand side, those providers are 100% employed specifically for telehealth. On the scheduled side, those are both providers and staff who are primarily working on in-person care.

What was the provider response?

Tim Lovell: When we were rolling out the non-integrated version of telehealth, the provider and staff adoption was a little bit slower than we had expected. We quickly realized the virtual workflow deviated too much from the in-person workflow, especially on the scheduled side. Based on their feedback, we really tried to integrate the workflow and emulate the in-person care as closely as possible.

Starting on the on-demand side, what did the workflow look like before and after the integration?

Bryan Wang: Our on-demand telehealth providers were documenting video visits in Amwell and then manually indexing those into the Cerner EMR. We also manually posted charges and created the encounters within the Cerner modules. There was a lot of back-end work after the initial encounter.

After the integration, now the patient list automatically flows into the EMR from Amwell. When a patient checks in to a virtual waiting room on the Amwell platform, we automatically create an encounter within Cerner, and the provider clicks into that encounter within Cerner and can start charting right away. Secondly, when they’re charting these virtual visits, the note types within Cerner already have the automatic video visit attestation built-in for legal and privacy purposes, which saves a lot of work for our on-demand providers.

How did the integration change the workflows for the provider and staff scheduling?

Bryan Wang: To give you some context, we have approximately 400 providers within our scheduled system; two-thirds of those are primary care physicians, and one-third are specialty care. Initially, there was a separate login for Connect Care, and we had to rely on staff to monitor the waiting room for patients.

The integrated scheduled workflow brought with it three components. When the provider wants to offer a video visit, they log in to the Amwell platform. Next, they go into the EMR as they would for an in-person visit, go to that specific patient’s chart, and click the video link that automatically brings them into the visit. The system also notifies them when a patient is in the video waiting room. The last component is that the telehealth assistance software populates the video visit window for them to see the patient. Compared to the in-person workflow, there is only one additional step, and that’s logging in to the platform. As we look ahead, there is going to be a more advanced single sign-on integration that eliminates the first step of the provider logging into the Amwell platform.

For the staff scheduling workflow, we recognize that clinic staff, especially schedulers, are one of our key constituents in telehealth adoption, so we wanted to offer a simplified workflow. Originally, no integration meant dual registration and scheduling in both the Amwell and Cerner platforms. By integrating Amwell and Cerner, we made sure that when they scheduled a video visit it was no different than if they were scheduling an in-person follow-up visit. We set up the different appointment types for telehealth within Cerner, and there is also an automatic telehealth designation for billing.

Can you give a high-level technical overview of these integrations?

Bryan Wang: We utilize an HL7 integration, which is the best way to quickly integrate needed components to enable a seamless provider experience. At a high level, the integration falls into three pieces. First is the registration piece, which is how we communicate that the patient has registered in Amwell, and how we sync that information back to Cerner. The second is the urgent care piece that notifies Cerner that a patient has checked into the waiting room and is ready to see a provider. And finally, there is a scheduled video visit piece, which is how we communicate a scheduling transaction from Cerner to Amwell, as well as how we embed the URL video join link directly within Cerner.

To learn more about Intermountain telehealth interoperability journey, watch this webinar recording.

In this two-part interview, leaders from Intermountain’s digital team discuss Connect Care’s telehealth integration and interoperability from the perspective of the patient and from that of the provider. Today’s interview focuses on telehealth integration and interoperability from the perspective of the patient—from Intermountain’s innovative Digital Front Door initiative to its broader vision of how telehealth fits into that consumer digital experience. Today we’ll be hearing from Tim Lovell, Director of Operations for Intermountain Connect Care, Bryan Wang, Connect Care Product Manager, and Jared Antczak, Director, Consumer Digital Solutions.

Intermountain is in the process of optimizing the patient telehealth experience. Can you tell us about Intermountain’s approach to consumer telehealth?

Jared Antczak: When we think about our patient experience, we recognize telehealth is critical to that strategy. Intermountain has actively been working on an initiative called the Digital Front Door (DFD). When we embarked on developing this initiative, it was critical to have support, guidance, and advocacy from our leadership. Our CEO Marc Harrison joined Intermountain in 2016 and he added the new executive role of chief consumer officer, which was filled by Kevan Mabbutt, who came from the Walt Disney Company.

We benefitted from having expertise from outside the traditional healthcare industry as we thought about how we wanted to provide an extraordinary consumer experience. We started with the ideal state in mind, meaning what would the perfect experience look like regardless of resource constraints, technical limitations, and costs? Then we worked backward to develop what we considered the minimum viable product (MVP).

Can you walk through what the consumer experience looked like before the DFD initiative, and what it will look like within the MVP? 

Jared Antczak: Intermountain started with a fairly sophisticated digital presence for our patients and consumers. We had mobile apps and websites, and they all provided a robust set of features and functionalities. The problem was that they were all developed independently of each other—many required different logins and all of them had a different user experience and design construct. What we did with the DFD was tie all these assets, features, and functionalities together into an intuitive and seamless digital experience that allows the consumer to navigate through their care journey much more easily than before.

We engaged consumers directly through usability testing, consumer surveys, and interviews to really understand what it could and should look like. What we ultimately ended up with was a new platform that uses one set of credentials to authenticate. It’s not just a collection of features; it’s a consumer journey where one action naturally flows into the next. For example, if you wanted to engage with a telehealth visit, you could do so with the same set of credentials you use to see your past clinic notes and lab results, or to pay your bill. All of that is tied neatly together on the back end, and from the end-user standpoint it feels like a single user experience and application.

How are you rolling this initiative out?

Jared Antczak: It was quite an undertaking, so we broke the work up into several phases that matched different aspects of the consumer journey, from finding care to managing care to paying for care. At our peak, we had over 150 full-time employees working on the product, with another 100 part-time cross-functional stakeholders from across the organization engaged in the initiative. We’ve developed and deployed our MVP into four pilot clinics with roughly 1,500 patient users. We are now preparing for a broad launch across our enterprise.

How involved has the telehealth team at Intermountain been in the DFD initiative?

Jared Antczak: The telehealth team has been critically involved to ensure the integration of our telehealth product into the DFD is seamless, performant and functional within this new platform. The goal is for this to be as good as, if not better than, the standalone telehealth application that previously existed.

Can you talk about the Digital Front Door initiative from a technology integration perspective?

Bryan Wang: We focused on how to integrate the consumer telehealth experience for Amwell into our unified DFD patient front-end experience. For the front end, we leveraged Amwell’s software development kit (SDK) to fully integrate all patient interactions into the DFD within both web and mobile. It’s important to understand that the experience is not simply a web view of the white label application; it’s fully customized and consistent with the rest of the DFD workflow. We worked closely and extensively with Amwell’s SDK team to make this a reality.

On the back end there are two parts to the integration.  First, how do we communicate intake and video feedback information back and forth between the DFD app and Amwell servers. This is generally taken care of by the SDK. Secondly, with the DFD we are introducing an additional identity source. In order to resolve the differences between DFD, Amwell, and Cerner and make sure these three sources are synced, we leverage some cutting-edge interoperability principles. For example, we leverage a lot of FHIR APIs to pull information from Cerner and communicate that with DFD. Then between DFD and Amwell, we leverage Amwell’s patient identity API. The final lever is Amwell back to Cerner, which uses our existing integration of the HL7 interface.

If you could share some top best practices with other health systems looking at these types of integrations, what would they be?

Tim Lovell: It’s important to design around the end-user experience. For the patient, ask yourself how this will affect their access to care, and for the provider how will it improve their efficiency? You also want to involve the right teams early on. The level of commitment required to coordinate this is not simple. The multiple layers of connectivity and integration need to be considered and thought through. Lastly, pivoting around roadblocks is critical and it’s a huge change effort. We encourage a lot of flexibility among team members thinking about things in different ways.

Check back next week for part two of the interview discussing Intermountain’s EMR telehealth integrations to improve the provider experience.

The current backdrop of COVID-19 testing

Although the Centers for Disease Control and Prevention has issued guidance for COVID-19 testing, testing protocols and priorities have been left to the discretion of state and local health departments and/or individual clinicians, leading to wide variations across locations and healthcare facilities.

As an example, some testing requires a doctor’s note or order, whereas testing sponsored by a public health department usually does not. A shortage of lab capacity and test kits, limitations on who can perform swab tests, and the inconsistent availability of drive-through testing are all adding to the uncertainty.

AMG’s role in testing

Our clinical protocols address which patients may be best served by COVID-19 testing. This is not a large group; most patients with COVID-19-like illness who do not have significant respiratory distress can be safely kept isolated in the home without the need for testing.

In some cases, however, testing may be reasonable for patients with mild-to-moderate symptoms who have complicating factors, including those who are immunosuppressed or chronically ill, are over the age of 60, or who have vulnerable family members at home.

If a patient with likely COVID-19 would benefit from testing, AMG providers offer a generic printable order and information on how to interpret the Yes/No results. This order is offered as a courtesy, with some important caveats:

1. Testing may not be available in the patient’s area.
2. The order may not always be accepted by the testing center (e.g., some centers require a doctor’s signature).
3. AMG does not expect to receive results as we usually do with routine lab testing.

In addition, AMG providers remind patients that the test is only to confirm our suspected diagnosis of COVID-19, and to aid with decisions about Isolation or in-person care should they become necessary. Keep in mind that these tests are not perfect, and that in some cases results may take as long as two weeks. Finally, the provider suggests that the patient contact their primary care physician or local health department or schedule a follow-up telehealth visit if they have additional questions.

At a time when many patients are anxious about COVID-19 and confused about how best to use telehealth and how to get tested, it’s important that we be clear in setting proper expectations and educating patients about what can and cannot be accomplished via telehealth. Thank you as we work together to help manage and combat COVID-19.

Peter Antall, MD is the Chief Medical Officer of Amwell.

To ensure patient safety and a good patient experience, we would like to set clear expectations with the public about when telehealth is and is not appropriate, and we are asking our clients to do the same.

Here are the most important points to be aware of:

1.Telehealth is not an emergency service

Patients with a medical emergency, including those with severe COVID-19 symptoms, should call 911 or seek care at their nearest emergency room immediately. (See more info on COVID-19 symptoms and risk categories below.)

2. Telehealth providers can evaluate patients with milder COVID-like Illness

Our clinicians are prepared to evaluate and recommend care for patients with COVID-like Illness and to triage higher-acuity patients to in-person care settings. However, our clinicians cannot treat severe COVID-19 symptoms or test patients remotely.

3. Telehealth providers can help with routine urgent care

Using telehealth for health conditions and concerns unrelated to COVID-19 can help reduce the number of people travelling to and from physical care facilities. Our clinicians support prescription renewals, chronic conditions like diabetes and asthma, behavioral health consultations, treatment for rashes and minor injuries, and other routine urgent care.

4. Wait times are much longer than usual

Wait times for telehealth urgent care visits have averaged 48 minutes over the past 7 days and can be even longer in high-demand locations and during peak times. Patients who enter the waiting room seeking urgent care should select “See First Available Doctor” to minimize wait time.

COVID-19 Telehealth Assessment

Amwell Medical Group (AMG) providers assess patients using the following COVID-19 risk categories:

Peter Antall, MD is the Chief Medical Officer of Amwell.

As an entrepreneur, former CEO, president, and venture partner, I have been in many discussions where we have a cursory discussion about if a particular company can meet unforeseen circumstances and scale up quickly.

The COVID-19 pandemic has brought this to the forefront in a way never before seen.  After seeing our volume swell as much as 10x from levels just a month ago – I have a new appreciation about why scale is so important.  When your customers need you to perform – will you be ready?  Will you deliver excellence and build long-term loyalty, or will you fail to deliver in the moment when you are needed most?  Are you prepared for a tsunami of scale?

Early on in one of my startup companies, we had an amazing opportunity.  A leading player in the market chose us as their technology vendor.  This brought legitimacy for our brand, significant revenue, and excitement across the team.  Unfortunately, when we hit “go-live” we quickly learned what our limitations were.  Our servers were not ready for the load, our customer support teams weren’t prepared for the surge in new complaints, and our leadership team learned the hard way that our platform simply wasn’t ready.  The next few months were consumed with around-the-clock efforts to fix a number of issues and ultimately, we lost the customer.  Even worse, we wasted precious time that could have been dedicated to advancing other priorities.

As I watch this pandemic unfold – I see a new set of criteria that I will use when discussing scale with future portfolio companies.  Thinking about the implications of the COVID-19 pandemic on a telehealth company and the lessons that any startup can use, here are some of the questions to consider when trying to answer the question of “will it scale”:

Volume: Are you ready for volume to go up 5x or more – not just over 6-12 months as you grow fast or have a successful marketing campaign – but what if that happens in days or weeks?

Supply Chains: If you produce physical products – is your supply chain insulated from critical shocks that disrupt labor overseas factories, slow down shipment times, or potentially furlough dockworkers en masse? Are your third-party logistics partners going to be disrupted with local regulations or work stoppages? What if all of this happens while demand for your products doubles or triples overnight – could you meet that demand?

Software Architecture: Are you ready for a 5x increase in traffic?  How quickly can you meet that demand? Are your licensing partners ready to add licenses as you hit peak volume?  Will that take minutes or days? Will you have access to your data centers?  If there is a run on servers and a shortage of parts – where will you get them? Do you have elastic scaling built into your data plans or automatic mechanisms to increase your capacity in the middle of the night? Think about every part of your backend – you may be able to increase server capacity for web traffic – but what about neglected microservices or features that don’t normally have as much demand such as reporting tools, provisioning servers, or administration portals – what happens if they are suddenly flooded with data?  Have you balanced these processes and optimized computing load so that unanticipated demand in one microservice doesn’t overwhelm another?

People: Can you hire implementation, customer support, or sales resources fast enough?  If you provide specialized services – can you find qualified people in weeks or even days? Have you simulated what happens when thousands of new users suddenly come on your platform – who will train them, set up their passwords, provision their accounts?  What self-service tools do you have? Will they all call customer support?  What if they are all working from home and their kids are using YouTube and their internet is slow? How will you diagnose the issues? Who will fix it?

Regulations & the Market:  What about legal review, contract processing, credentialing? What happens if your business is built around an obscure law that prevents others from having access to your market and then overnight that law is lifted or suspended? How will you deal with new competitors? What about your pricing models?  Your marketing outreach? PR campaigns? How will you quickly grab market attention if there is an opportunity?

Financing: Do you have ample cash to survive if funding markets dry up quickly?  Do you have resources to make strategic moves and acquire competitors or react to new market entrants?  Can you modify or spin up new products as the market quickly demands them?

The COVID-19 pandemic is a case study in ALL of these things happening at once.  If companies are not ready – that once-in-a-lifetime event a company is hoping for, is also one that could, unfortunately, weaken or destroy them.  However, if you are ready, market shocks and unusual events can present an amazing opportunity for technology partners to show their value, have a dramatic impact on outcomes and build lifetime partnerships and loyalty.  Market shocks and demand for scale pick winners and losers – which one will you be?

At Amwell, we’ve been impressed by the commitment our clients and partners have shown in taking care of their frontline clinicians while providing the highest level of care to an increased number of patients. We’ve been truly moved by the collaboration and tireless efforts that have taken place. We’ve also been humbled by longer-than-usual wait times that have increased with demand. We’re working to reduce these times by onboarding new clinicians at rates we’ve never seen before and by making enhancements to our platform to handle the surge — with more work still to be done.

As we continue our efforts, it’s also important that individual patients understand the role they too can play in this pandemic. For instance, considering the shortage of COVID-19 tests, patients can educate themselves about when they really need to get tested and, as medical visits soar both in-person and online, when they should consult a doctor.

Here are some commonly asked questions and advice for patients looking to take a proactive approach to their health, and the health of their family and community, during COVID-19.

Who should be tested for the virus?

People who have symptoms of COVID-19 AND who have been in close contact with someone with COVID-19, or who live in a community where there is active spread of COVID-19, should contact a healthcare professional to discuss whether testing is appropriate for them. The provider will decide whether a patient should be tested but remember: There is no treatment for COVID-19 and people who are mildly ill may be able to isolate and care for themselves at home.

Healthcare workers, the elderly, and those with underlying chronic conditions are at greater risk for significant illness from COVID-19 and may be more likely to get tested. People who are seriously ill, who are having difficulty breathing, or who have persistent chest pressure or pain should seek emergency medical attention.

How do I know if I should see a doctor via telehealth and whether or not that appointment can wait?

Patients should seek medical care through telehealth for COVID-19-related concerns if they have a persistent fever and cough, and don’t feel well but are not having trouble breathing. Patients who are healthcare workers, have an underlying heart/ lung condition or a weak immune system, should log on to see a doctor right away if they are encountering these symptoms. Patients with the aforementioned symptoms but who do not work in health care, do not have underlying conditions or a weak immune system should still seek medical care within the next few days, but it doesn’t have to be sought immediately.

How do I know if I should go to the emergency room versus wait to see a doctor online?

Patients who are having difficulty breathing, fever with severe cough, profound exhaustion or any medical emergency should seek emergency care immediately by calling 911 or visiting the nearest emergency room.

What can I do at home if I or someone in my household has been confirmed with or suspected of having COVID-19?

Should someone in your household be infected or suspect infection, the following measures will help protect yourself and others:

• Keep the sick person away from others. The sick person should stay in a separate room and use a separate bathroom if possible. They should also eat in their own room.
• Use face masks. The sick person should wear a face mask when they are in the same room as other people. If you are caring for the sick person, you can also protect yourself by wearing a face mask when you are in the room. This is especially important if the sick person cannot wear a mask.Remember that experts do NOT recommend wearing a face mask if you are not sick and not caring for someone who is.
• Wash hands. Wash your hands with soap and water often and for at least 20 seconds.
• Clean often. Here are some specific things that can help:
  • Wear disposable gloves when you clean. It’s also a good idea to wear gloves when you have to touch the sick person’s laundry, dishes, utensils, or trash.
  • Regularly clean things that are touched a lot. This includes counters, bedside tables, doorknobs, computers, phones, and bathroom surfaces.
  • Clean things in your home with soap and water, but also use disinfectants on appropriate surfaces. Some cleaning products work well to kill bacteria, but not viruses, so it’s important to check labels. The United States Environmental Protection Agency (EPA) has provided a list of products for use against COVID-19.

If I haven’t been tested for COVID-19 but have self-isolated/home quarantined based on symptoms and medical advice, how do I know when I can discontinue isolation?

Before someone can come out of self-isolation, at least seven days must have passed since symptoms first appeared AND at least three days (72 hours) must have passed without symptoms. Recovery from symptoms typically include resolution of fever without the use of fever-reducing medication such as acetaminophen (Tylenol), for example, and improvement in respiratory symptoms such as cough and/or shortness of breath.

American Well is welcoming the new decade with a renewed commitment to our Vision, Mission, Purpose and Values.  As part of this, we are rebranding our company and changing our name. Today, we evolve from American Well to simply, Amwell.

From the beginning of our journey, our Vision has been that digital care delivery will transform healthcare.

And, it’s happening.

Since our founding, we have built the infrastructure to mobilize clinical skill. With our growing roster of health system, health plan and innovator clients and partners, we’ve proven the model of scaling the availability of our country’s best doctors, bringing them and high-quality care to where it’s needed.

It’s through collaborative work that telehealth is increasingly recognized as core to care delivery and continues to evolve. No longer is telehealth merely a virtual urgent care service. Across our ecosystem and platform, Amwell, digital care delivery is fundamental to and enabling longitudinal care anywhere.

The evolution of telehealth and the transformation of healthcare continues. As drivers of it, we too, enthusiastically evolve to ensure we are steadfast in leading the industry to empower doctors and care teams to provide their services across the full care spectrum.

Along with our Vision, our evolution and actions are driven by our Purpose, Mission, and Values.  Our name change reinforces this:

So, Why Amwell?

“Amwell” reflects who we are in a simpler way and demonstrates our connectedness to our clients, partners, products, employees, and patients.  The heart check symbolizes the delivery of high-quality care through technology and a commitment to serve our colleagues, ecosystem and our communities.  Our name and logo reflect our friendly, approachable, clean, human and modern personality.

Today we unveil our new brand.

We are transforming care delivery.

We are Amwell.

This starts with protecting our health care workers who are on the front lines of this disease. To date, much of the conversation has focused on how the American people can and should prepare. However, should COVID-19 spread at the rate and to the degree that many are expecting, we must ensure that our care teams are as ready as possible to help not only fight the outbreak but keep themselves safe.

The Centers for Disease Control and Prevention (CDC) is already beginning to arm healthcare providers, schools and employers on proper infection control strategies. The new buzzword is “social distancing,” which essentially means staying away from crowds. What better way to do so than to get your healthcare from home?

Telehealth can be an important first line of defense when it comes to protecting possible patients, the public at large and the care teams. As I wrote in a Fierce Healthcare article, here are some of the ways hospitals and health systems can and should use telehealth to aid in the fight against COVID-19.

ED diversion

As the spread of COVID-19 continues, health systems can expect to see a surge of patients into their already resource-constrained hospitals. Further, large numbers of patients with respiratory symptoms showing up in emergency departments will overwhelm our infection control measures.

Using telehealth, virtual care teams can screen patients, assign risk, answer questions and recommend the next steps a patient should take. This capability already has been used during influenza outbreaks and has the potential to greatly minimize the demands and risks at in-person care centers, reducing unnecessary infection risk, costs and burden to patients and care teams alike.

In-home monitoring

Already today, the health departments are responsible for monitoring patients under investigation and those with confirmed disease both in the home and in inpatient environments. These workers must go to great lengths to protect themselves when assessing these patients and still must accept risk of contracting the disease.

Telehealth can be utilized through standard consumer devices in the home or cart-based endpoints in the hospital to allow these providers to assess patients without the risk of contracting the disease.

Maximize resources

Across the U.S., we have concentrations of clinical supply: healthcare excellence, expertise, and readily available resources, while at the same time we have areas that are relative care deserts.

Utilizing telehealth can effectively load-balance clinical availability with demand for those clinical resources regardless of geographic constraints or mobility restrictions and enable quality and convenient care at scale. Providers can be projected to rural regions, long-term care facilities and specialists can be projected into critical access or rural hospitals to extend care

Limit clinical exposure to infected patients

As an increasing number of patients become infected with the disease and are hospitalized, the ability for telehealth to allow providers to “see” patients without being in the same room as they cannot be overlooked. Hospitals can use telemedicine carts, for example, to bring a provider into the hospital room of a patient virtually and allow them to examine a patient while keeping that doctor or nurse a safe distance away from the infection. This is especially important during disease outbreaks when patients are to be isolated or quarantined.

Engage patients

Even the best telehealth programs will fall short in value if patients aren’t using the virtual services. It’s not enough for hospitals to simply offer a telehealth service, especially during times of surge and demand.

Instead, they need to inform patients about when and how to use telehealth should they be concerned about COVID-19 and communicate the value to getting seen by a doctor—even their own doctor, who they already know and trust—from the comfort of their home for the benefit of themselves and others.

Above all, coordination across providers, care teams, hospitals, health systems, and government agencies like the CDC is critical. We must create open lines of communication between all of those on the front lines of the epidemic, enabling stepwise care and referrals that minimize the risk of spread.

We must help each other, inform one another, follow the guidelines created by the experts and pool resources as necessary (using telehealth to assist with managing clinical resources).

We must also continue not to panic but rather get and stay prepared. The latest CDC guidance for hospital preparedness emphasizes the importance of training and equipping staff so that they are capable of dealing with COVID-19 patients.

As hospital and health systems work to ensure these guidelines are enacted and followed, they should also consider ensuring staff are trained and well-equipped to leverage telehealth to fight against the virus and limit the spread of the disease.

While many care organizations realize the value of telehealth, and the critical role devices play, what is required to build and successfully launch a virtual care program is often underestimated. Frequently industry experts and IT teams will question whether a build or buy approach to telemedicine devices and carts is right for them. If the sheer number of parts required to build a telemedicine cart doesn’t deter you, consider the fact that there are many nuances to telehealth that may not be familiar to IT departments, especially when starting out. Partnering with a telehealth company who lives and breathes virtual care and can provide a head to toe purpose-built device for telehealth is a much better way to go. This type of partner can provide carts that will enable a reliable and consistent experience to ensure simple care delivery.

Here are a few key qualities to prioritize when choosing a telehealth cart:

Ease of Use:

Embarking on your digital transformation journey and launching a telehealth program can be challenging enough, so when selecting technology, it’s important that it’s simple and intuitive. The easier it is to use the easier local site and clinical adoption will be. Additionally, having an on-site device training will help your clinical team be able to use the carts on day-one.

Purpose-built:

Most carts are not purpose-built for telemedicine. To qualify as such, carts should enable pre-configurations, provide seamless over-the-air software updates, and a stable video environment at a minimum. A single click-to-start visit and image integration are also important for improving the provider telehealth experience. Another critical consideration is the operating system running on the device. Using an OS that is designed and maintained for use in telehealth can make all the difference.

Security:

FDA registration is a must for all carts. This may seem like a basic requirement but it’s important to look for carts and peripherals that are all FDA certified to give you and your patients peace-of-mind that the cart will work as it’s intended and alleviate any liability concerns.

Reliability:

Telemedicine carts are meant to enhance the abilities of physicians, but if the technology is unreliable the relationship between the provider and the patient can be broken and there can be negative brand impacts. Reliable fleet management that’s embedded into the carts, coupled with a fleet dashboard will help your teams monitor and manage system controls, as well as, proactively address issues before they become problems.

Support:

Having an easily accessible and centralized support team will help ensure success. You and your staff should be able to turn to one place with questions or issues that arise, so make sure to choose a telehealth partner with a strong customer service team who can be with you every step of the way.

Many of our clients have achieved great success by relying on our expertly built telehealth carts. Take for example the work of NewYork-Presbyterian Hospital. As part of its digital health strategy, the hospital built two ED triage programs using our carts – one for low acuity patients and another for more complex cases. The Express Care Program is meant to expedite the treatment of low-acuity patients within the emergency room. Patients determined to be lower acuity are directed to a private room equipped with an AmwellC750 cart where they are connected to a remote physician who can diagnose and treat them. Through this program, the hospital has reduced ED door-to-discharge time by 70 percent. For patients with more complex conditions, the Medical Screening Exam program streamlines care by connecting ED patients with remote physicians or physician assistants via the carts, who then provide a medical screening exam and order all the appropriate labs and tests. Patients undergo these tests before seeing on-site physicians, who will already have all the information needed to diagnose, treat and optimize discharge. This workflow has been instrumental in accelerating care in the ED and has decreased the door-to-evaluation time by 57%.

Another powerful example is UAB Medicine’s use of telehealth to improve care delivery for stroke. Alabama faces many obstacles when it comes to serving stroke patients, including a lack of vascular neurologists, the highest stroke mortality rate in the country and patients living in very rural areas who need to be transferred which further delays care. By utilizing our C250 and C210 carts, UAB Medicine was able to roll out a successful statewide telestroke network, driving down the average wait time for a stroke consult to only six minutes. Over 430 consults have been completed since inception and nearly 12 percent of visits have resulted in a decrease in the administration of tPA.

You too can achieve these results! To see how and learn more about our fleet of telemedicine devices and carts visit: https://business.amwell.com/telemedicine-equipment/carts/

As someone who has been treating patients virtually for more than eight years, I’ve seen firsthand how telehealth can offer patients a convenient option for quality care, which can be especially useful for people who are feeling like they just can’t get out of bed – a common sentiment of flu patients. With this year’s flu season expected to be severe, yet highly dynamic and unpredictable, it’s important to know as much as you can about the flu and your health care options. Here are some of my tips and information on how telehealth can help:

Know the Symptoms

Many people often ask, what’s the difference between a cold and the flu and how can I tell? The biggest difference is the onset. With a cold you may have symptoms that creep up on you – perhaps it starts with a runny nose or a sore throat. With the flu you typically feel healthy one minute and very sick the next. Flu patients will also have more severe symptoms than those with just a cold. When you have the flu, you can expect to be down for the count for at least a few days if not a week. Whereas, those with a cold can sometimes muster up the strength to get to work. These are some of the signs I look out for when diagnosing patients with the flu.

Get Treated Fast

The CDC recommends taking a retro-viral as the most effective course of treatment for the flu, however this medicine needs to be taken within 48 hours of initial symptoms. Therefore, it’s important to get in to see a doctor as soon as you start feeling sick. Oftentimes, especially during a busy flu season, getting an in-person appointment with your doctor on short notice is not possible. This is another reason why scheduling a virtual visit, for which the wait time is typically just a matter of minutes, is such a good option.

Why Go Virtual

Seeing a doctor virtually for the flu is more-or-less exactly like seeing a doctor in-person, only it’s much more convenient and can be better for you as well as other patients. In addition to enabling you to get treated quickly, telehealth allows you to stay home and rest while getting seen by a doctor. When you don’t feel well, oftentimes rest is a major component of what’s needed to feel better. The flu is also highly contagious, especially at the start when it’s most important to see a doctor. If you have the flu, seeing a doctor virtually helps prevent you from getting others sick while in a doctors’ waiting room. If you don’t have the flu, staying home minimizes your risk of exposure from others.

Prepare Today

I recommend preparing for the flu when you’re healthy. Now’s the time to go out to the pharmacy to get ibuprofen, tissues, hydrating liquids and all your flu supplies. Washing your hands frequently is another good method to prevent against the flu, however the best way to prepare is by getting a flu shot. And it’s not too late. It typically takes about two weeks from the time of the shot for your body to develop the antibodies needed to fight against the flu. That means, if you get a shot now, you’ll likely be protected by Christmas! While it’s yet to be determined exactly how effective this year’s flu shot will be, the shot is still the best way to prevent the flu and can also help minimize the severity of the illness should you get sick.

At the end of the day, know your options. For many patients, a telehealth visit is a covered benefit under your health plan and hundreds of hospitals and health systems offer patients the ability to see a doctor virtually using their platform. In addition to providing telehealth solutions to these health plans and health systems, we also have our Amwell app for patients to use. Visit www.amwell.com to learn more.

Telehealth has recently gained traction for its ability to transform pediatric care. In a recently released case study, Pediatric Associates, the largest privately-owned primary care pediatric practice in the country, reveals how it uses telehealth to care for its more than 500,000 patients, more than 55% of whom are covered under Managed Medicaid. Here’s a short summary of Pediatric Associates approach to pediatric telehealth

The Problem

Due to its shared risk savings with insurance companies, Pediatric Associates performed a claims data analysis and saw that many pediatric patients were utilizing the emergency department for low-acuity conditions that could be better treated either in a primary care office or through telehealth. In addition to high emergency room utilization, Pediatric Associates also saw high patient volumes within their own primary care offices. To free up in-office availability for patients who truly needed in-person care by directing those who didn’t to another location, Pediatric Associates hoped to create better same-day appointment availability.

The Solution

Pediatric Associates partnered with Amwell to transform its triage line and implement telehealth as a care option. Prior to partnering with Amwell, Pediatric Associates clinical phone agents followed a set of triage protocols to determine if the patient needed to go to the emergency room, have a same-day office visit, have a next available office visit within 12-18 hours, be treated via phone, or get home care advice. Since implementing video visits, triage line protocols have been reexamined and many same-day and next available appointment conditions are now treatable via telehealth.

The Results

Since integrating video telehealth into its triage line in 2017, Pediatric Associates has seen impressive growth in patient and provider adoption. Specifically, utilizing established pediatric triage protocols and adapting them for video visits, Pediatric Associates was able to utilize its triage line to drive down unnecessary in-person visits for both commercial and Managed Medicaid patients. Through an integration between Amwell’s technology and the Pediatric Associates EHR, Pediatric Associates providers maintain care coordination while caring for patients via telehealth. To date, Pediatric Associates has seen:

• 75 percent decrease in patient wait times due to telehealth
• More than 3,000 video visits per month
• Exceptional patient and provider satisfaction of telehealth

And the program continues to grow. In February 2019, Pediatric Associates expanded KidzDocNow beyond its triage line to help care for all pediatric patients in the state of Florida. Now, in addition to patients that belong to Pediatric Associates, providers can also see patients who need urgent care services but may not have access to their own pediatrician. In 2019 KidzDocNow was also made available 24/7 for nonstop access to care.

To learn more about Pediatrics Associates and the results they’ve achieved using telehealth read the case study here: https://business.amwell.com/resources/pediatric-associates-how-telehealth-triage-evolved-into-the-nations-largest-pediatric-telehealth-program/

At this year’s Client Forum, hosted in Boston, MA, Amwell recognized some of our trusted clients who have been extraordinary leaders throughout their telehealth journey.

Clinical Innovation

First in Clinical Innovation, we recognized achievements in clinical use cases, provider adoption and engagement and clinical workflows. It was only a few years ago that Children’s Health was working alongside the Texas State Medical Board to legalize telehealth in the state. In addition to its robust urgent care services and school-based care program, Children’s Health has use cases like young women’s blood disorders live on its telehealth platform.

Pediatric Associates was also recognized for their triage telehealth program to successfully divert patients away from unnecessary emergency department visits. Their commitment in getting providers on board has been outstanding and a huge part of the reason they were given this award.

And the final award in this category goes to a long-time partner of Amwell’s. Cleveland Clinic deserved the recognition of Clinical Innovation for integrating telehealth into over 80 departments across its health system. Cleveland Clinic is a pioneer in adding new providers to its telehealth system.

Engagement Excellence

Next up: Engagement Excellence. This award recognizes success in engaging consumers and patient populations. WEA Trust serves Wisconsin public employers, their staffs and families, and through innovative giveaways and incentivized marketing—WEA Trust enrolled thousands of members in telehealth in less than a year.

Baptist Health South Florida was honored for all of the spent time at community engagement events, helping employees to download the app and training providers across multiple specialties. Thanks to their dedication to spreading this message, they are growing at an impressive rate, constantly striving to rethink healthcare in favor of their consumers and their community.

Also for Engagement Excellence, OSF HealthCare has seen continued success with their direct-to-consumer offering, which can be attributed to the different communication channels they have developed.

Integration Leadership

The Integration Leadership award recognizes those who have successfully managed integrating telehealth and building alignment within organizations. BlueCross BlueShield of South Carolina has collaborated with local provider organizations to offer telehealth services to their patients. BlueCross BlueShield of South Carolina has been working alongside the South Carolina Telehealth Alliance, a statewide collaboration of organizations, to expand telehealth services across the state.

UPMC has been a true partner since the start of our relationship; always eager and willing to partner on strategic initiatives. UPMC works closely with our Product Development team on partner integrations, helping us deliver value to all our clients.

CorVel seamlessly integrated telehealth into its Workers Compensation program. Corvel has successfully conducted a high volume of worker’s comp visits and has recently integrated a behavioral health and clinical pain management program into its offerings to support individuals at risk for pain medication addition.

Telehealth Maverick

The Telehealth Maverick award recognizes the forward-thinking innovators who have paved the way. The Mississippi State and School Employees Health Plan was a true maverick when they decided to incorporate telehealth into the state budget. Four years ago, Mississippi began gathering claims data, and more recently, biometrics data, and they have made these data actionable, using them to promote and propel telehealth adoption.

Concentra is utilizing telehealth to see injured workers immediately at employer work sites. Their telehealth program has been instrumental in addressing common pain points for occupational health, including delivering care to workers in remote areas, and providing round-the-clock care to employers who run 24/7 businesses.

Medical University of South Carolina understood that telemedicine needed to be a central component of the healthcare access options for their patient population. Today, MUSC provides a range of telehealth services across 463 distinct telehealth sites and has been spearheading telehealth for more than 12 years.

Key Connector

Finally, the Key Connector award recognizes clients who have consistently made meaningful connections within the ecosystem. Avera Health has always been willing to share and collaborate with other Amwell partners.

Intermountain Healthcare has joined Amwell’s Exchange and embodies a true leader in connecting the dots between telehealth and outcomes and has delivered a thoughtful ROI study to provide the industry with benchmark data when evaluating the cost of treatment across venues.

NewYork-Presbyterian doesn’t think about telehealth as a silo-ed initiative, but rather as a way to help their organization optimize care delivery and patient experience. They’ve launched programs across a variety of care settings, including emergency departments, inpatient facilities, pharmacies, schools, urgent care sites, and skilled-nursing facilities. NewYork-Presbyterian’s continued drive to continuously innovative to connect physicians remotely makes them an easy choice for the Key Connector award.

Congratulations to all of our award recipients – it’s a great honor to partner with each and every one of our clients. We sincerely thank you for your commitment to excellence.

Clinical Innovation:

• Children’s Health
• Pediatric Associates
• Cleveland Clinic

Engagement Excellence:

• WEA Trust
• Baptist Health South Florida
• OSF Healthcare

Integration Leadership:

• BlueCross BlueShield of South Carolina
• UPMC
• CorVel

Telehealth Maverick:

• The Mississippi State and School Employees Health Plan
• Concentra
• Medical University of South Carolina

Key Connector:

• Avera Health
• Intermountain Healthcare
• NewYork-Presbyterian

Diabetics who have been properly instructed by their healthcare professionals know all the times of the day and activities around which they are supposed to do spot checks on their blood sugar levels. However, even if these levels are recorded, they provide only a thin cross section of the person’s daily life. Telehealth gives the possibility of all day monitoring so that a whole day profile can be created to improve overall care. Existing technology is already in use for this very purpose. This approach has already been proven particularly effective among urban minorities, a population that is chronically underserved and among whom diabetes rates are climbing.

Integrating telehealth into diabetes care, whether a lifelong patient or newly diagnosed, can ease the strictures of lifestyle modifications that are required. That is, a series of smaller actions can be taken over time rather than a few big ones all at once. Among younger groups, it becomes just one more item in their smart device technological arsenal. And, as noted, the software can be integrated into existing general devices as well as be used through specialized equipment, and both come from qualified telehealth providers that will be there to assist patients and healthcare professionals alike with their needs.

A healthcare professional might reasonably ask about how telehealth can help older patients with their diabetes self-care. The answer is the same as for younger patients. There is ample evidence, both from studies and anecdotes, that senior citizens dislike change or doing something for no good reason they can easily see. However, this is changing. Every year, more seniors are going online, using smart devices, and interacting with an expanding world of relatives, friends, and colleagues. The age cohort at or near retirement age today were entering adulthood just as Neil Armstrong took his “one small step,” so integrating technology into their daily lives now is not the “giant leap” it might have been for generations before them.

Young and old, urban and rural, everyone with diabetes can potentially benefit from integrating telehealth into their self care regimen. Doing so will lower costs, ease the burdens of care, and save lives.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The primary focus is on assisting people with chronic conditions that require frequent if not constant attention. Two-thirds of people currently in the program currently have multiple chronic conditions. In the general population, right now about half of the population has some sort of chronic condition and many have multiple conditions. As our population ages, more and more will enter the Medicare system and we, as a nation and as healthcare providers, need to be ready.

Because chronic conditions can last for months and often whole lifetimes, continuity of care is a necessity for improving patient health outcomes and life expectancy. Collectively, chronic conditions account for 75% of all physician visits, 80% of hospital admissions, and 90% of prescriptions in the US. As more and more of the population ages, and begins experiencing age-related chronic illnesses, these numbers will only increase.

Telehealth chronic care makes all of this simpler, less expensive, and helps avoid unnecessary hospitalizations through the continuity of care it makes possible. These capabilities can be combined with the Independence at Home (IAH) part of the CHRONIC Care Act to help keep senior citizens in their homes longer where they are more comfortable and have more control over their lives. This works because staying at home, where a person has their family and friends nearby for support, helps improve adherence to medication and therapy regimens, thus benefitting them in both health outcome and quality of life.

This has become possible because of the expansion to telehealth services that the CHRONIC Care Act includes. The unanimous passage in the Senate means that they are all on board with the possibilities for care that telehealth is making possible. The Veterans Administration alone is already projecting a savings of $1 billion over the next 10 years from their partial roll out of telehealth services. Larger scale implementation, according to a CBO report, is projected to save just as much over the next decade.

This is good news for patients, healthcare professionals, and telehealth providers alike. But action is still needed in the House. The best way that this can be accomplished is by talking to Congress directly on Telehealth Lobby Day. If you are unable to go in person, you can contact them through phone and online routes.

Telehealth works. And it will work better once more people have access to it. The CHRONIC Care Act will make that possible.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Rather than having to go over the entirety of a patient’s history with a new healthcare provider, telehealth can inform new doctors and nurses immediately, completely, and accurately on the health status and history of their patients. This is particularly true for those with chronic illnesses who live in rural areas where doctor and nurse turnover rates are highest.

Currently, chronic illnesses account for roughly 75% of all physician visits, 80% of all hospital admissions and 90% of all prescriptions. These numbers will only grow as 50% of all Americans are projected to suffer some form of chronic illness by 2025, ranging from COPD to HIV. These conditions are manageable in most cases, and continuity of care makes that process simpler while improving both life expectancy and quality.

Though telehealth is usually considered in terms of acute care, where its effectiveness is beyond dispute, it also has a role to play in long-term care for those with chronic illnesses. The continuity of care that telehealth initiatives make possible is a must in today’s world. Telehealth can improve the results of triage to determine if a new symptom is related to the underlying chronic illness or something entirely new as well as reduce costs of making that determination by as much as 30%. Further, greater support for the patient in monitoring their own health makes following a healthcare professional’s instructions much more likely.

Perhaps more importantly, in addition to supporting patients who already have chronic illnesses, telehealth continuity of care can help prevent their emergence in the first place. Putting together in one place all the information a patient’s various doctors have gives their primary healthcare professional a better way to gauge their overall health and see signs that might be missed. This has proven particularly true for older adults or those at risk for COPD and related illnesses. With the full view of a patient’s current health and medical history that telehealth makes possible, healthcare professionals can work with patients to take appropriate preventive actions before fully-fledged chronic illnesses are established.

At present, 45% of Americans, 133 million people, have some kind of chronic illness and that number is only expected to grow. Telehealth chronic care is a proven tool in both managing these illnesses and in helping to prevent them from developing in the first place. Adopting telehealth technologies now is the best tool to minimize negative patient health outcomes from chronic illnesses in the future.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Few, if any, still doubt the usefulness of telehealth. It provides both ease of access for patients needing health and the continuity of care that allows doctors to help ensure the best possible patient health outcomes. Telehealth also helps lower costs by avoiding unnecessary emergency department visits and reducing unexpected readmissions, among so many other things. That is, there are no reasons not to do it.

So how do you get started? At the risk of a truism, you just do it. There are dozens of quality smart device apps already available that meet FCC HIPAA standards for privacy. Younger patients are already using them and older groups are also increasingly comfortable with technology. If you want the full telehealth carts for use in your office, there are programs available to help pay for it and the FCC has proposed an expansion to make this step easier and less expensive. So, if you choose one route or both, there are plenty of inexpensive options already available.

Scaling up will involve a bit more in-depth work to do it right. What do your current patients’ need? What are their likely future needs? These and other important considerations must be taken into account when deciding on how to expand your current telehealth offerings. Fortunately, there is already a standard of interoperability and cybersecurity from the FDA. This means that all telehealth services and devices must be able to speak to one another and share information quickly and accurately over secure connections.

A hypothetical: You have a group of patients with mostly the same needs. So, you have purchased one telehealth cart with that in mind. Now, an older local practitioner has retired and you have taken on many of their patients, who have very different needs from your original group. A second telehealth setup for them may be necessary. If so, the two machines will be able to share information back and forth, or with apps on patients’ smart devices, as if they were one device. In many cases, though, this will not be needed. With a software update and perhaps a few new peripherals, some with price tags as little as $10, your original machine can now work for everyone. And, if needed, a small clinic’s telehealth devices can connect to those run by specialists or at full hospitals should emergency or other acute services be needed. So, while scaling up is already comparatively easy, it may not even be necessary. But finding out for sure will require some mental legwork.

Regarding launching telehealth services, your patients are probably already started in that direction. For scaling up, the process is mostly simple, relatively inexpensive, and requires only a bit of research. The only people who stand to lose out are those healthcare professionals who do nothing.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

In some ways the field is limited only by your ingenuity, but a few markets are ready made. The three biggest are schools, employers, and correctional facilities. These groups also have the benefit of being able to see the same patients for years in a row. And, if a telehealth professional sets up an agreement with a statewide agency, you can work with the same system over a much larger area, which helps states rein in costs in an era of budget cutting.

So, all three groups benefit:

• Healthcare professionals expand their reach.
• Three distinct population groups get access to medical care they otherwise would lack.
• States can save money.

For our examples, Texas is a solid benchmark state which already has the advantage of the second highest overall population in the country. Public school enrollment is approaching 5.5 million, or about 1 in 9 of the nation’s total. Access to pediatricians in person is a serious problem, so visiting a school nurse may be the only primary care the child sees, and they are already handling an unprecedented variety of new maladies in their students, so it makes sense to work with them to secure telehealth access for all those students. Telehealth has already been shown to work in this context for almost every situation. Of the three groups, school children represent the population most likely to be helped by telehealth. Further, the student’s records will follow them as they move up within the grades of a given district, or experience a lateral move to another, guaranteeing continuity of care even if the on-site nurse changes jobs. This is part of why looking at statewide agencies is so important.

Moving on to employers, almost all are required to include some sort of healthcare insurance as part of their benefits package to more than 11.5 million working age Texans. Such coverage typically applies to whole families, meaning that records could easily transfer from one healthcare professional to another if both school and employer have telehealth access. While such access obviously benefits the children, it also benefits the employer’s bottom line. This is why so many are already including telehealth options in their coverage. If you weigh the cost of adding telehealth coverage to an existing insurance policy against work lost and poor performance while at work due to illness, it more than balances out.

Prisoners comprise the third major group. There are the obvious logistical and security concerns of bringing a healthcare professional into the institutional setting and still others with taking a prisoner to the hospital. Many prisoners’ maladies stem from mental health problems, which may be a large part of the reason they are incarcerated. This group is also quite large. The Texas prison population is larger than the total population of the 30 smallest states. Here, integration of telehealth may be the simplest because the University of Texas Medical Branch, which oversees 80% of Texas prisoners, already uses telehealth. The health care network is already in place, you just have to join. And, as with the other two groups, telehealth lowers costs. Just in the area of telebehavioral health, each prison saves about $106,000 a year.

There are populations that need medical attention as much as any other. Some of them have special problems, like moving between schools or being incarcerated for years on end. Telehealth has already shown how their situation can improve and the infrastructure is often already in place.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

They are doing so for a number of reasons, including better relationships with their patients and improved patient health outcomes. This works because app users are more engaged in their day to day health needs with interaction via their smart devices. From a user perspective, patients are already accessing a wide array of health apps, from workout evaluations to cardiac monitors. Most of the more than 10,000 apps are generic and not strictly speaking scientific in nature, but there are available apps that doctors endorse for their patients with specific conditions. These are the ones that matter.

In many respects, doctors and patients are already engaging with one another via telehealth: Emails, phone calls, online lab results, and so on. The beauty of choosing an app is that it centralizes all that contact in one location and guarantees a continuity of records. That is, instead of trying to integrate patient information from a dozen different platforms into a coherent whole, a good app can do it for healthcare professionals all at once. Further, in big practices, telehealth apps will make sure that different practitioners working with the same patient will all be fully informed on what everyone is doing. Thus, it fosters the team environment that has been proven so critical to positive patient health outcomes. It is also important to make sure a practice offering telehealth options understands the needs of their patients and how they interact with modern health technologies. That is, it is just as important to know what a given healthcare professional wants to make available via telehealth as it is to ensure patients know what their options are. Choosing the right telehealth provider is integral to success.

And, perhaps best of all for those wary of change, there is no need to jump in head first as the telehealth integration process begins. In fact, a methodical, planned out phase-in strategy is highly recommended. This helps both healthcare professionals and their patients as they acclimate to the new systems and openings for care. Once a given stage has proven successful and telehealth becomes normalized, it can easily expand via modular offerings.

Overall, change toward telehealth is a good thing for health professionals and patients alike. Concerns will be addressed in the early stages of implementation, and it is through the staged rollout that practitioners can find the best way to help their patients.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Stroke, more formally called central nervous system infarction, results from loss of blood flow to the brain, whether from a blockage (ischemic) or from a blood vessel rupture (hemorrhagic). As can be easily imagined, time is a factor in treatment. With each moment wasted, the quality of life for the stroke survivor worsens and the likelihood of death from stroke increases. Ischemic diseases, which include stroke, are the leading casue of death worldwide and fourth in the US. Within the US, stroke mortality rates are highest in the rural South, where almost 80% of the population lives more than half an hour away from an emergency department with a neurologist available.

Through telehealth, once the process is started, a response can be had in as little as 3 minutes with a diagnostic accuracy as high as 96%. If triaged in an ambulance before reaching the emergency department, diagnosis and treatment can begin even sooner with the added benefit of cost savings of up to 70%. Part of that quick treatment is a “clot buster” drug known as tPA (tissue plasminogen activator). At present, only 3%-5% of stroke patients receive it because it is only effective if administered in the first 3 hours after stroke onset, and it is even more effective if done in the first hour. But this is impossible if an emergency department has neither an on-staff neurologist nor access to telehealth. Amid sweeping and continued cuts to rural health budgets, telehealth is quite possibly the only answer.

How do we know that telehealth works? Because in almost 75% of cases where telehealth was available for stroke patients, tPA was administered within its effective time window. Those patients who receive anti-clotting medications in the early minutes of their stroke showed a 250% better recovery at the 3-month mark than those who did not.

Even for the 80% of stroke patients who survive, behavioral, cognitive, and physical impairment can last for anywhere from weeks to a lifetime. With the quick administration of tPA that telehealth makes possible through its quick, accurate consultation services, those effects can be minimized or even eliminated. Meanwhile, it enables a massive drop in the estimated $1 billion per day the US expends in care for stroke victims and lost economic activity.

Whether taking a purely utilitarian view of dollars and cents, or a human view of moral sense, telehealth is the way to go in the future of stroke care.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

As the fifth most common cause of death and the leading cause of long-term adult disability in the world, strokes pose a widespread public health dilemma. And while many studies have proven the viability of using telehealth services to rapidly address patient needs, providing cohesive care between facilities is a critical component that needs to be addressed.

A recent study by Kaiser Permanente said, “Particularly in hospitals with limited local resources and/or limited access to neurologic expertise, telestroke is an important tool to aid in the evaluation and treatment of potential stroke. We specifically found that unwarranted hospital variability in stroke care could be eliminated through a standardized telestroke program.”

As telehealth’s stroke treatment use continues to grow, Avizia remains committed to ensuring physicians and executives are informed regarding current industry standards. That is why we are sharing the Recent Stroke Guidelines from the American Telemedicine Association (ATA) regarding stroke treatment. Overall, this document aims to provide a standardized approach to assessment, diagnosis, management and consultative support to patients exhibiting symptoms and signs that are consistent with acute stroke syndrome.

The new ATA guidelines also address the roles and responsibilities of the responding telehealth team and provide hospital executives with recommendations for seamlessly incorporating telestroke services into their model of care. Furthermore, the guide paper states agreed-upon roles for coordinating telehealth are important for support and buy-in of key stakeholders, like the hub/distant site physician director, the program manager, the emergency department stroke champion and other roles.

Beyond the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information for Economics and Critical Health Act (HITECH), ATA’s guidelines encourage facilities to address privacy and security needs for each of its patients. It also states the importance of providing this information to acute stroke patient families and educating patients about the role of telestroke platforms, including any translation services they may need.

The guidelines encourage facilities to also create an ongoing telemedicine budget, so they may stay on top of hardware and software upgrades and address payer reimbursements, grants, private contributions and other fiscal items as they arise.

Perhaps most importantly, telehealth providers also need to have a concrete process to monitor quality and outcome metrics. In addition to ongoing patient care, the document discusses protocols for research and clinical trials. The guidelines recommend research activities should compare telemedicine with in-person evaluations and should conform to local institutional review board approval practices.

As for telehealth devices themselves, the guidelines say facilities must provide real-time, two-way communications, optimized for bandwidth and monitored for general mobile device management – this includes oversight of apps, data configuration, and security. Devices must also have a passcode, biometric identification or other login protocols and should be configured for point-to-point and, ideally, multiparty connectivity. Organizations looking to use telestroke should consider creating data policy and procedures regarding storage, restrictions and how those are communicated to the referring or consulting site.

As telehealth evolves into a more mature healthcare solution, the industry needs a set of guidelines like the ones created by ATA to ensure cohesive care between facilities. We at Avizia are encouraged by these updated standards and the bright future they detail for the future of virtual care.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Politics aside, the Bipartisan Budget Act of 2018 (H.R. 1892) includes four significant provisions that will greatly improve the delivery and expansion of telehealth services in the United States:

50302 – Expanding Access to Home Dialysis Therapy

• This provision allows Medicare beneficiaries an option by which they may elect to receive in-home dialysis monthly as well as ESRD-related clinical assessments via telehealth services.

50323 – Increasing Convenience for Medicare Advantage Enrollees through Telehealth

• This provision states that, beginning in plan year 2020, a new medial assistant plan may be able to provide additional telehealth benefits to Medicare enrollees.

50324 – Providing Accountable Care Organizations the Ability to Expand the Use of Telehealth

• Accountable Care Organizations (ACOs) will now be able to waive restrictions on the use of telehealth from 1834(m) of the Social Security Act, which placed limits on how and under what conditions telehealth services could be used by beneficiaries.

50325 – Expanding the Use of Telehealth for Individuals with Stroke

• Further expanding the use of Telestroke services, this provision waives 1834(m) restrictions on the treatment of stroke through telehealth services.

While many may be feeling frustrated with our current political climate, it is at least somewhat heartening to know that the use of modern telehealth technology continues to improve and expand, allowing providers and physicians to speed care when it is needed most. For stroke victims, expedited treatment means better odds at survival and improved chances for high quality of life after.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

One of the most common childhood health concerns is asthma, with roughly 1-in-10 children experiencing it at some point in their lives.

The wheezing, the struggle for breath, the confusion, they’re all distressing for child and parent alike. But before treatment can begin, which can successfully handle almost all symptoms via preventative medicine in combination with immediate measures, there must be a diagnosis. Minority children and those in other underserved communities largely are not receiving treatment, though this is true to some extent for all groups. This inevitably leads to preventable visits to emergency departments.

The study by the University of Rochester has shown that, through a blend of in-person care from school nurses and telehealth access at home, have better health results. The important factor is whether the child takes their medicine with supervision from a trained healthcare professional. At schools, this is done in the presence of a nurse who can ensure inhalers and other medications are properly administered. At home, though, even with help from a parent or guardian, delivery may be less than best. Telehealth access at home bridges that gap. Over the course of the study, emergency department visits for asthma-related health concerns were reduced by more than half and generally had more symptom-free days. Better, the most common participant in the home aspect of the study were school nurses or the child’s existing primary care provider. This means that established relationships, which are important in fostering trust and medicine regimen compliance, are strengthened.

To be direct, with the simple addition of telehealth to existing school nursing practice, kids with asthma were healthier, in school more often, and experienced fewer problems.

More and more hospitals and clinics are already using telehealth in pediatric care, for asthma and everything else, to the point that it is becoming the new normal. Almost two-thirds of parents surveyed indicated not just that they are willing to use telehealth but actually eager to do so. Better, multiple states have already awarded massive grants for pediatric telehealth, especially in “healthcare deserts.” So, in addition to working, pediatric telehealth is increasingly affordable.

Parents, healthcare professionals, and school leaders alike need to be paying attention to telehealth. It’s not the wave of the future. It’s now.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Community health centers and the programs they offer are often the most frequent healthcare professional contact people have, in part because a majority of patients are below the poverty line. Supporting these centers has the backing of virtually all elements of the American political and social spectrum, left and right alike. Why? The details differ based on whom you ask, but they all boil down to one thing: Because they work.

These establishments benefit not just the communities they serve, but the greater good as well by spotting potential epidemics before they happen. For obvious reasons, this is far less expensive in the long run. It is not, however, so inexpensive that switching to electronic recordkeeping is an obvious choice when prioritizing care, despite the fact that such measures have been shown to improve patient health outcomes. As time goes on, though, the requirements to do so will become stricter. This is why action needs to be taken now in order to keep these centers open so they can continue to help the largest number of people possible with their healthcare needs. Supporting these centers is as much common sense as a policy question as it is a good neighbor question.

There is good news on the horizon, though. With the boost in their finances provided by wider access to health insurance via the Affordable Care Act, such centers are improving their financial position while emphasizing care for those who need it most. Collaborating with all the stakeholders in a community, as is the case in supporting community health centers, is part of belonging to the social body. It is precisely this mindset of social responsibility that informs the actions taken by healthcare professionals at these centers in the first place. So, with just a little help, these centers can break through the few remaining barriers to adopting telehealth capacities for their patients. Everyone benefits.

Community health clinics are the bulwark of the modern medical system. They are the centerpieces in our fight against diseases. And they are mostly succeeding. But they need a little help. Working with them to improve their telehealth access both improves patient outcomes and means continued access to state and federal funding programs. If you want to have a positive effect on the nation’s health, helping these folks is the best way to start.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

As the number of children in the United States with significant health challenges rises, so does the need to provide experienced nursing care within schools.

Avera eCARE School Health partners with K-12 school districts to provide registered nurse coverage for the entire school day – ensuring immediate response to the health care needs of every student.

Within seconds, 8-year-old Aiden Knutson is connected to an Avera eCare nurse – Aiden at school in Toronto, the nurse in Sioux Falls.

“That’s part of why we’re here buddy, is we want to help you learn how to manage your diabetes so that you can do all of this stuff on your own someday,” said an Avera eCare nurse.

Like most rural school districts, there isn’t an onsite nurse at Deubrook Elementary in the small town of Toronto. So when Aiden was diagnosed with diabetes in June of 2017, his grandmother Carie Knuston worried about Aiden going back to school.

“I was like, are they going to be able to handle this and is it going to disrupt his class time and his activity level with the other kids,” said Knuston.

Deubrook Elementary principal Mitch Reid knew a higher level of care was imperative for Aiden. He says Avera eCARE made the most sense.

“It definitely gives us that sense of relief. With something that’s so serious as diabetes, having someone trained is huge for us and huge for him. And now he’s not always focused on what he needs and what he’s getting. He’ll let the nurse take care of that and he can focus on his education,” said Reid.

The Avera eCARE nurse provides great comfort for Aiden’s grandma.

“Having that eCARE service and knowing that somebody is available at any point in time, because right now we’re still in the state of learning ourselves. His blood sugar goes up and down. So having them available to answer questions or make suggestions or say you need to call the doctor because of this or that has been really nice,” said Knuston.

“For districts out there that are looking for that person, that expert for medical reasons, it really takes a lot of pressure off us,” said Reid.

“They help me get my shot and they tell me how much I need sometimes,” said Aiden.

“That was my main concern, one of the concerns too, is he not going to be able to do anything when he has diabetes and it’s just the opposite. You do everything you can to possibly make it available so that he can still be a kid,” said Knuston.

Not only does Deubrook Elementary utilize the Avera eCARE nurse for Aiden, but they also use it for everything from bumps and bruises to fevers.

View the original article and video from KSFY here. 

Net neutrality has been an underlying assumption of how online traffic would flow from its very inception as a civilian infrastructure resource. How do we know this? Sir Tim Berners-Lee, the grandfather of the internet, told us so. The idea is that an ISP has to carry traffic, called packets, regardless of the source, destination, or content. Without neutrality, they can “read” the information sent and slow it down or prevent delivery entirely. We know this because they have all done so at least once in the past.

Before the implementation of neutrality laws in 2015, there was a legal gray area and several firms tried breaching neutrality. Their efforts were quickly shut down. The reasons these companies cited were because they wanted to sell special streaming packages for video, the content was political in nature, and they wanted to quash innovative competition. In Canada, a similar effort had a telecommunications company blocking the site of a union then in a dispute with it. So, net neutrality repeal is great if you have no qualms about your ISP telling you what you can read or view and how quickly. But if you want access to a wide array of news on science, politics, arts, and other things that might be seen as contrary to your ISP’s interest, and especially their political connections, the repeal should have your hackles raised.

For telehealth specifically, the major concern is the ability to stream large amounts of real-time information from one user to another. In healthcare, especially emergencies, seconds matter. Repeal is almost certain to make telehealth use much more expensive for everyone. Mike Baird, Avizia CEO, has said, “For example, if internet service providers begin to prioritize certain types of traffic or demand higher fees for priority routing of things like a video consultation – this will add costs to the delivery of telemedicine – particularly hospitals in rural areas. Ultimately these costs get passed on to patients and will hamper the adoption of technologies like telehealth.” This is optimistic. ISPs have done exactly that before 2015 and did it again this year in anticipation of repeal. Repeal will raise costs to telehealth users, meaning fewer people have access to healthcare, meaning more people will die who could have been saved. This is just one of many Trump Administration changes that guarantee more people who are not among the ultra-wealthy like he is will die for no other reason than because they are poor by his standards.

But there is still hope. Congress has the power to tell the FCC to reinstate neutrality. ISPs have made contributions to 265 sitting members in both Houses of Congress and the FCC ignored the 83% of Americans who opposed repeal. Contact your Representatives and Senators and tell them to reinstate net neutrality.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

As with almost everything else online, this starts with Google. More than 75% of people who go online for health information start there or another of the big search engine sites. This means working out search engine optimization (SEO) strategies for what you do. There are plenty of websites out there that offer advice on how to do this on your own, but frankly the smart money is on hiring a professional. SEO techniques can be tricky and counterintuitive and may be outside your experience. So, hire a pro and get back to being an awesome doctor or nurse. Many telehealth providers will already have them on.

In person communication with your patients is a different story. You will always be your own best salesperson and face-to-face communication is still the strongest way to convey not just the information itself but also its importance. Among older patients, this remains a central point. They want to talk to someone. That said, today’s retirees watched Neil Armstrong land on the moon so they know the power of technology and are adopting it in droves.

Younger patients are already online for health and everything else. There is even some evidence that they may prefer mediated communication over face-to-face interaction. But they still have to talk to a person. A good bit of work has already been done in wearable and other smart devices that can track the health of a patient, or alert a healthcare professional if an emergency crops up. But it is unlikely artificial intelligence will replace humanity in this field in the foreseeable future. So, young, old, or in between, you will still have to talk to your patients.

Whatever the audience or the medium, talking to your patients openly and honestly is still your best bet.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Few, if any, still doubt the usefulness of telehealth. It provides both ease of access for patients needing health and the continuity of care that allows doctors to help ensure the best possible patient health outcomes. Telehealth also helps lower costs by avoiding unnecessary emergency department visits and reducing unexpected readmissions, among so many other things. That is, there are no reasons not to do it.

Getting Started with Telehealth

So how do you get started? At the risk of a truism, you just do it. There are dozens of quality smart device apps already available that meet FCC HIPAA standards for privacy. Younger patients are already using them and older groups are also increasingly comfortable with technology. If you want the full telehealth carts for use in your office, there are programs available to help pay for it and the FCC has proposed an expansion to make this step easier and less expensive. So, if you choose one route or both, there are plenty of inexpensive options already available.

Expanding Your Telehealth Program

Scaling up will involve a bit more in-depth work to do it right. What do your current patients’ need? What are their likely future needs? These and other important considerations must be taken into account when deciding on how to expand your current telehealth offerings. Fortunately, there is already a standard of interoperability and cybersecurity from the FDA. This means that all telehealth services and devices must be able to speak to one another and share information quickly and accurately over secure connections.

A hypothetical: You have a group of patients with mostly the same needs. So, you have purchased one telehealth cart with that in mind. Now, an older local practitioner has retired and you have taken on many of their patients, who have very different needs from your original group. A second telehealth setup for them may be necessary. If so, the two machines will be able to share information back and forth, or with apps on patients’ smart devices, as if they were one device. In many cases, though, this will not be needed. With a software update and perhaps a few new peripherals, some with price tags as little as $10, your original machine can now work for everyone. And, if needed, a small clinic’s telehealth devices can connect to those run by specialists or at full hospitals should emergency or other acute services be needed. So, while scaling up is already comparatively easy, it may not even be necessary. But finding out for sure will require some mental legwork.

Regarding launching telehealth services, your patients are probably already started in that direction. For scaling up, the process is mostly simple, relatively inexpensive, and requires only a bit of research. The only people who stand to lose out are those healthcare professionals who do nothing.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Whatever the medium used, provider-patient communication is a critical factor. This is even truer today in telehealth settings where people are still getting accustomed to a new way of speaking to and interacting with their healthcare professionals. Patient satisfaction surveys since 1990 all indicate that the effectiveness of communication is a critical component to how a patient views their care, no matter the result in purely physical terms. These surveys are frequently cited in efforts to improve care, whether at a small clinic or the largest hospital. Incorporating their findings regarding telehealth communications is a necessity as offerings and opportunities to use it expand. Thus, webside manner matters.

The basics of how to have a positive webside manner are similar to the best practices for bedside manner. The critical difference is in making sure to understand non-verbal communication as expressed via video links. This takes practice, as with any skill, but it can be mastered with effort. A major point in this type of interaction is that with telehealth, there may not be anything analogous to the “doorknob moment” where a patient makes a comment or asks a question just as the provider is leaving the room. Closing a telehealth connection, without preparation by the healthcare professional, has the same finality of hanging up a phone or turning off a television. But it does not have to be that way.

There are known, tested, and successful strategies for getting this sort of last minute question or comment from a patient before ending a telehealth consultation. With so many years of telehealth in the field, a consensus has even been reached on how best to do it. If done well, these techniques can even improve the rate of “doorknob moments” among patients who would otherwise let their health practitioners just walk out the door or close the connection, saying nothing at all. With the quasi-return to the house call that telehealth makes possible, people have been shown to be more communicative and generally willing to talk to their healthcare providers as fellow human beings invited into their homes rather than as strangers in an unaccustomed setting.

The long and the short of it is that what patients think about their healthcare matters. Being able to talk to patients in an open, honest manner is an absolute necessity, no matter if the consultation is face-to-face or online. Paying attention to webside manner with as much diligence as bedside manner is the key to it. Telehealth provides the tools. You have to make it work.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Expanded Telemedicine Access to PA and NP Clinics

In fact, the FCC has been explicit in including expanded broadband access to facilitate telehealth capabilities among RHP participants. These now include healthcare facilities run by nurse practitioners and physicians assistants, by far the most common sort encountered in rural areas. And, in 40 states, these healthcare professionals can write prescriptions with the same authority as a doctor. And yet they are not equipped for everything that they may encounter, whether from lack of training or equipment or sheer numbers. Regardless of the initials after a person’s name, America at large is experiencing a healthcare professional shortage across the board.

With the proposed funding expansion, and the stated intent of the FCC to include broadband access in that amount, telehealth options are on the table for the more than 5,500 hospitals and nursing homes served by the RHP. We do not yet have an accurate count on the number of physician assistant and nurse practitioner clinics covered by the RHP because their addition is so new, but the USDA estimates they are the primary healthcare professionals for 17% of the American population. The FCC move is intended to help provide medical care to the almost one-in-five Americans in that group and they intend to do it with telehealth, and the plan includes provisions for the PAs and NPs that serve rural populations in addition to bigger hospitals and nursing homes. The expansion program, by paying for the infrastructure of and access to broadband, makes these new technologies a viable option. But, as you may have expected, there is more.

Funding for Telehealth Equipment

The FCC proposal explicitly includes telehealth machinery, both for clinical use and for monitoring patients when at home. Starting the adoption process now, gathering the needed information for what a given care center and its patients need, is the best way to get ahead of the game once the expansion happens.

Then, depending on the precise plan that is adopted, telehealth equipment will either be paid for directly by the FCC or the care center will be reimbursed. At minimum, looking at the options is due diligence for taking care of patients.

In short, taking a look now at the avenues that are opening up for telehealth adoption and expansion means you will at least know the current state of the art. Better still, it will prepare your practice to move forward with telehealth implementation once the final plan is authorized and put into action.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

As might be expected, people with more severe conditions upon initial admission or a mental health disorder have a higher than average likelihood of an unplanned readmission within 30 days. What may not be expected is that the highest rates of readmission are among Medicare and Medicaid recipients. Those who qualify for these programs tend to be older and poorer than the average American, both of which have high positive correlations with poor health. The single biggest factor in reducing those readmissions according to an extensive Harvard Business Review study was effective communication between healthcare professionals and their patients. Both senior citizens and the poor often feel ignored, so someone really listening to them for a change is bound to have an effect.

But, to have its greatest potential effect, communication must continue after discharge. This is where telehealth comes in. Among senior citizens, more and more are comfortable with daily use of the internet and related technologies. Those who qualify for Medicaid and similar programs also often have access to Lifeline, meaning they have smart devices that can be used for their telehealth connection. Combined with expansion of the Smart City model, this means almost all urban Americans, and 77% generally, have some measure of access to the possibilities of telehealth communication with their healthcare providers.

The benefits of follow-up care are unambiguously positive, and this requires effective communication. Just talking to patients instructs, assists, and enables the necessary self-care that is so critical in the post-discharge phase and can reduce unplanned readmissions in the first 30 days by as much as 82%. This is no trifling figure, especially when the current rate of Medicare and Medicaid patient readmission is about 1-in-5, costing $26 billion annually. Telehealth extends that beyond the last minutes of a hospital stay out into the real world and assists the patient by making recovery part of their everyday lives.

The point, of course, is that communication between healthcare professionals and their patients is a necessity. Telehealth normalizes this process and makes it a welcome engagement rather than something to be avoided and keeps people out of the hospital as they are on the road to recovery.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Growth of Chronic Conditions

Almost half of American adults have some sort of chronic condition, and those can begin to stack up as people age. Currently, chronic illnesses account for roughly 75% of all physician visits, 80% of all hospital admissions, and 90% of all prescriptions. Those with chronic conditions make up the majority of the 71% of visits to emergency departments (EDs) that are either unnecessary or preventable. Indeed, in just one area of chronic care, telehealth has reduced unnecessary admissions by 20% and that number is growing. That is, with proper care at home, most of these people could stay there longer and have better quality of life when they do so, all while avoiding preventable visits to EDs. For many, telehealth can make remaining at home a viable option at a reasonable cost.

Telehealth Creates Ease

A significant component of telehealth making home care possible for patients with chronic conditions is that it eases communication between patients and caregivers. A metareview of over 1,200 studies on this topic showed that telehealth almost invariably facilitated accurate communication between all concerned parties, and thus contributed to better patient health outcomes. One related effect was that, with accurate and timely communication, patients were more likely to adhere to their treatment regimens, resulting in fewer visits both to their primary care physicians and EDs. This means that patients engaged in therapies more often and took their medications properly. While this increased pharmaceutical expenses, it lowered costs of care elsewhere that more than cancelled out the cost of drugs, again while improving the patient’s overall health. These other lowered costs mostly came from avoiding those unnecessary or preventable ED visits and hospitalizations. This, again, contributed to the patient’s ability to stay at home for a longer period of time, living their life as they wanted, with optimal health outcomes in both physical and mental health.

It all ties together and works in a positive feedback loop, each stage building on the one before it. Staying at home with telehealth chronic care costs less and improves patient health outcomes. These tools have already been proven effective for senior citizens. It is high time we do so for other adults with chronic conditions.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

More than 63 percent of healthcare providers now use telehealth, but the experience is only as good as the technology and healthcare professionals who interface with a particular platform. For these reasons, we have made it our mission to: 

• create a telehealth platform that works with every major EHR; and
• offer the entire healthcare chain (patients, providers, payers, etc.) a seamless, end-to-end experience.

We don’t simply want to host one-time virtual visits: Our goal is to make sure patients can access telehealth when they need great care, regardless of where they are located.

As we continue to grow, we’ve sought ideas for expanding our broader portfolio of customizable solutions. In October 2017, we announced our acquisition of Carena. The opportunity made a lot of sense: The company’s provider network is a natural extension of our own platform and their expertise in meeting consumer needs through 24/7 on-demand services can help us do a better job of meeting our healthcare partners’ telehealth needs. Together with Carena, we will expand our reach into a greater number of markets, and help hospitals and health systems strengthen and scale their existing telehealth programs. Since 2000, Carena has designed and operated virtual clinics for health systems, and today offers virtual care access to millions of consumers. Our combined company now supports a quarter of the nation’s hospitals.

As KLAS noted in one of its most recent industry reports, “Telehealth Virtual Care Platforms 2017,” Avizia has one of the most adopted telehealth platforms across use cases (on-demand, specialty, and scheduled) and is the best in EHR integration.

Prospective and existing customers will benefit from our broader range of telehealth solutions in the newly christened Avizia-Carena partnership. These solutions include a host of provider staffing models, which an organization or health system can choose to brand. Avizia Provider Services offers access to industry-leading, highly credentialed, board certified providers for virtual and onsite care coverage for a multitude of specialties across all 50 states.

Telehealth is expected to grow into a $38 billion market by 2022. Today, Avizia is trusted by four out of the top five IDNs in the nation and one in four U.S. hospitals. Moving forward with Carena, Avizia is excited to be driving better patient outcomes through our system-wide and comprehensive approach to telehealth.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

1.   Scheduling and Triage

Late fall brings the initial influx of acutely ill patients. Many of these patients have simple self-limited illnesses and may not need in-person care. The challenge is that within that influx are patients who may have more serious illnesses, complications, or underlying medical issues that put them at higher risk necessitating higher levels of care. Increased access and processes are needed to assure these patients get seen and not turned away because no appointments are available. Clinic schedules need to accommodate these patients but at the same time, must still fit in visits for chronic disease and preventive visits as well. A proactive plan to build schedules to balance those competing demands in the winter months is a must. At the same time, you don’t want to use valuable clinic visit slots as the point at which you first assess which patients have simple self-limited illnesses from those that truly need to be seen. Thus, having efficient triage in front of the schedule management is critical. Appropriate low acuity patients can be triaged to the virtual clinic instead of limited clinic appointments or the virtual clinic can be utilized as a triage access point in front of clinic scheduling.

2.   Patient Education and Communication

Patient education and overall communication is also important. This may include sending reminders on how to practice proper hand washing or self-care advice for simple conditions like the common cold. Campaigns to educate patients about inappropriate antibiotic use for viral illnesses can help avoid unnecessary visits and promote good antibiotic stewardship in the community. This is also a time to share your health system’s plan for the season including where to get flu shots without making a clinic appointment and increasing awareness of the different ways to access care. Educating patients on conditions and circumstances well suited for virtual visits and how to access virtual care can help drive appropriate, high-value utilization of the virtual clinic.

3.   Staff Preparedness

This is a great time to start reviewing staff workflows and fill any gaps in your system. Review last year’s cold and flu season and plan tactics to avoid having the same issues you had in prior years. Monitor local, regional, and national public health reporting on influenza and other seasonal illnesses to better anticipate your upcoming demand for clinical services and stay up to date with public health triage and management recommendations.

4.   Don’t Forget Quality!

During busy times, it is easy to feel the pressure of a full waiting room and limited staffing, which unfortunately often equates to shortcuts that can impact quality of care. By offering a telemedicine solution with Virtual Practice Guidelines (VPGs) – diagnosis and symptom-based virtual care treatment guidelines for urgent and primary care – integrated into your virtual clinic, you’ll be able to make sure your practices and processes are in order to ensure your team is delivering care efficiently and safely.

5.   Integrate a Virtual Care Program

If your health system doesn’t have a virtual clinic, this is the right time to invest in telemedicine. With virtual visits doubling in winter months, it is very important to be where your patients are. By launching a virtual care program during peak season, you’re able to meet your patients’ real-time needs including eliminating seasonal transportation challenges and reaching rural communities. Integrating a telemedicine solution into your system at this time will give your program instant traction in the market.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

In addition to the increase of 0.41% in reimbursement values, the updates remove much of the ambiguity in telehealth billing. Before, CMS had different telehealth rates and codes for both Medicare and Medicaid, as did most private insurers. With a standardization of these rates and codes, many of the logistical roadblocks to adding telehealth to a healthcare practice are gone.

Creating an Industry Standard

Though the published rules only technically apply to Medicare and Medicaid, it is standard among private insurers to adopt the same sets of codes so as to have an informal but widely used industry standard. Arriving at this kind of consensus by asking for input from all stakeholders has helped to ensure that the transition will be as smooth as possible. There may still be instances where a provider offers a platinum level plan with telehealth coverage and a bronze level plan without, but, where telehealth is included, the codes will at least all be the same.

Previously, many healthcare providers would use the same CPT codes to bill in-person and telehealth procedures that were otherwise identical. While a solid rule of thumb, this is not always the best idea. The expansion and standardization offered by the new final rules remove the uncertainty on whether or not this is the correct action by clearly defining telehealth procedures as having their own specific range of CPT codes independent of the ones used for in-person visits. The change has the added benefit of moving prices across the healthcare field toward a median figure, which benefits patients and insurers alike by knowing what their costs will be and healthcare providers by helping them know how much they will be paid. In one way or another, this is good for everyone involved.

A Look Ahead for Telemedicine Reimbursement

In short, yes, this is a rules change, and there are going to be some kinks to work out in the transition. Once the new rules are fully implemented in 2018, however, the standardization and clarification offered by these rules will more than make up for any difficulties encountered in the process.

New Update: Elimination of GT Modifier for Telehealth Services

As of January 1, 2018, Medicare is removing the requirement to use the GT modifier on professional claims for telehealth services.

Additional information can be found here: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10152.pdf

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Growth of Telehealth Apps

There are presently dozens of telehealth apps available for download to smart devices using all major OS platforms. Many of them proved their worth during Hurricanes Harvey and Irma. More generally, they have proven useful in monitoring health of senior citizens living alone, cardiac patients trying to lead normal lives, and veterans who may be many hours away from their nearest VA clinic. The only limits found thus far are in the imagination of people developing telehealth apps for release to the public. That is, they can be highly specific or generalized for almost any purpose.

It may rightly be pointed out that a significant number of people, even here in the US, still lack access to broadband internet, and that this might limit accessibility to telehealth apps. However, this ignores the fact that 77% of Americans have at least a basic smart device today. This means that the app market is wide open due to Wi-Fi access and mobile networks largely picking up the slack for the lack of broadband internet. This is especially the case as more localities around the world adopt the Smart City model of access.

Meeting Health System Goals

Healthcare professionals have already seen telehealth in operation and many are adopting the medium because it lowers costs for patients and providers alike, improves quality of care, and means more patients have access to healthcare. Best of all from adopters’ perspectives, is that telehealth apps often improve patient health outcomes in both physical and mental health spheres, reducing admissions by as much as 25%. Those who have adopted telehealth, some going entirely virtual, have noted that their practices flow more smoothly and that it reduces the workload in other areas. There is the added benefit for all concerned that unnecessary visits are avoided. This means doctors and other healthcare professionals can focus on those who genuinely need assistance while reassuring those who do not.

The apps are already out there in wide use. The only question is finding one that fits the needs of the healthcare professional and their patients.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The bad weather is far from over.

This is where telehealth is lending a hand. With the addition of a single dongle, a telehealth cart can be made compatible to run with satellite phones. This simple modification can connect disaster-stricken areas with medical experts from around the country. Many telehealth models readily available for both store and online purchase would add as little as $10 to the cost. To put it another way, the amount of money spent on a discount lunch special could instead be used to save hundreds of lives.

In Puerto Rico, where the need for medical assistance continues in the aftermath of Hurricane Maria,  former Health and Human Services (HHS) Secretary Tom Price has suspended many of the restrictions on Medicare, Medicaid, and other health programs for the duration of the emergency. This means that healthcare professionals and organizations have more flexibility to take action. The relaxation of rules also means that consultation with experts licensed to practice in places other than Puerto Rico is now allowed, and telehealth tools can facilitate many of these interactions where people are in need of care.

Deployed in conjunction with the USNS Comfort, the battery life of telehealth carts can be greatly augmented via easy recharging. Further, discussions are already underway between Gov. Ricardo Rosselló and innovators to engage faster restoration of the island’s power grid via solar panel deployment. Doing so would greatly increase the effective range of telehealth carts outside the major cities by making battery replacements easier, or, better still, via direct connection to a fully functional power grid.

If made a regular part of disaster response from FEMA, HHS, and other federal agencies, and done quickly, much of the human suffering in Puerto Rico could be alleviated.

As to the western wildfires, the challenges there are different and so present different opportunities. The flames do not care if a building is a house or a hospital. They burn just the same. And people in the endangered areas have to be evacuated as quickly and as safely as possible. Nursing homes in particular will need ready access to continuity of care, including monitoring of patients and medical records storage requirements, to make sure the necessary medicines and therapies experience the smallest possible interruption. Whereas swift deployment in the aftermath of a hurricane is the proper plan, preparedness with telehealth capacities before a wildfire occurs is the best route. Through the coordination capacities of telehealth services, nursing home residents and hospital patients can be routed to the facilities best able to receive them and thus ensure the best possible results.

The important thing here is that there are current, real, life or death medical needs in our country from the far Northwest to the island Southeast. Telehealth powered by trusted provider organizations, whether as part of a preparedness plan or deployed in aftermath response, can and should be used to help save lives.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The current Medicare rules on telehealth are counter intuitive and an outdated way to care for patients. Current policy restricts utilization of and reimbursement for telehealth by narrowly defining conditions around eligibility for Medicare coverage. As a result, care delivered via telehealth is limited to people who live in a rural area and willing to go to a specific care location.

Today, Medicare does not cover:

• “Store‐and‐forward” services (such as transmission of medical images) for the 43 million beneficiaries who live outside of Alaska and Hawaii.
• Services originating from a beneficiary’s home (even for the “homebound”), a hospice and other common non‐medical locations from which a beneficiary seeks service.
• Otherwise covered Medicare services of physical therapy, occupational therapy, speech‐language pathology, audiology and some other practitioners.
• Most health procedure codes, precluding the best judgment of physicians and other practitioners about the medical needs and other circumstances of beneficiaries.

Policy needs to change to empower physicians to use telehealth to improve access and quality, and lower costs. Luckily, the CONNECT for Health Act will push Medicare in the right direction.

Both consumer and physician mindsets toward telehealth are changing. Greater integration of technology in both parties’ lives are increasing both acceptance and use. These changing perceptions, coupled with CMS’ commitment to shift heavily toward value-based care, requires a new baseline. One that considers the advancements of the last decade, new data and evidence, and the evolving health care ecosystem.

The new baseline needs to eliminate the originating site geographic requirements, lift restrictions on store-and-forward technologies and expand the list of providers eligible to treat patients via telehealth. Passing the CONNECT Act for Health will be a big step in the right direction.

Read this complete article on HIT Leaders & News here.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

There were a reported 1.25 million DTC telehealth visits in 2015, a trend that is fueled, to some extent, by the belief that virtual DTC care leads to major cost savings because it can replace visits to the doctor’s office and keep patients out of the emergency room. Yet, because most virtual DTC care is episodic, occurring outside of a patient’s trusted health network, multiple clinical and financial issues can arise when patients and providers tap into this modality. Healthcare organizations and patients should be aware of potential disconnects when utilizing DTC telehealth, and make sure the proper checks and balances are in place.

DTC Telehealth Challenges

When patients reach out to physicians who are employed by “dial-a-doc” type services, they’re engaging with professionals who often have limited access to patients’ personal health records. Records from virtual visits can either be siloed, never to be seen again, or because most EHRs aren’t interoperable with telehealth systems, virtual episodes of care aren’t always documented in a way that is searchable. So, if the telehealth consultation contains critical information, the patient’s regular physician may miss it. Similarly, a virtual DTC doctor is at risk of giving inaccurate information or an incorrect prescription because he or she doesn’t have the patient’s complete health record immediately available.

There are also potential quality issues that arise with DTC telehealth services. For instance, a health network overseeing a patient may not have access to background information on the physicians who are employed by a DTC telehealth provider. The physicians are outsourced through the DTC vendor, and may not offer care that meets the standards of patients, insurers, or other stakeholders in a given health network. Many of these services are trying desperately to keep patient visits to 5 minutes or less to reduce costs.

A Hybrid Solution

The need for quality cannot be emphasized enough. Having a solid physician-vetting system to broker telehealth interactions can help avoid potential communication mishaps and wasted virtual visits. Hospitals, for instance, need to investigate quality metrics such as physician call times, prescriptions, or satisfaction ratings to make sure their telehealth DTC partners meet their standards.

Finding ways to bridge fragmentation through technology is also essential to maximizing the benefits of virtual DTC care. Leveraging telehealth networks that can integrate with EHRs and other patient care systems can facilitate better care. At the very least, healthcare providers need the ability to securely fax or email information about a telehealth consultation to one another – and ideally, implement deep EHR integration where patient data is shared bidirectionally in real time for true care coordination.

When virtual DTC care is integrated correctly within a larger healthcare network, with careful consideration to quality, it can work well to deliver value. Moving toward the goal of value-based care, healthcare providers need to look at the bigger picture, and ask whether the systems we rely on to improve quality and efficiency are being leveraged properly.

Read the complete article on Becker’s Hospital Review.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

With so many options available to patients, it is important for any health system to understand what the newest adult patients, millennials – who are no longer relying on mom and dad for healthcare guidance – are looking for.

Historically, health systems didn’t have to spend considerable energy considering how to maintain long-term relationships with their patients, because sticking with a provider long-term was standard behavior. However, for millennials (who range in age from early-20s to mid-30s), the end goal may not be to establish a relationship with a PCP or health system.

Millennials expect convenience.

Convenience of access to care is something millennials expect and, for better or worse, may feel entitled to receive. They do not want to spend their time commuting to a clinic or urgent care only to sit in the waiting room for hours, just for a ten-minute visit. Telehealth holds inherent appeal to anyone who prioritizes convenience and certainly speaks to many millennials as evidenced by this data:

• 52% of millennials would choose a primary care doctor who offers virtual care treatment options over one that does not (2016 Connected Patient Report, Salesforce Research)
• 74% of millennials would be open to virtual care treatment options as an alternative to an in-office visit because it’s more convenient (2016 Connected Patient Report, Salesforce Research)

Technology is a millennial’s friend.

With so many smartphone users in the U.S., particularly millennials, it is important to be mindful of incorporating a mobile-first approach into your marketing strategy.

• 100% of U.S. adults between the ages of 18-29 own a cellphone, 92% of which are smartphones (Mobile Fact Sheet, Pew Research Center)
• 70% of millennials would choose a primary care doctor who offers a patient app (which allows patients to make appointments, see bills, view health data, etc.) over one that does not (2016 Connected Patient Report, Salesforce Research)
• Millennials are 2.5 times more likely to be early adopters of technology than older generations (The Millennial Generation, U.S. Chamber of Commerce)

Considering the prevalence of smartphone usage in this demographic, it is not surprising that this technology would also be used to seek healthcare. As a matter of fact, Accenture reported their projections for 2019 that state 66% of U.S. health systems will provide online scheduling and 64% of patients will make appointments online.

Millennials are brand loyal and influential.

Millennials may be more likely to stick with a health system long-term based on a good experience, even if this wasn’t their initial intent. With strong preferences for companies who give customers a quality experience, millennials are more brand loyal than any other generation (Greyhealth Group, The New World of Healthcare: What Millennials Want).

With 10.8 million millennial households with children, accounting for 80% of live births each year, millennials are shaping the healthcare habits and outlooks of their children, as well as other family members.

• 64% of millennials are more brand-loyal or as brand-loyal as their parents. 24% consider themselves to be more brand-loyal than their parents (Adroit Digital, Millennials: The New Age of Brand Loyalty)
• 52% of millennials are referred to as “Health Activators” for their families, controlling healthcare decisions on behalf of others (Greyhealth Group, The New World of Healthcare: What Millennials Want)

By acknowledging the concepts of convenience, comfort with technology, and brand loyalty, your health system and providers will be more prepared to relate and market to this generation, ultimately leading to more long-term patient relationships.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

There has never been a better time to invest in telehealth. September marks the beginning of cold and flu season, a peak season for direct-to-consumer telehealth. This time of year, we typically see an increase in consumers going online looking for affordable care options. Activity will group through the fall and winter before tapering off in April and May.

The NBGH survey results found that large U.S. employers estimate that in 2018, their per employee benefit costs will surpass $14,000 including premiums and out-of-pocket costs. Employees will take on roughly 30% or nearly $4,400 of this cost while employers will cover the balance. This will be the fifth consecutive year with a 5% increase in healthcare benefit costs.

With nearly all large employers planning to offer telehealth services by 2020, there is an enormous opportunity for the local health systems to provide telemedicine services that meet the needs of local employers. Telehealth offered through the local health system reduces fragmentation and reinforces strong relationships between patients and local systems. When integrated into the local employer’s health plan the patient, health system, and health plan all benefit. This can pave the way to more integrated models and value-based reimbursement relationships.

CHI Health in Nebraska and Hospital Sisters Health System (HSHS) Medical Group in Illinois are two partners who have successfully incorporated employer virtual care programs to create valuable relationships with local employers and offer a competitive package that meets the needs of consumers and positions the organizations competitively for an at-risk environment.

CHI Health has a three-part commitment to their local employers – transparency, accountability, and affordability. This includes providing easy access to cost data, lowering costs to or below the regional cost average, and working with insurers to bring new options to market.

HSHS Medical Group has contracted with four local employers allowing their employees and their dependents to gain access through a dedicated portal or app.

With large employer telehealth adoption projected to reach 96% next year, health systems need to become a lot more competitive to gain and retain market share. This data presents an opportunity to build valuable partnerships with employers to better support the care continuum and reduce care fragmentation.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Avizia CEO Mike Baird and the executive director for the Alliance for Connected Care, Krista Drobac, spoke with Becker’s Hospital Review to discuss how the CONNECT for Health Act may ease telehealth restrictions—and provide Medicare beneficiaries access to better care.

Telehealth has the potential to help rural patients remotely access specialized healthcare — but convincing payers like Medicare to cover these services has proved challenging. Section 1834(m) of the Social Security Act established restrictions on reimbursement for telehealth and remote patient monitoring services under Medicare fee-for-service.

Many healthcare advocacy organizations say the statute is due for reform and have rallied around recent legislation like the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2017. The CONNECT for Health Act has garnered bipartisan support, posting 13 cosponsors and more than 50 endorsements from advocacy groups like the American Medical Association, the American Telemedicine Association and the Healthcare Information and Management Systems Society.

“At the end of the day, if we’re treating patients, it shouldn’t matter how we treat them,” says Mike Baird, CEO and founder of telehealth company Avizia. “Unfortunately, some of these restrictions that are in place create disincentives toward the adoption of telehealth.”

With certain restrictions, the CONNECT for Health Act would cover telehealth and remote patient monitoring as basic benefits in Medicare Advantage. The bill also proposes a bridge program to help providers report telehealth and remote patient monitoring practices under the Medicare Access and CHIP Reauthorization Act’s Merit-based Incentive Payment System.

But, the CONNECT for Health Act has been stuck in committee, so the Alliance for Connected Care is exploring braking the bill apart to push select reforms forward piece-by-piece.

“If the CONNECT for Health Act doesn’t move in entirety on its own, we want to be sure that pieces of it get enacted as other bills,” Ms. Drobac says.

Read more about the bill and its status at Becker’s Hospital Review.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

As the fifth most common cause of death and the leading cause of long-term adult disability in the world, strokes pose a widespread public health dilemma. And while many studies have proven the viability of using telehealth services to rapidly address patient needs, providing cohesive care between facilities is a critical component that needs to be addressed.

A recent study by Kaiser Permanente said, “Particularly in hospitals with limited local resources and/or limited access to neurological expertise, telestroke is an important tool to aid in the evaluation and treatment of potential stroke. We specifically found that unwarranted hospital variability in stroke care could be eliminated through a standardized telestroke program.”

As telestroke treatment use continues to grow, Avizia remains committed to ensuring physicians and executives are informed regarding current industry standards. That is why we are sharing the most recent guidelines from the American Telemedicine Association (ATA) regarding stroke treatment. Overall, this document aims to provide a standardized approach to assessment, diagnosis, management and consultative support to patients exhibiting symptoms and signs that are consistent with acute stroke syndrome.

The new ATA guidelines also address the roles and responsibilities of the responding telehealth team and provide hospital executives with recommendations for seamlessly incorporating telestroke services into their model of care. Furthermore, the guidelines present the agreed-upon roles for coordinating telehealth that are important for support and buy-in of key stakeholders, including the hub/spoke site physician director, the program manager, the emergency department stroke champion and other roles.

Beyond the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information for Economics and Critical Health Act (HITECH), ATA’s guidelines encourage facilities to address privacy and security needs for each of its patients. It also states the importance of providing this information to acute stroke patient families and educating patients about the role of telestroke platforms, including any translation services they may need.

The guidelines encourage facilities to also create an ongoing telehealth budget, so they may stay on top of hardware and software upgrades and address payer reimbursements, grants, private contributions and other fiscal items as they arise.

Perhaps most importantly, telehealth providers also need to have a concrete process to monitor quality and outcome metrics. In addition to ongoing patient care, the document discusses protocols for research and clinical trials. The guidelines recommend that research is needed to compare telehealth to in-person consultations and should conform to local institutional review board approval practices.

As for telehealth solutions themselves, the guidelines say facilities must provide real-time, two-way communications, optimized for bandwidth and monitored for general mobile device management – this includes oversight of apps, data configuration, and security. Devices must also have a passcode, biometric identification or other login protocols and should be configured for point-to-point and, ideally, multiparty connectivity. Organizations looking to use telestroke should consider creating data policy and procedures regarding storage, restrictions and how those are communicated to the referring or consulting site.

As telehealth evolves into a more mature healthcare solution, the industry needs a set of guidelines like the ones created by ATA to ensure cohesive care between facilities. We at Avizia are encouraged by these updated standards and the bright future they detail for the future of virtual care.

Avizia was acquired by American Well in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Avizia’s CEO and founder, Mike Baird, discusses why hospitals and health systems need to take a strategic and long-range approach to telehealth. Rather than focusing on single use cases, providers should take time to consider and how system-wide telehealth will contribute to the next generation of care delivery.

Hospital-based telehealth, as used in a case like stroke or behavioral health, is responsible for significant improvements in specialist access, reductions in length of stay (LOS), a reduction in expected deaths—and increased savings for hospitals participating in value-based reimbursement models. Best of all, patients who have used telehealth appreciate the convenience and access to care.

Stroke and behavioral health are great candidates for telehealth, but there’s a lot that goes into an implementation, like integrating with the EHR, PACS and established clinician workflow. It makes sense that many hospitals focus on one use case at a time, but that approach often leads to more difficult telehealth expansion down the road. Hospitals that see the most success with telehealth start with a system-wide strategy. They may not implement multiple telehealth programs at the same time, but it does give the organization an adaptable blueprint and the assurance that they’ve selected an approach and partners to accommodate changes.

Every healthcare organization is unique, but those with successful and integrated telehealth programs tend to share some common characteristics:

1. Strategic Leadership
2. Clinical Advocates
3. Collaborative IT Teams

Strong leadership from the top coupled with a culture of collaboration will set the right foundation. From there, providers can begin to develop a unique telehealth program that best serves their patient communities.

Creating a system-wide telehealth program is a long game. It won’t happen overnight, nor should the strategy. But there’s a payoff for hospitals taking a holistic view on the next generation of care delivery. Encouraging stakeholders from various departments to take a seat at the table and actively participate in plan development will set the stage for a thriving program.

Read the complete article in Becker’s Hospital Review.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

With proven results in patient access and outcomes, MUSC has plans to expand its program from 45 to 90 schools in the next year, many of which are in rural and underserved communities. MUSC credits the success of its network to hardworking school nurses, fostering a culture of collaboration between healthcare organizations and a flexible, open technology platform.

Read the article at mHealthIntelligence.

School Telehealth Growth Prompts New Role

School-based telehealth programs allows students to be be seen by a pediatrician or specialist remotely, from their school, ultimately minimizing missed classes and long commutes.

Williamsburg County is the first county in South Carolina to implement telehealth at all 11 of its schools, the use has increased over time. With the advent of higher volumes, MUSC developed a new position to offer school nurses support during these telehealth consultations.

Lynn Floyd is the first and now lead tele-presenter for MUSC. She was once a school nurse that used telehealth and now works with multiple school nurses in Williamsburg County. As needed, she presents students to a provider during a telehealth consultation.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The National Alliance on Mental Illness (NAMI) estimates that serious mental illness costs America $193.2 billion per year in lost earnings. While one in five adults experience a mental illness in a given year, and nearly one in 25 live with a serious mental illness, nearly 60 percent of those adults did not receive mental health services within the last year.

With this ongoing lack of care, patients with mood disorders, including major depression, dysthymic disorder, and bipolar disorder, end up receiving more expensive emergency care in place of consistent mental health services. In fact, these disorders are the third most common cause of hospitalization in the U.S. for both youth and adults between ages 18 to 44.

Unfortunately, the high cost of not receiving mental health treatment doesn’t stop there. Individuals that live with mental illnesses also have an increased risk of developing some physical illnesses, including cardiovascular disease, diabetes, stroke, and Alzheimer’s disease, according to the National Institute of Mental Health.

We Need to Do More

One of the top reasons patient do not seek care is the lack of available treatment providers. With approximately one mental health provider per every 529 individuals in the United States there are more than 4,000 areas in America who have a mental health professional shortage.

This existing provider gap can be bridged with the help of telehealth, and, on a positive note, we are making progress in healthcare when it comes to tele-behavioral health programs. A recent Health Affairs study states that tele-behavioral health services are up 45 percent – meaning more patients are getting the care that they need when and where they need it. Despite this encouraging progress, research and data continue to show too many Americans are still in need of care. As a healthcare community, it is critical that we work together and ensure we get every patient the services they need before it is too late.

Telebehavioral Health — Cost Efficient & Clinically Effective

Traditionally, delivering exceptional and efficient care to mental health patients is hard to achieve. Due to provider shortages and the rising number of patients, gaps exist in mental health care, especially in emergency departments.

From both a clinical care and financial perspective, the mental health burden on EDs is heavy and is only projected to worsen in the next decade.

Telebehavioral health, however, is flipping the script on mental health care. By improving access to care and ED throughput, tele-behavioral health is filling the gaps with a true 24/7 solution that is empowering more effective care coordination, decreased wait times and shorter lengths of stay. In both the short and long-term, tele-behavioral health programs better position EDs for a more clinically efficient and financially profitable future.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Strokes are one of the most pervasive medical emergencies in America, and the numbers are staggering. In the United States, a stroke occurs every 40 seconds and takes a life every 4 minutes. With this prevalence, most people might imagine that finding treatment for stroke victims is as easy as going to the nearest hospital. However, in many cases, there are limited options for patients.

According to a study in the journal Neurology, there is a shortage in the number of available neurologists, which results in dangerous and brain-threatening wait times for patients. The study also concludes that difficulty hiring new neurologists, and the large number of neurologists that do not accept new Medicaid patients, are among the top reasons for the provider shortage.

Telestroke has a proven track record of assisting Medicaid patients as well as other patients, with the expedited stroke care they need. An American Heart Association (AHA) study found that when using telestroke the average time between patient arrival at a hospital to administering tissue plasminogen activator (tPA) fell from 80 minutes to 40 minutes. Also, the average time between the initial onset of a stroke and receiving tPA fell from 150 minutes to 120 minutes when telestroke was available and utilized.

Today, one in 20 deaths in the United States are the result of a stroke. Providing fast, efficient care dramatically improves stroke survival rates. Hospitals with telestroke programs can not only outpace the neurologist shortage but also provide better care while treating more patients.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The U.S. Department of Veterans Affairs (VA) estimates a post-traumatic stress disorder (PTSD) incidence rate of 11 to 20 out of every 100 veterans that served in Operations Iraqi Freedom and Enduring Freedom. However, nationwide, only about 8 percent of the 5 million veterans using VA-provided care get diagnosed with the disorder. This large care gap comes at a somber price: Each day, an estimated 18 to 22 veterans die by suicide.

Telehealth can help address the lack of care our veterans face, particularly in instances where they are living in remote areas, far from specialist or an ideal point of care.

Today, approximately 3.3 million of the veterans in the VA’s purview live in remote regions with limited access to healthcare services. A study in the Journal of the American Medical Association found that telehealth was an effective option in treating veterans with PTSD that would otherwise resist treatment, either due to geographic reasons or the stigma surrounding mental health services. Additionally, a Telemedicine and E-Health Journal study found that telehealth visits were dramatically cheaper for the VA since many in-person visits to remote places required extensive travel.

When service members return from combat, deserve to have access to the care they need. Providing veterans with mental and behavioral telehealth care is just one way to ensure these men and woman receive the care they need when and where they need it.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

A recent Deloitte article “MACRA: Quietly transforming health care” discussed how MACRA rewards physicians for improving the way they deliver care while transforming payment and care delivery models to reduce costs and total expenditures under the Medicare program. The article continues to describe a meeting Deloitte Center for Health Solutions and the Network for Excellence in Health Innovation facilitated with 31 provider stakeholders to discuss some of the challenges they’ve encountered and how best to move towards a value-based care system.

Participants expressed a willingness to work through barriers and come up with solutions, despite the challenges they face in implementing MACRA. These challenges include tracking and reporting new quality measures, accounting for risks with new payment models, and overcoming obstacles that come with implementing new technology platforms.

Considering some of the challenges, we’ve identified that telemedicine can help support value-based care initiatives in the following ways:

• Access solution: Telemedicine extends patient reach and expands access to care to those in rural communities as well as those who are unable to travel to a health system’s facility.
• Engagement strategy: By incorporating telehealth, health systems are giving patients another avenue to engage. Telemedicine oftentimes allows for more one-on-one time with a patient compared to an in-person visit, resulting in more valued engagements.
• Adherence to practice guidelines: Quality is of utmost importance. By utilizing telemedicine and incorporating practice guidelines to a health system’s workflow, the quality of the virtual visits with patients greatly exceeds.

From a legislative standpoint, we’re getting to a place where telehealth is poised to play a pivotal role in, and have a strong impact on, the transition towards value-based care. Telehealth legislation is continuously changing, at both the state and federal level, allowing for greater opportunities to assist health systems move towards value-based care and scale their services to meet the needs of both patients and providers.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

A bill introduced last month in the House of Representatives seeks to improve access to telehealth services in the rural United States and takes square aim at expanding remote patient monitoring (RPM) related to chronic obstructive pulmonary disease and congestive heart failure.

Introduced by Rep. Sean Duffy (R-Wis.) the Helping Expand Access to Rural Telehealth (HEART) Act targets the Center for Medicare & Medicaid Services’ (CMS) strict limitations on RPM reimbursements in rural areas. Currently, CMS has a narrow definition of “rural,” which leaves many patients ineligible for reimbursement. Of the 107,000 telemedicine visits for Medicare beneficiaries recorded in 2013, approximately 40,000 of them served rural areas.

The HEART Act is one of many recent efforts to address the barriers facing telehealth, despite its low cost and high efficacy. During the month of May, the U.S. Senate also introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, which further aims to expand telehealth services in rural areas and allow the Department of Health and Human Services to lift existing telehealth restrictions.

Telemedicine programs are often cheaper than other options for patients. As of 2012, the average cost of a telehealth program was $1,600 per patient each year, versus $13,000 for home health services and $70,000 for nursing home care.

The heart-related diseases addressed by the HEART Act are disproportionately concerning in less populated areas. COPD is more prevalent in rural U.S. regions, and a 2014 study in the Journal of Rural Health found these populations face higher hospitalization rates and increased mortality, in spite of controlling for this population’s higher rate of smoking. A separate study in the Online Journal of Rural Nursing and Health Care found that telehealth improved knowledge, self-care behaviors and health outcomes of rural heart failure diseases while cutting cost and improving patient satisfaction.

Eliminating barriers for telehealth in rural populations is essential to providing high-risk patients with the care they need. Today, about one-fifth of the population in rural regions of the U.S. are on Medicaid and/or Medicare. Telehealth can provide these patients with easy access to care at a lower cost and with better outcomes. Removing reimbursement barriers is a logical and vital step in enhancing patient care throughout the U.S – particularly in rural regions.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

A bipartisan group of US Senators recently reintroduced the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (or CHRONIC, for short) Care Act of 2017 (first introduced in 2016), intended to improve healthcare outcomes for Medicare recipients living with chronic conditions. To facilitate these improved outcomes, the bill included various new provisions to Medicare. Several parts of the bill also created new programs to foster the innovation and advancement of telehealth technology, as well as expand access to it for Medicare enrollees.

One of the big reasons the bill was not previously considered had to do with concerns that it would lead to increased costs, or that altering the current Medicare reimbursement policy on telemedicine might result in increased healthcare spending.

All of that changed when the Congressional Budget Office (CBO) released their preliminary cost estimate report on the CHRONIC Care Act. The report gave the bill a favorable score, which lead to unanimous bipartisan support. The bill received a scheduled mark-up from the Senate Finance Committee and the legislation was put to a roll call vote. It was approved with a sweeping 26-0 vote. This means that the CHRONIC Care Act can now move on to the Senate for final vote and passage.

When it comes to telemedicine and telehealth, the CHRONIC Care Act of 2017 will put a number of new provisions into action, including (but not limited to) the following:

• Increase the cap on the total number of participating beneficiaries from 10,000 to 15,000.
• Establishes a two-year extension of the Centers for Medicare & Medicaid Services’ Independence at Home demonstration, establishing home-based primary care teams for Medicare beneficiaries with multiple chronic conditions.
• Starting in 2019, it will add home freestanding dialysis facilities, without geographic restriction, to the list of originating sites for monthly telehealth assessments.
• Also in 2019, it will eliminate geographic restrictions on telestroke consultation services. However, originating sites will not be separated. The hospital location and the location of physician providing a remote consult will not receive separate originating site payments.
• Beginning in 2020, it will expand telehealth coverage under Medicare Advantage Plan B.
• Lastly, it will provide increased flexibility for Accountable Care Organizations to use telehealth services.

Considering the amount of bipartisan support the bill has already demonstrated, the CHRONIC Care Act of 2017 is likely to be passed by the U.S. Senate in the very near future. Be sure to stay tuned to our blog for future updates.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

In the first installment of this two-part blog series, we discussed the goals and benefits of telestroke technology—what it is, how it is used, why it matters, etc. However, telestroke programs need to be implemented along with the proper tools and infrastructure/support in order for them to be truly effective. In this second and final installment, we will be looking at both the basics of telestroke systems as well as some of the amazing telestroke technology that healthcare providers are using to save the lives (and brains) of stroke victims.

The Basics of a Telestroke System

The basic arrangement of any telestroke system begins with establishing a secure but efficient method of video/audio communication that links the facility/patient to the attending neurologist. As its foundation, any telestroke program must be equipped with reliable and high-speed internet that is capable of handling the kind of high-resolution, real-time video conferencing solutions that make it possible for the neurologist, nursing staff, and patient to communicate clearly and without interruption. After all, the entire point of implementing a telestroke system is to allow the attending neurologist to remotely evaluate the patient—symptoms and severity, remote viewing of CT scans, observe motor skills/function, etc.—in order to expedite diagnosis and delivery of treatment.

Considering that there is only a three hour window for administering treatment after a stroke, time is the most critical factor. After that three hour window expires, the odds of patient recovery plummet significantly. According to one study, stroke victims who were treated with anti-clot drugs within the first ninety minutes had a nearly 250% better chance of recovery after three months (when compared to patients who did not receive treatment within three hours). This means that a having a properly equipped telestroke system is crucial to its success.

Game-Changing Telestroke Tech

While it is safe to say that any stroke treatment facility would benefit from the implementation of a telestroke system, it is important to remember that such a system is often only as useful as the technology that supports it. Luckily, a lot of amazing telestroke tech is already on the market and advancements in new tools and solutions are being made every year. Let’s take a look at some of the game-changing technology that is transforming the world of stroke care:

• Telestroke/Telemedicine Carts: These “carts” are actually mobile communication units equipped with everything a neurologist needs to administer remote care—internet capability, high resolution cameras, microphones, multiple viewing screens, and more.
• Telestroke/Telehealth Software:To put it simply, these apps are what makes the remote use of telestroke hardware (telemedicine carts) possible. The neurologist can remotely connect to the cart via a secure, HIPAA-compliant software and apps that allows him or her (using and computer, laptop or mobile device) to speak with/observe/evaluate the patient, view CT scans, give instructions to nursing staff, etc. Mobile telestroke apps have untethered stroke care providers from desktop computers, allowing them to deliver nearly immediate care from anywhere and at any time.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Since the turn of the millennium, the United States has experienced a continuing surge in the number of stroke victims seen in hospitals across the country. According to a study released in 2015 by the American Heart Association, roughly 795,000 people experience a new or recurrent stroke annually and an estimated 6.6 million Americans age 20 or older had experienced a stroke by 2012. In 2011 alone, strokes accounted for 1 in every 20 deaths in the US (a 35.1% increase from 2001), and on average, a death from stroke occurred roughly every 4 minutes. The study also predicts that, by 2030, an additional 3.4 million Americans age 18 or older will have experienced a stroke (a 20.5% increase from 2012).

As one would expect, this continued rise in stroke cases has created a growing need among neurologists, hospitals, etc.—for more efficient and speedy care methods for both new and recurrent stroke patients. Rising to meet this need, healthcare tech firms such as Avizia are creating new and developing “Telestroke” technologies to assist healthcare providers in their increasingly frequent battles to save the lives (and brains) of their patients.

What is Telestroke Technology?

Telestroke technology (sometimes called “telestroke services” or “telestroke solutions”) refers to a specific type of tools and/or solutions—both hardware and software—that provide neurologists with the ability to perform immediate, real-time, and/or remote diagnosis and treatment to a stroke victim.  While this sort of technology is considered a part of the broader telemedicine spectrum, it focuses specifically on speeding up the delivery of care to stroke patients. And, when it comes to strokes, every moment matters.

Any stroke (whether ischemic, hemorrhagic, or TIA) causes immediate damage to the human brain. Every minute the patient goes without treatment, the odds of his or her recovery (and, in some cases, even survival) steadily worsen. Therefore, it is crucial that a neurologist begins treating a stroke victim as soon as possible.

In the days before telestroke, when a patient arrived at the hospital, the on-call neurologist had to be contacted and then had to physically travel to the hospital before treatment could begin. This, obviously, took precious time… time in which the patient was not able to receive a potentially lifesaving tPA or PLAT treatment.

In today’s world, however, the advancement of the internet, high resolution imaging, and digital communications has made it possible for telestroke technologies to vastly improve the speed of care. In fact, according to information from Kaiser-Permanente, they experienced a 73 percent increase in use of tPA/PLAT for patients with acute ischemic stroke after they implemented use of telestroke technology in their facilities.

In Part 2 of this blog, we will discuss the basics of telestroke programs as well as examine some of the game-changing tools and solutions that are helping to saves the lives and brains of today’s stroke victims.

Interesting in learning more? Check out this video recording of our Advancements in Telestroke webinar with Dr. Lee Schwamm, the Professor of Neurology at Harvard Medical School and Executive Vice Chairman of Neurology at Massachusetts General Hospital.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The Interstate Medical Licensure Compact (IMLC) — a plan devised by a group of state medical board executives, administrators and attorneys to provide cross-state licensure to physicians to bolster telehealth practices — saw its first eight states enact the measure. Now, medical professionals that maintain primary licensure in Alabama, Idaho, Iowa, Kansas, Mississippi, West Virginia, Wisconsin and Wyoming can practice telemedicine in any of the 18 states involved in the compact. The remaining 10 states‚ Arizona, Colorado, Illinois, Minnesota, Nebraska, New Hampshire, Nevada, Pennsylvania, South Dakota and Utah, are still preparing to accept applications for verification and background checks but currently cannot act as the state of principal licensure.

Prior to the IMLC, physicians that wanted to provide telehealth treatment via telemedicine outside of their primary state had to apply through a separate licensing process — one that varies widely between states and can take years to complete.

For additional states to join the IMLC, their state legislature must pass a bill — containing identical language as the states currently in the compact — authorizing it to do so, which then needs to be signed by the government.

This is an important step for the telehealth field, which has been seeking parity in comparison to traditional, in-person medicine since its inception. In a 2015 report, the American Hospital Association named licensure one of the major legal and regulatory challenges that could stymie telehealth adoption.

Many of the states participating in the compact contain rural populations that have less access to medical care. The National Rural Health Association reported in February that this trend will likely continue, with more than one-third of rural hospitals potentially facing financial instability in the near future, leaving 11.7 million patients at risk of losing their health care access.

The IMLC can provide these patients with convenient access to top doctors and specialists, for everything from preventative care to ongoing treatment to emergencies. This compact is a step in the right direction for a medical future democratized by telehealth.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

We at Avizia want to do our part to ensure that everyone is aware of the early warning signs of this cerebrovascular disruption, the benefits of using telemedicine in the event of a stroke and the steps every patient should take after receiving treatment.

Detecting a Stroke

The American Stroke Association (ASA), an affiliate of the American Heart Association (AHA), pioneered the FAST method of detection, a four-step guide to identifying a stroke. Here’s how to tell if a person is in need of help:

1. Face Drooping — Can the person smile evenly or is half their smile drooping or numb?
2. Arm Weakness — Does the person have difficulty raising both arms over their head? Is one arm is weak or numb?
3. Speech Difficulty — Can the victim repeat simple phrases without slurring their words?
4. Time to Call 911 — Patients do not have to experience every one of these symptoms to need care. If any of them are occurring, call 911 and get them to a hospital immediately.

Strokes may also present through other symptoms, like sudden confusion, numbness or weakness on one side of the body, trouble seeing in one or both eyes, sudden dizziness or loss of balance, and a severe sudden headache with no known cause. Be sure to educate those you know and act quickly before the symptoms escalate.

Treating Strokes with Telemedicine

It is widely known in the field that when it comes to stokes, time lost is brain lost. With industry reports showing that the demand for neurologists is projected to increase from 18,180 in 2012 (11 percent shortfall) to 21,440 by 2025 (19 percent shortfall), telemedicine offers a fast, reliable solution for patients and caregivers to access the right point of care before it is too late. Aside from filling the existing provider gap, telemedicine offers numerous additional benefits in the event of a stroke, including:

1. Time Savings — Telestroke is a highly effective tool for minimizing long-term damage from stroke and preventing death. Accessing care quickly in the event of a stroke is critical and with telestroke services specialists are never more than a click away.
2. Cost Savings & Improved Quality of Life — According to researchers at Mayo Clinic when comparing a rurally located patient receiving routine stroke care at a community hospital, a patient treated in the context of a telestroke network incurred $1,436 lower costs and gained 0.02 quality-adjusted life-years over a lifetime.
3. Post-Stroke Services — If you or someone you know has suffered a stroke you may need additional care or services that can be difficult to access after an event. With telemedicine, specialists can perform live video consultations and review patient medical images from any smart phone, tablet or computer with a web browser – meaning patients get the care they need when and where they need it.

Recovering From a Stroke

After a stroke patient has received care, it’s important they feel confident during their recovery. The ASA recommends that patients and their friends and family discuss a few important details with their health care provider to ensure the best possible recovery.

1. Understand What Happened — Discuss with a doctor what your diagnosis was and what caused the stroke. This can help guide future visits and help the patient make lifestyle choices that fit their diagnosis.
2. What’s Next — Could the patient have another stroke? How long should recovery and rehabilitation take? Knowing the possible physical, emotional, behavioral and communication challenges after a stroke are important to gauge the steps of recovery.
3. Living Arrangements — Can the patient live alone? Should they take any safety precautions to prepare their home? Are there any tasks they will need help with? These answers can provide friends and family with the knowledge the need to feel secure with the patient’s path ahead.
4. Medications — Knowing what types of medication and medical supplies a patient needs going forward is critical to ongoing care. They also need information on what their insurance covers and other ways to get help with costs.

For a complete stroke patient checklist, visit ASA’s website.

Someone in the United States has a stroke every 40 seconds. Knowing the signs and symptoms and providing them with quick access to care is essential to improving their prognosis.  At Avizia, we are committed to cutting down time to care, and being armed with the right information is the first step. See how Avizia is helping emergency departments access stroke neurologist hundreds of miles away.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The Journal of the American Medical Association found that one-third of adults that screen positive for depression have never received treatment. While there are countless reasons why people skip making an appointment, part of the blame lies with lack of access to mental care.

As of March 2012, nearly 91 million people live in a Mental Health Professional Shortage Area. These staggering numbers are backed by the U.S. Department of Health and Human Services, who estimate 55 percent of rural counties have no psychologists, psychiatrists or social workers.

This is a problem that telehealth can help address.

A study in the Journal of Clinical Psychiatry found that tele-psychiatry is just as effective as in-room psychotherapy regimes. Certainly for rural populations, telehealth is often the only way to access mental and behavioral health care, but for busy people on the go, getting an hour out of their week each week to talk to a therapist can also be difficult. If these patients could get the same benefits as an in-person appointment from the comfort of their own couch, it could give them the opportunity to access the care they need.

In addition to planned telehealth visits with a psychiatrist or psychologist, telemedicine for behavior health could help fill the critical psychiatric care gap at rural emergency departments. These patients are often admitted to the hospital and wait for a specialist, or are transferred to a regional facility where a specialist can address their needs. These unnecessary admissions and transfers are costly to hospitals and result in longer wait times for patients in need of immediate care.

In a nation where one in five adults experience a mental health issue in a given year, addressing the mental health care gap is critical to providing the services these patients need. Whether these patients are in rural areas or are just having difficulty carving out time for an in-person visit, telehealth can provide a quick, easy-to-use solution to ensure they are getting the mental health services they need.

Avizia is empowering hospitals and health systems to offer tele-behavioral health consultations from mental health professionals to quickly deliver care to patients presenting in an emergency department or other medical settings. As a result, hospitals are lowering their costs while patients are gaining immediate access to better quality care.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The Interstate Medical Licensure Compact is a streamlined process that allows physicians already licensed to practice in one state that is participating in the compact, to become licensed in other states participating in the compact without going through the full licensure process. There is a nursing compact for RNs interested in streamlining the licensing process as well. The purpose behind these compacts is to make it easier for physicians and nurses to obtain licenses in other states in order to increase accessible healthcare to individuals in underserved and/or rural areas. It also assists in the overall ease of consulting with a medical professional through telemedicine to the general population.

As telehealth continues to grow as an industry, more of these resources and innovative payment models will begin to surface. Here are three of the most common questions asked regarding licensing and credentialing for telehealth:

Do telemedicine providers have to be licensed in the state where their patients are?

Yes. States do require providers to be licensed in each state that they practice in, which means it is essential for them to know which state the patient is calling from to verify that they can indeed participate in the virtual visit. The physical location of the provider is not considered an important factor in regards to where they are licensed, though this varies state-to-state.

What is Credentialing?

Credentialing is the process of evaluating and verifying the qualifications of physicians, nurses, organizational members, or organizations’ current licensure and assessing their background and legitimacy. This process tends to be completed by the organization that will bill for the provider’s services.

Do telemedicine providers have to be credentialed? If so, where?

Telemedicine provider credentialing requirements are usually based on the source of payment the patient chooses to use for the service. Whether or not the provider must be credentialed at the facility where they are located while practicing is typically specific to the type of facility and what the rules and guidelines are for that facility. Providers do generally need to be credentialed at the facility where the patient is located as well.

These questions are just a starting point. To learn more about licensing, credentialing, and the ever-changing telemedicine landscape, visit the Center for Connected Health Policy.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

To help our partners do this effectively, we’ve developed a set of critical questions. Crystal-clear answers to these questions are required for a successful telehealth implementation:

• What goals are we trying to achieve?
• What metrics will we use to measure success?
• Are we using telehealth to virtualize a practice or virtualize our health system?
• How can we integrate telehealth in the continuum of patient experience?
• How can telehealth extend our efforts to manage and coordinate care?

Our partner, HSHS Medical Group, understood how important these questions are to the success of their virtual clinic. Clarity of purpose was an essential first step for our partnership with them; their strategic goals for the virtual clinic shaped the design and operation of the service:

Their goals:

• Grow their affiliated patient population in Illinois and Wisconsin
• Meet consumer and corporate buyer needs with an innovative service
• Educate staff on the inclusion of telemedicine to better meet consumer needs

These goals determined specific design requirements for their virtual clinic and shaped HSHS’s commitment for system-wide adoption.

To grow their patient population, we had to create a virtual care program that included robust support for digital and traditional marketing to generate awareness of and reasons why to use the service, and to optimize the consumer experience to eliminate friction for consumers seeking care. To that end, the virtual clinic was operated entirely under the HSHS Medical Group. Consumers recognize a familiar community institution in the branding, letting them know that this is clinical care they can trust.

To meet consumer and corporate buyer needs, the virtual clinic needed to serve distinct patient populations with experiences configured for their unique needs. HSHS created access for consumers in their service area with a virtual clinic entry point open to the public. HSHS also offered the service to local employers extending virtual care access to their employees as a benefit. This flexible design on the front-end of the virtual clinic serves each populations’ needs while maximizing efficiencies within clinic operations.

Incorporating a new offering to HSHS’s list of services wasn’t complete without educating staff on the importance of the virtual clinic. Through grassroots efforts—lunch and learns, newsletter communications, and collateral—HSHS educated staff on how this new offering could extend their reach and more importantly provide patients with convenient access to its services.

To truly adopt the benefits of the virtual clinic, HSHS decided to offer a virtual clinic program for employees showing them the value of virtual care. This inclusion of telemedicine created employee advocates and helped increase patient utilization by more than 50%.

Learn more about their virtual care program by listening to their recent webinar with Becker’s Hospital Review.

Virtual clinics can support many value propositions for health systems, but achievement of their full impact depends on alignment of the service to your top priorities. Regardless of the avenue a health system takes in executing virtual care into their organization, these strategic questions are vital for methodical planning and strategizing in order to achieve overall success and longevity of a virtual clinic.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Telehealth is a hardware and software solution

Telehealth is a broad field that includes both software and hardware-based medical approaches for urgent, tele-stroke and tele-psych treatment. Other disciplines also include physical therapy, home health, counseling, and consumer education.

Telehealth generally falls under two approaches:

• Asynchronous. A static messaging service that enables email and text messages to be delivered securely between patients and providers. The patient sends their chief complaint through email or text and the provider then has time to research and prepare a treatment plan for the patient. Or a provider captures information to be reviewed by care teams to prepare a diagnosis and treatment plan.
• Synchronous. A real-time communications service that enables phone or video conferencing between patients and providers. A patient and provider can connect with a face-to-face without having to be in the same physical location.
  • Scheduled and Unscheduled Communication — Synchronous solutions can provide patients with the option to access a provider at their time of need through unscheduled 24/7 on-demand care. Or, virtual video visits can be scheduled on the patient’s terms with the visit time and provider that works best for them.

Avizia’s Anytime Virtual Clinic offers a synchronous software solution to health systems that wish to extend their practice outside the four walls of a hospital or clinic with video and telephone conferencing.

Avizia’s software is white-lableled, ensuring the virtual clinic is a natural extension of the health system’s brand, mission, and service. The goal is to connect consumers to their trusted providers.

The configurable implementation process, which includes clinical and business workflows and design, allows health systems to launch a virtual clinic platform that meets the needs of their unique market in as little as 60 days.

Telehealth is a human solution

Integrated telehealth software is not an automated service or a healthcare algorithm. It is technology that enables real-time communication between a patient and a live provider.

• Prioritizing customer experience. Patients have control of their healthcare with the ability to request care 24/7/365 online or over the phone. Patient concierge staff guide patients through the phone intake process and can re-direct patients to in-person care in the event of an emergency.
• Flexible staffing. Hybrid clinical staffing allows health-system providers to see patients virtually and enlist support from Avizia-employed providers during after-hours or at peak utilization times.
• High quality care and integration. Clinical and business workflows, designed by the health system, along with Avizia’s Virtual Practice Guidelines (VPGs) support the entire virtual visit process to effectively treat patients and determine whether a diagnosis can safely be made in a virtual setting. Seamless integration allows the virtual clinic to be securely embedded in a health system’s operations giving providers the ability to push and pull patient data and operate all visits based on a health system’s standards. 

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Not surprisingly, the hospital of the future will require technology solutions like telehealth to meet growing patient demands for remote access to health information and providers. While technology will ultimately help provide better care, it will undoubtedly change the day-to-day roles and responsibilities of IT teams, executives, and clinicians.

If hospital executives and providers want to be successful in the changing healthcare climate, they will need to take an interdisciplinary approach to care coordination and internal communication, working across all departments. The hospital of the future won’t be the hospital you grew up going to, but with all the promise technology can bring – improving the patient experience and driving down costs – that might be a good thing. Here is how we see the provider climate evolving and what that means for the day-to-day roles providers will have to play. 

Hospital IT: Driving change

In today’s hospital, IT teams are in charge of driving innovation and making the technology decisions. IT teams are working on the forefront of change, but in some instances, they seem siloed from clinicians, making the implementation of new technology difficult. In Avizia’s “Closing the Telehealth Gap” report, 25 percent of respondents cited clinician resistance as the main barrier to implementing telehealth.

Since the hospital of the future will be driven by new technologies, IT teams will have an important role to play. IT staff will be expected to take on more of a leadership role and will be charged with working alongside clinicians to help them implement new technologies. In the future, expect IT teams to become an integral part of both the leadership and clinical teams. They will not only drive innovation, but help put it into practice. 

Hospital executives: Bridging the divide

As the decision makers for their hospitals, executives have the final say on which technologies are implemented and across which service lines. By focusing on the adoption of enterprise capable clinical solutions, technology can help hospital executives with the challenges they may face in the future, including physician shortages. According to the Association of American Medical Colleges, we will face a shortage of up to 90,000 physicians by 2025. To minimize the impact to your organization, you’ll need to look to technologies like telehealth and remote patient monitoring to avoid coverage pitfalls many executives may face. The good news is that many companies now offer end-to-end, scalable coverage and telehealth platforms.

Overall, executives in the hospital of the future will work in a more connected hospital with secure apps and messaging as part of an enterprise-wide care collaboration model. This will enable them to make informed decisions and meet the demands of patient care while improving clinical workflow and clinician engagement.

Future executives can expect to have the ability to check the pulse of their entire hospital with the click of a button.

Clinicians: Becoming the advocate for change

Over the past few years, clinicians have faced a number of changes to their daily jobs, from EHRs to ICD-10 to new technologies like telehealth. Sadly, these changes are beginning to have a negative effect on the physicians’ perception of the workplace. According to a recent report from Geneia, clinician job satisfaction is on the decline, with 78 percent feeling rushed to see patients and two-thirds reporting knowing a clinician with job burnout. With more demands on their time, clinicians are hesitant to implement any new technology that does not easily incorporate into their workflow, are difficult to use, or have limited value add. This resistance can end new technology implementation before it even begins.

To be successful in the hospital of the future clinicians will need to be engaged in a way that encourages advocacy of technology, not resistance. As part of an interdisciplinary team, that includes working closely with a hospital’s IT team to explain the difficulties of using new technologies and working together to find solutions that can seamlessly integrate into their daily work. In the future, technology will be tailored to meet their specific needs, ultimately allowing them to spend more time with patients and less time with paperwork.

In the hospital of the future, technologies like telehealth will no longer be a “nice to have” but will become an integral part of care delivery. Exciting opportunities that will revolutionize care are just on the horizon, but creating a technology-friendly, and focused mindset in your hospital is the first critical step.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Published By: Break Health Podcast

Steve Krupa, host of the Breaking Health Podcast, delves deep into Avizia’s history and its approach to developing the right products for hospitals.

How does it identify the features providers want, as well as those they may not know they even need? Listen to find out!

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Amwell is proud to say that three of our clients, Intermountain Healthcare, CVS Health, Cleveland Clinic, have been recognized for their outstanding work in improving life at sustainable costs. These three renowned organizations were recognized with other great institutions like Ochsner Health System, Ascension Health System, Johnson & Johnson and more.

Intermountain Healthcare, based in Salt Lake City, Utah, took the top spot this year—up from third place in 2014 and 2015—while Cleveland Clinic, based in Cleveland, OH, rounded out the top 10.  As Gartner stated, “Intermountain Healthcare’s journey to the top is the culmination of strategy, talent and capital coming together in a sustained effort to transform its supply chain.”  Amwell has been lucky enough to see first-hand how these innovative health systems  have aligned key stakeholders and defined value for their patients and optimized the patient experience—through telehealth offerings and beyond.

Below is the full Healthcare Supply Chain Top 25 list for 2016:

1. Intermountain Healthcare
2. Cardinal Health
3. Mayo Foundation
4. Mercy
5. McKesson
6. Owens & Minor
7. CVS Health
8. Johnson & Johnson
9. AmerisourceBergen
10. Cleveland Clinic
11. Walgreens Boots Alliance
12. Banner Health
13. Medtronic
14. Ascension Health
15. Ochsner Health System
16. BD
17. Novartis
18. Pfizer
19. Advocate Health Care
20. Amgen
21. BJC HealthCare
22. Henry Schein
23. Duke University Health System
24. Roche
25. Abbott

We are proud to partner with these pioneering healthcare organizations, and look forward to transform healthcare together in 2017.

Massachusetts has long been a draw for Israeli companies looking to expand operations in the U.S. and recently, there is even greater interest from Israeli-led healthcare and technology firms in moving to the state. As such we sat down with Dr. Ido Schoenberg, our co-founder and chairman, to find out more about what drew him and his brother to establish Amwell’s headquarters in Boston.

Q: In just a few words – why Boston as the corporate headquarters for Amwell?

Ido: Boston is in many ways the healthcare capital of America. We have a lot of healthcare companies, fantastic hospitals and health systems, pharmaceutical companies, and amazing healthcare talent through the local universities. It’s a wonderful place for a healthcare technology company to build a business, find partners and recruit the best people.

Q: That’s a great summary from a business-making perspective. On a personal level – what about Boston made you want to live here?

Ido: I really like Boston. It reminds me in many ways of Europe, in that it’s understated and refined. People here are very accomplished, but are more modest about their accomplishments. As for lifestyle – it’s a great place to be. We have an amazing education system, for one. In terms of a U.S. location, we have family back in Israel and prefer to be closer to home. The West Coast is not an option in that respect. The weather could be better, though [laughs].

Q: Amwell has been around for 10 years, and you’ve lived in Boston about 20 years. Looking back, how would you describe your original impression of Boston versus now?

Ido: I’m very happy we made the choice to set up shop in Boston. Over time, we’ve developed a lot of personal and professional relationships that have made us very successful. It’s the benefits of working in a cosmopolitan city combined with the feeling of knowing people – I go to restaurants where I know the chefs, I can walk into a local conference or event and recognize many faces. It’s a big impact town but it feels like a small town, too, which I like.

Q: That’s very true about Boston – all the perks of a city, without the anonymity. As a business leader, recruiting the right people must be top of mind for long-term growth and success. How do you see Boston as a great place for finding talent?

Ido: Absolutely, you want to establish your corporate headquarters in a location where you can recruit and retain the best people. Through the universities and healthcare organizations already established in Massachusetts, we have access to many talented, new and seasoned professionals. There is a domino effect that occurs when you are in close proximity to other star companies. As we see more, promising healthcare technology companies emerge in Massachusetts, we will become a more attractive place for employees to live and work. Leaders like Amwell, athenahealth, Optum, Vertex, IBM, and now newcomers like General Electric, will help continue to position Boston as a great place to find work.

Q: Do you have any advice for other entrepreneurs looking to move or expand operations to Massachusetts?

Ido: If you’re a serious company looking to succeed in healthcare or technology, and you want access to the best talent, strategic partners, and the support of an innovation-friendly local government, then Boston can’t be beat.

By: Albert Ferreira

A day does not pass where a healthcare provider, a technology vendor or a media outlet shares a heartwarming story that demonstrates the impact telehealth has on patient care. That was not always the case…

Not long ago, advocates were on the front lines promoting the value and benefits of telehealth to healthcare stakeholders. Naysayers and skeptics had their doubts and concerns about what role telehealth would play and how it would enhance patient care.

Over time, telehealth evolved and its presence increased. As a result, many provider organizations began their telehealth journey with pilot projects. Those pilots eventually grew into full-scale programs supporting patient care across multiple service areas. Around the world, traditional barriers were overcome, reimbursement policies were updated, technology capabilities advanced and new clinical use cases were identified.

So, the question now becomes… Where do we go from here?

Telehealth has reached the next phase in its evolution. The industry has graduated from the “Make the Business Case” phase to the “Show me the ROI” phase. With that, industry leaders, experts and supporters have the responsibility of pushing telehealth to greater heights in this next phase.

Over the next 12 to 24 months, we expect telehealth to evolve and adapt to the rapidly changing requirements of healthcare delivery. Keep an eye on consumer health. As individuals play an increasingly active role in their care, the future model of healthcare will offer consumers more convenient access to care, and increased means to communicate with providers. To be the preferred choice of consumers, healthcare organizations need to adjust to future market demands and integrate telehealth into their care offerings.

Success Step 1: Organizational Readiness

How does a healthcare system prepare their environment for telehealth? Organizational readiness is an important first step in the process.

Many organizations undervalue this phase and do not adequately prepare to integrate telehealth services into their care delivery processes. This is where many telehealth programs get off track and lose the support of key stakeholders.

Getting off to the wrong start is difficult for telehealth programs to recover from. To ensure program success, invest the required time and resources to prepare the organization for telehealth services and gain the buy-in from the key stakeholders and clinical champions.

Preparing for Telehealth

• Leadership willingness and commitment
• Clinician readiness and buy-in
• Program staffing and resources
• Process changes and training
• Creating a sustainable and scalable program

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

“The Exchange combines an outstanding mix of high-quality technology, numerous healthcare providers, and innovative thinking to stoke wider acceptance of telehealth as a mainstream medical service delivery channel.”

At Amwell, we are constantly looking to innovate at the edge of our industry, to meet the challenges of our trusted partners, their providers and patients, and continue to deliver on our aim of making care more accessible and more connected. As a culture, we also don’t just stop when a goal is achieved. Rather, we quickly move on to determine our next goal and carefully plot how we’ll achieve it.

The Exchange is a great example of our culture of relentless innovation. The Exchange requires advanced technologies and capabilities, professional services and legal support, marketing expertise, and the shared vision of our clients – health systems, health plans and employers – in seeing the value of the Exchange now and in the future. Getting the Exchange up and running this past May with the first named partners – Cleveland Clinic, LiveHealth Online and Nemours Children’s Health System – was one, significant achievement. Garnering national visibility for the Exchange and being awarded “Production Innovation of the Year” is another great achievement.

But we are already onto our next and far more ambitious goal with the Exchange – adding every major health system and health plan partner to it, and slowly, opening up a vast provider network to the whole world.

We’re excited for what’s to come and we are humbled by the validation of our industry peers in selecting the Exchange as a telehealth Product Innovation of the Year.

For more on why Frost & Sullivan calls the Exchange a “revolutionary network with tremendous potential to supply extended medical treatment,” you can access the full report here.

Dr. Ido Schoenberg, chairman and CEO of Amwell, a company that provides telemedicine technology to health care companies, said that it doesn’t make sense to provide virtual care without in-person physical care. “It’s how to make care teams fully centric,” he explained.

Telemedicine, which is expected to be worth more than $34 billion globally by the end of 2020, is still very much in its early days, he added. “Right now 2% of health care is done online. In the future, it will be 20% to 30% of care,” Dr. Schoenberg added.

Read the article on Fortune.com or watch the full session here.

Here’s what they found:

Views on Telehealth

There are essentially two camps of telehealth adopters: vision adopters and business case adopters. These two groups are primarily separated by differing expectations regarding the return on investment and alignment to corporate strategy.

Both types of organizations are in agreement in how they view the potential of telehealth.  These leaders:

• Utilize DTC telehealth as an enabler of strategy, not a strategy itself
• Innovate across multiple use cases to maximize their investment
• Place significant emphasis on education to both consumers & providers

Current Use Cases

Across the board, early adopters are using their telehealth platforms to launch urgent care visits to start, but they’re not relying on DTC telehealth solely for urgent care issues. As they launch an urgent care service, these organizations are envisioning their next set of applications in such areas as:

• Post-surgical follow-up appointments: Orthopedics, neurosurgery, general surgery, cardiac surgery
• Specialty video consultations: Neurology, autism screening, sleep, orthopedics, heart and vascular, head and neck
• Virtual clinics: Catering to targeted patient populations in behavioral health, rheumatology, nutrition counseling, lactation support, and pediatrics

Expected Benefits

Regarding their expected returns, early adopters anticipate both financial & strategic benefits:

Promotion & Education

A key insight that emerges from these telehealth pioneers is their deliberate and extensive efforts to promote telehealth both internally to their providers and staff, as well as externally to consumers.

For consumers, health systems use multiple channels to drive adoption:

• Owned and earned media
• Digital
• Paid targeted ads
• Reward incentives
• Provider-led introductions to their patients

For providers and staff, efforts focus on building provider acceptance to drive innovation and scale:

• Early clinical engagement in decision-making and operational rollout to gain buy-in
• Inclusion of physicians and staff to design workflows and clinical protocols
• Involvement of executive and clinical leadership to communicate telehealth goals and encourage education & training

These insights provide health systems with a glimpse into telehealth utilization by early adopters.  As telehealth continues to evolve, we can expect these industry pioneers to set more standards for future innovation and growth.

Interested in learning more about adopting telehealth? Check out our webinar with The Advisory Board on Unlocking the value of Direct-to-consumer telehealth.

Note: The Advisory Board Company is a partner of Amwell.

To learn about how health systems are thriving and succeeding in this era of greater risk, watch Dr. Kosowsky’s session: New Entrants–Breaking in is hard to do.

Edward Prewitt: What drivers in the healthcare marketplace are creating needs and opportunities for new players?

Jeffrey Kosowsky: There are five general drivers in the broader marketplace…and all affect telehealth. The first is the looming non-viability of the payment model. … For telehealth, the first adopters were payers, then employers, because telehealth visits head-to-head are cheaper.

The second driver is new technologies enabling new workflows. … You could say that telehealth existed as far back as Morse code, but it didn’t enter into viability until real-time video…and mobile broadband.

The third driver is new modalities for healthcare. ….  Read the Q&A in its entirety here

This article originally appeared on Forbes.com

In the world of telehealth, we are well beyond the time when physicians worry whether they are within their clinical rights to provide care through technology. Whether through action by state medical boards or acts of state legislature, nearly every state has upheld that the standard of care for physicians when provided through these technologies should be equivalent to care provided in brick and mortar environments. Come January, these doctors will have an even easier time projecting this care throughout the nation when the Federation of State Medical Boards Interstate Licensure Compact is set to be fully operational – making it easier to secure multi-state licensure.

These accomplishments are not insignificant. They create a vital infrastructure for telehealth to do its job – make care more accessible, timely and cost effective. But there’s a fundamental question left unanswered that will diminish the number of providers who elect to embrace telehealth and say “yes” to increasing the amount of care available to our nation’s sick.

“Will I be paid?”

Read the full article on Forbes.com

A study published in February 2015 by the Journal of Clinical Psychiatry noted that depression is the leading cause of disability for U.S. adults ages 15-44 and results in nearly 400 million disability days per year. These statistics indicate that unmet behavioral health needs have a significant impact on our daily lives.

Telehealth for behavioral health is sometimes referred to tele-mental health, tele-psychiatry, tele-behavioral health or tele-therapy. It allows immediate, convenient access to care, alleviating the overwhelming feelings that often accompany patients dealing with a behavioral health issue by stripping away the stigma of an in-person visit.

For patients – digital therapy is provided by high-quality, licensed clinicians, with the opportunity for specialized and multidisciplinary care. Not only is it more affordable than brick and mortar therapy, increasingly it is covered by major insurers. The easy access to multiple providers reduces the uncertainty and confusion frequently experienced when searching for a therapist, and eliminates the frustration associated with finding therapists who are not accepting new patients.

Telehealth addresses longstanding problems faced by consumers of behavioral health treatment. For example, finding a therapist outside of business hours, when most working adults want an appointment, is very challenging. Through telehealth, employees can access therapists after work from the comfort of their own homes, via a scheduled or on-demand visit. For those individuals who still feel a stigma attached to therapy, telehealth provides a more private solution. Telehealth has also been shown to decrease the cost of healthcare through reduced traveling costs, improved management of chronic disease, and shorter hospital stays and visits.

Telehealth can also provide treatment for the following:

• Anorexia/Bulimia
• Anxiety Disorder
• OCD
• PTSD
• Bipolar Disorder
• Depression
• Substance Abuse
• And more

Amwell now offers online psychiatrists, in addition to psychologists and behavioral health therapists. Patients can log onto the Amwell app to find a psychiatrist that’s right for them, self-schedule appointments and experience our suite of coordinated care services.

As employers, patients, health plans and hospitals experience the positive impact of greater availability of mental health services, telehealth as a solution will continue to expand and treat more patients.

We’ve witnessed this firsthand during some of our recent client telehealth launches. Amwell proudly supports the strategies of our clients, all of whom launch telehealth with the common goal of expanding care and access to patients.

Here are just a few recent client launches that have recently expanded access to quality healthcare:

Baptist Health South Florida

Baptist Health South Florida launched Care On Demand to its more than 1 million annual patients. Baptist Health is an innovator in the healthcare space – in 2016, the organization was recognized by U.S. News & World Report as the highest performing healthcare organization in South Florida and as one of Fortune magazine’s 100 Best Companies to Work For in America.

Emergency Medicine Physician David Mishkin, MD, is leading the effort as medical director for Care On Demand. “This new platform provides patients with a new option that complements traditional healthcare,” said Dr. Mishkin. “It expands access to quality care, allowing you to conveniently communicate with a doctor through an interactive live video and audio chat to discuss treatment and ask questions.”

BayCare

BayCare, a leading not-for-profit healthcare system in the Tampa Bay and central Florida region, launched BayCare Anywhere as a complement to its 14 hospitals, 10 urgent care centers, hundreds of ambulatory/office locations, and inpatient and outpatient services that include acute care, primary care, imaging, laboratory, behavioral health, home care, and wellness.

Northern Arizona Healthcare

Northern Arizona Healthcare recently launched Be Well Now. Northern Arizona Healthcare is the largest healthcare organization in a region that encompasses more than 50,000 square miles. Their team of more than 3,000 doctors, nurses and other experts work to serve more than 700,000 people across the area.

Academic HealthPlans

Academic HealthPlans is a leading student health insurance provider, and is now making video doctor and behavioral health visits available to students at more than 100 colleges and universities. Many college students find themselves stressed, homesick, or overworked, and may benefit from psychology and behavioral health services. Telehealth provides a quick and easy way for students to receive the support they need.

Value Drug Company

Value Drug Company, a Pennsylvania-based wholesale distributor, has partnered with Amwell to provide telemedicine services 24/7/365 to more than 600 independent pharmacies and their customers. The partnership allows patients in rural and underserved areas to access medical care, behavioral health therapy and online nutrition
counseling and diet support by using the Value Health Center platform or by visiting a Value Health Center kiosk inside a participating pharmacy.

The use cases for video visits continue to expand with each client launch, and range from post-surgical follow up to chronic care and readmissions management. Thanks to our clients, high quality healthcare is being delivered to more and more new patients. The stars are truly beginning to align.

With more and more hospitals and health care facilities implementing electronic medical records (EMRs) into their IT infrastructure, telehealth is gaining traction as a way for physicians to keep in touch with their patients.

In the webinar, EMRs + Telehealth: Tying it all together, Amwell’s Craig Bagley, director of sales engineering, spoke on how to utilize the company’s telehealth system.
“Integrating your telehealth program into your existing clinical information systems allows for the ongoing care and chronic care management of patients, in addition to being able to treat patients on their terms, wherever they are physically located,” said Bagley.

He described the Amwell telehealth enterprising system as a “fully-branded, white-labeled” system, which means that someone viewing a facility’s telehealth page does not see the Amwell logo and instead sees the facility’s own brand.

Read more on DOTmed.

It can certainly seem like a big task, but when you break it down to a few key lessons, your chances of success grow. Sarah Martin, Assistant Vice President for Product Development & Member Engagement at Blue Cross Blue Shield of South Carolina, shared her insightful thoughts with us on a webinar on implementing telehealth for health plans:

#1: Soft launch first, then market more widely

BlueCross BlueShield of South Carolina launched a telehealth program, Blue CareOnDemand, with American Well in January 2016. Instead of immediately launching marketing campaigns for members, the team spent January in a soft launch phase before introducing the service more broadly to members. This testing allowed the team to make any needed technical changes before marketing the service to their member population in early March. A softer launch prior to marketing ensures health plans can test the system and adapt to any learnings during the test phase.

#2: Push targeted marketing to your diverse member base

In terms of marketing, BlueCross BlueShield of South Carolina knew they should target those members that frequent the emergency room or could be redirected to a lower cost setting through Blue CareOnDemand. They wanted to go further, however, and look at other targets within their member population. They conducted persona research and analysis to better understand who would be more likely to use the service and benefit. Through research, they were able to do specific target marketing to different populations and implement a multi-faceted marketing plan with the right marketing mix to reach these other target segments.

#3: Recognize that your employers will want reporting

If you want your employers to invest in telehealth, they will want to see clear statistics and reporting on a regular basis. Through its telehealth platform, BlueCross BlueShield of South Carolina provides detailed reporting for employer clients. Before launching your telehealth offering, think about what you want to get out of reporting. This requires bringing all your stakeholders together and identifying the metrics that you want to benchmark and track on the analytics side.

Take note of these key lessons and you’ll be well prepared to launch telehealth, satisfying your members, employers and the stakeholders across your health plan.

The annual “Most Wired” list is designed to measure the level of information technology adoption in hospitals and health systems across the U.S. and serve as a tool for leadership to map their IT strategic plans.

This year’s list prominently featured those hospitals and health systems that are ramping up their efforts in telehealth, population health and IT security. Among the “Most Wired” were the following American Well partners:

• Avera Health
• Baptist Health South Florida
• Bon Secours Health System
• Carolinas Healthcare
• Children’s Health System of Texas
• Christiana Care
• Cleveland Clinic
• Hackensack UMC
• Intermountain Healthcare
• MedStar Health
• Memorial Healthcare
• Nemours Children’s Health System
• Nicklaus Children’s Hospital
• Providence Health and Services
• Reid Health
• Riverside Health system
• Luke’s University Health Network
• Tampa General Hospital

We could not be more proud to partner with so many innovative provider organizations and work together to transform healthcare by bringing the best of real-world care online.

Click here to read a success story about Avera’s innovative work in telehealth.

The U.S. News and World Report recently released its national ranking of the Best Children’s Hospitals. Always a go-to resource for learning about the most innovative and effective hospitals, the report gathers clinical data and compiles surveys from more than 10,000 pediatric specialists on where they would send the sickest children in their specialties. This year’s report is an impressive list of hospitals who are bringing new methods to care that improve health outcomes for children across the U.S.

Given our role in the healthcare spectrum, we congratulate all of the nearly 80 pediatric hospitals included, and we want to recognize the following hospitals:

• Cleveland Clinic Children’s Hospital
• Nemours, Orlando
• Nicklaus Children’s Hospital, Miami
• Children’s Medical Dallas
• Riley Hospital for Children, Indiana University Health

What do they all have in common?

Besides being the best of the best in caring for children in specific specialties, they all believe in the power of telehealth. American Well, in turn, powers that telehealth. We’re proud to support these health systems in the incredible work they’re doing on behalf of patients to improve care outcomes for everyone they serve.

Pediatrics is one of the many use cases we see our clients implementing in telehealth and it goes well beyond urgent care. Children’s Medical Dallas has a pediatric telemedicine for their clinically integrated network doctors to use the platform for scheduled follow-up visits. Hospitals are using telehealth to treat pediatric patients for neurosurgery, nutrition education and orthopedics.

Here are a few specific and unique ways that pediatric hospitals are applying video visits for their patients.

Kiosks: making healthcare available where the parents are

Children’s Medical Dallas provides kiosks to its employees in two of its major acute care hospitals, providing streamlined care to the doctors, nurses and staff who serve pediatric patients each day. Our client Avera has placed telemedicine kiosks in grocery store chain Hy-Vee, providing video care to busy parents and children aged two and up while they’re at the store taking care of errands. Avera has also set up nutrition counseling and health events in the stores to promote quick, seamless care to the moms that shop at Hy-Vee. If you’re interested in learning more about Avera’s kiosks, check out their telehealth case study.

Telemed Tablet: offering consults to school nurses

Children’s hospitals are benefiting from our Telemed Tablet in unique ways. The tablet is a unique tool enabling provider-to-provider consults via video right from the bedside of a patient. By placing tablets in schools, nurses can connect immediately with specialists who provide consults on medical issues that falls within their expertise. That specialist can recommend follow-up care or solve the issue right on the consult. This eliminates the need for a child to be transported to an emergency room or office visit when it might not be needed.

The Exchange: making world-class pediatricians available beyond geographic boundaries

Nemours is making its providers available through the American Well Exchange. The Exchange is a virtual storefront – enabling health systems to offer their healthcare services to patients across the American Well network. In the case of Nemours, this means that any patient who uses the Amwell app (American Well’s direct-to-consumer app) in Florida can see a Nemours provider. Nemours makes its physicians and clinicians available to a much wider audience, introducing new patients to its top-ranked doctors and services. For the physician, it is as easy as clicking from one virtual patient examination room to the next. Pediatric hospitals who choose to work with American Well have the opportunity to open up their services to many more pediatric patients who could benefit from that care.

Pediatrics is an area of growth and opportunity for telehealth, and in fact, the American Telemedicine Association has a Pediatric Telehealth Special Interest Group dedicated to educating other organizations on how to best implement a pediatric telehealth strategy. We salute all of our health systems recognized this year for their innovation and quality care and we celebrate the early adopter providers who see telehealth as an innovative, effective tool for enhancing outcomes for pediatric patients.

Amwell Engineers Seamlessly Advance Telehealth

As seen on VentureFizz – Excerpt below

For the first time, the agency urged states to consider telemedicine as they create their individual network adequacy standards for private Medicaid plans. This is a significant stake in the ground.

Historically, CMS adequacy measurements have not allowed for telehealth to meet these criteria. However, this new regulation combined with the National Association for Insurance Commissioners model state legislation, which if codified, would formally add telehealth as an acceptable element of meeting adequacy standards, gives states the tools and the encouragement they need to better serve their Medicaid populations through technology.

CMS estimates that approximately 74 million Americans will receive care through Medicaid this year. In order to provide sufficient provider access to these millions of patients, states must now act and modernize their laws and regulations to take full advantage of the benefits of telehealth.

We look forward to hearing thoughts and discussing these new requirements with the industry.

Healthcare Tech Outlook recently published their 10 Most Promising Telemedicine Solution Providers of 2016, noting Avizia’s transformational telehealth solutions for optimal patient care. Enterprise telehealth requires certain commitment, governance, and planning. Avizia has helped large health systems, provider networks, and home care agencies, to prepare for successful system-wide telehealth implementations. Avizia’s flexible end-to-end telehealth platform is designed to tackle the most common modalities that healthcare providers are striving to address today–behavioral health, general medicine, and emergency care–in additional to newly emerging telemedicine applications.

Avizia’s telemedicine carts and peripherals help connect physicians, specialists and their patients to the point of care from geographically dispersed locations. While facilitating collaboration with the care teams, patients can hold their interactions with doctors or nurses via Avizia’s medical devices from the luxury of their own homes, or even from outskirts of the cities.

Further, a telehealth program can only be successful if it can mimic the existing clinical practice. Avizia has designed its workflow software to achieve all levels of optimum care from scheduling patients to delivering care and tracking their recovery. Avizia offers a complete suite of software designed to integrate with an organization’s existing Electronic Health Record (EHR) systems.  At a glance, Avizia ONE enables more efficient care coordination, communication, and virtual care.

Read the complete article on Healthcare Tech Outlook.

Avizia was acquired by American Well in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Title: Senior Product Manager

Department: Product Management

Start Date: December, 2014

What attracted you to Amwell?

When I was interviewing, I was struck by the enthusiasm of everyone I met. I saw joining Amwell as an opportunity to be part of a team where everyone was completely invested in what we’re doing and where we’re headed. Day in, day out, I’ve always felt that it’s the people that make the organization.  Right away, I could tell I would be joining a really strong group and working alongside a great set of people. After trying our product, it was easy to see so many opportunities for it to improve the healthcare experience on a wide scale. The potential to make an impact felt really high, which was exciting then, and remains so today!

What does a day in the life of a Product Manager look like?

Every day is completely different – that variety is one of the things I love about working at Amwell.  In product, one of our core functions is to manage the product roadmap. We look to customers to provide information on their needs and experiences, and we consider how the product could address their challenges. We meet regularly with each customer’s project manager to understand how the customer is using the product, and discuss high priority issues.

For me, every day starts with Agile style stand-ups with our web and mobile development teams. We talk about what’s going on in the development process for a release cycle, and raise any blocking issues.  We’re always looking forward to the next release so I spend a good deal of time collaborating with colleagues in Development, QA, and Visual Design to define new features. This may include wireframing a redesigned version of the patient homepage, or just whiteboarding requirements with the team.

Depending on the day, I might also be writing Release Notes, working with other internal departments at Amwell, or speaking with another company with whom we might collaborate.

What are your hobbies outside of work?

I enjoy running and exploring new neighborhoods around Boston. Some friends and I have a paint club, where we get together and all paint the same scene. I also really enjoy camping in the Summer and Fall, especially at Hermit Island Campground in Maine.

 Have you used Amwell’s direct-to-consumer app, Amwell?

Yes, many times! I had my first ‘real’ visit just a few weeks after starting at Amwell. I had flu-like symptoms, a terrible sore throat, and was losing my voice. When the video visit began, I got out two words, and my voice was completely shot. I gestured to my boyfriend to come over and tell the doctor about my symptoms. The doctor guided me to shine a flashlight i to my mouth so that she could look at my throat. I also used the chat function to type answers to the doctor’s questions. It turned out I had a robust case of laryngitis.

What are your thoughts on the ways healthcare is changing and what we can expect to see in the future?

In healthcare, quality always matters. More and more, I think people expect that quality to be easily accessible, and affordable. I’m convinced that having a visit online will soon be a very common way to access care, whether for an urgent care issue, a follow-up appointment, or to manage a chronic condition.  Telehealth will be just another way to receive care, and often the most convenient.

Each release, I see how new features, like multiway video, can enhance how patients get healthcare, and allow them to get the support they need. At this moment, there are still a lot of challenges we face in healthcare, but there’s so much focus on this area, and our momentum is growing. I think there are endless opportunities for technology to solve healthcare problems, and it’s a tremendously exciting time!

What were you doing before you came onboard?
Optimus Prime, Megatron, Dinobot Slog – before Amwell, I was on Hasbro’s Transformers Global Brand Team. I worked on core products as well as the new Transformers television show. Before that, I worked at the Harvard School of Public Health for seven years, which helped me to better understand the challenges we face in providing healthcare to all.

When you talk about telehealth with friends and family, what do you say?

I start with the basics that when they’re sick, they can go online and get immediate help from a doctor, 24/7. This scenario resonates with everyone who has raced to an urgent care clinic, only to wait around for a long time feeling crummy. But, Amwell does so much more, and I talk a lot about how much choice our platform offers customers. Whether it’s getting wrap-around support from the Online Care Group, offering therapy or nutrition appointments, or adding on Kiosks or Telemed Tablets, Amwell’s offering can be modular, and completely flexible. It allows the customer to launch quickly, and then continue to enhance its offering. When I talk about work, folks are always surprised at just how much the Amwell platform can offer, and how much choice the customer has in designing the patient experience.

In Dr. Pitt’s latest edition to At the Intersection of Technology and Health, he explores why doctors don’t question hospital transfers, and how patients who are unnecessarily transferred face financial risk. Today, 30% of bankruptcies in America are caused by medical expenses. Telemedicine technology is becoming a valuable alternative to costly hospital transfers.

Historically the phone has been the only option for communication between hospitals. With no other information, the open door policy made sense. But times have changed. Just as you can Skype with friends over long distances, expert care can also be delivered remotely. Such advances are extremely important for credibility between providers and between providers and patients. Video improves relationships and credibility in the care cycle. Enabled by video (a primary tool of telemedicine), centers of excellence could complete their mission, support the outline facility, and still be more selective in which patients they accept for transfer.

This business model has worked effectively for telestroke treatment. Rural emergency room physicians weren’t comfortable initially with the administration of clot busting agents (t-PA) for stroke. But through the use of telemedicine, stroke experts now stand behind rural physicians, helping them decide whether or not to administer t-PA and whether or not the patient is to be transferred. This partnership allows patients to receive a higher level of care, while the number of transfers has diminished. It’s a win-win for both rural hospitals and urban centers of excellence. The same change in process, replacing the phone with video, is widely applicable to all sorts of clinical scenarios.

The healthcare community is built on principles of compassion and a chance to heal. But well-intended efforts that make it easy for patients to get care at tertiary facilities have unintended consequences. Care decisions need to be gauged against the ultimate outcome for our patients. Of course we need to take care of those patients who need tertiary services. However a blanket open-door policy for transfer may not be the right answer in 2016. To save someone who didn’t need saving, while ruining their financial health in the process, is not just a matter of outmoded policy; it is something close to a crime of neglect.

Click here to read more At the Intersection of Technology and Health.

Avizia was acquired by American Well in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Typically found in communities that face economic and healthcare burdens, School-Based Health Centers (SBHCs) exist to meet the healthcare needs of children and parents, as well as local community members. The synergy of telehealth and SBHCs enables primary care medicine to reach into schools for assessment, diagnosis and prescribing, reducing the need for parents to usher their children from school to the doctor’s office.

When children get sick at school, it can be a big disruption. Kids miss class, and their parents need to leave work, try to schedule a last minute doctor’s appointment or visit the Emergency Department. Telehealth is changing the equation by connecting kids to pediatricians without leaving their school’s campus. That’s the idea behind Children’s Health in Texas innovative program which has gone from reaching several hundred kids to thousands.

Children’s started a telehealth program at a pair of preschools in 2013. Today, there are telemedicine carts in 57 urban and rural campuses across North Texas. It’s one of the largest school-based telemedicine programs for kids in the country. Dozens of schools across the country are experimenting with telemedicine – from Kansas to Arizona and Georgia. Most are collecting data to see if the programs help kids miss fewer days of school while helping parents save time and money.

Click here to read the original article published by NewsWorks.

Avizia was acquired by American Well in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

This intro to AW9 video features insight from Roy Schoenberg, our CEO

The mobile SDK, which makes it possible to plug telehealth into another app, is an industry first, and was a major point of interest at HIMSS

Another game-changer in AW9 is Multiway Video, which allows patients and doctors to invite others to join their telehealth visits

AW9 also introduces new functionality to the Telemed Tablet, which brings specialist care to wherever it is needed with the touch of a button

For details on these key features and more, check out our press release and our completely revamped product page.

Title: Business Development Associate

Department: Marketing

Start Date: January 21, 2016

I think telehealth is the way of the future. My generation is accustomed to having everything at the click of a button – a car ride, fast food, or a hotel room. Why should healthcare be any different?

What attracted you to American Well?

I studied Community Health in college. I have always been very passionate about reducing health disparities between those that have access to quality healthcare and those that do not. American Well’s technology not only expands access to healthcare, but also improves the quality of care being delivered. I like being part of an established company, but one that is constantly innovating and evolving. That was exciting to me.

What were you doing before you came onboard?

I worked at Big Brothers Big Sisters, a non-profit in Boston. I was an Enrollment Coordinator, responsible for interviewing potential mentors and matching them with kids in need of support. I spent a lot of time in the community – interviewing families in their homes, and visiting kids at their schools. I became very comfortable interacting with a diverse group of people (and also tracking people down!). I think that skill set translated nicely to the role of a Business Development Associate.

What does a day in the life of a Business Development Associate at American Well look like?

Every day is different, however, my main responsibility is to find opportunities for new business. Leads come to my team from various sources, such as events, webinars, our website, and word of mouth. As a Business Development Associate, I track these leads and identify the ones that might be interested in our services. I focus on health systems. Part of the job is also doing some detective work – finding out which hospitals might be interested in telemedicine. I also enjoy getting involved in department initiatives. Recently, the marketing team launched a chat feature on the company’s website. The Business Development team has been responding to a lot of inquiries about telehealth through the chat, such as “how do I apply to be a physician” or “can a doctor treat me for this?” We wear many hats, and that is what makes the job so exciting.

What are your hobbies outside of work?

I like being active. I love trying different fitness studios around the city. I also enjoy exploring Boston. In my previous job, I traveled to all of the neighborhoods in the city. I am also part of a book club, and I play softball through Social Boston Sports in the spring. I like cooking and trying new restaurants (especially those that are vegetarian-friendly!).

Have you used American Well’s direct-to-consumer app, Amwell?

I wanted to show the app to my parents, so we all participated in a visit together. My mom had a question about nutrition. My parents, who were initially somewhat nervous about the new experience of seeing a doctor online, loved the visit! They thought the doctor had great “webside manner.” This was quite the compliment, given that my mom worked for an organization whose mission is to promote compassionate healthcare.

What are your thoughts on the ways healthcare is changing and what we can expect to see in the future?

I think telehealth is the way of the future. My generation is accustomed to having everything at the click of a button – a car ride, fast food, or a hotel room. Why should healthcare be any different? I think that most people would agree our healthcare system is broken. It’s expensive, and often very inefficient. Telehealth is only one piece of the puzzle to improving healthcare, but it is a critical one. If we can treat patients remotely – regardless of where they are in the world – then we can revolutionize the way healthcare is delivered.

Published February 18, 2016 by The Western PA Healthcare News Team

By Dr. Alan Pitt

In a WSJ article entitled“Why ER Visits for Non-Emergencies Aren’t Going Away,” Dr. Paul Auerbach, a teaching professor of Emergency Medicine at Stanford’s School of Medicine, summarizes some of the critical factors contributing to and causing over utilization within emergency departments. As outlined by Dr. Auerbach, emergency departments are currently a necessary part of American healthcare. However, active marketing of hospital emergency departments as “America’s clinic”—seems ill conceived. To understand why, let’s look at the emergency room experience from all sides: that of the patient, the provider, and the hospital.

The Patient’s Perspective

Although policy makers and insurers would like to believe otherwise, when you’re sick, injured or in pain, you’re not in a frame of mind to make rational decisions about the lowest cost, highest quality provider. Patients want answers and reassurance as quickly as possible. Unfortunately, access to prompt care has become a real issue. Often people prefer to pay a convenience charge (or they don’t pay) to be seen immediately rather than wait weeks (or even months). Emergency physicians often provide such instant gratification, but they are not equipped to deliver long-term solutions.

The Provider’s Perspective

Overworked and overbooked providers often use the emergency department as a backstop for their practice. One way they do this is through the nearly universal after-hours use of the recording, “If this is an emergency, hang up and dial 911,” which pushes the patient to the emergency department. Alternatively, some primary care physicians actively send patients to the emergency room simply to expedite specialty care. Here at my center it is not uncommon for a patient to come to the ED with back pain because the neurosurgeon’s next available appointment was eight weeks out.

The Hospital’s Perspective

Emergency departments can be a profit center. Charges for the same low acuity conditions treated in primary care clinics increase two to three fold in an urgent care setting, and then another five to ten times in an emergency department. Also, to some degree, and based on federal legislation, hospitals are forced to treat (or at least triage) all patients coming to their emergency department.

In short, Americans’ addiction to emergency departments represents a perfect storm of circumstances: Patients want rapid answers; primary care providers have a pop off valve for after-hours or specialty care; and hospitals get revenue. As a result, many hospitals have begun actively promoting ED care. If you call my hospital and many of our competitors, a pleasant recorded voice says, “We heard you. You didn’t like waiting in our emergency department. So why not sign up, stay at home and we’ll call you when it’s your turn.”

But wait? Stay at home until you’re called? Doesn’t this—almost by definition—make the situation not an emergency? Seeking help for an emergency health issue after hours shouldn’t be like taking a number to be served at the deli counter.

What are some possible solutions? For starters, rather than compete for the most compassionate marketing slogans, perhaps resources could be devoted to “right spacing” and “right placing” patients. Imagine being worried about a headache, back pain, fever, or a myriad of other typically non-life threatening conditions. You get yourself to an emergency room, where a healthcare professional meets you and determines your condition is non-life threatening. You are offered to be shuttled to the primary care clinic a block away, or alternatively, you can walk over to a kiosk ten feet away—just like the ones at many local drug stores. In either case, you could be offered follow up treatment as part of the solution.

Yes, there are obstacles to overcome. Most notably, providers would have to be paid for this type of care. Emergency physicians rightfully object to triaging patients (with the associated liability that comes with such work) without some form of reimbursement. Ultimately however, the patients we’re responsible for are better served at a lower cost in less emergent settings. As healthcare professionals, doctors, and administrators, we’re in the business of dispensing diagnoses and treatments. But, shouldn’t we be something more, a guide helping our patients make good choices in terms of where and how they are treated during their journey through the healthcare system?

Dr. Alan Pitt is Chief Medical Officer at Avizia, as well as an attending physician and professor of neuroradiology at the Barrow Neurological Institute.

Avizia was acquired by American Well in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

The team at MyDocNow is pleased to announce their easy to use telemedicine platform is now available in the Philippines. The new service offers virtual medical services that connect medical professionals and patients seamlessly using a telemedicine portal that has been successful in the United States.

The new platform will offer a real-time experience for patients, offering everything from video consultations with doctors, comprehensive patient education, remote monitoring from a smartphone device, delivery of prescriptions and medications, lab tests results, and doctors/nurse home visits 24/7 in selected metro areas.

“All these services are combined in a single user experience with a soon to be released mobile app, not available in any other country in Asia” … Mr. McClung, CEO MyDocNow.

MyDocNow is partnering with US-based company Avizia, a pioneer in the delivery of a telehealth platform that works with large health systems and insurance providers to connect patients to healthcare specialists anywhere in the world.

“The MyDocNow platform is ideally suited to support a large scale deployment for public health purposes in rural deployment in the Philippines for the people” …. Dr. Jose Miquel Vergara, Chief Medical Officer MyDocNow

MyDocNow operates a call center, which is a 24/7 facility fully staffed by highly skilled nurses who are trained to perform basic triage, use the functions of telemedicine to manage the doctor/patient connection in order to facilitate a consultation and follow up with a patient and doctor satisfaction survey.

MyDocNow encompasses Lifeline Rescue, a Manila-based organization with over a 100 doctors providing emergency response services in urban areas while delivering other innovative services.

Since it is estimated that 65% of interactions with healthcare organizations will be conducted via mobile devices by 2018, MyDocNow is proud to offer a streamlined mobile platform that will bring both medical professionals and patients in the Philippines into the next generation of healthcare.

MyDocNow is also partnering with Davao Doctor Hospital to deploy it services. “We see the MyDocNow service as an extension of our objective to be a technology leader in delivering new services to Philippine patients as well as Beyond our Borders.” … Raymund del Val, President & CEO.

The company will offer its services to doctors, the general public (via apps in Google Play and Apple Stores) and insurance companies.

The new virtual healthcare delivery system will make it possible for healthcare providers in the Philippines to save time while providing premium services to patients. Patients will receive the quality care of a doctor at their convenience. It is simple, secure and confidential.

About MyDocNow

MyDocNow was created by a dedicated and dynamic team of medical and health professionals, information technology specialists, and prominent business leaders.

Avizia was acquired by American Well in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Our fabulous events planner, Liz Kelliher, flew in early to set up the American Well booth, #2154.

Doesn’t it look great?

On Monday, Katie Ruigh, our VP of Product, was interviewed about our newest product release, AW9 by Joe Lavelle, with intrepidNow

And again Wednesday, this time with Danielle Russella, President of Customer Solutions, by HIMSS Media

Our Chief Medical Officer, Dr. Peter Antall, was just interviewed by MobiHealthNews

Here’s Ali Hyatt, one of our Marketing Directors, with Dave Plummer, one of our Account Management Execs, celebrating the announcement of American Well’s partnership with the Advisory Board 

Our Product Specialists have been giving demos all week. Check out Lauren Meyer in action

Wednesday night’s Tele-tini Happy Hour was a success!

Keep your eyes peeled for Dr. Roy Schoenberg, our CEO, caught here in a rare moment of stillness at the booth

If you’re at the conference and you haven’t had a chance to say hi yet, head on over to see us at Booth #2154. The team would love to meet you!

The post-ACA era environment marks a drastic change in employer-sponsored benefits. Healthcare roles are rapidly evolving, while the types of organizations available to serve employees continue to expand. Discussion at the forum zeroed in on consumer understanding of private exchanges, the new role of brokers, and how healthcare organizations can help eliminate consumer confusion about healthcare benefits in general.

Amwell attended the forum, which underscored the rise of telehealth in the employer market and addressed its integration into private exchanges. Our employer experts sat on two key panels.

What Do Employers and Consumers Want From Telehealth?

Andrea Comporato, Amwell’s SVP of Health Plans and Employers, sat on a panel to discuss what consumers and employers want from telehealth. The key takeaway from Andrea’s presentation was that “each one of us has the chance to improve quality and reduce costs.” The rise of private exchanges signals that consumers are looking to innovative care delivery solutions like telehealth to add value to their care.

Andrea’s co-panelist, Jake Cleer from New Benefits, believes that consumers still require education about the benefits of telehealth. He projects that as consumers become more informed and telehealth use cases move beyond urgent care, organizations will need to look at exchanges and groups as a mechanism for purchasing a telehealth platform.

Chronic Care Management in the Telehealth Age

Claudia Rimerman, Amwell’s VP of Channel Relationships, led a discussion on consumer acceptance of treatment via telehealth, with a focus on chronic care management. Other telehealth companies, wellness companies, carriers, and consultants participated in the discussion, expressing the opinion that the ability to manage chronic care on a platform is a unique enabler. A key takeaway from the discussion was that telehealth is evolving beyond urgent care and the types of use cases for physicians and patients are becoming much more varied. Beyond urgent care and chronic care management, telehealth can now deliver behavioral health services, general health assessments, nutrition, diabetes management, and smoking cessation services. And with platforms like Amwell, telehealth can improve health outcomes, reduce costs, and drive engagement.

If you attended the Forum, what are your thoughts? How can organizations continue to be health advocates for consumers?

Your Guide to Telehealth at HIMSS

There’s so much to see in such a short time. Here’s our guide to telehealth at HIMSS. See you there!

Learn here.
MON. FEB. 29 – 8:30 AM – 4 PM: Connected Health Symposium
Topics include the impact of telehealth and mobile tech on policy, payment, and how to achieve clinical and financial results.

Test drive here.
TUES. MAR. 1– THURS. MAR 4: Check out AW9: Booth #2154
Meet with Amwell’s professional product team and receive live demos of our newest product features including industry first video solutions.
We’re also hosting live demos of our kiosk on March 1-2.

And keep an eye out for our leadership team – Roy Schoenberg, Danielle Russella, and Peter Antall will all be there. They’ll be joined by John Jesser from LiveHealthOnline and many of our other partners.

Read the abstract, then download the full paper:

With the rapid evolution of the health care industry, health care delivery organizations are leveraging innovative solutions to meet these challenges. It is imperative that provider-centric organizations seek solutions that combine disease management, health informatics, and supporting technologies to improve access to care and health outcomes. Telehealth—the provision of high-quality, real-time video encounters between patients and providers—is a powerful tool that can support healthier patients. At its core, telehealth aims to provide care anytime, anywhere, on any type of device—be it a web browser, a mobile phone or tablet, or a standalone kiosk. When telehealth is fully integrated into an existing health care system, patients have access to on-demand care from an accredited provider with the touch of a button. This bypasses lengthy wait times and can avoid a high-cost urgent care visit. A patient’s location and mobility does not limit the scope or quality of available care. The need to travel to a brickand-mortar facility is no longer an assumed requirement or barrier to care. Rather, a patient can engage in a virtual visit with a provider from the comfort, security, and privacy of home—or wherever he or she may be.

Sadly, this is rarely the case these days. As treatment options have increased so has medical sub-specialization. Many of today’s highly skilled physicians have sacrificed breadth for a depth of knowledge. Physician reimbursement pressures have exacerbated the problem, resulting in 12-minute visits with little time for patient questions and no time to build a trusting relationship. The result: a fragmented healthcare experience for the patient.

As providers we have to ask ourselves, what’s missing? The specialist may be the right person in the right role, but at a given time they may not be the ideal primary care provider. The reason for this lies in the current structure of care in the United States, a structure I see as the healthcare pyramid.

The Healthcare Pyramid

Imagine our healthcare system as a pyramid.

• At the top you’ll find a shrinking number of expensive specialists focused on fixing an immediate need, NOT building a relationship with each patient.
• The bottom is comprised of a growing population of patients that demands access to care from the right doctor, at the right time, and from someone who cares.
• In the middle we are missing someone to build and maintain a trusted relationship with patients.

So, how are we going to fix that? The solution is found in the marriage of people and technology. On the technology end, we have the emerging platform of Telehealth. Also called telemedicine, it has many applications and is a tool that can be utilized by a range of healthcare professionals. On the human side we have healthcare providers. Now, to fill that gap in the pyramid, let’s look at how telehealth makes possible and supports a new kind of healthcare provider called the healthcare navigator.

The Healthcare Navigator

Healthcare navigators are team members who have the time and patience to establish and maintain a trusting relationship with patients. These providers do not have the training of a specialist and are therefore less expensive. However, supported by experts in near real time via telemedicine tools, they would be both credible and critical in accessing the right expertise at the right time, navigating the healthcare waters for the patient.

Initially, healthcare navigators would build trust through one or two in-person visits with the patient. After that, they could turn to cost-effective tools—text, phone and video—to maintain the relationship. This arrangement eliminates repeated office visits that are too costly, both in terms of time and travel for the patient, and it is equally efficient for the navigator. It’s also flexible, allowing for in-person intervention when necessary.

Let’s illustrate what a healthcare navigator experience would look like with the following scenario: Patient John Doe is 80 years old and has been discharged from the hospital after heart surgery. A few days later, his wife is concerned with John’s appearance and believes something is wrong.

• Without a Care Navigator: John’s wife calls the specialist asking for a call back. If no one is immediately available the front desk is trained to recommend that John be taken to the ER. Patients hate re-entering the ER queue, and hospitals can’t afford it. Re-admissions drive up costs, providers can be penalized, and hospitals can lose Medicare supplements.
• With a Care Navigator: John’s wife calls her care navigator to report the concerns. The care navigator meets John and his wife virtually or at an outpatient facility to review John’s records and gather diagnostic data. The care navigator then directly contacts the specialist for expert advice, receives the specialist’s instructions, and writes John a prescription for a different medication to avoid negative side effects.

Here we see how the new role of the care navigator restores some of the human element so often lacking in healthcare today. But clearly what makes such a position possible is telehealth. Telehealth is the mortar that fuses each layer of the healthcare pyramid together. Without the proper tools, providers are plagued with archaic methods for managing encounters, patient engagement, and care team collaboration. As telehealth platforms emerge, we’re seeing tools that were previously siloed become integrated into enterprise systems with healthcare’s role-based hierarchy built-in. Through telehealth we can connect the right provider to the right patient at the right time. And in doing so, we will reverse the fragmentation of the patient’s healthcare experience.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

No two mHealth or telehealth programs are alike. Some telehealth platforms look great from the outside, but fall short of expectations. That’s why today’s healthcare providers looking to transition into telehealth must to consider both internal and external criteria before deciding what programs to pilot and what solutions to implement.

“A lot of the problems are with a fear of the unknown,” says Shawn Valeta, director of telehealth for the Medical University of South Carolina, which has had an extensive telehealth platform for more than a decade. “There’s so much out there; you have to sit down and think about what you really want to do with it before you start.”

Backed by $50 million in state funding, MUSC has developed a solid telestroke and tele-behavioral health program and has plans to grow its school-based telehealth program, provide telehealth services to correctional institutions, build a platform for large employers and get into remote patient monitoring.

In 2015, MUSC rolled out its school-based telehealth program to 3 select schools. MUSC began by identifying schools in the state’s poorest regions, where children with any sort of health issue went straight to the nearest ER. By linking with those schools, MUSC gave children and their parents – and school staff – a quick and convenient link to healthcare, reduced absenteeism, improved morale and reduced the strain on local hospitals. The school-based telehealth program is now in 20 schools, and MUSC plans to double that total by next year.

“Telehealth used to always be about distance and time, but now it’s about maximizing efficiency” for both patient and provider, says Valeta. “To do that, you need to make things more user-friendly. You don’t even think about the technology for a while – that comes last, and the people and the processes come first.”

In nearby Georgia, Rena Brewer overseas the Georgia Partnership for Telehealth (GPT) network that spans three states and is branching into Central America. Brewer joined the GPT after serving as the director of the Southeastern Telehealth Resource Center, one of 14 federally funded centers (12 regional and two national) scattered across the country to provide guidance to local healthcare providers and others interested in launching and sustaining telehealth programs. While she recognizes the growth of telehealth across the country, Brewer has also see a lot of telehealth projects fail.

“Technology can be very intimidating, and many people make the mistake of thinking that’s where you have to start,” Brewer says. “Some hospitals just can’t get past that initial loss of revenue, so they lose interest or fail to push back. … They don’t realize that you don’t have to buy the Cadillac – you look at what you have and what your community really needs the most, you manage expectations and you create relationships.”

GPT also sees the potential in growing school-based telehealth, with more than 70 schools in Georgia alone are connected to their network, in addition to dozens of schools in neighboring states and a few colleges. Brewer and the GPT are also developing tele-behavioral health programs, and are pushing into skilled nursing facilities (SNFs).

Hospitals are also partnering with local physicians and clinics to create a community health network to extend the care typically only available in hospitals to patients who simply need to visit their local provider.

Both MUSC and the GPT are partners with Avizia, a Reston, Va.-based developer of telehealth platforms. Mike Baird, the company’s CEO and Alan Pitt, its chief medical officer, see three factors supporting the growth of telehealth:

1. legislative interest
2. consumer demand
3. electronic medical record (EMRs/EHRs)

“Software is leading the trend,” says Baird. “EMRs haven’t been great at integrating” with telehealth platforms and mHealth devices, “but it’s becoming an evolution. Healthcare is pushing that forward, is demanding new ways to integrate.”

“The EMR is an operating system that isn’t deep,” adds Pitt, “so it needs apps to be more functional. That’s where telemedicine comes into play.”

Dr. Pitt has been monitoring a shift in how health systems approach care coordination. Traditionally, they created external business partnerships, but now they are bringing resources back into the institution. Fee-for-service care is giving way to role-based care, with the provider being the link. Business models are changing, but there are challenges. Hospitals generally have poor strategic roadmaps, says Pitt, and aside from the organizations with telehealth directors or chief innovation officers (a rare but growing C-suite position), few have someone on hand to “own” telehealth. In addition, the industry as a whole isn’t mature enough yet for health system to simply pick up the technology, plug it in and make the best use of it.

Click here to read the complete article on mHealthIntelligence.com.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

Let’s talk digital—specifically, the main digital marketing channels and how they can be collectively leveraged in a campaign to drive patient engagement with a health system’s telehealth service.

But first, what do we mean when we talk about digital marketing for telehealth?

Digital marketing is an umbrella term—it refers to all the different types of technology available today to support marketing efforts. Digital marketing tactics are immediately attractive simply because of the world we’re living in. There’s not much that patients can’t do on their mobile phones—including addressing a medical issue through a telehealth visit. It’s common sense to market a technology service like telehealth via the web and social media, but beyond that, a digital marketing campaign also works for telehealth because it can serve up some really powerful results at a low cost. This is crucial in the early days of a telehealth service when utilization is still building.

Websites

A website is the anchor of a digital marketing campaign. It’s the best way to share information about your telehealth service with your patients—the consumers you built the service to help. There are a range of options, from building a single, well-constructed telehealth page on an existing health system website to creating a standalone microsite dedicated solely to the service. Either way, leveraging a health system’s website is low cost (compared to paid advertising), and it gives you control over content and messaging because you own it. Beyond dedicated pages or websites, you can also strategically place messaging about your telehealth service on key pages of the website. Your analytics program (e.g., Google Analytics) will help you identify the high-traffic “go to” pages patients visit—not necessarily the home page, but perhaps an urgent care page, “find a doctor” page, or specialty page—you can place information about telehealth there, increasingly the service’s visibility to your patient population.

Blogs

Blogs are an all-around win. Not only are they low cost, they’re also easy to set up, easy to use, and are a great way to show your patients how telehealth will help them. Blogs help you increase the amount of content you have online–in fact, feel free to re-purpose existing content on your blog so more patients see it. To create a high-value blog, post about issues your patient population cares about, whether that’s access to care, chronic disease management, specialty services, or something else. Blogging is a great way to educate your patients about telehealth and the ways it benefits them, and then you can link blog readers back to the website to access the telehealth service. Because the purpose of a blog is to engage patients on the issues that are important to them, follow the 80/20 rule. At least 80% of the content must speak directly to patient interests in a non-promotional way. Don’t make a blog an advertisement for your telehealth service—instead write a post about how telehealth saves patients time and money while effectively treating their health conditions. One final note on blogging—to build an audience you have to commit to a regular posting schedule. Start with one post a month and increase the frequency as resources permit.

Email

Like most of the tools in the digital toolbox, email is low cost and user-friendly. With email you can reach a wide audience easily through one of the many intuitive email tools designed for mass outreach. Email is the best vehicle to tell your patients about the great content available to them through your owned assets, like your website and your blog. Through email, you can open the lines of communication with your patient population, designing campaigns that communicate how your telehealth service can give them greater access to care. Email campaigns are most effective if you build out a great contact list, which you will do as you encourage patients to enroll in telehealth and learn more about the service. Email lets you talk to patients about telehealth, even if they haven’t yet had a visit. Another way to effectively leverage email marketing is to include a strong call-to-action with every message. For example, if you have a blog post on the convenience of telehealth, your CTA could say “Learn how telehealth can help you get back the time lost in the waiting room” and link patients over to an enrollment page with information about the clinical services you offer through telehealth.

Organic search

When people talk about search engine optimization, aka SEO, they’re typically referring to strategic placement of keywords to guide people to your website. For a digital marketing campaign to promote telehealth, good optimized content (from your blog, webpages, etc.) will ensure your patients find your telehealth service when searching the web for care solutions. Seeing the need for 24/7 acute care solutions, many health systems launch telehealth for urgent care first, so a good SEO strategy would bring up your telehealth service when a patient searches for urgent care after hours. But SEO today goes far beyond keywords. SEO is really about building credibility with Google. You can start by reviewing Google’s best practices  for building healthy website architecture, along with creating high-quality and regularly updated content that your patients read and share.

Paid digital ads

Paid is the glitzy side of digital marketing—think social media ads, paid search ads, display ads/banner ads, and video. Paid ads are more high profile (e.g., Facebook), but they are also high cost, not only in terms of dollars but time. Effective paid ads are the result of extensive testing to find out which patients to target and what will grab their attention. Paid is a long-term strategy with high dividends, but the ramp-up is slow and it takes work to find the “special sauce.” The best way for a health system to reach patients through paid digital ads is to partner with a company that specializes in this channel and is an expert in telehealth. Paid is always challenging, but a relatively new service like telehealth is particularly complex and really requires an expert. Learn more about Amwell’s paid digital marketing services.

Owned social media pages

Saving the best for last, the final component of an integrated digital marketing campaign is social media. Why is social media so great? It’s free and it’s fun. Healthcare is serious business—hospitals face a big challenge in overcoming the perception of clinical coldness that patients associate with care. That’s all the more reason to get creative with social, engaging your patient population and reminding them that the healthcare “machine” is actually powered by humans. There’s a lot of opportunity to get creative with telehealth promotion—For Valentine’s Day, our in-house direct-to-consumer marketing team created eCards for consumers who use our Amwell app to share with friends and family. Not only are they creative and fun, they promote the telehealth app. A final note on social media—like blogging, to gain followers and get “likes” and shares, you need to commit to posting regularly on topics of interest to your followers. Social media is a way to build relationships with your patients, and like any other relationship, one nurtured through social needs regular attention.

Putting it all together

There are a lot of options when it comes to digital marketing, which can make the idea of launching a digital marketing campaign daunting, especially when a health system is devoting so many resources to building the telehealth service itself (learning the platform, training the doctors, selecting the best services to offer). But the two go hand in hand—without a digital marketing campaign to put telehealth in front of patients, telehealth won’t be utilized. The good news is health systems are not in it alone. When a health system partners with a consumer-focused telehealth company like Amwell, that company comes with a team of expert client marketers ready to support you across all the digital channels that successfully share your telehealth service with your patients. It’s ok to start slow, and don’t be afraid to test new ideas or ways of doing things.

Twelve states have enacted the Interstate Medical Licensure Compact so far, with 12 more states introducing Compact legislation—6 of them in the 2016 legislative season. (Map courtesy of the Federation of State Medical Boards, http://licenseportability.org/)

Arizona joins five states (Alaska, Colorado, Kansas, New Hampshire, and Washington) in introducing model Compact legislation this year. Twelve states already have enacted the Compact, “a comprehensive process that complements the existing licensing and regulatory authority of state medical boards and provides a streamlined process that allows physicians to become licensed in multiple states,” according to the bill. The Utah and Wisconsin legislatures unanimously approved the Compact for their respective states.

The Compact is a result of cooperative efforts of state medical and osteopathic boards and is administered by an Interstate Commission consisting of two representatives from each state that has enacted the Compact. It’s built on a system of state-based regulation proven to ensure safe health care delivery.

The Federation of State Medical Boards says the Compact “is expected to expand access to health care, especially to those in rural and underserved areas of the country” and “would strengthen public protection because it would help states share investigative and disciplinary information that they cannot share now.”

The Compact is supported by 31 state medical and osteopathic boards and endorsed by multiple medical associations and health systems, including the American Medical Association, American Osteopathic Association, and American Academy of Family Physicians.

How the Compact works:
The Compact provides physician licensure that is recognized among all Compact states, but each state in the Compact maintains local enforcement in order to protect its own citizens.

Physicians designate a “state of principal license,” which is the state where the physician holds a current license to practice medicine and is also the state where the physician lives and/or the state where at least 25% of the physician’s practice of medicine occurs and/or the state where the physician’s employer is located. Physicians apply for Compact licensure through the member board of the state of principal license. The expedited license is good in all Compact states.

The Interstate Commission coordinates information sharing among the Compact states’ member boards regarding any public action or complaints or disciplinary or investigatory information against a Compact-licensed physician.

States can leave the Compact by repealing their Compact statutes.

What the Compact does:

• Enables physicians to treat patients as the patients move among states.
• Allows physicians to efficiently obtain licensure in all participating states.
• Speeds up licensure of physicians who want to serve Arizonans and thereby reducing our physician shortage.
• Preserves Arizona’s existing licensure processes.
• Reduces the likelihood of federal preemption of states’ authority over physician licensure—a powerful tool for States’ Rights.
• Facilitates new delivery models involving telemedicine and cross-border practice.

What the Compact doesn’t do:

• Change Arizona’s existing medical practice act.
• Supersede Arizona’s autonomy and control over the practice of medicine.
• Affect the ability of Arizona’s medical boards to assess fees, determine fee structure, or collect fees.
• Affect Arizona’s disciplinary process.
• Preclude physicians who don’t meet Compact standards from obtaining licensure through traditional Arizona processes.

To protect patients, standards are high for physicians eligible to participate in Compact licensure:

• Must have graduated from an accredited medical school.
• Must have passed the US medical or comprehensive osteopathic medical licensing exam within three attempts.
• Must hold specialty certification.
• Must have successfully completed approved graduate medical education.
• Must possess a full and unrestricted license to engage in the practice of medicine issued by a member board.
• Must never have been convicted, received adjudication, deferred adjudication, or community supervision or deferred disposition for any offense.
• Must never have had a license subjected to discipline by a licensing agency.
• Must never have had a controlled substance license or permit suspected or revoked.
• Must not be under active investigation by a licensing agency or law enforcement authority.

You can help Rep. Carter to enact the Interstate Medical Licensure Compact into law by reaching out to your Arizona Representative and Senator—letting him or her know that you support HB2502. Always ask your Representative and Senator to vote for HB2502. If you need help finding your Arizona Representative and Senator, go to http://azredistricting.org/districtlocator/. Also, I urge you to consider telling others about this opportunity to improve availability of quality health care for Arizonians.

For more information on the Interstate Medical Licensure Compact, including its legislative status in each state, endorsements, and a discussion Compact myths and facts, go to http://licenseportability.org/.

About the Author

Mike Keeling, Esq., partner in Keeling Law Offices, describes the Interstate Medical Licensure Compact to the Arizona Telemedicine Council in Phoenix January 20.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

By Dr. Peter Antall, Chief Medical Officer

Unless you’ve been living under a rock, you’re aware that telehealth technologies are on the rise. Telehealth is being adopted by major health systems, health plans and employers in order to deliver more immediate access to care that can also reduce overall costs to the organization and the people or patients they serve. This widespread adoption is being driven in large part by consumers who want telehealth-based care. In a survey conducted by Amwell, we found that 65 percent of consumers want to use telehealth and 7 percent would consider leaving their primary care physician for one that offered telehealth.

Fortunately, the lure of telehealth for hospitals and providers is not solely about the risk of losing patients – it’s also about gaining market share. For hospitals and providers, telehealth enables more frequent connections with existing patients and the ability to reach new patients in new markets. It also offers a tool to improve team-based care and coordination.

With any new technology that has the potential to radically change the care delivery model, there are questions and fears. As the Chief Medical Officer of telehealth company Amwell and Medical Director of our national medical network Online Care Group, I have compiled the top 10 questions I typically receive from providers considering telehealth.

#1: How does it work?
Telehealth can be accessed from anywhere across all types of mobile devices – smartphone, tablet, and desktop or laptop computer. For acute-care needs, providers can be accessed for on-demand visits. For follow-up, team-based or specialist care, scheduled visits are also available. Video-based telehealth enables a two-way, face-to-face conversation between the patient and provider that allows you to see the patient and guide them through a physical examination, as well as see elements of their environment for more informed decision-making.

#2: Is it legal? 
In short – in most states today, yes, telehealth is permissible. It is important, however, to understand the medical board regulations with regard to telehealth. For example, with few exceptions for second opinions and specialist provider-to-provider consultations, it is a prerequisite that the provider be licensed in the state in which the patient is located. Generally all states’ medical boards allow telehealth to occur between a patient and provider that has a previously established relationship with an in-person visit. All states generally accept consultations from providers who have not established a prior in-person relationship with the patient if the patient is at a clinical site and is presented by a clinical presenter. To be sure, we recommend contacting your local state board or you can visit the American Telemedicine Association site for more information.

#3: How can I get paid for using telehealth?
Each major payer type – Medicare, Medicaid and Commercial payers – has different guidelines for reimbursement and telehealth coverage. The good news is that telehealth continues to receive increased levels of reimbursement – a trend we expect to pick up steam in the next 6-12 months – and it’s important to continue to review with your selected technology provider what the opportunities for payment are based on insurer type.

#4: Which use cases or conditions should I treat with telehealth?
It makes sense to start with the low-hanging fruit. Many providers choose to start with after-hours urgent care or office hours because offering telehealth here addresses an immediate need for additional care. Another key use case is medication management, and telehealth can have significant impact in adherence. Additionally, chronic care and follow-up appointments can be efficient applications of telehealth since a patient already has an existing relationship with the provider.

#5: How do I examine a patient?
While telehealth is a different modality and type of visit, we find that providers very quickly adapt to a telehealth examination. For one, when evaluating a patient, the provider uses the same skills as they would in another setting – this is primarily true when doing a face-to-face video. While there are limitations relative to a brick-and-mortar visit, a live video based visit is more robust than a phone call or any asynchronous communication. At a high level, there are a few key factors when conducting a live telehealth video visit: taking a good history; assessing the overall appearance of the patient – including mental status, pain level, and toxic or ill appearance; and whether or not the patient might need in-person care. For the latter, it’s important to take more of a triage stance. An added benefit to examination over telehealth is that the provider can gain information from the home that would not have been available in a clinical setting. Patients are generally comfortable in their home and often open up more. The provider has access to the patient’s social setting and may see family members.

#6: How do I go about building a program?
Building a program depends a lot on the use case. Offering on-demand visits simply involves ensuring that a provider is available to meet the patient in the virtual waiting room. These providers can be in the office setting and integrated with the reception staff workflows or can be done from the home with no need for support staff.

While a telehealth platform like Amwell does support an independent schedule, most providers desire to have one unified schedule, typically in the EHR. When offering follow-up or chronic care, it helps to develop workflows in which existing staff schedules the visit and provides the patient with the appropriate instructions.

#7: What is the liability?
To date, telehealth is associated with a very low incidence of malpractice or board action. In four years of practicing nationally, Amwell’s medical network, Online Care Group, for example, has not had a single malpractice case or physician called before a medical board. This is similar to the experience nationally.

#8: What kind of results can I expect to see? 
Patients love telehealth. This form of care is convenient, cost-saving, and high-tech. Patients love how this can improve access as well as how it helps them save time and money. Telehealth can extend care to after hours or weekends, and when this care is offered by a known physician, it provides comfort to the patient in addition to ensuring care continuity.

Most physicians have had the experience of seeing patients in an ER or urgent-care center in which the patient has had a long wait. These patients are already dejected from enduring a poor experience. In telehealth, instead, patients are generally pleased and even excited at the short wait and the convenience. This makes for a positive experience and results in higher patient satisfaction – in turn fostering stronger relationships between the patient and provider and ties to the associated hospital brand.

#9: What’s the best medium for practicing telehealth? 
I strongly believe in video as the most robust form for a visit – while traditional telephone-based telehealth visits are attractive to some patients – and Amwell and other providers offer them – it does not allow for face-to-face physical and behavioral examination. Some use cases would be impossible to treat over phone telehealth versus video telehealth. A good example is dermatology. If a patient is presenting a specific type of rash, they would want to be able to show that to their provider, and that’s obviously not something that can be done over the phone.

#10: Why should I do telehealth? 
There are many reasons our providers cite for getting into telehealth, but the most commonly cited are: (1) the interest from consumers and want to retain patients as well as attract or reach new patients; (2) the efficiency of delivering a video visit, on-demand or scheduled, based on a provider’s own availability and flexibility to work remote; (3) extended hours – ability to pick/choose hours based on a provider’s own schedule and work outside the clinical setting; (4) the great value you’re delivering to patients through a relatively low-cost and convenient visit; and (5) the potential to use telehealth to have more frequent touch points with patients to help manage chronic conditions, such as diabetes or cancer.

Title: Director, Sales Engineering

Department: Sales

Start Date: July, 2009

Amwell is in a unique position to continue to drive the [healthcare] industry forward and deliver on the change that patients want and need.  It gives me a tremendous amount of satisfaction to be involved with that.

What attracted you to Amwell?

When I interviewed for my first position at Amwell, which was in Hosting, I was just a kid coming out of college looking for a job related to my degree. I hadn’t really defined what I wanted to do professionally beyond that. But during the interview process, I became really enthusiastic about the company’s product and potential. I also felt the enthusiasm that others had within the company. And once I really understood that energy and its power, I knew I wanted to become a part of it – I was hooked. Seven years later, I’m still here and I love this place.

What were you doing before you came on board?

My focus in college was computer and electrical engineering, so most of my experience was in hardware and electronics design, though I’d done some software engineering work. I’ve worked in three different departments at Amwell, and I’ve really appreciated the opportunity that’s given me to expand my knowledge base and try out different roles.

What other positions have you held here? Tell us a little bit about your Amwell journey.

I think the better question is, What positions haven’t you held here? When I was first hired at Amwell I worked in Hosting. That gave me a great opportunity to learn about the architecture of the application, how it’s built and deployed, and how it’s supported behind the scenes. Also, getting to work under the VP of Hosting was great; he’s one of my mentors at Amwell.

From there I moved to Technical Services (TS). This was a dramatic change because I went from working on the systems that support the application to actually configuring the application for our customers. We were frequently warping the different configurable parts of the application to perform in ways they weren’t designed, so it was always an exercise in “thinking outside of the box.” While in TS I was given the opportunity to travel to Australia to work as a consultant with a new customer, so my girlfriend, now my awesome wife, traveled with me. During my time in Australia, in addition to supporting them with the hardware, I was able to become familiar with the front-end of the product and what the deployment is like from our customer’s point of view. From both a career and life perspective, going to Australia is the best learning experience I’ve ever had.

My current position is in Sales Engineering. This position has been challenging, but also satisfying and rewarding. I love having the opportunity to work with talented people like our VP of Product on a daily basis. When I first spoke with our CEO about the position he told me about “evangelizing for the product.” That’s a phrase I’ll never forget. Evangelizing for the product is something that I truly enjoy doing and something I strive to get better at every day.

What does a day in the life of a Sales Engineer look like?

My days can be focused on many different things. From a prospective customer standpoint, I’m usually speaking about the technical aspects of our product. This could involve the hosting of our application for large clients, the security in place to protect those assets, or the different ways in which our product can work with a client’s patient portal, mobile applications, and integrate with their electronic medical record software. When I’m not doing that, I’m usually answering technical questions in RFPs, working with other departments on internal projects, or trying to pry information from people in Product, Marketing, and the Online Care Group, just for my own knowledge.

At the end of every day, it remains an undying effort of mine to understand this business and this company from every angle that I can. There’s a lot of intrigue for me in understanding where we see this product going over the next few years, learning how we can convey that to customers and prospects in an effective way, and seeing how all of that is sustained on the business side.

What are your hobbies outside of work?

I’m huge into volleyball. I’ve played for about 15 years. I met my wife playing volleyball, and I’ll always maintain some schedule of indoor and beach volleyball in my life. Travel is next on the list. My wife and I love going to locations that are off the beaten path. Part of our honeymoon was a visit to Myanmar, which was a dream of mine! I’m also a rabid fan of the New England Patriots, Conor McGregor, and reading historical non-fiction.

Have you used Amwell’s direct-to-consumer app, Amwell?

I’ve used Amwell tens of times. The most interesting story happened about a year ago. I was playing tennis ball with my sister’s golden retriever, Tucker. He’s a tank. He brought the ball back to me, but it was still about 5 feet away. As it bounced toward me, I attempted to kick it and Tucker lunged forward to push it closer to me. I kicked him square in the mouth. He took it like the champ that he is, but my foot was split open with a really deep gash. He stood over me as if to say, “Hey man, why aren’t you throwing it anymore?” So, I threw the ball and then called Amwell. Teresa Myers, my favorite Amwell doctor, saved me from the hassle of sitting around an urgent care clinic on a Saturday afternoon.

What are your thoughts on the ways healthcare is changing and what we can expect to see in the future?

One of the awesome aspects of my job is that I get to travel around and speak with health systems and health plans about intentions and ability to deliver healthcare to their patients. Every prospective customer that I speak with articulates the fact that they want to deliver quality healthcare to their patients in a convenient way. While the definition of convenient quality care is changing and will continue to change, I think Amwell is in a unique position to continue to drive the industry forward and deliver on the change that patients want and need. It gives me a tremendous amount of satisfaction to be involved with that.

When you talk about telehealth and your role here with friends and family, what do you say?

When I talk to family and friends about my role here, I like to talk about our products as a whole. I think people see or use Amwell and they think that’s all that our company does. In reality, there is so much more behind our product than just direct-to-consumer telehealth. Sure, DTC telehealth is part of it, but we’re working with some of the most prestigious health systems and health plans in the country to find new and innovative ways to deliver care to patients using our technology. That’s the part I like to talk about, and people seem very interested in learning about that.

Interested in a career at Amwell? View open positions.

Yesterday, Democrats and Republicans from both the House and the Senate came together in a bipartisan effort to introduce important legislation with significant positive impact for telemedicine. The Creating Opportunities Now for Necessary and Effective Care Technologies CONNECT for Health Act (S. 2484 in the Senate and H.R. 4442 in the House) would greatly expand providers’ ability to leverage innovative telehealth healthcare technologies to increase access to healthcare for Medicare enrollees—and be appropriately paid for doing so.

The number of online medical consultations is expected to increase from less than one-tenth of 1% of the total for medical consultations today to 20% or more within the next 20 years. Hospitals, health systems, health plans, employers, and provider groups have rapidly been adopting telehealth for its ability to increase reach, better manage chronically ill patients, and produce better clinical outcomes.

Removing Medicare Barriers to Telemedicine

But as the proliferation of these technologies has increased, Medicare policy has lagged significantly behind.  The infrastructure for commercial and Medicaid payment for telehealth and remote patient monitoring has steadily improved, with states and health plans committing to reimburse providers who extend their care through technology. Only Medicare has remained stuck, requiring patients to drive to the care they need, rather benefiting from technologies that can bring the care to them. Up to this point, only rural Medicare enrollees could benefit from these innovative care models, and only if they were willing to travel.

The Connect for Health Act will help providers transition from today’s fee-for-service environment to the goals of alternative payment created by the Medicare Access and CHIP Reauthorization Act (MACRA). Providers making this transition will be able to use telehealth and remote patient monitoring without the current geographic barriers. Telehealth would become payable in alternative payment models without site restrictions, and become a part of the basic benefits package for Medicare Advantage. The bill will also significantly increase the number of approved locations and use cases for leveraging these technologies.

This announcement marks the most significant effort to embrace technology as a vital part of our health care ecosystem since EMRs. With 50 million Medicare enrollees, many coping with multiple chronic conditions, mobility issues, and significant wait times to access care, it’s time to take off the handcuffs.

We, as a nation, have a wonderful habit when faced with fundamental challenges. We innovate.  It’s time to innovate in our policy making and unlock the potential for care delivery for our most high need patients. The CONNECT for Health Act is the path forward.

This news broke yesterday, and already the Act has significant endorsement. Read press releases from these key supporters:

American Telemedicine Association

American Medical Association

ERISA Industry Committee

For more background on this important issue, read our introduction to provider reimbursement for telemedicine, and look for more posts as the reimbursement landscape continues to evolve.

Kofi Jones is the Vice President of Government Affairs for Amwell. Her primary focus is on collaborating with federal, state, and congressional leaders to ensure the proliferation of modernized and safe telehealth policies. Prior to joining Amwell, Kofi spent four-and-a-half years working for the Deval Patrick Administration, first as a Public Affairs Director and spokeswoman for the Governor’s Economic Development Secretary, and then as the Executive Director of the Commonwealth Marketing Office. She has also spent over 15 years as a communications and media expert, with a decade of experience in television news as a producer, reporter, and anchor.

Towers Watson predicts that by 2018, 80% of employers will offer a telehealth benefit to their employees. This projection is in stark contrast to 2014, when just 22% of employers had adopted telehealth, and the close of 2015, which marked a further rise to a third of employers offering the benefit. Clearly the trend is growth, but what is the story behind it?

At Amwell, we set out to answer this question, fielding a broad survey of over 240 employers in Q4 2015. Our survey took a close look at the drivers of growth, as well as what employer telehealth looks like today—from use cases to the structure of the benefit to utilization—and what the benefits experts we surveyed envision it will look like in the near future. Importantly, our survey yielded insight that is not only relevant to this market, but to the health plan and health system sectors as well.

A Snapshot of the Growing Employer Market

Our survey contained key questions such as which employers offer telehealth today, how long these employers have had the benefit, and for those that don’t yet offer it, when they plan to add it. Despite telehealth being a relatively new benefit for most employers, adoption is on the rise.

Drivers of Growth

Why are employers embracing telehealth? What is the value-add for businesses of all sizes? Our survey identified the top five reasons employer adoption continues to grow, listed here in order of importance:

1. Reducing medical costs—81%
2. Improving access to care—78%
3. Making employees happy—56%
4. Improving employee productivity—53%
5. Attracting new talent—21%

These priorities point to both a clear belief in quantifiable ROI and an understanding of the more qualitative benefits of a telemedicine offering. For a more in-depth look at each of these factors, download our free eBook, which summarizes the findings of this benchmark study.

Use Cases

While urgent care remains a priority for employers, both today and looking toward the future, our survey revealed that employers are remarkably forward thinking when it comes to services they offer through telehealth.

Top of mind both today and in the future are the following:

• Urgent care
• General health assessments
• Behavioral health
• Diet and nutrition
• Diabetes counseling
• Smoking cessation

Looking ahead, we see even more creativity, with a desire to launch asthma counseling, lactation support, occupational health, and more specialized services using telehealth as a vehicle.

The Structure of a Telehealth Benefit and the Challenges Employers Face

Employers are acutely aware of the need to make the benefit attractive, and to that end, they use strategies such as low co-pays, telehealth kiosks, and integration of telehealth with existing services.

Many still are challenged by low utilization rates of the benefit in these early days, but there are certainly solutions here. Experienced telehealth companies like American Well can help employers market the service to their employees and even provide tailored communications and creative digital and print campaigns to drive engagement. On top of these best practices, employers benefit from working with companies that offer utilization reports and best practices.

Impact for Other Players in the Healthcare Market

Now is the time for telehealth—with our survey and others confirming growth in the employer market, there is no doubt that those employers who delay risk becoming viewed as laggards. And the same goes for the health plans, private exchanges, and health systems that depend on relationships with these employers. Employers want telehealth—and not just a neat, out-of-the-box urgent care offering, but a nimble platform that can support infinite use cases and promote the many healthcare goals of their unique populations.

Download the eBook today for more on market impact. For more information on the employer market, visit our online Resource Center.

There’s been a lot of talk in the healthcare world about telemedicine kiosks lately, as HealthSpot recently notified its customers that it was no longer in business as of December 31, 2015. HealthSpot made a valuable contribution to the industry, with the company’s products and services going far in demonstrating the benefits of telehealth. In this post we’ll share our insight on kiosks based on our own product line, to address the many questions raised by our partners and industry experts. Our own experience with kiosks has been quite positive – we’ve seen great growth and potential in telehealth kiosks.  We’re now deployed in many states to a number of partners in the hospital and health system, retail, and employer spaces.  

On-Demand Care 

There are many reasons why our customers are so excited about kiosks and how they’re using them. One key difference between our kiosks and HealthSpot’s kiosks is that ours deliver care on demand – you can go into an Amwell kiosk and see a doctor immediately, whereas other kiosk companies require scheduling ahead of time.  Our workflow allows patients to connect with a doctor or clinician right in the kiosk, which eliminates the need for on-site staff members to accompany each kiosk at all times. When a patient begins to interact with one of our kiosks, they are matched to an appropriate provider (both in terms of licensure and specialty) within seconds, and a live video visit begins.  The kiosks can be remotely staffed by a client’s providers, or staffed by Online Care Group, our exclusive affiliate national telehealth provider group.  Telemedicine on demand, whether in a grocery store or in an office, is a key reason our partners are so excited about the kiosk line Amwell offers.

Here are a few more reasons that employers, retailers, and health systems are excited about kiosks.

Employers

Employers are using kiosks in a multitude of ways.  Kiosks are a simple, cost-effective option for opening an on-site clinic.  With kiosks, employees can be matched with a doctor of their choice within seconds, and biometric devices come as part of the setup to address the needs of the visit.  Having a kiosk on site provides affordable access to care, for both the employer and the employee.  

A kiosk also helps reduce absenteeism and increases productivity for the employees, as well as freeing up time for staff that would otherwise run an on-site clinic.  In a manufacturing environment, kiosks are quite an effective way to keep employees healthy.

Retailers

Retailers offer kiosks because they’re a simple, highly visible way to offer consumers healthcare where they need it.  In comparison to a staffed, on-site clinic, the costs are much lower, while still providing the healthcare benefits that customers need.  

Kiosks increase store traffic, bringing in – and retaining – new customers with this value added service.  Retailers also acquire opportunities to work with important partners such as health plans, hospitals, and employers.

Health systems

Health systems and hospitals also find value in using kiosks, often to expand their brand to surrounding areas.  Kiosks help hospitals project their presence into retail or office locations, bringing healthcare services to new locations.  Health systems are always looking to expand their patient bases, and kiosks allow them to introduce their services to large groups of new patients. Kiosks can provide valuable services like biometric screenings in more rural locations, giving patients the information they need to take necessary steps toward improving their health.

Overall, kiosks can be a powerful tool in delivering healthcare where the patients are.  Kiosks expand awareness about telehealth in general, helping deliver treatment and care to patients who need it.

If you’re interested in learning more, sign up for our upcoming kiosk webinar on January 26th at 1 pm, or get more information here.

Mike Lemovitz is a Director of Client Relations at Amwell, working with our health system clients to roll out telehealth.

Amwell is pleased to share that our affiliate national telehealth network of providers, Online Care Group, just received certification from the National Committee for Quality Assurance (NCQA) for physician credentialing, with a perfect score of 100 percent!

With this certification, Online Care Group demonstrates its continued commitment to excellence under the leadership of Dr. Peter Antall, who has led OCG from its inception and was recently promoted to Chief Medical Officer. Dr. Antall works with our partners, providing thought leadership, support for new clinical programs (including provider training, use-case design, workflow development, and clinical quality), and engagement of physicians. Under Dr. Antall’s leadership, Online Care Group will expand to new specialties this year, including pediatrics, dermatology, and psychiatry.

Read more about the NCQA certification in our press release, and visit our webpage to learn more about Online Care Group and the services available through this national network.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

This week the Centers for Medicare & Medicaid (CMS) unveiled the Next Generation ACO Model, which allows select Medicare ACOs to assume more risk in service of pursuing efficient and effective patient care. One of the most exciting opportunities in this program is clearly the ability for them to utilize telehealth above and beyond what is currently permissible in fee-for-service Medicaid.  This may be just what telehealth advocates have been waiting for – a clear demonstration of the value of telehealth in FFS Medicare, which bodes well for provider reimbursement for telehealth visits.

The American Telemedicine Association (ATA) published a press release in support of the Next Generation ACO Model. “Today is an important day for Medicare beneficiaries getting access to value-based telehealth care,” said Gary Capistrant, Chief Policy Officer of ATA. “We think all Medicare ACOs should be able to use telehealth to provide the Medicare range of coverage, and we hope that Congress and CMS will explore allowing more use of innovation to serve better Medicare beneficiaries.”

Read more about the importance of this opportunity to this new class of ACOs and the entire telehealth ecosystem on The HealthCare Blog.

And for a broader understanding of the telemedicine reimbursement landscape, read the reimbursement blog post from 2015. The Medicare section goes into detail about the barriers to reimbursement, providing a full-scope view of the challenges for telemedicine. For more on the significance of the Next Generation ACO program, read mHealth’s analysis.

Look for more insight into the provider reimbursement issue in 2016 on the blog, as we continue to look at what it takes for providers to get paid for telehealth.

Kofi Jones is the Vice President of Government Affairs for Amwell. Her primary focus is on collaborating with federal, state, and congressional leaders to ensure the proliferation of modernized and safe telehealth policies. Prior to joining Amwell, Kofi spent four-and-a-half years working for the Deval Patrick Administration, first as a Public Affairs Director and spokeswoman for the Governor’s Economic Development Secretary, and then as the Executive Director of the Commonwealth Marketing Office. She has also spent over 15 years as a communications and media expert, with a decade of experience in television news as a producer, reporter, and anchor.

Title: Business Communications Manager

Department: Sales Operations

Start Date: October 12, 2015

In this age of convenience, we’re all about the right now. And telehealth does exactly that for healthcare.

What attracted you to Amwell?

I heard about Amwell through a former colleague (and friend!)—what got me excited about the opportunity was the idea of being part of something really big. Telehealth has the potential to completely reshape the way all of us think about healthcare. The swift evolution of technology is thrilling—and to belong to the generation that was the first to really see it become a critical aspect of everyday life, it’s an amazing feeling. To me, what Amwell is doing is another iteration of that concept. Every day, there’s something new. The world is changing. Healthcare is changing. And Amwell is leading the way.

What were you doing before you came onboard?

Most recently I was a copywriter for an international cruise line. I generated a vast assortment of sales and marketing collateral. It really honed my writing skills and prepared me for my role at Amwell.

Prior to that, I was an editor and project manager for a multinational publishing and education company. My role there was very similar to what I do now at Amwell. One of the things I loved most about that job was the tight relationships I formed with the sales team—something I missed when I moved over to the cruise line. Here at Amwell, I’m once again working closely with sales representatives on a daily basis.

What does a day in the life of a Business Communications Manager at Amwell look like?

One of the best aspects of this job is that no two days are alike. It’s the most challenging position I’ve ever held—every day I’m growing (as a professional and as a person) and learning something new. A large portion of my time is spent fielding queries from potential clients who want to know more about Amwell and the products we offer. I work directly with the sales team to facilitate these exchanges.

My team and I are also constantly working to brainstorm and generate new sales collateral. What do our clients want to know? What is it they need? What engages them? How do we pique their interest? How do we get them to commit to Amwell? These are just some of the questions we ask ourselves. As Amwell continues to blossom and flourish, I feel privileged to be helping shape the “Amwell voice.”

What are your hobbies outside of work?

My top priority in life is to always experience something new—every day, if possible. I’m willing to try (almost!) anything, at least once. I love to explore, be it the Blue Hills south of Boston, or the bustling city streets in The Hub. I love the outdoors—jogging through my neighborhood of Dorchester, camping up north in New Hampshire, or spending a lazy afternoon at the beach. I love traveling too, and try to plan at least one big vacation a year (I spent two weeks in Central Europe this past year, and it was one of the greatest experiences of my life). I love to cook—and even more, I love to eat! But none of it would be quite as enjoyable without my Boston terrier, Baxter, by my side.

Have you used Amwell’s direct-to-consumer app, Amwell?

I’ve used the Amwell mobile app once so far, and it was a fantastic experience. Back in 2014, I suffered from a pretty serious case of reactive arthritis. A few months ago, minor stiffness in one of my joints returned, and I was unsure if the arthritis was returning or if it was something completely unrelated. I didn’t want to lose an entire day meeting with a rheumatologist, unless I was certain it was something serious. So, I decided to try out Amwell. I spoke with Dr. Mia Finkelston and she was superb. We discussed both my previous and current issues. Her breadth of knowledge was outstanding—and seeing her there, in her white lab coat, it truly felt like an in-person visit. In the end, she recommended a basic pain reliever, and in no time, the discomfort in my joint was gone!

What are your thoughts on the ways healthcare is changing and what we can expect to see in the future?

The deeper I submerse myself in the world of telehealth, the more I’m convinced it’s the way of the future. In this age of convenience, we’re all about the right now. And telehealth does exactly that for healthcare. I’ve experience it for myself—immediate access to quality care is right there in front of you. While the different uses for telehealth are just beginning to be realized, as technology advances, and more businesses start offering the service, it won’t be long before “telehealth” is a household word.

In Dr. Pitt’s latest edition to At the Intersection of Technology and Health, we re-visit the dawn of teleradiology, its application, and how telemedicine opportunities are present in other specialties.

Teleradiology moves images from one location, typically where the patient had the exam, to another for interpretation. This transfer allows load balancing and sub-specialty interpretation within a pool of radiologists. By having the right radiologist read the right case, outcomes improve while the cost of care is reduced.

What if teleradiology networks could be used for more than X-Rays? What if the channels built to moving images could also facilitate other care opportunities for telemedicine?

After all, the requirements for telemedicine and teleradiology have significant overlap, both in terms of technology and business relationships. Radiology practices are well positioned to offer an up-sell in the form of additional services on the networks. Hospitals in need of remote radiologists are likely in need of other specialists. Specialty expertise and load balancing are not problems specific to radiology. For example, neurologists and psychiatrists would all benefit by partnering with the existing imaging networks.

As one of only three clinical departments (the other two being lab and pharmacy) providing critical results, radiology is well positioned to act as a hub enabling communication and collaboration throughout the care continuum. There would be some challenges with the workflow and video, in addition to how radiology uses store-and-forward while clinical care requires face-to-face real time encounters. However, these challenges are not insurmountable.

Radiologist’s primary role will always be domain experts for imaging. However, CT, ultrasound and MR haven’t changed much in the last 30 years. Radiology should explore other opportunities. By leveraging decades of experience in managed services, teleradiology can add value to many other forms of care.

Click here to read more At the Intersection of Technology and Health.

Avizia was acquired by Amwell in July of 2018. Information on this page refers to activities that occurred prior to the acquisition and are presented for historical context. Together we provide a comprehensive acute care offering—a full end-to-end telemedicine solution for health systems and their providers.

On the road to telehealth adoption, there are many different factors employers need to take into consideration to determine which offerings and vendors are right for them. This set of questions will guide you during your search, choose who to work with, and help you ultimately implement a successful program:

Did you have a visit?

Telehealth offerings differ in many ways, and  you need to understand exactly what you’re signing up for. The best way to do that is to test the product yourself by having an online doctor’s visit. During the visit, ask yourself these questions:

• Is it straightforward or confusing to sign up?
• Is it easy and intuitive to select and connect with a doctor of your choice?
• Would your employees be able to use the program easily and effectively?

These may seem like simple questions, but you’d be surprised how often they can be overlooked. The main goal of telehealth is to make medical care quick, convenient, and affordable without sacrificing quality of care; but if the process isn’t seamless, your employees will never use the service and reap its benefits.

When do you plan to launch?

Contrary to popular belief, you don’t have to launch telehealth with you annual benefits cycle. In fact, often it’s better to launch telehealth off-cycle to help highlight the benefit to employees without added distractions. Once you decide what works best for your business and when you’re going to launch, you need to work with your vendor to set up a practice, tailor communications to employees, and ensure health plan notification and carrier readiness.

How quickly do you want to launch?

It’s important to set timeframe goals for a launch, and then compare them to vendor launch plans to see if they’re realistic. Knowing exactly how long it will take to bring telehealth to market is essential for scheduling an effective launch date. Telehealth vendors should be transparent in communicating what a launch entails, including setup, design, benchmarks, marketing initiatives, and more.

Who will you offer telehealth to?

Will you offer it to employees and dependents, or will you offer it only to employees who take advantage of employer health benefits? The choice is ultimately yours, but we believe that by making telehealth available to all employees and dependents, you realize higher cost savings and see more wide-spread use.

Will you add a kiosk to your telehealth offering?

Some employees use telehealth kiosks to provide an on-site clinic for employees.  If you already have some form of on-site clinic or care service, you have to decide if you will replace it with a kiosk or integrate a kiosk into your current on-site offerings. These questions are critical when considering kiosks:

• Does the experience require that the kiosk be staffed or can it operate unstaffed?
• Does the telehealth vendor provide their own kiosk and support, or do they outsource it from a third-party vendor?

Do the cost savings make sense?

Many employers turn to telehealth not only to provide their employees with a great benefit, but to reduce medical costs and save money. Compared to urgent care and emergency visit options, telehealth costs a fraction of the price; even with primary care visits, telehealth is typically a better value. This means if only a portion of your employees’ replace their traditional healthcare visits with telehealth visits, your cost savings can be substantial. That being said, it’s important to have an ROI model that is based on your expected costs. Don’t rely on averages. Make sure the telehealth vendor works with you to create a realistic and attainable ROI model based on your company’s unique telehealth goals.

Are you integrating telehealth into your current benefits package?

Integrating telehealth with your health plan allows for automated eligibility and claims. Real-time eligibility calls are used to verify coverage, services, and copays for your employees, while claims are generated automatically so doctors don’t have to focus on paperwork—just patients. Whichever vendor you choose should be experienced in these types of integrations, as well as be able to work with any health plan you select.

How are you going to communicate?

Unlike most healthcare services that offer open enrollment once a year and then go radio silent, a telehealth provider can actually provide ongoing communications throughout the year. Make sure you ask yourself how and how often you want to communicate the benefits to your employees. It’s also important to ask vendors if they help provide that ongoing communication. Communication about the service drives utilization, which in turn drives cost savings. If employees are unaware of the benefit, they won’t use it. It’s up to you and your vendor to education and inform in the most effective way possible.

How will you track utilization?

Once you have successfully implemented telehealth, it’s important to track utilization. Utilization not only shows how many employees are taking advantage of the benefits; it can also give you a glimpse into how accurate your ROI model is. Be sure to ask vendors if they provide utilization reports by month and year so you can track progress and cost savings over time.

 Dr. Lauralee Yalden is a board-certified Family Medicine physician and graduate of Ross University School of Medicine who has been in practice for over 10 years. She balances her time between providing online care for Amwell and working in the local emergency room at The Veterans Administration.  Dr. Yalden is very active with the AAFP (American Academy of Family Physicians,) where she founded and chairs the AAFP Telehealth Member Interest Group.

What motivated you to want to practice medicine online?

Dr. Yalden: I have been practicing online with the Online Care Group for three years, and initially it was just part of a big job search. I needed to move from Florida to New York City, so I did a very extensive search and was fortunate enough to learn about Amwell. I was very impressed by Amwell’s unique vision and forward-thinking ideas. As a family medicine physician, I was used to taking calls at all hours of the day and night from home. Being able to actually see the patients by video really adds to your diagnostic capabilities, and really offers a comprehensive evaluation, diagnosis and treatment plan.

How did you become trained to practice online?

Dr. Yalden: The training included a member of the Online Care Group staff coming down to my home in Florida and demonstrating the capabilities of the platform and the EHR. The EHR is very similar, and in many cases easier to use, than many of the other EHRs on which I’m trained. We reviewed all the different options that are available for communicating with the patient, went over good documentation, how to review a patient’s medical records, and how to access reading materials in order to offer patients the best treatment plan possible. All the training physicians also practiced with one another to simulate what it was like to see someone online. We took turns playing doctor and patient online to see what is was like diagnosing, evaluating and managing a patient. We were also doing our best to optimize our treatment for each individual condition.

How many patients do you see online?

Dr. Yalden: It really depends on the day, shift and number of physicians available. Typically, I work full-time day shifts and see two to three patients per hour. I am able to see 40-50 patients per week, but this number can vary. During cold and flu season the number is usually higher, and during weekends I tend to be busier.

As an individual doctor practicing within a medical group, how do you work together around developing clinical protocols?

Dr. Yalden: That’s a great question. Online Care Group is a very robust medical practice with full-time physicians spanning the entire United States. We come from different medical backgrounds, with the majority being primary care physicians—but we have physicians who are board-certified in emergency medicine, pediatrics, etc. We really work together as a group, meeting once a month and each serving on many different committees as part of the Online Care Group. One of our main objectives is to try to optimize our diagnoses and treatment of different medical conditions online. We discuss different medical conditions and develop templates and overall standards of care to practice medicine online. You do have to tailor your physician exam and questions to patients online, but we’re really seeking to answer the same questions and diagnose the same conditions as we do in a brick and mortar practice.

How did you adapt your practice for the online environment?

Dr. Yalden:  I can give you an example of a patient case that I saw earlier today. It was a very nice mother and her son calling in with a case of conjunctivitis. This is something you would see in any office—pediatrics, primary care or online. Conjunctivitis is one of those conditions where you can really make an excellent diagnosis online. With mom’s help, we were able to do a good evaluation of her son. I was able to see the eye up close, and using the iPhone I could take a look inside the mouth at the tonsils. Mom was able to touch and feel for any lymph nodes, and she touched the ears to make sure there weren’t any other cold symptoms or aches and pains. Parents are very educated and knowledgeable about what is going on with their children. She had already taken his temperature and had a whole bunch of wonderful information even before she logged in. She had a very good sense of the child’s health, medical history and immunizations.  It was wonderful to be able to provide this level of care at home. Mom was very excited about not having to take the time to go in and see the pediatrician, and she was happy to be able to do this online.

How would you handle a medical emergency if you were presented with one online?

Dr. Yalden: These kinds of things do happen from time to time exactly as they do in an office setting. Someone will connect with you online and they’re having chest pains or difficulty breathing, and by looking at them and getting a sense of their medical history you’re able to assess really quickly if these symptoms are more complicated than something you can manage online. In cases like that, I assess if the patient is in a safe environment, and figure out if they’re home alone or if there is a family member available to help—either by calling 911 or by taking that person to a higher level of care. There have been times where I’ve had to activate my 911 emergency protocols and stay on the line with the patient until the ambulance has arrived and picks up the care of the patient. The bottom line is we do have protocols in place for these types of situations.

Interested in learning more? Join us on Thursday, December 17^th at 2:30 pm for the 2015 Physician Survey Insights Webinar.  Mary Modahl, Senior Vice President at Amwell, will review the research and share additional insights on the Physician Survey, while Online Care Group (OCG) doctor, Mia Finkelston, MD, answers your questions during a live Q&A.

]]> Ali Hyatt https://www.americanwell.com/?p=4676 2020-03-17T19:15:12Z 2015-12-07T20:42:21Z

As telehealth becomes more commonplace, consumers need a way to judge the quality of care offered by a company or hospital via this relatively new care delivery system. The American Telemedicine Association (ATA) offers just that through its accreditation program for online patient consultation. Earning this accreditation is a testament to a company or hospital’s ongoing commitment to patient choice, high-quality care, and cutting edge technology.

What exactly is the ATA’s accreditation program?  And how do you get accreditation?  Here’s a look at what it takes to gain the ultimate level of credibility in telehealth.

What is the ATA?

The ATA is the governing agency that telehealth organizations look to for guidance. Founded in 1993 this non-profit organization has been instrumental in educating medical professionals and consumers about telehealth as a new mode of healthcare delivery, raising awareness, promoting research and innovation, and helping develop policy.

In 2014, as more healthcare organizations adopted telehealth services, the ATA launched the first and only accreditation program for online patient visits in the United States. It is similar to other medical accreditation programs in that it looks at all aspects of the practice of virtual medicine, from providers treating patients and the clinical standards they are held to, to the security of the platform, to consumer benefits such as transparency and provider choice.

Which organizations are eligible for ATA accreditation?

To be eligible for the accreditation program, an organization must provide online, real-time patient consults directly to patients. Applicants range from primary care providers to specialty service providers to health systems to businesses with direct-to-consumer offerings. The first business to be awarded this accreditation was Amwell, for our direct-to-consumer offering, Amwell. In the health system realm, Avera Health recently became one of just a few health systems to receive accreditation for its consumer telehealth service AveraNow.

Erika Anderholm, Senior Manager of Provider Services for Amwell’s physician affiliate group, shares her experience going through the ATA’s accreditation process for Amwell in this video.

What are the criteria?

The ATA’s primary concern is consumer safety. It hosts a site dedicated solely to providing consumers with information about telehealth and guidance on selecting a telehealth service that offers high-quality clinical care. To ensure that organizations they accredit protect consumers, the ATA’s application process focuses on the following areas:

• Security of patient information (HIPAA compliance)
• Compliance with laws and regulations
• Transparency in pricing and operations
• Qualifications and licensing of the providers on the system
• Provider training
• Clinical practices and guidelines

What is the process to become accredited?

In addition to attesting to their strengths in the referenced areas, applicants must do the following:

• Provide substantial documentation in all of these areas
• Show the ATA the online resources that their patients have access to about their service
• Give the ATA a live demonstrations of their service

Note that the initial application packet is fairly sizeable, and the selection committee may ask for clarification or additional information during the review process.

How long does the application process take?

The timeframe depends on the organization, and the number of applicants under review, but the ATA is efficient. Avera, for example, launched AveraNow in June and announced their accreditation in November. Avera is now listed, along with other accredited services such as Amwell, on the ATA’s consumer safety site.

Should our organization get accredited?

In a relatively new industry with explosive growth, the answer is yes. Accreditation serves important functions:

Accreditation helps an organization assess its services against the market standard. If the organization falls short, it can make quality improvements and ensure a better service and experience for patients.

Accreditation helps attract and retain patients. Patients who are “new” to telehealth and potentially unsure about using it will be reassured by the ATA’s seal of approval.

Above all else, accreditation shows an organization’s commitment to delivering the highest quality of care.

Have more questions about accreditation or insight from your own organization’s experience? Please share comments.

Dr. Michael Gray, MD, Staff Physician and a doctor on Amwell, provided his own comprehensive telemedicine review. Here’s a look at why he got into telehealth and the surprises he’s found along the way.

Digital medicine

I was originally interested in telehealth for the chance to be part of a cutting-edge technology solution for healthcare delivery, its more flexible work schedule and the convenience of working from home.

I had worked for a few smaller telehealth companies prior to Amwell, so I was familiar with the concept of telehealth.  I chose to work with Amwell because it was rapidly gaining a reputation in the industry for trying to do it “right” and as a doctor, that’s important to me  The company has invested heavily in software development and have always been very supportive of their doctors.

I did, however, have a couple of areas of concern, to be transparent. The first concern was the technological aspect. I wasn’t sure how I was going to be able to properly interview a patient while simultaneously using the webcam and other tools to collect information. Secondly, how was I going to adapt brick and mortar practice guidelines to telemedicine?

Watch the video: Telehealth App for Providers

Training for success

Since I was one of the earlier hires, much of the training was one-on-one with a physician coordinator.  There were a couple of online modules, but much of it was through interactive sessions online.  I also received a background packet on the company, which covered Amwell’s structure, leadership and goals.

We were trained on how to report software issues and connection problems, and then conducted many test calls before we were let loose on the public. When I finally got to practice telehealth, I felt well prepared and knew that if an issue came up there were peers and administrative personnel ready and willing to help.  This helped immensely in making me feel more comfortable with the technology aspect and enabling me to be prepared to do my job well.

Remote can be personal, and effective

My initial thought was that the webcam discussions would be impersonal, but that turned out to be quite contrary to the truth.  You really can make a connection with a patient by video.  Expressions and body language give so much more insight than I initially expected.

Having spoken to different doctors, I think some believed that after training you would be just as comfortable seeing patients online as in a brick and mortar setting. While training lays the groundwork and gives you the technical background necessary, adapting brick and mortar treatment paradigms to telemedicine is something that cannot be taught during training.  In fact, how to most effectively evaluate and treat online and what the standard of care should be is not even known—It’s something that all of us collectively are determining as time goes on and it’s a constant dialogue.

Amwell has always encouraged our efforts to determine what the standard of online care should be for various chief complaints. For example, we were never told that we had to treat sinus infections a certain way, although we collectively devised practice guidelines for common conditions so that newer doctors could be brought up to speed. It also provided a basis upon which to ensure quality.

Treating the nation

Overall, one of the most fascinating aspects of telemedicine is meeting patients from other areas.  Even if you have one state license, you will see patients from the far reaches of your state—patients that you never would have met had you practiced in one brick and mortar office.  That constant variety adds to the rewarding experience of practicing telemedicine, and is an educational experience that is hard to find elsewhere.

It’s great to hear from the doctors who are practicing telemedicine each day.  Look out for future posts sharing the perspective of the digital doctor.

The Lay of the Land

Telemedicine is a hot topic in healthcare, with consumers more willing than ever to see a doctor remotely. In a national study of over 2,000 consumers, 64% said they would be willing to have a telehealth visit with their doctor via video. The Alliance for Connected Care concludes that a telehealth visit for acute care represents $126 in savings over an in-person visit. Furthermore, research on telemedicine also shows a pattern of positive outcomes for patients. The Alliance states that patient issues are resolved 83% of time during an initial telehealth visit. And more than half of doctors themselves are willing to see patients over video. Why then, haven’t more health systems and individual physicians incorporated this means of delivering care into their practice models?

While no single factor accounts for the lag, arguably none has had as big an impact as the confusion surrounding provider reimbursement for these visits. Lack of understanding about how each of the three major payer types—Medicare, Medicaid, and commercial payers—reimburse for telemedicine visits has understandably prevented many providers and delivery systems from making informed decisions about adopting this technology.

This post will explain how each major payer type makes decisions around reimbursement and clarify when telemedicine visits are covered. Beyond providing this important knowledge foundation, it will also reveal trends toward increased levels of reimbursement—especially in the commercial sector. Physicians today can feel positive about bringing this powerful tool into their practices as telemedicine continues to receive increased levels of reimbursement.

Medicare 

With 49 million Americans enrolled in Medicare, it’s important for providers to understand how this program makes determinations about telemedicine reimbursement. Generally speaking, fee-for-service Medicare reimbursement is dictated by four key areas: the patient setting, the type of technology, geography, and provider type.

Patient Setting

Medicare requires that the patient setting, termed the “originating site,” be a clinical site such as a doctor’s office or hospital. However, multiple congressional efforts have focused on expanding Medicare payment and demonstrating the clinical and financial value of serving this population through telehealth technologies. The Alliance for Connected Care estimates that choosing telemedicine visits over in-person treatment for acute care when medically appropriate would actually result in costs savings for Medicare—$45 per visit—a convincing argument for defining the patient setting more broadly. In fact, as part of its Next Generation ACO initiative, Medicare will actually remove this restriction for participating ACOs, arguably the first step toward lifting this restriction for its entire population.

Technology

Medicare is quite forward-thinking when it comes to the technology, defining reimbursable telemedicine as “interactions between a healthcare professional and a patient via real-time audio-video technology” (CFR Title 42, Part 410.78, “Telehealth Services.”). This definition is in line with the model policy of the Federation of State Medical Boards (FSMB), which represents the 70 state medical and osteopathic regulatory boards. Because the FSMB is considered the ultimate arbiter of quality in medical practice and regulation, its recommendation carries considerable weight, setting the standard for the industry.

Geography

Medicare is also the most focused on geographic restrictions, while many state Medicaid programs and private insurers are more likely to see telemedicine as location-agnostic. Geography refers to the type of area in which the patient resides (i.e., urban, rural, etc.). Medicare only covers telemedicine when the patient is presenting from a defined rural area termed a Professional Shortage Areas or a county outside of a defined Metropolitan Statistical Area. While this is currently a barrier to telemedicine adoption, the Next Generation ACO initiative will also remove these restrictions, painting a hopeful picture for future policy change.

Provider Type

Medicare scores well here, reimbursing a reasonable number of defined provider types for telemedicine encounters. These include physicians, nurse practitioners, psychologists, social workers, and dietitians, among others.

A Final Note – Medicare Advantage

While the current telemedicine landscape for fee-for-service beneficiaries is limited, primarily due to “originating site” restrictions, many Medicare Advantage enrollees are currently covered for telemedicine services, regardless of location. Commercial plans have added telemedicine as a supplemental benefit, realizing the clear value and benefit that exist for the Medicare population. This is an extremely positive signal for the future, as these at-risk, capitated plans are not known to make investments that don’t yield results.

Medicaid

Forty-eight state Medicaid programs and the District of Columbia have some type of telemedicine coverage. However, Medicaid differs from Medicare in that its policies vary from state to state; each state has flexibility to determine how it will reimburse for telehealth, and many have gone well beyond the scope of Medicare.  Each year, additional states expand their scope of reimbursement, and new proposals are filed constantly.

Here are some key high-level insights, although it’s important for medical professionals and administrators managing the systems they work in to review state-specific resources. The American Telemedicine Association’s (ATA) report, State Telemedicine Gaps Analysis, is one particularly comprehensive and accurate resource.

The following overview of Medicaid policies is broken down by the determining factors of patient setting, technology, and provider type.

Patient Setting

According to the ATA’s report, 24 states and the District of Columbia do not specify a patient setting as a condition for reimbursement, and 25 states recognize the home as an originating site. This means that many Medicaid patients do not have to travel to a traditional healthcare setting, allowing them to take advantage of the convenience afforded by telemedicine. While some state Medicaid regulations do still require a telepresenter, the overall trend is favorable for reimbursement across diverse patient settings.

Technology

Similar to the patient setting, no one policy dictates reimbursable technology across all state Medicaid programs. A broad span of modalities—from telephone to video to remote monitoring and store-and-forward technologies—is in play. According to the ATA, states are slowly but surely embracing a variety of new technologies for delivery of telemedicine.

Provider Type

While states can vary with regard to the provider types they reimburse, generally the outlook is positive. Fifteen states place no restriction on the provider type, according to the Berkeley Research Group. In addition, only four states restrict reimbursement to physicians. There is also an overall encouraging trend toward Medicaid coverage for mental and behavioral health services delivered via telemedicine.

Commercial Payers

Commercial payers—that is, private insurers—have been most aggressive in reimbursing for telehealth visits. Many national plans embrace this healthcare innovation and have been steadily broadening coverage through partnerships with telemedicine services companies. Amwell, for example, now covers 50 million commercial lives for telehealth visits through 30 separate major health plans. This is happy news for doctors and the systems in which they work. Their patient populations are steadily gaining telemedicine benefits, and companies like Amwell offer real-time eligibility and claims processing, letting the provider know prior to starting a telemedicine visit if the patient’s plan will reimburse them for their services.

Regulation affects the commercial payer realm as well. Today, 29 states and the District of Columbia have parity laws that mandate commercial payers provide comparable coverage and reimbursement for telemedicine services as in-person services. This is great news for providers, as it suggests that over time telemedicine will gain parity footing with in-person consultations across the board. Beyond these laws, the high potential for cost savings in the commercial sector—an average of $126 per visit for acute care—has incentivized many plans to cover telemedicine.

All of this is not to say that the commercial realm is without issue. Payers are not universally compliant with parity regulations, and few of these laws bear teeth in terms of required dates for compliance.  Telehealth coverage has grown so fast in the commercial realm because visits are less expensive, so parity reimbursement could have a chilling effect on health plan promotion of telemedicine for patients. Commercial insurers are also still grappling with issues such as building telemedicine codes into claims systems and determining their level of coverage for various specialist services, from teledermatology to telepsychiatry.

Despite all this, reimbursement through private insurance companies is the least confusing and the most promising. With national health plans such as United Health Care and Anthem advertising their telemedicine visits and coverage on television and the web, it’s clear that some powerful players stand behind telemedicine and are dedicated to making it work as an integrated part of the healthcare system, not just for patients, but also for providers.

An Exciting Future

Telemedicine has huge potential to improve access to quality care and decrease costs, and to make healthcare encounters more convenient and satisfying for providers and patients. Understanding how and when providers are reimbursed for delivering healthcare through telemedicine can be challenging, but not impossible. Breaking it down by each type of payer makes it easier for providers to gain clarity and make informed decisions about telemedicine.

And there’s more good news—there are positive indicators for reimbursement across all three major payer types, and restrictions on reimbursement continue to be lifted as industry advocates work with federal and state government and commercial payers to integrate telemedicine into our healthcare system. Not too long ago, there were a number of states where it was illegal to practice telemedicine. Today, 47 states are “green” for telemedicine. Industry advocates are working just as hard on the issue of reimbursement. Doctors who want to adopt telemedicine have support—both for understanding reimbursement today and changing reimbursement tomorrow.

Kofi Jones is the Vice President of Government Affairs for Amwell. Her primary focus is on collaborating with federal, state, and congressional leaders to ensure the proliferation of modernized and safe telehealth policies. Prior to joining Amwell, Kofi spent four-and-a-half years working for the Deval Patrick Administration, first as a Public Affairs Director and spokeswoman for the Governor’s Economic Development Secretary, and then as the Executive Director of the Commonwealth Marketing Office. She has also spent over 15 years as a communications and media expert, with a decade of experience in television news as a producer, reporter, and anchor.

Additional resources

eBook

Telehealth Index: 2015 Physician Survey, Amwell and QuantiaMD

Reports

Telehealth Utilization: Potential Benefits of Expanded Coverage and Reimbursement, Berkeley Research Group

Assessment of the Feasibility and Cost of Replacing In-Person Care with Acute Care Telehealth Services, The Alliance for Connected Care

Imagine this: It’s Thanksgiving and a mother is in the middle of preparing a feast for 20 beloved family members when her first grader suddenly starts complaining of an ear ache.  There’s a turkey in the oven, two other children are destroying the just cleaned house, and her husband is picking up the in-laws from the airport.  Great time to pile everybody in the car and head to urgent care, right?

If you’re shaking your head, eyes wide with fear, you’re not alone. In fact, some of the most prominent pediatric health systems in the US have started to offer telehealth services for the entire family.  The use cases are endless, but here are a few key ways pediatric telehealth is delivering great benefit today.

Urgent care is now online

Nemours Children’s Health System just partnered with Amwell on its virtual visit platform, available on web or mobile, to eliminate situations like the one described.  Nemours CareConnect allows families to connect with a Nemours board-certified physician, day or night, from the comfort of their own homes.  Mom or Dad can forget the stress surrounding a doctor’s visit and instead focus on getting their little one better.  Typical urgent care scenarios that CareConnect addresses are allergies, abdominal pain, cold or flu symptoms, and rashes.

The doctor will see you…in the nurse’s office

It’s no secret that kids are prone to getting hurt at school – from the germs floating on tables and chairs to breaking bones during recess, the nurse’s office is often the busiest place on campus.  Despite the expertise of most school nurses, parents are often called out of work or other duties to pick up sick kids and tote them to the doctor,  taking parents away from busy work days and pulling kids out of class. Children’s Medical Center of Dallas is looking to change this reality by placing mobile telehealth carts in the nurse offices of 26 Dallas-area schools, allowing for a virtual visit with a Children’s physician when a child presents with an illness.  When a child presents himself with a symptom that is out of the nurse’s realm of expertise, the nurse can easily consult with a physician who can help diagnose or recommend care.

Let’s follow up in 6 weeks, from home

Ultimately, children and teens are going to see their pediatricians for health issues and care other than a regular physical, an ear infection, or common cold.  Acne, allergies, changes in hormones, and other long-term issues frequently bring families into the waiting room.  Telehealth services are beginning to address the need for easy yet comprehensive follow-up care that eliminates the time involved with trekking to the doctor and sitting in a waiting room.  Pediatric telehealth allows the physician to remain in the loop for follow-up care that doesn’t require an in-person visit and allows the family to be happy and healthy.

What’s on the horizon?

The need for accessible care is no different for kids than it is for adults and in many ways, providing virtual pediatric care eases a burden on all family members, not just the little one complaining of an ear ache on Thanksgiving Day.  In an age when children know how to swipe an iPad before learning to speak, many will agree that we can expect to see this generation more comfortable with telehealth than any of its predecessors.  Today, parents can expect to see a continued influx of creative uses for telehealth popping up in and around their pediatricians’ offices, making ease of care the new normal.

Learn more about how telehealth is being applied to pediatrics at the Boston Children’s Hospital Global Pediatric Innovation Summit on November 10, 2015.  We look forward to following up on this topic and seeing how quickly pediatric telehealth becomes a critical tool on the path toward more effective pediatric healthcare everywhere.

“We want fee for value all day long” was one of several opening statements made by Optum CEO Larry Renfro at the start of the Digital Healthcare Innovation Summit on Tuesday November 3 in Boston.  This statement underscored a theme that permeated the majority of the day’s conversation, led by executives at some 60+ emerging and established digital health companies.  Panelists addressed the mobile workforce, security challenges in health tech, population health management, the advent of telemedicine, and above all, the challenge of delivering effective care tools that will engage consumers and clinicians while also providing a cost incentive for industry support.

The bottom line: the opportunity in digital health has never been greater – and that made for a packed agenda, of which I’ve pulled out a few key trends:

B2B2C and the rise of the consumer

Optum CEO Larry Renfro talked about how the health services platform and subsidiary of UnitedHealth Group is looking to more effectively reach consumers. Renfro said that Optum doesn’t yet have a “front door” for consumers, something the company is working to develop. He sees digital health tools and analytics as a way to better assess and manage the millions of consumers Optum touches daily – starting with the 66 million prescriptions the company transmits on behalf of consumers each day.

Smartphone usage requires mobile-first strategies

Mobileron VP Ojas Rege noted that for the first time last month, more than half of internet activity was accessed over mobile. Reje added that 80 percent of people are likely to choose convenience over security when communicating on mobile – proving a great challenge for healthcare innovators as they look to create streamlined, intuitive mobile experiences that are also HIPAA-compliant and secure.  Rege advised companies developing a mobile experience to adopt a mobile-first strategy when establishing their security infrastructure.

Telehealth 2.0 is a win for population health management

Amwell Chief Medical Officer Dr. Peter Antall discussed the future of telehealth as a tool to manage chronic care since it empowers doctors to use telehealth visits to treat patients with chronic conditions remotely. Antall also gave an example of in-hospital telehealth usage that would allow a doctor who just met with a patient having a mental health crisis to immediately refer that patient to a psychotherapist for a live video visit. This would eliminate the wait for a follow-up appointment – which can often take a month to schedule – and reduce the risk to the patient who is suffering.

Evolent COO Tom Peterson addressed the need for the industry to better integrate care encounter data – such as benefit and network information – into mobile health technologies, for effective real-time population health management.  Without that data readily available, the industry risks disrupting the consumer experience, or worse, sub-par care delivery.

An internet of healthcare that needs collaboration

athenahealth CEO Jonathan Bush addressed the futuristic ideas of an “internet for healthcare” that would serve as a marketplace for consumers to shop for healthcare goods and services, in the way that Amazon.com exists today for things like pillows. Bush added that due to the millions of patient records and providers currently on their platform, the company is by default building a “cloud system for the hospital” – but that they don’t want to “go it alone.”  Clearly the opportunity is ripe for continued collaboration in healthcare.

Consolidation vs. business formation

Throughout the panels, different leaders discussed the trend towards consolidation in healthcare and compared recent, pending health insurer mergers with the rise of health insurer startups (Oscar, Zoom). Remedy Partners Chairman and CEO Steve Wiggins said that he’s “concerned about consolidation” and advocated for continued entrepreneurship and new business formation.  He added that, particularly in healthcare, entrepreneurs often must “wait for the markets to catch up” – something we have witnessed first-hand here at Amwell, given the rapid adoption of telehealth in just the last couple years.

There were so many exciting topics discussed at Digital Healthcare Innovation Summit that it’s difficult to capture all of it in one summary.  If you attended, what were your key highlights?  Any topics left off the table?