Originally published on Oct 2, 2018.

 

Telehealth technology presents a unique opportunity to revolutionize multiple aspects of healthcare.
2018 has been a breakout year for telehealth – the majority of States now allow the practice of telepharmacy and healthcare practioners are becoming more receptive to the technology and how it can help them do their job better. The backbone of the success of telehealth is, as with everything else, technology innovation.
A few breakout companies are bringing telehealth capabilities to operations through white-label software products including AzovaHealth, Teladoc (used by CVS), SnapMD and MDLive.
Recent Traction: Publix and BayCare & CVS MinuteClinic Video Visits
CVS, in their horizontal and vertical march through the healthcare continuum, recently launched MinuteClinic Video Visits through their CVS Pharmacy App. Patients with minor illnesses and injuries, skin conditions and other wellness needs will have access to health care services 24 hours a day, seven days a week from their mobile device.
In a more extensive offering, Publix and BayCare Health System are offering patients a kiosk which allows patients to easily enter their symptoms and work with medical tools such as thermometers, otoscopes, blood pressure cuffs and high definition cameras to help doctors make an accurate diagnosis.
Who Wins? Efficiencies Realized
The potential cost-savings for healthcare providers and dispensers is immediately obvious. In many cases, it will no longer be necessary to have a full staff at numerous locations; instead, a doctor can diagnose (in many cases) and a pharmacist can supervise filling a prescription – from thousands of miles away.
Patients, especially those with limited mobility, will benefit from being able to check-in with doctors and receive care from the comfort of their own home.
OIG Scrutiny… and Approval of Telemedicine Arrangement
Of course, no new technology can be launched without bad actors attempting to take advantage and so the OIG has been on high alert. In April, the watchdog agency identified $3.7 million in improper Medicare telehealth payments, potentially inviting more scrutiny for providers.
Some positive news for the burgeoning sector, however, is the FDA OIG also recently approved an arrangement where a clinic would provide free HIV consultations and then refer patients to a hospital for care, as needed. The OIG did note, however, if the pharmacy was more closely tied (and there was evidence of steering prescriptions), that a case could be potentially made for improper activities.
New Technology Opportunities
We can expect a host of new patient health monitoring devices (heart rate monitors, fitness trackers, sleep monitors, etc.), along with their software apps, to connect with telehealth platforms in the near future. Combined with medication adherence software apps, doctors and pharmacists will have more in-depth data on their patients that will drastically improve healthcare.
States Allowing the Practice of Telepharmacy
  1. Alabama
  2. Alaska
  3. Arkansas
  4. Colorado
  5. Delaware
  6. District of Columbia
  7. Florida
  8. Guam
  9. Idaho
  10. Illinois
  11. Indiana
  12. Iowa
  13. Louisiana
  14. Minnesota
  15. Montana
  16. Nevada
  17. New Mexico
  18. North Carolina
  19. North Dakota
  20. Oregon
  21. South Dakota
  22. Tennessee
  23. Texas
  24. Vermont
  25. Washington
  26. West Virginia
  27. Wisconsin
  28. Wyoming
Future & Further Legalization of Telehealth
On a Federal level, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, signed in February 2018 will eliminate geographic restrictions on telestroke consultations in 2019 and expand telehealth coverage under the Medicare Advantage Plan B in 2020.
Additionally, on a state level, regulators seem keen on adopting regulations that will allow for the continued expansion of telehealth services.
Navigating Legal Statutes
State-approved telehealth laws that are effective since January 1, 2018 per the Center for Connected Health Policy.
  • Arkansas: Senate Bill (SB) 146 amends the definition of telemedicine, specifies requirements for establishing a professional relationship through telemedicine, and outlines requirements for a health care professional delivering services through telemedicine in a school setting to a minor who is enrolled in the Arkansas Medicaid program.
  • California: Assembly Bill 401 establishes requirements for registered pharmacy technicians working at a remote dispensing site.
  • Colorado: SB 207 creates a behavioral health crisis response system and crisis service facilities walk-in centers mobile response units, and addresses the role telehealth can play in these situations.
  • Illinois: SB 1811 establishes practice standards for providers engaging in the practice of telehealth, including the requirement to be licensed and to follow the same standard of care that is applied to in-person services. House Bill 2907 does not require a physician or other licensed health care professional to be physically present in the same room as the patient for the entire time during which the patient is receiving telepsychiatry services.
  • Oregon: SB 786 allows dental care providers to use telehealth if they determine it is appropriate and within their scope of practice. The Oregon Board of Dentistry is required to treat services delivered through telehealth the same as it would treat those delivered in person.”
  • Michigan: Sections 333-16283 through 333-16288 allow for telemedicine but the Board of Pharmacy has not yet promulgated rules related to telehealth.
Five Rivers RX – Solutions and Partnerships
In taking advantage of telehealth offerings, it will be crucial for healthcare providers to ensure proper and compliant billing through robust compliance programs. Our consultants can address these concerns efficiently and effectively, providing a lift to your bottom line while minimizing risk.
Accreditation Programs are also launching – ClearHealth Quality Institute announced two new telemedicine accreditation modules that cover Telemedicine Outcomes and Remote Patient Monitoring in September 2018.
Additionally, Five Rivers RX recently partnered with AzovaHealth to help their clients navigate the patchwork of Federal and State regulations in the practice of telehealth. If your company is interested in building telehealth capabilities, including independent pharmacies wanting to become an originating site or remote dispensing site, please reach out to us at hello@fiveriversrx.com!

 

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