Article archive / August 1, 2013
Originally published: . Volume 4, No. 12. Source pages: 5.
A study group charged with looking into expanding the ways that health care providers can assist patients through electronic communications, called “telehealth,” drew the attention of the state medical board in June, when a report authored by Kathy Kliebert was reviewed by the physicians. Among other recommendations, the report suggested repealing the law defining “telemedicine,” saying that it is too narrow in its definition.
Kliebert, Department of Health and Hospitals Deputy Secretary, signed the report which listed the main findings of the group. The task force was created by a 2012 House Concurrent Resolution to look into the benefits of telehealth, and called for the Department of Health and Hospitals (DHH) to study issues that could expand access to telehealth services.
The Resolution noted that telemedicine is the term typically used to refer to medical information exchanged between sites. The resolution, HCR 96, suggested a broader definition.
“… the term ‘telehealth’ encompasses telemedicine as well as other health services which can be provided remotely through communication technologies,” noted the author of the Resolution. “… common examples of telehealth services in practice include primary care, medical specialty consultations, behavioral health services, and home monitoring of chronic disease; …”
“WHEREAS, if our state is to achieve much needed improvement in health outcomes, a prudent and responsible policy for doing so would be to balance patient safety and access to care through expanding access by Louisianians to telehealth services,” wrote the Resolution’s author, Representative Simon.
The medical board’s discussion was prompted by a January 30, 2013 report, signed by Kliebert, to the Chairs of both Health and Welfare Committees. In the report, Kliebert noted the legal definition of telemedicine in R.S. 37:1262 and said, “Telehealth is more comprehensive than telemedicine. Telehealth can include innovation methods to deliver health services through home monitoring, synchronous (real time) or asynchronous interactions.”
Kliebert wrote that the study group recommends a new model for telehealth and to repeal the provisions of the 2005 Telemedicine Rule, (LAC 50: I.501–503) in its entirety. “This Rule has a narrow definition of telemedicine limited only to live interactive audio and video. The provisions do not provide guidance on provider types, reimbursement policies, or location of health services,” she wrote.
Kliebert’s letter also noted a recommendation to develop and adopt a new comprehensive Rule that redefines telemedicine to telehealth and include issues of “… services, modes of delivery, provider types, and reimbursement protocol to encourage private health insurers and Medicaid Program to reimburse for encounters between health care providers and clients regardless of location of patient and, when appropriate, health care providers.”
Kliebert wrote that another recommendation is to identify and recognize a Telehealth Consultation Standard, which is different from a “Face-to-Face” Consultation Standard, and establish reimbursement for in- home telehealth monitoring.
The authors of the in the study group also included concerns about telehealth, research, and benefits of telehealth, in their report.
The participants in the study group, set out by the HCR came from these groups: The health care services division of the Louisiana State University System, Tulane University School of Medicine, The Louisiana State Medical Society, The Louisiana Primary Care Association, The Louisiana Health Care Quality Forum, The HomeCare Association of Louisiana, The Louisiana Hospital Association, The Louisiana Association of Health Plans, and The Louisiana Cable and Telecommunications Association.
The full report from the HCR 96 study group can be found at http://dhh.louisiana.gov/assets/ docs/LegisReports/HCR96- 2013.pdf
The state medical board reviewed a memorandum prepared by then Executive Director, Robert Marier, MD, regarding the expansion of telehealth services, according to their June minutes. They agreed to express concerns about the redefining of “telemedicine” to “telehealth” and to inform the study group of the board’s willingness to participate in the future.
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