Bluestream Health, a virtual care Platform-as-a-Service, has enabled access to virtual care for Mankato Clinic’s 13 healthcare facilities across four rural communities in southern Minnesota.
Bluestream Health’s virtual care platform provides access for patients to Mankato Clinic’s full spectrum of health specialties, services, and programs for primary care to care management to pediatrics. Bluestream Health is also providing interpreting services to patients through the virtual platform.
The House of Representatives has drafted a bill that would provide new virtual care options for American employees.
WHY IT MATTERS
The proposed Telehealth Benefit Expansion for Workers Act would enable job creators to offer standalone telehealth service programs – not unlike dental and vision plans – in addition to existing health insurance plans.
The legislation was introduced by Reps. Suzan DelBene, D-Wash., Jackie Walorski, R-Ind., Tim Walberg, R-Mich., and Angie Craig, D-Minn. It would expand access to employer-sponsored health benefits by classifying telehealth as an excepted benefit.
Specifically, the bill would amend HIPAA and the Affordable Care Act to allow employees to receive this benefit, maintaining that any standalone telehealth service would remain separate from traditional health plans, rather than as a replacement.
Internet Innovation reports..
Medicare beneficiaries completed 54.5 million virtual office visits in 2020, according to a new federal report released by the Department of Health and Human Services’ Office of Inspector General. The analysis considers Medicare fee-for-service claims data and Medicare Advantage encounter data from March 1, 2020, to Feb. 28, 2021, and from March 1, 2019, to Feb. 29, 2020.
The COVID-19 pandemic caused telehealth use to skyrocket. Medicare beneficiaries used 114.4 million telehealth services from March 2020 to February 2021, which is 88 times the use of these services by this population the year prior.
From March 2020 through February 2021, 43 percent of Medicare’s 66 million beneficiaries – more than 28 million people enrolled in Medicare – used a telehealth service. Prior to the pandemic, just one percent of beneficiaries used telehealth.
A bipartisan bill to reduce the country’s high maternal mortality rate has been passed into law as part of the omnibus bill.
Senator Tina Smith, author of the Rural Maternal and Obstetric Modernization of Services, or MOMS, Act, says the U.S. is 46th in terms of maternal mortality rates and the only industrialized country where the number of women who die in childbirth is getting worse and not better. When she learned about those statistics, she also learned that half of the rural counties in Minnesota have birthing services in their hospitals. Both the Pew Trust and the Commonwealth Fund have written about the increase in the closure of OB units and the heavy reliance on midwives to fill the gap, potentially placing women and babies at risk.
Smith explains the MOMS Act “provides additional resources and training to rural hospitals and clinics to help them improve their maternal care, prenatal care, and as well as postpartum care when moms and babies go home it even allows for additional use of telehealth, which can make a big difference in improving prenatal care and postpartum care when babies come home.”
Smith stressed the telehealth angle in that when new parents in more rural areas who have a long drive to get to their prenatal or postpartum care stay connected to their providers, instances of postpartum depression can be identified early and treated before it becomes serious. She added that telehealth is not a replacement for face-to-face care, “but it can make a difference for moms as they do some of that more routine prenatal care, which is important because that reminds you; am I eating the right things? Am I taking the vitamins that I need? And also maybe I have some symptoms I don’t understand that can be evidence that you need to get into the doctor’s office because you might be having issues with hypertension or other kinds of early warning signs for a meeting that meaning that you have a higher risk pregnancy and needs to be seen the doctor more often.”
Great Plains Telehealth Resource & Assistance Center (gpTRAC) will be hosting their annual in-person conference, Telehealth Everywhere, May 24-25 at the Radisson Blu-Mall of America. This conference will feature excellent keynote presenters and breakout sessions. The opening keynote speaker, George Demiris, PhD, UPenn, will discuss the need for inclusive design in telehealth and other digital health tools. He will also present various case studies that highlight ways to facilitate ongoing and effective patient engagement. Attendees will again have the opportunity to discuss emerging telehealth information with their peers and colleagues.
Vox reports on the connection between COVID deaths and broadband access…
Two years into the pandemic, researchers are still trying to understand what makes some people more likely than others to die from Covid-19. Although we know some of the risk factors — like age and underlying disease — others are less obvious. Identifying them could ease our current pain, protect communities from future epidemics, and point us toward some of the societal fractures we should most urgently try to mend.
One of the more surprising answers to this question is one that appears to have a relatively straightforward solution: internet access.
This March, researchers at the University of Chicago published a study in the journal JAMA Network Open that showed one of the factors most consistently associated with a high risk of death due to Covid-19 in the US was the lack of internet access, whether broadband, dial-up, or cellular. This was regardless of other demographic risk factors like socioeconomic status, education, age, disability, rent burden, health insurance coverage, or immigration status.
The study authors estimated that for every additional 1 percent of residents in a county who have internet access, between 2.4 and six deaths per 100,000 people could be prevented, depending on the makeup of the region.
Why is lack on broadband a factor?
These inequities were not created by chance. In the US, private internet service providers developed the infrastructure for broadband internet access where it was profitable. As a consequence, many of the country’s most marginalized communities have the fewest, most expensive, and lowest-quality choices when it comes to an internet service provider.
As those access gaps persisted over the years, more and more health services came online. That left those without access unable to use telemedicine, or even easily look up information about health conditions. Over the last few years, researchers have started to see internet access, and in particular high-speed broadband, as a critical component of health — something vital for connecting people not only with health care, but also with food, housing, education, and income, all of which are considered social determinants of health.
Then, as Covid-19 pushed routine health care provider visits into the telehealth space, people without internet access — many of them already medically underserved — found health care even harder to access. Home broadband drew a sharper line than ever before between haves and have-nots; access to internet bandwidth suddenly determined access to educational instruction, economic stability, food pantry sign-ups, vaccine availability and safety information, human contact, and so many other resources.
The MN Senate Republican Caucasus reports…
The Minnesota Senate recently approved legislation that establishes Minnesota as a member of the Nurse Licensure Compact (NLC). Minnesota would join 39 other states and jurisdictions as members of the compact, which has been around for 20 years. Joining the NLC would allow Minnesota nurses to obtain a single license to work in multiple states. The licenses reflect the same high standards and safety of current state licensure, but provide a modern system that supports nurses and patients in giving and receiving the best care possible.
Hospitals and health care facilities across the state are struggling with severe staffing shortages. Joining the NLC will increase access to care, support telehealth, and help Minnesota be better prepared to meet health crises such as the pandemic. It will also increase our service for military individuals, spouses, and families. It will enable us to serve patients and families beyond our state boundaries.
Duluth News Tribune reports on telehealth at local at Essentia in Baxter…
Prior to March 2020, Essentia reported it had never conducted a virtual visit. But in a robust response to the pandemic, the health care provider was performing more than 3,500 per day within weeks. Two years later, they had about 645,000 telehealth visits.
The article goes on to give a nice glimpse of what that looks like for different patients. For folks with substance use disorders, depression and anxiety…
Staff at Essentia Health’s clinic in Baxter, Minnesota, said they were initially working with their technology services to add telehealth for patients who had substance use disorders, depression and anxiety. The goal was to disrupt their lives as little as possible while working with them to improve their health and their lives.
Then the pandemic hit and those telehealth visits expanded exponentially as a way to reduce exposure to the virus. The Baxter facility went from two rooms for virtual visits to six in the family practice clinic. Patients across the board are able to schedule virtual visits, or video appointments, and speak directly to their doctor using computers, tablets or smartphones.
For Nutritionists …
Nutritionists could see what people had to work with at home. Those who were working from home, with children at home or other family to care for, could still connect for a needed appointment. Older residents didn’t have to make the trip or feel they had to find someone to take them to an appointment. Those who may have had trouble getting time off from work could still do a check-in and consult with their primary care provider.
HeathCareBusiness reports on tech upgrades in hospitals La Crosse and Mankato. Telehealth can be a double edge sword in rural areas, it brings better healthcare to your home but it puts the local hospital in jeopardy. So it’s nice to see how two local non-metro hospitals are finding a middle ground of sorts by providing even better service online with technology…
Mayo Clinic Health System will build a new six-floor, 70-bed hospital in La Crosse, Wisconsin, and expand and modernize the hospital in Mankato, Minnesota, by adding three new floors atop the existing building….
Mayo Clinic Health System in La Crosse and Mankato will have technology-enabled hospitals that foster a culture of excellence and equip staff with the latest tools to Cure, Connect and Transform community health care. These hospitals will incorporate telehealth, digital health and artificial intelligence technologies, along with design elements and efficiencies to support innovative care models and enhance the patient and staff experience for years to come.
Here are some details on the hospital improvements in Mankato…
The Mankato project features a 121-bed expansion. The project will include a three-floor vertical expansion atop the Emergency Department, Cancer Center and Specialty Clinic foyer.
Hospital floors within the new tower will link to the existing hospital and include:
A new and expanded ICU and Progressive Care Unit
A new Medical-Surgical Unit.
A new Family Birth Center, including Labor and Delivery, Postpartum, Triage, a cesarean surgical suite, and a Level 2 nursery.
The two projects constitute a $353 million investment in the future of Mayo Clinic Health System. Construction is expected to begin this spring at both locations and will be completed in 2024.
The hard part about technology is not always the technology, sometimes it’s the user and sometimes it’s the policy. MN Senate Republican Caucus talk about getting nurses certification that help promote telehealth…
Sen. Carla Nelson (R-Rochester) was joined by a group of legislators and health care professionals today to spotlight legislation (SF 2302) that would have Minnesota join 39 other states as members of the Interstate Nurse Licensure Compact (NLC).
The NLC is a national agreement that allows nurses in participating states to obtain one license that is valid across all member states. Nurses with an NLC license are able to practice quickly and easily in other NLC states, improving access to care, alleviating staff shortages, reducing costs, and eliminating unnecessary red tape.
A coalition of 60 organizations representing nurses, providers, telehealth supporters, and military family advocates supports Minnesota joining the NLC. Minnesota nurses overwhelmingly support joining the compact. A 2022 survey by the Minnesota Board of Nursing shows nurses favor Minnesota’s joining the compact by a ratio of nearly 10 to 1.
The Minnesota House Higher Education Committee convened five student groups from across the state, including the Minnesota Student Association (MSA), to talk about the upcoming session and what students want to see from legislators.
MSA Director of Government and Legislative Affairs Grace Johnson and Ranking Voting Member Carter Yost spoke on behalf of the group at the Feb. 2 meeting. Johnson and Yost highlighted increasing student minimum wage and public safety while also bringing up housing reform, expansion of telehealth services and amending the Board of Regents selection process.
The live reaction from legislators was relatively silent, with one of the 19 committee members asking Johnson and Yost questions after their testimony. Afterward, Yost said he heard from lawmakers.
“I received a few folks sending messages thanking me for being there and congratulating us on the advocacy,” Yost said. “It seems to me that there’s a general sense of elected officials really wanting to find that student input.”
AJMC reports on the various benefits of telemedicine in the oncology world once COVID lower barriers of reimbursement, including weather resilience…
Rajini Katipamula-Malisetti, MD, a medical oncologist and hematologist with Minnesota Oncology who practices in Coon Rapids, has seen telehealth’s usefulness up close. She spoke with Evidence-Based Oncology™ in December 2021, as the Omicron variant fueled another surge of COVID-19 cases and triggered another rise in hospitalizations.4 This happened as Minnesota reached the season when, in prior years, a wintry blast could wipe out an entire day’s schedule.
But now, schedulers at Minnesota Oncology know that if patients call to say they can’t come in because of a snowstorm, there’s a solution. “We’re just asking them to offer telehealth appointments,” Katipamula-Malisetti said. “We don’t want to cancel appointments.”
Better yet, the team can look at the forecast and proactively switch patients to telehealth appointments if a storm is coming. “It’s been really helpful,” she said.
… telemedicine reduces exposure to infection and makes staffing easier…
Having patients see their physician, social worker, or nutritionist via telehealth obviously reduces the opportunity for infection, but that’s not the only problem it solves, Katipamula-Malisetti said. Staffing shortages have emerged across health care, and Minnesota Oncology may not have staff at each clinic for every type of service. Telehealth helps address that: “There are certain specialties where we’re still leveraging telehealth significantly,” she said.
… telemedicine makes it easier to get family history when family can join the call…
Another example: a genetics session at which family history is taken—having multiple family members participate is a plus, she said. Depending on the practice or the insurer, telehealth was used for these visits even before the pandemic due to the relative scarcity of certified genetic counselors.4 She cited visits about nutrition as a third example.
The article outlines the best uses of telemedicine (based on survey results)…
The Minnesota Oncology experience with telehealth generally aligns with survey results reported at the most recent ASCO meeting, in May 2021. Only 3 types of visits were found appropriate for telehealth by more than 50% of the providers: discussions of imaging or laboratory results, chemotherapy education, and genetics counseling. More than 50% of survivors found visits on imaging or laboratory results or financial counseling to be appropriate; 90% of providers thought financial counseling was appropriate within the context of a broader visit on supportive care. Follow-up care found appropriate for telehealth by more than 50% of both providers and survivors included symptom management; for survivorship care, more than 50% of providers and survivors endorsed nutrition consultations and patient navigation via telehealth.
And notes that of course these benefits only apply when patients have access to broadband, devices and the skills to use them…
For all the positives that telehealth can offer, the question of whether all patients have the same access to technology has lingered since the start of the pandemic. The ASCO survey results showed that among survivors, 2.5% reported having no phone or no smartphone, 6.7% reported no or unreliable broadband or internet access, and 10.9% reported being uncomfortable using technology.
Telehealth took off during the COVID-19 pandemic, and a new study shows even people with serious mental health conditions can benefit from online appointments.
The findings are good news for rural folks who live miles away from psychiatrists and psychologists.
“This study showed that patients with multiple psychiatric conditions and who also struggle with several chronic physical health problems can engage well in mental health treatment with their primary care doctors or remote mental health specialists,” said study co-author Dr. Jennifer Severe, an assistant professor of psychiatry at the University of Michigan, in Ann Arbor.
But it also showed that patients with drug problems and manic symptoms from bipolar disorder may need additional support to get started on psychotherapy or to stay with it, the researchers said.
The study was conducted before the COVID-19 pandemic, to see if people living far away from mental health care providers could benefit from telehealth services. The work was timely, given that many health care visits have moved online because of the pandemic.
Mayo Clinic Health System’s mobile health clinic marked its one-thousandth patient appointment this month.
The mobile clinic launched in July of 2021, bringing year-round care closer to patients in rural communities in southern Minnesota.
The clinic is also celebrating ten thousand miles of travel among the four rural Minnesota communities it serves.
The mobile health clinic features two exam rooms, an on-site laboratory, and telehealth equipment to connect patients to specialty care.
Folks might remember Kairos Alive! , our most interactive partners at our first (2020) all online annual conference. They were the folks that got us jumping around and dancing between sessions. They have a weekly online program/concert/exercise series coming up that looks like fun. It might be a break in your business day and/or a chance to connect with loved ones who are more homebound, be that a grandparent, parent-of-a-newborn, or someone with compromised health issues. You can meet in the clubhouse…
Connect, Create, and Move for Wellbeing
Get your 9-week pass to the Clubhouse: Thursdays, February 3 – March 31, 2022, 10:30 – 11:15 AM Central and 1-1:45 PM Central.
On Zoom and YouTube Live.
Experience joy, adventure, and friendship this spring in this 9-week research-based program from Kairos Alive. Building from over two decades of practice and expertise as performers, teachers, and artists, our work is informed by and contributes to a wide breadth of research ranging from social wellness, elder care, memory loss, and mental health. The Clubhouse will play with and explore music, dance, and storytelling from intercultural, intergenerational, and community-centered forms of art-making. Email email@example.com for the Zoom link and information about the program.