Telehealth is here to stay in rural Minnesota

WCCO TV reports

WCCO found the successes and the future of the practice for some patients in outstate Minnesota.

A former firefighter and medic, it was a bad fall after retirement that put Bart Cedergren in a wheelchair.

He lives up north with his wife. The three doctor visits a month could take much of the day, but are now done in a fraction of the time because they’re all online.

“Telemedicine I think is the wave of the future,” Cedergren said. “The only thing we go in for these days are basically lab.”

Family Nurse Practitioner Janelle Terhaar now dedicates one full office day a week in Long Prairie to her telehealth patients.

“We went from maybe having one or two a month to now we’re maybe having steady patients every day,” Terhaar said.

From parents with a sick child, behavioral health, and an older population, Terhaar says patient profiles come from all over and that even web cams don’t lie.

Telehealth is one way to help mental health resources reach rural Minnesota

The Bemidji Pioneer reports on Mental Health month…

May marks Mental Health Awareness Month in the United States, and during the last year, the topic has been increasingly brought to the forefront due to the coronavirus pandemic.

They recognize the challenge of reaching rural areas and the advantage telehealth brings

Outside of hub communities in the state like Bemidji, though, mental health resources can be scarce. Mulvihill said getting treatment options into more rural areas has been an effort by the organization recently.

“It’s certainly something we acknowledge that we have to just do a lot better on,” Mulvihill said. “It is a lot harder to find a mental health provider in Greater Minnesota, it’s just the reality. I think there have been some movement around telehealth certainly during the pandemic and we have really been advocating to maintain the things that were kind of made temporary with telehealth.”

While Mulvihill acknowledged telehealth options aren’t a fix for everyone, Mulvihill said it does provide a solution for a segment of the population.

Mayo Clinic doctor says Digital Healthcare is Healthcare

KTTC Rochester reports…

Three Mayo Clinic health professionals spoke virtually Tuesday about the advantages of remote care and the future of the health care provider-patient relationship.

Telehealth has been growing…

At its height, the pandemic is blamed for an 80 to 90% drop of in-person health care appointments.

“Beyond the height of the pandemic, we have witnessed a decline in the use of digital health care but not back to the pre-pandemic levels,” Damaerschalk said.

A new law in Arizona is expanding the definition of telehealth to be more inclusive, meaning providers will be compensated for helping patients when they aren’t in-person or virtually face-to-face.

“From a reimbursement standpoint, both government and commercial payors are reimbursing telemedicine activities on the same basis as in-person activities,” Ommen said.

The trio of doctors hopes to see that law adopted in Minnesota and Florida as well.

The doctors were very supportive…

Damaerschalk also recounted his difficulty to tell the difference between telehealth and in-person practices from a provider standpoint.

“I was completing documentation on my patients, and I had actually forgotten in several instances whether I had seen that patient in person or if I had seen them by telemedicine,” Damaerschalk said. “I paused for a moment, because to me that resonated, as it should, that digital health care is health care.”

Mental Health Telehealth Visits increase by 2,515 percent during pandemic

Business Wire reports

Medica members accessing mental health care through telehealth technology has increased by 2,515 percent since the pandemic began in March 2020. Meanwhile, Medica’s network of providers offering mental health care via telehealth has increased more than sixfold in the same period.

More details…

In the first quarter of 2020, early in the pandemic, Medica processed approximately 650 telehealth claims for mental health. During a similar time stretch spanning late 2020 to early 2021, Medica had processed 17,000 claims.

An analysis of mental health telehealth claims provide some insight to the effect of the pandemic. The top three conditions treated by telehealth were anxiety, depression and trauma (which includes diagnoses for post-traumatic stress disorder, acute stress disorder, adjustment disorder and reactive attachment). For those conditions, approximately 70 percent of claims were telehealth visits.

A breakdown of mental health telehealth claims for all conditions shows that people ages 35 to 49 used this service the most when seeking mental health care, followed by those ages 27 to 34. For those claims, women outnumbered men by a 3:2 ratio.

In the first few months of the pandemic, the number of Medica’s in-network providers offering mental health services through telehealth increased from 5,500 to 39,800 nationally. In Minnesota, the number increased from 3,841 to 7,130.

Medica will continue to support telehealth…

Medica has placed a priority on ensuring its members have access to mental health care in the setting that is most comfortable for them. To ensure they have access to the highest quality providers, Medica will continue to reimburse these visits – office and telehealth – at the same rates.

Increased access to telehealth is patient-centered care in Aitkin County MN

Aitkin Age posts a letter from a reader (and healthcare worker) about extending rules that support and promote continued telehealth…

The arrival of COVID-19 in Minnesota in early 2020 presented a series of challenges for Minnesota’s hospitals, health systems and the communities we serve.

Our health care providers at Riverwood Healthcare Center were confronted with preparing for and responding to COVID-19 while also providing non-COVID-19 care. Our patients were faced with making decisions about accessing care – including whether care capacity was available and whether they felt safe seeking care.

Expanding the use of telehealth was a way for providers to see patients and preserve personal protective equipment and a way for patients to access care but feel safe from exposure to COVID-19. Its use in Minnesota grew significantly during the pandemic. Now we have the opportunity to increase access to telehealth for Minnesotans and make permanent some of the temporary advances that occurred during COVID-19 through bipartisan legislation, Senate File 1160 and House File 1412. The bills are sponsored by Republican Sen. Julie Rosen and DFL Rep. Kelly Morrison, one of two physicians in the Legislature.

While previous law required patients to go to a health care provider site to access telehealth, this bill would continue to allow providers to deliver telehealth services directly to a patient’s home setting via audio-only telephone calls, or via secure two-way audio-video services on a tablet or computer. The legislation would allow scheduled visits to be conducted by telephone when a patient does not have access to internet or the appropriate electronic device at their location. These care delivery practices are currently in effect due to COVID-19.

Increased access to telehealth is patient-centered care. Allowing patients to access telehealth from their own home setting without the need to travel removes a barrier to getting needed health care and enhances equity within our statewide system of care.

At Riverwood, we have seen the positive results of increased adoption of virtual visits. We serve a rural community where patients often need to drive significant distances of 20 to 30 miles or more to get care in person at one of our clinics. A virtual video visit for more routine care like discussing medications and how they’re working is a huge benefit when the patient can do this from home.

The pandemic accelerated the adoption and practice of telehealth in all aspects of care delivery, which has reduced barriers to health care access and made a difference for our patients and communities across the state. Please join me in contacting our local legislators so we can keep this expanded access to telehealth in our community.

Timothy Arnold, MD, Riverwood Healthcare Center

Minnesota Telehealth Act looks good in Legislature

Mankato Free Press reports…

Telehealth service expansion in Minnesota appears all but certain as state lawmakers approved telehealth proposals this week.

The Senate unanimously passed the so-called Minnesota Telehealth Act Tuesday while the House passed a health and human services omnibus package Monday that included a similar bill.

The bill would raise reimbursement rates for video or audio consultations between patients and medical professionals. It also expands the state’s definitions of telehealth to include more medical services, such as mental health or substance abuse treatment, as well as expand coverage for those services. It also codifies several pandemic-related telehealth measures into law.

It’s looking good for telehealth…

Telehealth is one of the few things that won’t need much discussion when lawmakers head into conference committees to negotiate budget bills next month. Rosen pointed out there are still a few concerns lawmakers may address — she successfully introduced an amendment for a study on how insurance plans and providers adapt to the telehealth changes — but the measure has almost unanimous support within the Legislature.

The Health Variant gives an up close look at telehealth in NW MN

Bemidji Pioneer shares a podcast that talks about telehealth from the frontlines of Northwest Minnesota…

In the fifth episode of NewsMD podcast “The Health Variant,” host and Health Correspondent Jeremy Fugleberg talks with Dr. Sarah Manney of Essentia Health about the expanding world of telehealth

Last year, almost overnight due to the COVID-19 pandemic, telehealth such as virtual visits and home monitoring became crucial and common. Manney of Duluth, Minnesota-based Essentia Health tells us what has changed, and what’s next, in telehealth.

It’s a practical and first person account of what it’s been like for staff and patients.

MN Legislature can pass telehealth bills to make permanent telehealth expansion experienced during the pandemic

Albert Lea Tribune reports on regulatory changes that supported successful expansion of telehealth during the pandemic and permanent changes required to make sure access and expansion continue…

A swift though lesser-remarked-on transformation happened as well in medical care. As lockdowns loomed, state and federal regulators eased restrictions on “telehealth.” That led to more virtual visits in Minnesota and elsewhere, with doctors and patients communicating via video or a phone call in lieu of a clinic appointment. A year later, there’s a timely debate at the Minnesota Capitol over whether to maintain telehealth expansion measures, which are set to expire 60 days after the end of the peacetime COVID emergency. The answer should be yes, let’s keep going. A dispute between two key health care stakeholders — providers and insurers — over payment levels for telehealth care shouldn’t derail the legislation to do so.

Telehealth changes during the pandemic have provided convenient new options for patients. Previously, Minnesota patients may have had to drive to a clinic or hospital to use their telemedicine facilities. Now, they can connect from home using a personal device. Including mental health practitioners also is an advance.

Legislation to extend telehealth changes is enthusiastically backed by respected medical providers and organizations, including the Minnesota Medical Association (MMA) and the Minnesota Hospital Association (MHA). If this yearlong experiment wasn’t going well, these organizations would be the first to sound the alarm.

Some details about the bills…

Rep. Kelly Morrison, DFL-Deephaven, and Sen. Julie Rosen, R-Fairmont are commendably leading the efforts to pass the telehealth bills (HF 1412 and SF 1160) this session. Morrison is a physician, and Rosen has an admirable record of forging compromise and muscling legislation through.

That latter experience will be crucial. The telehealth legislation faces some headwinds. A key challenge is resolving differences between large health care lobbies over payment. The dispute involves “payment parity,” meaning providers are paid the same for a telehealth visit as they are for one in a traditional clinic. Before the pandemic, Minnesota was one of six states requiring comprehensive telehealth parity, said Lucas Nesse, president and CEO of the Minnesota Council of Health Plans. Since the pandemic, 14 more states have established parity during the pandemic, with requirements often in effect only for the COVID emergency, he added, citing a National Conference of State Legislatures report.

And a compromise…

A February telemedicine report points out one potential compromise: “setting payment parity as the baseline while expressly allowing providers and plans to voluntarily negotiate alternate payment rates and depart from the baseline.” This solution, or other innovative approaches, are needed to ensure that Minnesota moves forward on telehealth, not backward.

Minneapolis Star Tribune promotes legislation to expand telehealth

The Minneapolis Star Tribune Editorial Board posts…

The COVID-19 pandemic forced sweeping changes in how we work, with many workers doing their jobs remotely for much of the past year.

A swift though lesser-remarked-on transformation happened as well in medical care. As lockdowns loomed, state and federal regulators eased restrictions on “telehealth.” That led to more virtual visits in Minnesota and elsewhere, with doctors and patients communicating via video or a phone call in lieu of a clinic appointment. A year later, there’s a timely debate at the Minnesota Capitol over whether to maintain telehealth expansion measures, which are set to expire 60 days after the end of the peacetime COVID emergency. The answer should be yes, let’s keep going. A dispute between two key health care stakeholders — providers and insurers — over payment levels for telehealth care shouldn’t derail the legislation to do so.

Telehealth changes during the pandemic have provided convenient new options for patients. Previously, Minnesota patients may have had to drive to a clinic or hospital to use their telemedicine facilities. Now, they can connect from home using a personal device. Including mental health practitioners also is an advance.

Legislation to extend telehealth changes is enthusiastically backed by respected medical providers and organizations, including the Minnesota Medical Association (MMA) and the Minnesota Hospital Association (MHA). If this yearlong experiment wasn’t going well, these organizations would be the first to sound the alarm.

Telehealth is becoming more common for good reasons…

In 2019, just 3% of patient visits used telehealth. In 2020, that rose to 28%, according to data released last August. In addition, 83% of physicians surveyed reported that telehealth met patients’ needs “acceptably, well or very well.”

Doctor in Duluth asks policymakers to make COVID telehealth changes permanent

The Duluth News Tribune runs a letter to the editor from Dr. Sarah Manney is the chief medical information officer at Essentia Health in Duluth…

We didn’t conduct our first virtual visit until mid-March 2020. Within weeks, we were performing thousands per day, peaking at more than 3,500. One year later, we have surpassed 400,000 virtual visits. Further, 80% of our mental health encounters were done via virtual visits this last year. For those patients, when one of the biggest hurdles is simply getting out of the house to seek help, that initial obstacle was rendered obsolete by the accessibility of virtual visits.

We’ve also done more than 100,000 e-visits, which are targeted at 20 of the most common conditions, pushing Essentia’s telehealth encounters in a single year well north of half a million. And this was only the first year; imagine how many more people will benefit from these innovative offerings as they become more prevalent.

Right now in Minnesota, we have a tremendous opportunity to increase that access. We can make permanent some of the temporary advances that occurred because of COVID-19 through bipartisan legislation — specifically, Senate File 1160 and House File 1412. The bills are sponsored by Republican Sen. Julie Rosen and DFL Rep. Kelly Morrison, one of two physicians in the Legislature.

While previous law required patients to visit a health care provider site to access telehealth, this bill would continue to allow providers to deliver telehealth services directly to a patient’s home setting via audio-only telephone calls or secure two-way audio-video services on a tablet or computer. The legislation would allow scheduled visits to be conducted by phone when a patient does not have internet access or the appropriate electronic device.

These care-delivery practices are currently in effect due to COVID-19. But we feel strongly that they should become a staple of 21st century health care, even after the pandemic. They let patients receive treatment that may prevent the worsening of chronic health issues and may reduce potentially avoidable emergency-room visits.

Aitkin County interested in extending waivers that support telehealth

Aitkin Age reports

Last March, Gov. Tim Walz declared a peacetime state of emergency, issuing waivers to health care providers that temporarily granted them increased flexibility in responding to the COVID-19 pandemic. Across Minnesota, standard regulations for treatment location, telehealth services, and administrative activities were relaxed.

The state of emergency is set to expire on April 14. It is not known whether Walz will extend it beyond that date.

Cynthia Bennett, the director of Aitkin County Health and Human Services, said that a number of the waivers, such as more flexibility in terms of remote work, should stay in place.

“We had to make all these adjustments because we were not supposed to be face-to-face and we needed to comply with the governor’s executive orders for social distancing,” she said. “And it worked out well, so we would like to continue that, because we found cost savings for taxpayers.”

The waiver are what made telehealth possible and affordable during the pandemic. The increase in use is one of the silver linings of the pandemic allowing more patients to be seen and reducing drive times for patients and often for family or friends who would drive them to appointments out of town.

EVENT April 7: World Health Day Symposium 2021

Global Minnesota is hosting a meeting next week and broadband will be a featured topic – because broadband is key is health equity, especially during a pandemic..

Global Minnesota hosts an important virtual symposium to mark World Health Day on April 7. The official theme for the day is Health Equity.

This enormous topic extends all the way from local grassroots issues to global policy initiatives. With its reputation for health care, organizations and companies based in Minnesota are in a unique position to share expertise in improving global health. As the facilitator of this symposium, Global Minnesota serves as a conduit of information that can take local innovations and extend their reach across the world.

What projects around the globe can shape solutions that support developing health equity? How can the United States and Minnesota learn from global innovators?

Register now to hear the perspectives of local, national, and international organizations and corporations that provide leadership in health care, research, and policy.

The list of speakers include some folks well steeped in the world of broadband, such as…

  • Ali Dalio – Managing Partner, United Ventures; Managing Director, United Capital Group
  • Juan José Gómez Camacho – Ambassador of Mexico to Canada
  • Jean-Paul Smets, PhD – Founder, Nexedi; Founder RapidSpace; CTO, Blutel Wireless

COVID19 opens the doors for continued legislative support for telehealth

Minneapolis Star Tribune reports

The use of electronic devices in patient care, known as telehealth, has long held promise as the next big thing in the industry, but not until the coronavirus hit, raising a host of safety concerns, did it become commonplace.

Nearly 30% of health care visits are now conducted electronically, much of it made possible because federal and state regulators, as well as insurance providers, responding to the pandemic emergency, relaxed some of the rules and requirements that made it more difficult to use telehealth.

For example, under Minnesota law, some patients had to drive to a clinic or hospital to use that facility’s secure telecommunications equipment if they wanted to talk with a doctor located at another site. In the past year, that rule has been waived.

As the number of COVID-19 cases begins to rise once again in Minnesota, there is bipartisan support at the Legislature to make permanent many of the changes that have driven the increase in telehealth, with both chambers advancing bills to rewrite the state’s telehealth laws.

That’s quite an increase…

Before the pandemic, telehealth accounted for 3% of patient visits, according to a Minnesota Medical Association survey.

And there are benefits…

“The addition of virtual care clearly was a benefit to the patient, their satisfaction went up, quality went up and overall costs went down because we really architected our system to take advantage of virtual care,” he said.

The virtual visits worked best with patients who already had an established relationship with the physician and clinic and where hands-on care, such physical exams or blood draws, were not needed.

Telehealth also has been extremely popular in mental health and substance use treatment, with many health care systems reporting high volumes of therapy visits.

But providers need the reimbursement to make it happen…

Providers say it is important that they get the same insurance reimbursement payments as in-person visits because overhead costs are the same for virtual visits.

“It is not bricks and mortar costs as much as the infrastructure and all the people behind it to do that work,” said Ingham. “You can’t have virtual visits without those foundational costs.”

Telecom bill introduced in MN House: HF2215 911 funds for creating GIS

According to MN House Chief Clerk’s Office on March 15…

Edelson introduced:

HF. 2215,A bill for an act relating to public safety; directing that unspent funds in the 911 emergency telecommunications service account be used for grants to counties to design, develop, implement, operate, and maintain the geographic information system; appropriating money; amending Minnesota Statutes 2020, section 403.11, subdivision 1.

The bill was read for the first time and referred to the Committee on Public Safety and Criminal Justice Reform Finance and Policy.

Here is the full bill

A bill for an act
relating to public safety; directing that unspent funds in the 911 emergency
telecommunications service account be used for grants to counties to design,
develop, implement, operate, and maintain the geographic information system;
appropriating money; amending Minnesota Statutes 2020, section 403.11,
subdivision 1.

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