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March 2017    
HTRC's monthly telehealth bulletin

Heartland Telehealth Resource Center is here to meet your telehealth needs. We are a federally funded organization serving Kansas, Missouri and Oklahoma, with a wide range of services, and many of them are free. Email us at or call us at 877-643-HTRC.
Legislative Update
Many legislative bodies are approaching the midpoint of their legislative sessions and telehealth has been on the agenda in all three states in HTRC's coverage area. The list below provides updates on telehealth-related legislation. 

Last month KanTel members presented to the Kansas House Committee on Health and Human Services in support of insurance parity bill House Bill 2206. The bill was later referred to a working committee and KanTel now plans to present an educational session for the committee this summer. 

Oklahoma legislators have been considering several pieces of legislation related to telehealth. House Bill 1580, now dormant until 2018, would have required insurance companies to reimburse at the same rate for telehealth services as for in-person services. This bill was requested by the Telehealth Alliance of Oklahoma and the Oklahoma Hospital Association.

An AARP requested bill, House Bill 1893, sought reimbursement parity for remote telemonitoring. Currently the bill is still "alive" but is likely to be amended significantly and eliminate parity language. Instead, plans for a pilot program are being considered. The pilot would be administered through Oklahoma's Medicaid administrator, the Oklahoma Health Care Authority and would test the cost effectiveness of remote patient monitoring.

Another bill to watch, Senate Bill 726 was submitted by direct-to-consumer company, Teladoc, and would alter the definition of telehealth, among other changes.
Finally, House Bill 1390, if enacted, could impact the Oklahoma Universal Services Fund (OUSF). OUSF, among other things, subsidizes the cost of broadband for health care facilities providing telehealth. The bill would reallocate funding from OUSF to 211, a Federal Communications Commission service for the public to access health-related information by phone.
One proposed Missouri bill, House Bill 939, would create a task force to review the scope of practice for advance practice nurses. The use of telehealth for nurses and their collaborating physicians to communicate would be included in the study. The bill has been referred to the Professional Registration and Licensing Committee.
This list is not exhaustive. For questions about legislation in your state, please contact HTRC at 877-643-HTRC.

MTN Training Conference
Columbia, Mo.
April 18 - 19

The Missouri Telehealth Network (MTN) provides formal and informal training to new and existing members of the network. This training offers a thorough overview of telehealth including:
  • How to use telehealth devices and trouble-shoot equipment problems 
  • Public and private policies impacting telehealth, billing requirements, JCAHO standards and HIPAA regulations
  • Clinical, administrative and educational applications of telehealth
  • Telehealth use in specialties and other programs such as Show-Me ECHO

Orlando, Florida
April 22 - 25

Join us for Telehealth 2.0 in Orlando, April 23-25, the telehealth industry's premier event for technology innovation and networking. Highlights include:
  • Women in telehealth events
  • Expanded Experience Zone
  • Three time Pulitzer Prize winning author Thomas Friedman
  • Featured speaker Patrick Kennedy
Washington, DC
June 1 - 2

At CTeL's 8th Annual Executive Telehealth Summit, leading thinkers and innovators in the medical community grapple with all of the issues surrounding the use of emerging technologies that hold potential to improve the delivery of safe and quality medical care.
Here is a sample of sessions on the agenda that might be of special interest to Telehealth Resource Centers (TRC):
  • Expanding Telehealth Reimbursement: CTeL Working Group Update on the Effort with the Congressional Budget Office (CBO) 
  • Telehealth: The Undefined $20 Billion Industry 
  • 3-Step Patient Engagement Training Workshop 
  • A Workshop for Setting Up Your Telemedicine Operations 
Past attendees can attest that the TRCs both benefit from and contribute to the value of the Summit experience. 


Study finds DTC telehealth visits not a panacea  

A study released in the March issue of the Journal of Health Affairs indicates that direct-to-consumer (DTC) telehealth may not be the cost-savings cure all that employers are seeking. The study looked at claims data for upper respiratory illnesses, the most common complaint by direct-to-consumer telehealth users. Their data estimated that only about 12 percent of the DTC visits replaced in-person visits. In other words, around 88 percent of the visits represented patients who would not have otherwise sought care. This was an unexpected result given that in patient surveys about telehealth, a much higher percentage of patients say that they would have gone to the doctor in person if telehealth had not been available.       
In the case of upper respiratory infections, most people tend to get better even if nothing is done and they rarely lead to more expensive health complications. However, the researchers pointed out that for chronic conditions like diabetes, which can lead to a host of other medical problems if not managed well, telehealth could have a broader impact on cost savings.
Though the study may be unwelcome news for employers looking to lower costs by adding telehealth, this is a silver lining for healthcare facilities that want to grow their patient business. The fact that 88 percent of the visits in this study would not have occurred without telehealth indicates that virtual visits could increase patient load for brick-and-mortar organizations making virtual visits available for the convenience of consumers. When INTEGRIS Health of Oklahoma added virtual visits in 2015, they found that 60 to 70 percent of users did not have a current primary care physician and they were successful in helping virtual patients establish care with a primary care provider at INTEGRIS. In addition to the other incentives, improving continuity of care for consumers can provide lasting health benefits. 
The study additionally dealt a blow to speculation that telehealth might actually be more expensive than in-person care when the "episode" cost is considered. For example, a telehealth visit for an infection might result in a need for an additional in-person visit or lab work, all constituting the cost of the same "episode." However, the study found that DTC telehealth episodes cost an average of $79, while office visits averaged $146. ED visit were of course much higher at $1734.  
Project ECHO

Project ECHO is a program using telemedicine to revolutionize medical education  and improve access to specialty care. Project ECHO, which was developed by the University of New Mexico School of Medicine, works by connecting primary care clinicians with specialist teams via videoconference. 

Each specialty area has its own ECHO, such as autism or chronic pain. ECHO teams meet regularly to hear cases from providers and make recommendations.

Heartland Telehealth Resource Center | | 
 4330 Shawnee Mission Parkway   Fairway, KS 66205