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TELEHEALTH BEAT
HTRC's monthly telehealth bulletin
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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 [email protected] or call us at 877-643-HTRC.
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Telehealth likely to remain hot topic 
As a new year and a new presidential administration begin, telehealth is poised to remain a hot issue on both the state and federal levels. Though the incoming Trump administration has not yet staked out any clear policy position on telehealth, telehealth advocates are hopeful that policy agendas set by the outgoing administration will help set a course for continued growth of telehealth. Specifically, the
21st Century Cures Act passed by the 114th Congress requires the Centers for Medicare and Medicaid to report to Congress within one year on recommended new regulations for Medicare reimbursement for telehealth.
The Cures Act explicitly addresses originating sites and the current limitation to medical facilities in rural census tracts. Experts say that these limitations have slowed the usage of telehealth.
In 2015, CMS spent only $17.6 million on telehealth, compared to more than $646 billion in overall spending, as illustrated in the graphic below.
In an interview with Healthcare IT News, Lisa Schmitz Mazur, a health law partner at McDermott Will & Emery said the Cures Act may be a new beginning for telehealth.
"The Cures Act takes the first step to opening the doors for the delivery of telehealth services to Medicare beneficiaries who are located in non-rural areas or who have conditions that can be managed, treated or observed outside the four walls of a medical facility, such as at home or work."
In addition to the 21st Century Cures Act, Congress recently passed the ECHO Act with overwhelming bipartisan support. This act authorizes the U.S. Department of Health and Senior Services to evaluate the effectiveness of the ECHO model on a national scale.
State Policy
Telehealth is likely to remain a priority for state policy in 2017 as well.
In December 2016 a survey by the Federation of State Medical Boards identified telemedicine as the number one regulatory priority for state boards of medicine, edging out opioid prescribing. Interestingly, the number three priority was the Interstate Medical Licensure Compact, which could positively impact telemedicine populations along state borders by making it easier for physicians to work across state lines.
For questions about emerging telehealth policy, contact HTRC at 877-643-HTRC.
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Jefferson City, Mo.
January 26, 2017
The Missouri Telehealth Summit brings together leaders, policymakers, providers and payers for in-depth conversations about where we stand now and where we are going in this critical component of the health care industry. This year's keynote speaker, Julie Hall-Borrow, EdD, helped establish a successful school telehealth program in Dallas, Tx.
Columbia, Mo.
February 28-March 1, 2017
 Ready to implement your own ECHO program? In February, the Missouri Telehealth Network will host a
two
day, in-
person ECHO Immersion Training which
will offer a general overview of Project ECHO and dive deeper into the ECHO model
. The training will focus on
next steps for implementation
including participati
on
in an ECHO clinic.
If your organization is ready to replicate ECHO, please contact Lindsey Beckmann at [email protected] or by phone at (573) 884-3753.
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Telehealth program implementation strategies revealed
The Telehealth ROCKS (Rural Outreach for Children of Kansas) grant, now in its second year, seeks to improve treatment and assessment of children with developmental and behavioral health challenges in rural Southeastern Kansas. In September 2016, the project started accepting referrals.
The schools or providers identify parents who are interested in services via telehealth and the parents are connected with the University of Kansas Center for Telehealth and Telemedicine (KUCTT) for assistance with the intake process and then linked with services.
"Our goal is to help get services to children sooner through telemedicine," said Project Coordinator Shawna Wright in a recent interview with the Parsons Sun. "If a referral is made to a specialist, sometimes it can be six, nine, 12 months before they can be evaluated in the city. We're hoping through telemedicine we can cut that time down. It is our hope with this program parents can acquire an assessment and diagnosis much sooner."
Wright also revealed implementation strategies they have used to build and sustain the program.
Build on existing connections
Instead of spending months finding new contacts, Wright decided to first work with established contacts and scale up from there.
"I live and work in Chanute, Kansas, and I'm familiar with this area and familiar with Allen County, so we've had more of a response and a buildup there. So my approach to the grant has been get rolling with the providers we know and that we have," said Wright, adding that she plans to expand to Parsons and Coffeyville this spring.
Be creative on finding space
One implementation challenge for the project has been finding dedicated telehealth space in facilities. Many rural clinics and hospitals are already maxed-out on space, so although a provider may be interested in serving as a telehealth site for the program, they don't have the space for a dedicated telehealth room. Wright has turned to other solutions to help remedy this situation, including locating space in a local community college and an elementary school. They have also coordinated with a Southeast Kansas Mental Health Center which has agreed to dedicate one day per week to serving as a site and they are also in talks with the Allen County Health Department to provide space.
In addition to traditional diagnostic and treatment services, the grant has offered a diverse array of services, including
parent/child interaction therapy and toileting clinics. The grant has also helped fund Project ECHO, the telementoring program for primary care providers. These ECHOs covered childhood epilepsy and psychopharmacology and a new ECHO is planned for childhood asthma.
Telehealth ROCKS was recently awarded an extension grant for expanding telehealth services to schools. They will continue to expand services over the remaining two years of the grant.
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Missouri governor cuts telehealth funding
Missouri's new governor
,
Eric Greitens, recently announced deep budget cuts to higher education, social services and transportation. Among the cuts were two that will directly impact telehealth in Missouri. The governor withheld $121,250 from the budget of Missouri Telehealth Network, money that was planned for use in Show-Me ECHO, Missouri's telementoring program for primary care providers.
Additionally, $146,168 was withheld from the Department of Social Services funding that will delay Missouri's planned expansion of telehealth reimbursement under Mo HealthNet. When released, the regulatory changes will allow schools to serve as originating telehealth sites.
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Sunflower Foundation Capacity Building Grants
The Sunflower Foundation is now accepting proposals for capacity building grants. Nonprofit organizations providing health services to underserved populations in Kansas are invited to submit by February 15, 2017. These are one-year grant awards of up to $30,000.
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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.
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4330 Shawnee Mission Parkway Fairway, KS 66205
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