Virtual Medical Care
Topic Collection
August 29, 2024
Topic Collection: Virtual Medical Care
The continuing increase in the use and capabilities of virtual medical care (also referred to as telemedicine, although care may be provided via telephone, web, or other means) has led many in the emergency medical community to plan or implement call centers and web- or telephone-based triage and treatment systems in anticipation of and during public health emergencies. Additionally, health systems are using virtual platforms to coordinate care and provide remote access to specialty care and assessment (e.g., trauma, stroke, and psychiatric) which can be leveraged during disasters to broaden access to specialty consultation (e.g., for patients with burn injuries or pediatric patients). These resources highlight strategies for implementing virtual medical care during a disaster, including lessons learned from recent events.
Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category. Additional information can be found in the following Topic Collections: Influenza Epidemic/ Pandemic; Natural Disasters; SARS/MERS; and Utility Failures.
Must Reads
This webpage provides an overview of key issues related to telemedicine for physicians to reference, including: how to locate resources to support the implementation of telemedicine; how telehealth resource centers can assist providers; legal, regulatory, and licensure issues; and reimbursement issues.
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The authors explain the development, testing, and implementation of a model to enable community health call centers (e.g., poison control centers, nurse advice lines) to support home-management and shelter-in-place approaches in certain mass casualty or health emergency events. The report includes a matrix with possible call center capabilities aligned with National Planning Scenarios and other guidance that can be tailored by call centers.
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This well-organized issue brief highlights how telehealth is being used in disaster preparedness and response and summarizes the challenges and potential solutions associated with this mechanism of healthcare delivery.
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This webpage provides information on the Interstate Medical Licensure Compact, an agreement between 29 states, the District of Columbia and the Territory of Guam, where physicians are licensed by 43 different Medical and Osteopathic Boards. Under this agreement licensed physicians can qualify to practice medicine across state lines within the Compact if they meet the agreed upon eligibility requirements.
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This workbook guides planners through the process of determining the need for a call center, as well as how to operationalize a call center during public health emergencies.
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The author proposes 3 steps for telemedicine disaster preparedness: Acknowledge telemedicine as a Standard of Care; establish tools and workflows before disaster strikes; and form partnerships between public and private organizations.
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The authors describe the successful use of a telephone nurse triage line (NTL) set up by the Minnesota Department of Health for evaluating individuals with influenza-like illness and tele-prescribing of anti-virals. The NTL diverted callers from acute care visits at low cost and had a high rate of satisfaction among callers.
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This collaborative resource was created “to provide an overview and framework for implementing telehealth in critical access hospitals and rural areas.” It includes a listing of research related to telehealth and outcomes, and lessons learned and best practices from organizations that successfully implemented telehealth programs and contributed to this document.
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The University of New Mexico School of Medicine. (2016).
Project ECHO.
The Extension for Community Health Outcomes (known as Project ECHO) was created to help healthcare providers in rural and underserved areas with information they need to treat conditions such as Hepatitis C, chronic pain, and behavioral health disorders. In the event of a disaster, one or more of ECHO's "hubs" could assist with virtual healthcare education and consultation / provider collaboration.
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Applications for Telemedicine
This article describes practical tips about how to provide psychological services to older adults living in nursing homes during the COVID-19 pandemic.
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The authors conducted a literature review covering 2007-2012 to identify mobile health care technology solutions to aid in disaster management. They found five types of applications: disaster scene management; remote monitoring of casualties; medical image transmission (teleradiology); decision support applications; and field hospital information technology (IT) systems, most of which were still under development at the time of their review.
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The authors describe a mobile application that uses digital images of patients' burns superimposed on a patient-specific 3D model. The application was found to more accurately estimate burn size than burn experts when tested at two separate international burn meetings.
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The authors developed and measured a model application in order to quantitatively analyze the potential health benefits of telemedicine in disaster response. They found that the model can support disaster response activities and enhance surge capacity; enhance the speed and effectiveness of medical response; and improve resource and operations planning, as well as internal and external situational awareness.
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The authors tested an in-ambulance telemedicine system and found that pre-hospital diagnoses were in agreement with final diagnoses 90% of the time; pre-notification of the hospital via text message was successful 90% of the time; and transmission of a pre-hospital report was completed 95% of the time. Challenges experienced were related primarily to limited connectivity, but also to hardware, software, or human error.
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Call Centers and Triage Lines
The authors developed a Call Volume Projection Tool to estimate national call volume to Flu on Call® during an influenza pandemic. They extrapolated data from the 2009 experience of the Minnesota FluLine (during the H1N1pandemic) and applied it to a 20% attack rate, and case hospitalization rates from the 1968 and 1957 pandemics, respectively, to provide an estimated national weekly call volume.
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The authors explain the development, testing, and implementation of a model to enable community health call centers (e.g., poison control centers, nurse advice lines) to support home-management and shelter-in-place approaches in certain mass casualty or health emergency events. The report includes a matrix with possible call center capabilities aligned with National Planning Scenarios and other guidance that can be tailored by call centers.
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The authors describe a pilot program in which dental school faculty members received training in outbreak investigation and telephone triage to assist the New York City Department of Health and Mental Hygiene in preparing to respond to pandemic influenza. They propose the use of dental professionals and/or other "nontraditional healthcare personnel" in support of call centers and telephone triage lines.
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This article discusses the successes and challenges experienced by Washington DC since integrating triage nurses into its 911 Call Center in April 2018. Logistical, medical, and financial (including insurance) considerations are presented, and may assist other jurisdictions in developing a similar model, which could support disaster response and recovery through efficient management of ambulance services.
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The authors describe the Centers for Disease Control and Prevention's Nurse Triage Line Project and its goals of using a coordinated network of nurse triage telephone lines during a pandemic to assess the health status of callers, help callers determine the most appropriate site for care, disseminate information, provide clinical advice, and provide access to antiviral medications to those who need it.
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This webpage includes information about Flu on Call®, an initiative modeled on successful statewide projects that were implemented during the 2009 H1N1 pandemic to establish a national network of telephone help lines designed for use during a severe influenza pandemic. Links to a toolkit, frequently asked questions (FAQs), and relevant publications are included.
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This workbook guides planners through the process of determining the need for a call center, as well as how to operationalize a call center during public health emergencies.
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The authors discuss a 3-week observational study they conducted to determine outcomes from a triage protocol that had an emergency medicine physician consult with a triage line nurse, or with a patient directly, when the triage line nurse determined from call line disposition algorithms that a patient should be seen in the Emergency Department (ED). They concluded that this model could safely mitigate some unnecessary ED usage.
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The Minnesota Department of Health developed several tools to support healthcare providers during the 2009 H1N1 influenza pandemic, including MN FluLine, a nurse triage line, that reached many rural and uninsured residents, and, according to the authors, may have prevented up to 11,000 in-person health-care encounters.
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The authors describe the successful use of a telephone nurse triage line (NTL) set up by the Minnesota Department of Health for evaluating individuals with influenza-like illness and tele-prescribing of anti-virals. The NTL diverted callers from acute care visits at low cost and had a high rate of satisfaction among callers.
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The University of New Mexico School of Medicine. (2016).
Project ECHO.
The Extension for Community Health Outcomes (known as Project ECHO) was created to help healthcare providers in rural and underserved areas with information they need to treat conditions such as Hepatitis C, chronic pain, and behavioral health disorders. In the event of a disaster, one or more of ECHO's "hubs" could assist with virtual healthcare education and consultation / provider collaboration.
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The author proposes bringing together the expertise of emergency response organizations, public health agencies, and poison control centers to institute call centers and/or triage lines to disseminate information to the public during emergencies, and answer questions and concerns to keep concerned individuals from flooding local emergency rooms. Real-world examples of successful collaborations from Canada, Great Britain, and the U.S. are included.
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Event-Specific Lessons Learned
This tip sheet describes the use of telehealth and how it has changed during the COVID-19 pandemic. For the full report, access https://files.asprtracie.hhs.gov/documents/aspr-tracie-covid-19-and-telehealth.pdf.
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Denver Health is a Level 1 Trauma Center and Urban Safety Net hospital with 550 beds and nine federally qualified community health centers located throughout the city. Before the pandemic, the hospital had 227 adult medical surgery/critical care beds, 47 were intensive care unit (ICU)-level beds, and 12 were intermediate care beds. They ran near or at capacity and often experienced adult emergency department boarding. Patrick Ryan, MD, MPH, and Connie Savor Price, MD (from Denver Health and the University of Colorado School of Medicine) shared their experiences creating the “Virtual Hospital at Home” model to manage the significant surge in COVID-19 patients in the fall of 2020.
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BlueCross BlueShield of Texas reviewed member claims for the 6 months post-Harvey and compared them to the same time period the previous year and found that “many people turned to technology in the form of telemedicine for the first time.” There was a rise in mental and physical health conditions such as post-traumatic stress disorder (PTSD), as well as infectious and parasitic diseases post-Harvey. The claims data also showed an increase in substance abuse, pneumonia and Chronic Obstructive Pulmonary Disease (COPD).
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This article discusses key findings from the 2018 Usher-Pines, et al. paper, which analyzed the experiences of Doctor on Demand in the weeks following Hurricanes Harvey and Irma in 2017. Study data showed that use of the service peaked three to six days after the hurricanes made landfall, with patients seeking treatment for “chronic conditions, advice, counseling and refills, and back and joint concerns, including injuries.” Notably, referral rates for in-person care were in line with those seen in telemedicine during non-emergency times.
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This resource is a transcript from an interview discussing the use of a specific telemedicine system to provide medical care after Hurricane Harvey. It includes a good characterization of the types of nonemergency medical needs a community may have after a disaster, as well as the role telemedicine can play in response.
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This paper identifies the types of Veterans Affairs telehealth services used following Hurricane Sandy (2012) during the 7 months the Manhattan Veterans Affairs Medical Center, and examines the patient characteristics of those users. The most commonly used telehealth services included those for primary care, triage, mental health, home health, and ancillary services.
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The presenters in this 17-minute video discuss New York Presbyterian Hospital’s experience leveraging its telemedicine program to bring specialty consultation to Puerto Rico after Hurricane Maria in 2017. They discuss the lessons learned from their experience, which include allowing for time to obtain necessary regulatory approvals, and having the needed equipment and connectivity to successfully establish a telemedicine program to support a disaster-stricken area.
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The VA’s Telehealth Emergency Medicine team exercised its signal strength capabilities during the July 4th, 2018 holiday on the National Mall to demonstrate how VA technologies could be used during an emergency. This exercise could serve as a reference for other entities when developing testing plans for their respective telemedicine systems.
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This well-organized issue brief highlights how telehealth is being used in disaster preparedness and response and summarizes the challenges and potential solutions associated with this mechanism of healthcare delivery.
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This article reviews findings from the 2018 Uscher-Pines study that looked at telemedicine use by individuals affected by hurricanes Harvey and Irma. Notably, diagnosis codes for the first 7 days of the study were consistent with those for the remaining study days—31% of patients presented with acute respiratory issues, while 8% had rash and dry skin concerns. In addition, researchers found that 63% of patients were new telemedicine users, and that most accessed the service between days 3 and 6 post-disaster.
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The authors describe the development of a telemedicine approach to assess residents from rural long-term care facilities for potential (costly) ransfer to hospitals. The pilot test was promising, as it reduced stress levels and costs associated with transfers.
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The authors, whose work focuses on telemedicine to meet post-disaster mental health needs, conducted semi structured interviews with both regional key informants and national organizations with Gulf Coast recovery interests and determined seven factors for telehealth success: funding, regulatory, workflow, attitudes, personnel, technology, and evaluation. Included in this resource is also a discussion of prior research conducted on the use of telemental health services.
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The authors discuss the use and role of telehealth and how different modalities can be used to help manage disaster-related health effects.
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This article discusses telehealth use during past emergencies and disasters, including blizzard and loss of power by Massachusetts General Hospital in 2014 (wound imaging for follow-up of post-operative patients and general maintenance of appointments for patients with chronic illness), and Hurricane Ike in 2008 (wound imaging and video messaging for bites from bees, fire ants, or mosquitoes, wounds or rashes, and skin infections from contaminated floodwaters). It also reviews how telehealth can help with chronic disease monitoring and prescription refills following mass evacuations, and how it could support 911 triage and ambulance deployment.
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The authors reviewed incidents where 2,857 of 127,928 qualifying emergency department (ED) encounters consulted telemedicine. They found that telemedicine decreases ED door-to-provider time and length of stay, and they emphasize the need for future research on the impact of telemedicine in rural areas.
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In 2018, Hurricane Florence forced thousands to evacuate their homes in Wake County, NC. Six shelters were set up and a local telemedicine firm staffed them. Of the 95 patients seen over a 10 day period, nine were sent to the emergency room for further evaluation. Eighty percent reported that they would have gone to the emergency room had they not been cared for by a telemedicine provider.
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The authors describe the successful use of a telemedicine videoconferencing system to treat patients following a 2013 nightclub fire in Brazil.
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This press release describes the findings of the 2018 Uscher-Pines, et al. report, “The Role of Direct-to-Consumer Telemedicine in Caring for People Impacted by Natural Disasters.” Specifically, the study found that the most frequent diagnoses during the first month post-hurricane included acute respiratory illnesses and skin problems, and “during the first week post-hurricane, telemedicine visits for chronic conditions, advice, counseling and refills, and back and joint concerns, including injuries, were more common among people affected by the hurricanes than among the other patients treated by the service.”
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In this literature review, the authors described how clinical information systems (CIS) (e.g., electronic health records, telehealth, artificial intelligence and machine learning, geographic information systems, digital contact tracing) were used during the pandemic to support the response. CIS contributed greatly to the effective distribution of information, provision of patient care, and global response to the pandemic.
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This article describes how the University of Virginia used telehealth to support communication with patients in isolation, as well as to allow health care professionals in PPE to visually consult with physicians back in the United States without having to doff their PPE.
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During Hurricane Harvey and its aftermath in 2017, Harris County, Texas public health staff reached out to tuberculosis (TB) patients via mobile phone, landline or text messages to patients via its telemedicine application (app) to support medication compliance. Patients were given a month’s worth of medication prior to the storm, and asked to upload videos of themselves taking their medication through the app.
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The authors describe the successful use of a telephone nurse triage line (NTL) set up by the Minnesota Department of Health for evaluating individuals with influenza-like illness and tele-prescribing of anti-virals. The NTL diverted callers from acute care visits at low cost and had a high rate of satisfaction among callers.
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The author discusses patient demand for telehealth services from 2 Florida hospitals during Hurricane Irma in 2017. One saw a 554% increase in installation of its telemedicine application, and the other had more than 2,700 patients sign up over a 3-day period.
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This collaborative resource was created “to provide an overview and framework for implementing telehealth in critical access hospitals and rural areas.” It includes a listing of research related to telehealth and outcomes, and lessons learned and best practices from organizations that successfully implemented telehealth programs and contributed to this document.
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The second story in this article discusses how telemedicine was implemented in shelters following hurricane Florence in 2018 to provide care, order prescriptions, and minimize transport to emergency departments (EDs). Emergency Medical Services (EMS) Branch Directors were assigned to each shelter, all of which had iPads to connect with the telemedicine application used by a local hospital ED, with power and internet service provided through generators and portable WiFi units.
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The authors analyzed administrative data from Doctor on Demand in the 30 days following Hurricanes Harvey and Irma (August–September 2017) to characterize post-disaster telemedicine use. Use peaked on days 4-6 after landfall and 63% of the patients were first-time users.
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The authors reviewed data on 206 patients who had an intubation attempt while on a video telemedicine link from May 1, 2014 to April 30, 2015. The success rate (96%) matched those of large-center studies.
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Authors from the University of Texas Medical Branch (UTMB) describe how UTMB was able to get its telemedicine services up and running within a week following Hurricane Ike due in part to the flexibility of its data network and plasticity of its telemedicine program. They offer lessons learned from the UTMB experience for future disasters.
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The authors examined two types of tele-emergency department (ED) pediatric programs (specialized and general) to determine how "tele-ED models have implications for evaluative measures."
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This report analyzes changes in telehealth usage among Medicare beneficiaries early in the COVID-19 pandemic, including the effects of increased flexibilities available during the public health emergency.
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The author proposes bringing together the expertise of emergency response organizations, public health agencies, and poison control centers to institute call centers and/or triage lines to disseminate information to the public during emergencies, and answer questions and concerns to keep concerned individuals from flooding local emergency rooms. Real-world examples of successful collaborations from Canada, Great Britain, and the U.S. are included.
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Using experience from the 2010 Haiti earthquake, the authors discuss the need to ensure that networks are properly constructed and wireless connectivity is robust to optimize health care delivery, medical documentation, logistics, response coordination, communication, and telemedicine during disasters.
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General Information
This webpage provides links to the “Telehealth for Community-Based Organizations Webinars” developed by ASPR's At-Risk Individuals Program. This three-part series focuses on implementing telehealth services to address the access and functional needs of at-risk individuals in partnership with HUD during the COVID-19 pandemic.
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This webpage provides an overview of key issues related to telemedicine for physicians to reference, including: how to locate resources to support the implementation of telemedicine; how telehealth resource centers can assist providers; legal, regulatory, and licensure issues; and reimbursement issues.
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During a pandemic, healthcare facilities may need telehealth/medicine capabilities. Telehealth policies help to prevent potential exposure in the workplace, thus limiting the impact to the health of the healthcare workforce. This guide is a resource for administrators to initiate those capabilities.
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This page includes resources related to the use of electronic information and telecommunications technologies for remote healthcare services and information. Resources include information on establishing and managing telehealth services, free courses and webinars, updates on the effects of recent legislation and regulations on telehealth services, handouts, and various articles and links.
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This guide includes background information on telehealth and its different modalities, telehealth legislation and regulation at the federal and state level, and considerations for developing a telehealth pilot. Case studies on how ten states are using telehealth to improve health outcomes in their jurisdictions are included.
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The authors discuss the use of telemedicine to bring the specialized expertise of burn centers to more patients. They also describe its challenges, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and the need for more evidence of its value and efficiency.
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This article describes practical tips about how to provide psychological services to older adults living in nursing homes during the COVID-19 pandemic.
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This presentation, created for the Washington Association of Medical Staff Services, discusses The Joint Commission (TJC) and Centers for Medicare and Medicaid Services (CMS) standards with regard to credentialing and privileging telehealth providers, as well as common pitfalls and best practices related to credentialing and privileging for telehealth.
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This toolkit provides information and guidance for safety-net healthcare systems seeking to initiate, expand, or improve their telemedicine programs in equitable ways.
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This resource discusses the list of services payable under the Medicare Physician Fee Schedule when furnished via telehealth for coverage years 2018 and 2019.
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This report describes the Multinational Telemedicine System (MnTS) for disaster response, developed by subject matter experts from Europe and the U.S.
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This e-learning module reviews: how to select a telemedicine service model; steps to determine the technology and support needed while following all applicable privacy, state, and federal laws; and practice guidelines to initiate a telemedicine service model.
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This well-organized issue brief highlights how telehealth is being used in disaster preparedness and response and summarizes the challenges and potential solutions associated with this mechanism of healthcare delivery.
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The author presents a rationale for locating telemedicine data centers below ground to limit the potential for operational disruption during natural disasters.
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This article discusses key legal considerations for providers to consider in their provision of telehealth services. Specifically, it discusses: the Anti-Kickback Statute and Stark Law; the Corporate Practice of Medicine Doctrine; and scope of practice and licensure issues.
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Latifi, R. (2010).
Telemedicine for Trauma, Emergencies, and Disaster Management.
(Book available for purchase.)
This book discusses the use of telemedicine in the management of trauma, disaster, and emergency situations. Critical discussions on the practicality, logistics, and safety of telemedicine from recognized experts in the field are included.
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The authors conducted a literature review covering 1980-2013 to identify when telemedicine or telepresence was reported for disaster management, both in real life and in mock and simulation situations. They concluded that it is critical to establish telemedicine infrastructure and protocols in areas prone to disasters prior to an event occurring to avoid having to establish a telemedicine program in a chaotic environment.
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The author presents strategies for preventing Ebola disease transmission through the use of telemedicine. Specifically, she discusses a national Ebola hotline to triage at-risk cases; using Bluetooth digital monitoring for high-risk suspect cases without symptoms; video enabled ambulance transfers; and an electronic ICU set up that minimizes exposure of live caregivers. Similar strategies could be applied to the management of other emerging infectious disease outbreaks.
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This document provides best practices and technical requirements for video-based platforms and apps.
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The authors discuss how telehealth provides surge capacity by providing medical and public health expertise at a distance, limiting safety and logistical concerns. They note several applications for telehealth in disaster response, and propose ways to expand its use more broadly in future.
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The author proposes 3 steps for telemedicine disaster preparedness: Acknowledge telemedicine as a Standard of Care; establish tools and workflows before disaster strikes; and form partnerships between public and private organizations.
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Though written for the state of Florida, the analysis and recommendations related to the 6 topic areas for potential expansion of telemedicine services (defining telehealth; health insurance coverage; reimbursement for telehealth; health care practitioner licensure; patient/consumer protections; and technology) may be valuable to planners in other jurisdictions as they develop or expand their respective telemedicine programs in support of disaster response.
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This blog reviews key aspects of billing for telehealth reimbursement, including considerations related to Medicare, Medicaid, and private insurance.
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This collaborative resource was created “to provide an overview and framework for implementing telehealth in critical access hospitals and rural areas.” It includes a listing of research related to telehealth and outcomes, and lessons learned and best practices from organizations that successfully implemented telehealth programs and contributed to this document.
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This paper describes the use of telemedicine in the pre-hospital setting for disaster response. The authors discuss telemedicine disaster applications and technology, as well as implementation barriers and legal and ethical issues.
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This report to Congress discusses telehealth and its potential uses during public health emergencies and disaster medical responses. Payment and reimbursement considerations, as well as pertinent legal issues, are included.
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Upper Midwest Telehealth Resource Center. (n.d.).
Resources.
(Accessed 11/7/2019.)
This webpage includes links to resources to assist healthcare facilities with developing telemedicine programs. Included are: a business plan template; a fact sheet that discusses services for Medicare beneficiaries; links to archived webinars; and a report that discusses coverage of, and payment for, telemedicine. (Users can choose resources from tabs located on the left of the page.)
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This resource discusses several potential uses of Direct-to-Consumer (DTC) telehealth across the acute response, subacute response, and recovery phase of a disaster, and reviews the logistical, legal, and policy challenges that must be addressed to allow for expanded use.
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This resource includes a comprehensive overview of telemedicine, including content that discusses benefits and shortcomings of telemedicine; applications for telemedicine; regulations and reimbursement considerations; and barriers to telemedicine and associated solutions.
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The authors developed and measured a model application in order to quantitatively analyze the potential health benefits of telemedicine in disaster response. They found that the model can support disaster response activities and enhance surge capacity; enhance the speed and effectiveness of medical response; and improve resource and operations planning, as well as internal and external situational awareness.
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Legal, Regulatory, and Insurance Considerations
This web page provides general information on COVID-19 and lists what is covered by Medicare, including "virtual check-ins."
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This document provides frequently asked questions and answers related to the Telehealth Expansion Waiver. The first section includes questions around waiver policy, and the second section describes questions around data submission requirements.
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This resource discusses the list of services payable under the Medicare Physician Fee Schedule when furnished via telehealth for coverage years 2018 and 2019.
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This article explains how the Centers for Medicare & Medicaid Services have worked to enable virtual check-ins and related services possible since 2019. This can be especially helpful during an infectious disease outbreak.
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This short guide discusses the following in the context of reimbursable services: originating sites; distant site practitioners; telehealth services; billing and payment for professional services furnished via telehealth; and billing and payment for the originating site facility fee. It also includes a resource listing.
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This guidance document is geared towards Medicare Fee-For-Service Providers. It highlights the sites that are eligible for Medicare-covered "specific (Part B) physician or practitioner services furnished through a telecommunications system. Telehealth services substitute for an in-person encounter."
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This article provides a general overview of limitations in state laws that may create liability associated with the delivery of behavioral health services through telehealth technology.
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The authors discuss the implications for practice following the passage of new telehealth-related legislation in February of 2018.
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This resource discusses the increased potential for medical malpractice risks, cyber risks, and challenges related to regulatory and legal exposures stemming from telemedicine use as technology has outpaced laws and regulations that govern healthcare practice.
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This webpage provides information on the Interstate Medical Licensure Compact, an agreement between 29 states, the District of Columbia and the Territory of Guam, where physicians are licensed by 43 different Medical and Osteopathic Boards. Under this agreement licensed physicians can qualify to practice medicine across state lines within the Compact if they meet the agreed upon eligibility requirements.
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This article discusses the successes and challenges experienced by Washington DC since integrating triage nurses into its 911 Call Center in April 2018. Logistical, medical, and financial (including insurance) considerations are presented, and may assist other jurisdictions in developing a similar model, which could support disaster response and recovery through efficient management of ambulance services.
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This resources is a detailed review of the ASHRM Telemedicine Whitepaper (which users must log into ASHRM to obtain), which provides a general overview of telemedicine, and discusses the potential risks of telemedicine under a risk management framework provided by ASHRM.
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This report to Congress discusses telehealth and its potential uses during public health emergencies and disaster medical responses. Payment and reimbursement considerations, as well as pertinent legal issues, are included.
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Plans, Tools, and Templates
During a pandemic, healthcare facilities may need telehealth/medicine capabilities. Telehealth policies help to prevent potential exposure in the workplace, thus limiting the impact to the health of the healthcare workforce. This guide is a resource for administrators to initiate those capabilities.
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The authors explain the development, testing, and implementation of a model to enable community health call centers (e.g., poison control centers, nurse advice lines) to support home-management and shelter-in-place approaches in certain mass casualty or health emergency events. The report includes a matrix with possible call center capabilities aligned with National Planning Scenarios and other guidance that can be tailored by call centers.
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This flowchart can aid medical staff in triaging calls. The tool may identify high-risk patients for consideration of initiation of antiviral treatment prior to an office visit.
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This infographic reviews the Flu on Call® triage process. Free log-in to the NACCHO toolbox is required.
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This workbook guides planners through the process of determining the need for a call center, as well as how to operationalize a call center during public health emergencies.
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Agencies and Organizations
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U.S. Department of Health and Human Services, Health Resources and Services Administration.
Telehealth Programs.
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