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Videocast with ATA: Mobile health predictions for 2014

A couple of weeks ago while I was in Washington for the U.S. News & World Report Hospital of Tomorrow conference, I stopped by the headquarters of the American Telemedicine Association to record a videocast with ATA CEO Jonathan Linkous. We discussed some of my predictions for 2014 in the fields of mobile health and telehealth:

  1. Imperative to cut costs will drive demand.
  2. More mental health services will be delivered remotely.
  3. Clarity from the FDA means more diagnostic apps and smartphone add-on devices.
  4. Patient engagement in Stage 2 Meaningful Use might finally make untethered PHRs and consumer-facing apps viable.
  5. Home monitoring and video chats will help prevent hospital readmissions.
  6. State licensing issues persist but some states are looking to adapt their rules to facilitate telemedicine.

I’m going to try to embed the video here. If not, here’s the ATA’s link.

 

November 15, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Breaking down ignorance about telehealth

AUSTIN, Texas — I’m at my very first American Telemedicine Association annual conference, which starts later this afternoon. This morning, I gave a short presentation to the ATA’s Industry Council, made up of technology vendors, about trends in the telehealth industry.

My slides are here: ATA 2013 presentation.

I want to draw your attention in particular to slide 9, which is a letter to the editor of the Kearney (Neb.) Hub newspaper. Honestly, it’s one of the most ignorant, poorly argued pieces of garbage I’ve seen in a long time, and I can’t believe the editor actually accepted it and published it with such a weak argument. (Really, there’s “no scientific way to diagnose a patient with a mental illness,” but it’s OK to make a diagnosis in person?) Unfortunately, I can believe that someone would be so misinformed about telehealth and healthcare in general (“doctors are being paid millions to visit with patients for five minutes …”).

Thankfully, a commenter took the author, Kearney resident Kristyn Drahota, to task. I took her to task this morning, too. I hope you will join me in helping to combat such ignorance about telehealth.

 

May 5, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Not just an EMR, but an HIE for mental health

Last month, I asked if anyone has been successful with an EMR for mental health. I wondered if an iPad might make it easier for a psychotherapist to take electronic notes during a session without making the patient feel like the computer was getting in the way, because a desktop PC certainly would be a distraction. I also wondered about where mental health fits in the realm of truly comprehensive EHRs.

(Yes, I make a distinction between EHR and EMR here, since, while it’s important to have a complete medication list to avoid harmful interactions, there’s little reason why an orthopedist or dermatologist would need to know whether a patient had been diagnosed with a mental illness. The same goes for records of sexually transmitted diseases or any other condition that patients may not want a lot of people to know about.)

I got a partial answer on Monday, when I interviewed Justin Bayless, president of Bayless Behavioral Health Solutions, which just launched a portal to share patient records with other caregivers, insurance companies, case managers, educators, probation officers and skilled nursing facilities. (See my story about this in InformationWeek.)

EMRs do indeed have a role in mental health, even if it’s mostly administrative. “It saves therapists a lot of time because it automatically generates forms,” Bayless said of the Credible Behavioral Health Software EMR that Bayless MHS clinicians carry on laptops to treatment sites such as assisted living facilities, nursing homes, schools and community centers. (That’s a quote you won’t see in the InformationWeek story.)

And segmentation of behavioral health information from other parts of a comprehensive EHR won’t be too much of an issue for a while—Bayless believes it could take 10-15 years—since so many providers still use paper right now.  Remember, psychologists, addiction counselors, licensed clinical social workers and any other mental health professionals that aren’t psychiatrists (i.e., anyone without an M.D. or D.O. degree) don’t count as eligible providers for “meaningful use” purposes.

 

May 16, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

EMRs for mental health?

I’ve been wondering, has anyone in mental health truly had success with an EMR? I can’t imagine any psychotherapist sitting at a computer typing notes while there’s a patient on the couch. That would be particularly bad for a patient with self-esteem issues.

I imagine that tablets like the iPad may make this a little easier, but what psychotherapists really need is something like a pen tablet (with a stylus rather than touch-screen) or digital ink to mimic taking notes on a pad of paper.

The other issue related to EMRs in mental health is the exchange of notes with other physicians. Will an electronic note from therapist back to the primary care physician wind up in the electronic chart that might get sent, say, to an orthopedist or gastroenterologist? The only thing other specialists really would need to know is the patient’s medication list, not a psychiatric diagnosis or treatment history, right? Segmenting out sensitive parts of an EMR like treatment for mental health and sexually transmitted diseases is something vendors and CIOs have struggled with for years, and I believe continue to struggle with.

In both cases, I’d love to hear your anecdotes here.

April 22, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

HIT stimulus apparently leaves out mental health

According to the National Council for Community Behavioral Healthcare, both the House and Senate versions of the economic stimulus bill exclude mental health providers from the $20 billion in funding for health IT.

“The National Council is deeply concerned about the lack of direct support for persons with addiction disorders and mental illnesses in the stimulus bill, formally known as the American Recovery and Reinvestment Act. In particular, the economic recovery measure contains no new federal investments for the Substance Abuse and Mental Health Services Administration (SAMHSA). In fact, it appears that SAMHSA is the only operating division within the United States Public Health Service that did not receive emergency funding in either the House or Senate version of the stimulus legislation,” National Council President and CEO Linda Rosenberg, MSW, says in a statement e-mailed to reporters today.

“Also, while privacy protections in the Health Information Technology (HIT) for Rconomic and Clinical Health Act have wide support in the addictions and mental health communities, we were dismayed to learn that the vast majority of our nation’s residential, community-based and individual providers of addiction and mental health services are not eligible to receive Medicaid and Medicare financing or direct grant support under this new HIT initiative. Without the additional resources included in the bill, the goal of community behavioral health organizations to help people with mental illnesses and addiction disorders recover and lead productive lives will be compromised. The community organizations will face many barriers to receiving the Medicare and Medicaid incentive payments for the adoption of HIT technology and will likely be excluded from the grant/loan programs, infrastructure funding, and other HIT provisions of the bill,” Rosenberg continues.

“Let us be clear: parity does not stop at private health insurance coverage. Mental health and addiction providers, both those that receive SAMHSA funding and those that do not, are as much a part of America’s healthcare safety net as physicians and hospitals. Indeed, we confront the same economic conditions including a significant spike in average caseloads combined with successive rounds of state budget cuts.

“The National Council urges Congress to include community behavioral health organizations as eligible entities in the economic recovery bill.”

February 11, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.