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Incorporating Telehealth into Your Practice Troy Cascia, Au.D. Lead - - PDF document
Incorporating Telehealth into Your Practice Troy Cascia, Au.D. Lead - - PDF document
10/16/2018 Incorporating Telehealth into Your Practice Troy Cascia, Au.D. Lead Senior Audiologist, UCSF 1 10/16/2018 2 10/16/2018 3 10/16/2018 The mode of delivering health care services and public health via information and communication
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“The mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self‐ management of a patient's health care while the patient is at the
- riginating site and the health care provider is at a distant site. Telehealth
facilitates patient self‐management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.” CA Business & Professions Code Sec. 2290.5
- 1. Its purpose is to provide clinical support.
- 2. It is intended to overcome geographical barriers, connecting users
who are not in the same physical location
- 3. It involves the use of various types of ICT
- 4. Its goal is to improve health outcomes
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- Increase access to audiology services
- Improve outcomes with consistent continuity of care
- Provide services to patients who cannot travel or have limited
access to healthcare
- Convenience to patients
- Increased patient satisfaction
Synchronous
- Live
- Videoconferencing
Non‐synchronous
- Store and forward transfers
- Cloud based
- Hearing aid/cochlear implant programming
- Hearing screening/test apps
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Desktop/laptop computer Tablet Smart phone Synchronous interaction (real time)
- Individual videoconferencing
- Counseling
- Group videoconferencing
- Interdisciplinary collaboration
- Information sessions
- Support groups
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Videoconferencing apps
- Facetime
- Skype
- WebEx
- Zoom
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- Non‐synchronous interaction (store and forward
transfer)
- Several hearing aid manufacturers have products
capable of remote programming
- Resound LiNX 3D, ENZO 3D, and LiNX Quattro
- Signia Primax, NX, and Styletto
- Starkey Livio and Livio AI
- Oticon Opn and Siya (pending)
- Tech savvy
- Has computer, laptop, tablet, smart phone
- Has WiFi or internet connection
- Long distance
- Mobility or transportation challenges
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California law
- Provider must be licensed in the state where the patient is located at
the time of the appointment
- Must verbally consent to participation in a telehealth appointment,
and must be documented
- Limited to the scope of practice allowed by licensure
- H.R.2550 ‐ Medicare Telehealth Parity Act of 2017 introduced to
expand Medicare coverage of telehealth services to audiologists (and
- thers). Pending.
HIPAA
- All transmissions must be encrypted to prevent breach of
protected health information (PHI)
- All PHI must be protected as with any in‐person patient
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- If the patient isn’t known to you, verify identity by checking
two patient identifiers (e.g. full name and birthdate) or have patient show ID
- Be sure provider badge is visible on screen to patient
- Do not record encounters
- Both provider and patient must have appropriate technology
- Hardware and software
- Connectivity
- Adequate bandwidth
- Must be comfortable using technology
- Limited appointment types / No physical contact required
- HIPAA compatible
- Inertia
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- Schedule as video visit
- Send instructions to patient
- Call patient to make sure they checked their equipment
- Check your own equipment
- Ensure space is available for visit
- Consider starting with a pilot program with 1 or 2 providers
(including a “telehealth champion” and 1 support person
- Eventually provide training for all providers and support staff
- Perform routine equipment and connectivity checks
- Have a back up plan if connectivity fails
- Have IT support available, if needed
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- Not covered by insurance
- Visits must be no charge or self pay
https://www.audiology.org/practice_management/resources/tele‐audiology‐toolkit https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934956§ion=Resources https://www.speechandhearing.ca.gov/licensees/telehealth.shtml https://www.medicare.gov/coverage/telehealth https://www.dhcs.ca.gov/provgovpart/Pages/Telehealth.aspx
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