Telehealth under the Ryan White Program in Maryland Ashley Wu - - PowerPoint PPT Presentation

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Telehealth under the Ryan White Program in Maryland Ashley Wu - - PowerPoint PPT Presentation

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Telehealth under the Ryan White Program in Maryland Ashley Wu Prevention and Health Promotion Administration Center for HIV Prevention and Health Services May 8 2020 Prevention and Health Promotion Administration MISSION AND VISION MISSION

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Telehealth under the Ryan White Program in Maryland

Ashley Wu Prevention and Health Promotion Administration Center for HIV Prevention and Health Services

May 8 2020

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MISSION AND VISION

MISSION The mission of the Prevention and Health Promotion Administration is to protect, promote and improve the health and well-being of all Marylanders and their families through provision of public health leadership and through community-based public health efforts in partnership with local health departments, providers, community based organizations, and public and private sector agencies, giving special attention to at-risk and vulnerable populations. VISION The Prevention and Health Promotion Administration envisions a future in which all Marylanders and their families enjoy optimal health and well- being.

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Prevention and Health Promotion Administration

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Key Terms and Definitions

Introduction

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What’s the difference between Telehealth and Telemedicine?

  • Telehealth is a broader scope of remote health care

services that includes non-clinical services

  • Telemedicine refers specifically to remote clinical

services

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Types of Telehealth

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Providing Sites

  • Distant site: a site at which the licensed distant site

provider is located at the time the service is provided via technology-assisted communication.

  • Originating site: location of an eligible Medicaid

participant at the time the service being furnished via technology-assisted communication occurs.

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Telehealth in Maryland

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Background

  • First telehealth laws passed in 2012
  • Interstate Medical Licensure Compact (IMLC): allow

physicians to practice in multiple states, connect with patients in underserved and rural areas

  • Several bills have been passed to support insurance

coverage of telemedicine services (Senate Bill 781, 789, 496, 198)

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Provider Registration

  • Providers need to register as telehealth providers,

and enrol in the Maryland Medical Assistance program (MMAP)

  • Credentialing: verify provider education, insurance,

standard of practice

  • Hospitals can contract providers from other states
  • Exception: VA health care providers can provide

telehealth services within their scope to VA beneficiaries, irrespective of State or location.

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Licensing Process

  • Licensing: securing authority to practice medicine

within a state

  • For telehealth, licensing process can be expedited

by leveraging existing provider information

  • Providers then choose number of states they desire

to practice in (no additional fee charged)

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Medicaid Coverage

  • People receive Medicaid first before assistance

from RW Program

  • Medicaid covers inpatient and specialty medical

care coverage

  • “Hub and spoke” model

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Eligible Sites

  • University health office
  • Local health dept
  • Hospital
  • Nursing facility
  • Private practice office
  • Outpatient mental health center
  • Residential service site
  • Community based substance use provider

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Eligible Providers

  • Nurse practitioner
  • Nurse midwife
  • Physician
  • Physician assistant
  • Community based substance use disorder provider
  • Opioid treatment program facilitator
  • Outpatient mental health centers
  • Federally qualified health centers

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Case Studies

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Success stories from other states

  • VA Affairs (rural Illinois and Iowa)
  • LaPHIE (Louisiana): public health info exchange

network

  • TelePrEP (Iowa): deliver PrEP medication to growing

rural population at high risk for HIV

  • Illinois prison telehealth program: first time

incarcerated patients

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Patient Outcome

  • Indicators
  • Reduce total medical expenditure
  • Improved retention rate in care
  • Improvements in viral suppression rate
  • Increase patient satisfaction

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Federally Qualified Vendors

  • Qualifications
  • Secure
  • Mobile access
  • Customer support
  • Potential vendors
  • AmericaWell
  • MDLive
  • Tytocare (under Epic Systems, work with Johns Hopkins

Hospital)

  • eVisits

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Addressing Infrastructural Barriers

  • Connectivity considerations
  • Internet speed
  • Funding for improving service in rural area
  • Focus on services independent of internet
  • Access to providing sites
  • 71% of patients live >60 minutes away from HIV clinics,

27.4% could save travel time by utilizing telehealth

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Next Steps

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  • Contacting UMD STAR TRACK pediatric HIV clinic,

Chase Brexton on launching pilot partnerships, and expand to various county helath departments in the near future

  • Accelerate telehealth for HIV care in light of COVID-

19 pandemic

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References

  • American Association of Family Physicians (2018, November 12). What's the difference between telemedicine and

telehealth? Retrieved from https://www.aafp.org/media-center/kits/telemedicine-and-telehealth.html.

  • Telepresenters. (n.d.). Retrieved from https://www.ortelehealth.org/content/telepresenters.
  • Telehealth Use in Rural Healthcare. (2019, December). Retrieved from

https://www.ruralhealthinfo.org/topics/telehealth/project-examples.

  • Telehealth Use in Rural Healthcare. (2019, December). Retrieved from

https://www.ruralhealthinfo.org/topics/telehealth/project-examples.

  • Telemedicine in Maryland: State Regulations, Laws & Policies. (2019, October). Retrieved from https://evisit.com/state-

telemedicine-policy/maryland/.

  • Interstate Medical Licensure Compact. (2019). Retrieved from https://imlcc.org/.
  • Interstate Medical Licensure Compact. (2019). Retrieved from https://imlcc.org/.
  • MD Medicaid Telehealth Program. Telehealth Provider Manual
  • Title 10 Maryland Department of Health: Medical Care Programs Telehealth Services. (2019, October). Retrieved from

https://mmcp.health.maryland.gov/SiteAssets/SitePages/Telehealth/10.09.49 October 2019.pdf.

  • Salzman, S. (2018, November 20). Telehealth May Improve HIV Viral Suppression for People in Prison. Retrieved from

https://www.thebodypro.com/article/telehealth-may-improve-hiv-viral-suppression-for-p.

  • Murphy, K. (2015, February 5). Which Federal Agencies Are Involved in Mobile Health Policy? Retrieved from

https://mhealthintelligence.com/news/which-federal-agencies-are-involved-in-mobile-health-policy.

  • Wicklund, E. (2017, March 29). VA Tests Telemedicine-based Collaborative Care for Rural Vets. Retrieved from

https://mhealthintelligence.com/news/va-tests-telemedicine-based-collaborative-care-for-rural-vets.

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Prevention and Health Promotion Administration

https://phpa.health.Maryland.gov