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19 Jan 2017

Puerto Rico fights back doctors’ exodus granting them huge tax incentive

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Published January 10, 2017 –

Reposted by Physician Licensing Service

In an attempt to prevent more doctors from leaving, and perhaps even pull back the hundreds gone over the last couple years, the new governor of Puerto Rico has included in his first package of bills a measure that is basically a lifesaver for the medical profession on the island.

















An orthopedic technician attends to a patient at the Medical Center pediatric clinic in San Juan.  (AP)


The measure seeks to lower the fixed income tax rate on all practicing physicians, from the current 33 percent to 4 percent. It also proposes a tax exemption for the first $250,000 earned.


Puerto Rico’s governor Ricardo Rosello, a scientist with no political experience, was sworn in last week.


“Puerto Rico’s recovery begins today,” he said in his inauguration speech.


Over the last 12 years, Puerto Rico lost 2,422 doctors – about 347 doctors per year – according to local newspaper El Nuevo Dia, This has led to a dramatic shortage of health services in the island.


“Perhaps without knowing it or having planned it, we are training professionals to go to other places,” said Jaime Plá, executive president of Puerto Rico’s Hospital Association.


“Puerto Rico is becoming the supplier of professionals, not only in the health area but also in engineering,” he said, as quoted by the paper.


Puerto Ricans have been hit with dozens of new taxes in the past four years and increases in utility bills as former Gov. Alejandro Garcia Padilla aimed to generate more revenue for a government he said was running out of money.


Despite those and other measures, the island’s government has defaulted on millions of dollars’ worth of bond payments and declared a state of emergency at several agencies.


Rossello said he also aims to boost public-private partnerships and use that revenue to save a retirement system that faces a $40 billion deficit and is expected to collapse in less than a year.


He pledged to work closely with a federal control board that U.S. Congress created last year to oversee Puerto Rico’s finances, and he has said he supports negotiations with creditors to help restructure a public debt of nearly $70 billion.


The federal control board has requested a revised fiscal plan that has to be approved by end of January, saying that the one Garcia Padilla submitted last year was in part unrealistic and relied too heavily on federal funds — he refused include austerity measures.


Rossello has said he would request an extension of that deadline as well as an extension of a moratorium that expires in February and currently protects Puerto Rico from lawsuits filed by angered creditors.


The AP contributed to this report.




16 Jan 2017

Telemedicine In Schools Helps Keep Kids In The Classroom

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Many states are experimenting with telemedicine to address health disparities that can depress student achievement.


telemed lady


Veronica DeSimone, the school nurse at Ducketts Lane Elementary in Elkridge, Maryland, has conducted nearly 25 telemedicine visits with doctors this school year. Telemedicine is becoming more common in schools across the country.



Originally posted: 01/04/2017 10:14 am ET | Updated Jan 04, 2017

Reposted by Physician Licensing Service

By Michael Ollove



ELKRIDGE, Md. — In late November, on the first cold morning of the season, a second-grader at Ducketts Lane Elementary School had trouble breathing during recess.



When the school nurse, Veronica DeSimone, examined the girl, she heard wheezing in her chest and noted her low oxygen levels. DeSimone determined that the child was having an asthma attack.



The nurse would have administered relieving medication, but the girl’s parents hadn’t yet signed a permission form or delivered their daughter’s medicine to the school. The girl’s father, the only parent available, was at work at least an hour away. There was not time to wait for him to come get his daughter.



Not long ago, DeSimone would have had to call an ambulance to take the child to the emergency room, forcing her to miss the rest of her classes that day.



Instead, DeSimone set up an online video and audio link to an emergency room pediatrician at Howard County General Hospital. With earlier permission from the girl’s parents to participate in the school’s telemedicine program, DeSimone examined her with a digital stethoscope, which allowed the pediatrician to listen to the girl’s lungs remotely.



The doctor quickly confirmed DeSimone’s diagnosis and directed her to administer the necessary medicine. Within 10 minutes, the child was breathing normally and back in class.


map tele







Telemedicine, increasingly used in prisons, nursing homes and remote areas, is becoming more common in schools. According to the American Telemedicine Association, at least 18 states authorize Medicaid reimbursement for telemedicine services provided in schools and 28 states plus Washington, D.C., require private insurers to cover telemedicine appointments as they would face-to-face doctor visits.



Telemedicine, increasingly used in prisons, nursing homes and remote areas, is becoming more common in schools.



Telemedicine can’t always replace an in-person examination — a doctor often has to touch a patient, for example, to diagnose the cause of abdominal pain — but it does make it less likely that a child will have to miss class for a visit to the doctor’s office.



“The piece for me that is so exciting is how many more kids are able to stay in school,” said Heidi Balter, principal of Ducketts Lane, which was outfitted with telemedicine equipment a year ago.



Lawmakers and educators around the country echo that enthusiasm. “School telehealth will be a game changer in terms of children’s health, keeping them in school and improving educational outcomes,” said Democratic state Rep. Kip Kendrick, who helped pass a new Missouri law that allows Medicaid payments for telemedicine in the schools.



$27,000 in Equipment



Many states still limit Medicaid reimbursement for telemedicine, and, according to the American Telemedicine Association, 24 states specify settings, such as a doctor’s office, where a patient must be in order to participate in a telemedicine appointment.



In Texas, the state Medical Board is involved in a legal dispute over its insistence that “a doctor-patient relationship” be established before telemedicine can be used. The dispute, however, doesn’t apply to school telemedicine as long as a school nurse is present.



But as state policymakers become more accustomed to telemedicine and familiar with its benefits, “we’re seeing many of the restrictions falling to the wayside,” said Latoya Thomas, the director of state policy for the American Telemedicine Association.



The impetus for school telemedicine in Howard County, where Ducketts Lane is located, came from former County Executive Ken Ulman. Ulman believed that health disparities in lower-income areas of the county were depressing student achievement, and that telemedicine might help.



In 2015, the county chose Ducketts Lane and five other elementary schools to be the first to offer telemedicine services. All of the schools drew students from economically disadvantaged areas and all had full-time nurses.



The county found a willing partner in Howard County General, which was looking for ways to expand access to its services. The hospital agreed to pick up the costs of making its emergency room pediatricians available for telemedicine calls from the six schools during school hours.



The county picked up the tab for the $27,000 in telemedicine technology that each school required. The equipment included a video monitor, a camera, and digital stethoscopes and otoscopes, to check ears, noses and throats and transmit the images.



Two local pediatric practices also agreed to make their doctors available. Unlike Howard County General, which is forgoing reimbursement, the practices bill private insurers when the children they treat have that coverage. Maryland Medicaid only covers telemedicine when a doctor or nurse practitioner (not a registered nurse, like most school nurses) is present during the exam.



Quicker Diagnoses



Even when kids must miss school because they have contracted a contagious illness, such as strep throat or conjunctivitis, telemedicine allows remote doctors to make a quick diagnosis and prescribe medicine, hastening the child’s return to school, said Sharon Hobson, the head of telemedicine in Howard County schools.



Often telemedicine doctors are able to rule out a contagious condition, recognizing, for example, that reddened eyes are the result of allergy rather than conjunctivitis. “We used to have to send them home in the chance that it was pink eye,” said DeSimone. “Now we can keep them.”



Last year, the six Howard County schools conducted 150 telemedicine exams. Midway through this year, the total is 87.



Ninety-eight percent of the kids who are treated through telemedicine (not including those who are contagious or have conditions that can’t be treated through telemedicine) immediately return to their classes.



Other school systems have reported similar results. Studies have also shown that telemedicine in schools reduces trips to the emergency room.



“Not having to pull my child out of school & take him to the pediatrician is a huge benefit,” one parent wrote in a Howard County schools survey. “Saves time & money.”



Managing Chronic Illnesses



In the future, Hobson hopes that telemedicine in Howard County will be able to not only address acute health conditions — the sudden onset of symptoms — but also help students manage chronic conditions, such as asthma, attention deficit hyperactivity disorder and obesity. She also hopes to use telemedicine to provide mental health counseling.



Schools in the Bronx and in South Carolina already are using school telemedicine for mental health. It is being used for speech pathology in Michigan, and in New Mexico, an effort is underway to use school telemedicine in oral health.



The Medical University of South Carolina, in Charleston, provides telemedicine services to 47 schools. James McElligott, the medical director for telehealth at the hospital, said he is most gratified by the work the hospital does with Pace Academy, a school for children with multiple disabilities.



In the past, many of those children simply had to endure minor ailments, such as rashes and earaches, because it was just too difficult to transport them to a doctor or hospital. Now, using telemedicine, the Medical University can provide almost immediate relief.



Some doctors say they actually prefer telemedicine encounters to face-to-face exams with children. David Monroe, medical director of the Children’s Center at Howard County General, said the images provided by the telemedicine instruments are often better than what he can see using conventional equipment on a squirming child. “It’s easier because you get this high-definition picture, which I never get otherwise,” Monroe said.


Original article link:



10 Jan 2017

How to set up a telemedicine practice

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As more hospitals move from fee-for-service to value-based payment models that reward providers for keeping costs low, telemedicine offers a valuable tool for achieving that goal. Smartphones are everywhere, internet connections are faster and consumers are eager to engage with doctors on their own time from the convenience of their home or office. According to the American Telemedicine Association, more than 15 million Americans receive some kind of remote medical care, and that number was expected to grow by 30% in 2016.


AUTHOR: Meg Bryant
PUBLISHED: Jan. 5, 2017
Reposted by Physician Licensing Service 


Health systems are also primed to offer telemedicine services. Expanded access to primary and specialty providers, reduced emergency room visits and inpatient hospitalizations, and improved care coordination among a patient’s providers are some of the benefits telemedicine can provide.


Telehealth technology company American Well already has more than 50 health system partnerships. Among those that sealed the deal last year were New York Presbyterian, Bon Secours, and Baptist Health South Florida.


However, setting up a successful telemedicine practice requires serious planning and fitting a lot of disparate pieces into the healthcare puzzle. The SAMHSA-HRSA Center for Integrated Health Solutions developed a resource guide on starting and sustaining a telemedicine practice. Topics covered include what services to provide, billing and reimbursement, and policy guidelines and considerations.


Sarah Sossong, director of the Center for Telehealth at Massachusetts General Hospital offers seven useful steps in planning and setting up a telemedicine practice.


  1. Align the hospital’s approach to telemedicine with a specific strategy. Is the aim to increase, access? Improve patient outcomes? Attract consumers? Reduce cost? Expand reach?
  2. Select appropriate telemedicine solutions (video visits, e-visits, second option, etc.) to attain that goal.
  3. Identify the site of care (outpatient, inpatient, ER, etc.), pain points and goals for the telemedicine practice.
  4. Establish a structure to support the practice.
  5. Take time to ramp up each specialty regarding operations, legal and regulatory issues and the technological aspects of the practice — software and hardware, training and systems integration.
  6. Determine how telehealth practitioners will get paid. Will it be through some sort of grant funding? Institutional reimbursement? Patient self-pay? Contract? Or public and private payers?
  7. Align to the regulatory and reimbursement environment (licensure, credentialing, practice standards, etc.) in the state or states the organization serves.


Another thing organizations need to consider is whether they should go it alone or partner with an established telemedicine company. Hospitals with limited resources to commit to telehealth and a short timeline to get the practice up and running may see a partnership as a way to address those issues. Vendor demonstrations and partnerships can also help an organization better refine what they are interested in achieving through a telehealth practice, Sossong says.


If a hospital does decide to partner, they should consider the capabilities of the different vendors carefully, she adds. “Partnerships don’t minimize the need for an internal dedicated lead, or team, but they can definitely help you achieve your goal more quickly, though at a cost. The cost of building internal infrastructure can also be significant depending upon your goal,” she says.


Despite enthusiasm for telemedicine, there are some concerns. Telehealth is governed by a patchwork of state regulations, which can be hard to sort out. Interoperability of electronic health records and questions about privacy and security are other potential concerns.


Some physicians may not be comfortable conducting a virtual patient exam, making a diagnosis or presenting a treatment plan without a face-to-face visit. The Texas Medical Board recently began requiring that physicians meet with patients in person prior to providing telemedicine services, which prompted telemedicine company Teladoc to file a lawsuit challenging the rule. This could limit when and how the services are used.


There are also technological costs and challenges. Telehealth services require special software, which in turn require training and support. If either the software or hardware fails during a doctor-patient encounter, the session ends without resolving the health issue that prompted it.


“While there are pros and cons to providing a telemedicine service, I don’t think it’s something that healthcare providers will long have a choice about,” Sossong tells Healthcare Dive. “Telemedicine services are becoming an expectation of consumers. In the same way that I expect that my bank will allow me to deposit checks via a mobile app without going into a brink and mortar facility, consumers will expect that appropriate telemedicine services will be provided by their healthcare provider, and paid for via insurance in the same way that appropriate face-to-face services are paid for.”


What kind of return on investment can organizations expect from a telehealth practice? “The ROI to be achieved depends upon your strategy, you solution and your goals,” Sossong says. Aligned with a population health management strategy, ROI could be improved patient engagement, patient outcomes and/or access to care. It could also be reduced costs via fewer readmissions or emergency room visits.

29 Dec 2016

Telemedicine Market Size to Reach USD 113.1 Billion by 2025: Grand View Research, Inc.

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Grand View Research, Inc. 

Dec 06, 2016, 05:30 ET

Original post found here. Reposted Dec 29, 2016 by Physician Licensing Service.


The global telemedicine market is expected to reach USD 113.1 billion by 2025, according to a new report by Grand View Research, Inc. Key drivers of the market include increasing incidences of chronic conditions and rising demand for self-care. Furthermore, enhancing application of internet and rising demand for centralization of healthcare are expected to save on cost incurred, which is one of the critical success factors attributing for the growth of telemedicine market.



Telemedicine also helps in reducing emergency room visit and hospitalization rate, there by augmenting the market growth. The telemedicine industry is segmented on the basis of products, and region. The service offers prime channel for various providers to communicate on the same platform and thus, centralize all the available data.



Telemedicine products are distributed by direct supply contract amongst the manufacturers and end users or maybe concluded via a third party supplier. Government initiated healthcare programs across the nation are anticipated to propel the direct agreement method by conducting private bidding and voluntarily sponsorship by market players.



Browse full research report with TOC on “Telemedicine Market Analysis by Product (Hardware, Connectivity & Network), By Region (North America (U.S., Canada), Europe (UK, Germany), Asia Pacific (Japan, China, Latin America (Brazil, Mexico), Middle East & Africa), And Segment Forecasts, 2014 – 2025” at:



Further key findings from the study suggest:

Connectivity & network is anticipated to be the fastest growing product segment of this market over the forecast period.


Increasing demand of automation and synchronization across the system is anticipated to be the vital drive for the market growth.


North America, being a pioneer in IT technologies, dominated the global telemedicine market. Available advanced organization with plenty funds contributed to its domination.


Asia Pacific is predicted to witness lucrative growth over the forecast period. Economic reforms, boosting IT industry, and low functioning costs are the key factors attracting market players to participate in this region.


Some of the key players in this space include IBM, Intel Corporation, Philips Healthcare, McKesson Corporation, AMD Telemedicine, GE Healthcare, and Cardio Net Inc.

23 Dec 2016

HAPPY HOLIDAYS from everyone at Physician Licensing Service

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A heartfelt seasons greetings and thank you to all of the physicians, hospitals, and medical groups that we work with in North America and all over the world. May this season of giving find you happy and healthy with opportunities abound.


Our services have helped physicians for over 20 years to outsource the labor of medical licensure to competent professionals that specialize in United States medical licensing. Please call us to find out how we can help you individually with that new state medical license, or help your group or practice acquire multiple medical licenses at discount rates. Take advantage of our holiday licensing special by emailing or calling 801-816-1149.


The new years rush is on for medical licenses and the medical boards with certainly be busy in the new year. Get your order in today and beat the rush.

16 Dec 2016

Telemedicine for PTSD no less effective than in-person therapy

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ptsd(Reuters Health) – Veterans with posttraumatic stress disorder (PTSD) who have difficulties making it to in-person therapy sessions may be able to get treatment that’s just as good by videoconference.

Original post by: By Shereen Lehman –  HEALTH NEWS | Tue Dec 13, 2016 | 12:36pm EST


Researchers compared home-delivered prolonged exposure therapy – which helps patients confront memories and situations that trigger their symptoms – to the same treatment given in U.S. Veterans Affairs clinics, and found no difference in effectiveness.


“The best treatment for PTSD, with the most empirical support, can be delivered at no loss of effectiveness, directly into a veteran’s home, rather than having the veteran come into clinic,” lead study author Ron Acierno told Reuters Health by email.


“We can now save the travel time and bring the treatment right to them” if a veteran lives too far away to attend 12 to 15 weekly sessions, can’t take off work or feels stigmatized coming into the clinic, said Acierno, a psychologist and researcher with the Ralph H. Johnson VA Medical Center in Charleston, South Carolina.


For the study, published in Behaviour Research and Therapy, Acierno and colleagues recruited 132 veterans who had been diagnosed with PTSD, 127 of them men.


All the participants were assessed with standard PTSD scales designed to measure symptom severity and depression. They were then randomly assigned to two groups – each would receive 10 to 12 prolonged exposure therapy sessions, but one group would attend sessions at a VA medical center while the other would have sessions at home by video conference.


The participants who got treatment at home were provided with videoconferencing software to use on their own computers, tablets or smartphones. Videophones or tablets were provided to participants who didn’t own the proper equipment.


The researchers repeated the PTSD scales after three months of treatment and again three months later. They found that at both time points, the vets who were treated at home showed similar improvements in PTSD symptom severity as those treated in the clinic.


The at-home treatment scores for depression were not as good at three months, but by six months they were similar to the scores of the group treated in the clinic.


“Our effects with PTSD were just as good in person vs. home based telehealth,” Acierno said, “however, people doing the treatment via home-based telehealth did report more difficulty.”


About 33 percent of the at-home group did not complete the program compared to 19 percent of the clinic group.


Acierno said participants who dropped out reported difficulties such as feeling worried about losing control during exposures, the feeling they couldn’t tolerate assignments to go out in public and that imagined exposures made them feel bad.


Acierno said he and his collaborator Dr. Melba Hernandez-Tejada are exploring the idea of pairing peers who have been through prolonged exposure therapy and no longer meet criteria for PTSD with veterans currently receiving the treatment via telehealth to help them through the difficult parts of the therapy.


Acierno said the Charleston VA currently offers the home-based therapy to patients.


“We have had tremendous response combining home telehealth with peer support during exposure, which is new,” Acierno said, adding that in the past peers were involved only to encourage people to get into treatment, not actually helping to perform the treatment.


Peter Kane, a psychologist at the University of Wisconsin in Madison said the study was able to show that, at least in the VA health system, effective PTSD treatments can be successfully delivered in multiple ways.


“Patients with PTSD could be treated effectively in the clinic or by using home based telehealth,” Kane said. The findings are especially important given the common barriers that make it harder for those who need these services to access them, he noted.


“Studies such as this one may change how mental health services are delivered in general, not just for PTSD or within the VA system,” Kane said. “It may be the case at some point in the future that mental health clinics may offer home based telehealth as an alternative to traditionally clinic-based care.”


SOURCE: Behaviour Research and Therapy, online November 22, 2016.

06 Dec 2016

Common Medical Licensing Misconceptions- First Edition

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  1. Getting the application to the medical board is the most important part of starting my license…


Humans are linear thinkers- we like timelines and rational processes and we really like our numbers to run in sequence: 1, 2, 3, 4, etc.; so we get easily frustrated and panicky when is seems like a process is not moving along in line with our perceived expectations.


When licensing on one’s own, the logical first step is to fill out an application, send it to the medical board and then compile a list of verifications to request to be sent to the medical board. This process is fine, if your licensing needs meet the following requirements-



  1. You want to do all of the footwork yourself.
  2. You don’t have a specific timeframe or deadline for licensure.
  3. You don’t mind re-doing the work if the verifying entity does not respond in a timely manner or responds with the incorrect information.


If you have a deadline for licensure (such as a starting date in a new job) and/or  you don’t have the time or money to spend on re-doing verifications, then you should look into allowing a reputable licensing agency assist you in the process.



A word of fair warning-  any reputable licensing firm is not going to operate in a linear fashion when processing your licensing request for any number of reasons- preventing a client from incurring unnecessary duplicate expenses, eliminating errors and/or redundancy, ensuring that only a complete file is submitted to an analyst for review, etc.  You must trust your agency’s process and re-evaluate your linear thinking when expediting your license though an agency. If you don’t understand why, then ask first, before you panic.


Each medical board has their own internal process for initial file reviews and an experienced licensing agency is going to leverage their industry knowledge to ensure a timely review of a complete and accurate file.  A reputable licensing firm ensures that all parties involved in licensing an applicant are treated with respect.  Accuracy, dependability and reputation are keys to successful and timely review of your file and, ultimately, a speedy issuance of your medical license.









2. Already Licensed in Another State- Do I Qualify for Reciprocity?


Reciprocity is a thing of the past.  Reciprocity of a state medical license used to be a very common practice. Most states entered into an unofficial compact with the basic understanding that the previous medical board was diligent in accurately verifying all of the educational information of the applicant in questions, and was, in essence, ‘vouching’ for the applicant’s credibility.


In the early days of physician licensing, it was quite easy for physicians to move around the country practicing medicine. Unfortunately, it also made it quite easy for unqualified practitioners to follow suit.



In the 1990’s a number of board members from one U.S. medical jurisdiction were indicted on fraud charges after an investigation by the FSMB and FBI concluded that they were ‘selling’ medical licenses in their jurisdiction which allowed unqualified practitioners to apply for reciprocal  licenses in other states where they would not otherwise qualify.



Additionally, as America grew, regional demographics dictated the need for some medical boards to implement additional training or certification requirements to ensure that their practitioners met the needs of the local populations.



Obvious examples are ‘Snowbird” states, which see a massive influx of doctors during the winter months, and suffer a critical dearth of adequate medical coverage during the dog days of summer.  Not to mention that many of the winter practitioners are often transitioning into retirement and are not providing the hours of coverage needed by the local population or are increasingly interested in sub-specialties such as Geriatrics or boutique practices as their own desires to slow down and practice less increase- thus broadening the area shortages in Pediatrics or Primary Care.



In order to meet the growing and changing needs of local populations, state medical boards have felt increased pressure from political lobbyists seeking to ensure that the local populace is adequately represented by “qualified’ applicants. Watchdog groups and increasingly frivolous malpractice claims have added to the loss of reciprocity and increased scrutiny of each state’s application and verification process, as each medical board seeks to protect itself from legal action and its constituents from inadequate healthcare.




Currently about 150,000 physicians seek new or additional state medical licenses each year. When the amplified practice demands on physicians and staff are combined with the increased qualification and verification requirements of each state medical board, licensing timeframes can increase exponentially.



Today’s licensing applicants must research their options thoroughly before giving notice, selling their practice or relocating their families to a new state or jurisdiction. New employers, state licensing boards and credentialing coordinators are unsympathetic to an applicant who did not conduct adequate research prior to pulling the trigger on a significant lifestyle change.



Please contact Physician Licensing Service for more information about state medical licensing timeframes and individual requirements before giving notice or accepting a new employment position.



28 Nov 2016

FCVS: What You Need To Know

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Federation Credentials Verification Service (FCVS)

We run into questions regarding FCVS on a daily basis. What do they do? What don’t they do?  Here are some of the basics: Read more

18 Nov 2016

Doctors Work on ‘Webside Manner’ As Telemedicine Becomes More Popular

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Get ready to text your doctor.

Fortune Brainstorm Health Wednesday, November 2, 2016 San Diego, CA 12:40 PM CONCURRENT LUNCHES: SOLUTION SESSIONS HELP FROM AFAR: THE POWER OF REMOTE HEALTHCARE Intervention Track Hosted By: Insigniam Mobile technology is enabling doctors and patients to meet anytime and anywhere. Thanks to advances in telemedicine, physicians—even psychiatrists—can now monitor patients and do the kind of detailed patient workups and counseling that had once been possible only in an in-person visit. In theory, it’s easier for patients, it’s cheaper for healthcare systems, and the results (in early testing) seem just as good. So what’s stopping us from making remote healthcare the norm, especially for those with chronic diseases who need frequent monitoring? And how can other Uber-like platforms (doctors on demand) improve cost, efficiency, and the quality of care as well? Firestarters: Hill Ferguson, Chief Executive Officer, Doctor On Demand Suneel Gupta, Head of Mobile, One Medical Ron Gutman, Founder and CEO, HealthTap Dr. Vivian S. Lee, Dean, School of Medicine; Senior Vice President, Health Sciences; CEO, University of Utah Health Care, University of Utah Rick Valencia, President, Qualcomm Life, Qualcomm Inc. Moderator: Leena Rao, Fortune Photograph by Stuart Isett for Fortune Brainstorm Health



by Erika Fry@ErikaFry – NOVEMBER 2, 2016, 7:41 PM EST


Reposted by Physician Licensing Service admin – 11/17/2016



Why go to the doctor, when you can just Skype or text her? That may sound glib, but these days, it’s a serious question. And in a field where many trends—skyrocketing drug prices and healthcare costs—tend to defy logic, the rise of telemedicine is one that makes a lot of sense, said Vivian Lee, CEO of University of Utah Health Care, speaking on a panel about virtual health at Fortune’s Brainstorm Health conference in San Diego on Wednesday.


Indeed, the service wins rave reviews from patients and providers. Practitioners of telemedicine say virtual appointments greatly enhance access to care and engagement with patients, both of which tend to benefit health outcomes. Suneel Gupta, head of mobile, for One Medical, said patients engage with his company’s virtual health platform 25 to 30 times a week. While there’s a convenience factor, there are also safety implications. Telemedicine keeps the sickest patients at home, and out of the hospital, where there is greater risk of infection.


Especially, as the Center for Medicare & Medicaid Services makes its push to value-based, rather than fee-based care, it’s likely that telemedicine, which saves costs and improves outcomes, has a role to play, said Lee.


That’s not to say there aren’t a few wrinkles to work out. Not all doctors are naturals at virtual care. They often have to work on their “webside manner,” said Hill Ferguson, CEO of Doctor on Demand, a telemedicine company that serves corporations and large employers. (Ron Gutman, CEO and Founder of HealthTap, another virtual health start-up, says his company’s users actually prefer texting to video care.)


And regulation hasn’t yet caught up with the telemedicine trend. Doctors must be licensed in both the state in which they’re giving care, as well as the state in which that care is being received. For health systems that have hospitals in many states, that’s an especially tedious challenge.


Oh, and one other thing: in many cases, telemedicine sessions are not reimbursed. That makes it an even more difficult for health providers to decide whether to build out virtual health infrastructure.


For Lee, it’s a no brainer: it’s worth it. It’s a way to keep up with demand for care—virtual appointments save time—and to provide greater access to services, particularly for patients that may be hundreds of miles away from the closest hospital. She says the platform is also just as useful to connect doctors and nurses with other healthcare professionals, who can offer a second opinion or medical guidance.


Telemedicine has also been embraced by Carolinas HealthCare System. The investment in telemedicine will save the company from building many new hospital beds, and make better use of the ones it has, said Guy Glorioso, director of virtual care at the organization. Such a platform saves the system in the longrun, he says, driving down hospital readmissions, the cost of ambulance services, and other expenses.

16 Nov 2016

What telemedicine, Blockbuster and Netflix have in common

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We saw it with video, we saw it with banking, and now we’re seeing it with digital health.

PLS Customized Service

Originally posted By Jeff Oldham – November 14, 2016

Reposted by Physician Licensing Service – November 16, 2016

Having all of your information available on one digital platform is the new norm, and it’s no wonder healthcare is moving in the same direction. Now that Americans are transitioning from co-payments to bigger deductibles due to the rise of high-deductible health plans (HDHPs), digital health is peaking interest when it comes to cutting costs. Employers are helping their employees manage these high deductibles by offering telemedicine benefits, and I predict it’ll be the next Blockbuster to Netflix movement.

According to Benefitfocus’ 2016 State of Employee Benefits report, 52% of large employers now offer at least one high-deductible health plan, and 41% of employees select an HDHP over a traditional plan when given the option. In an age where healthcare costs are skyrocketing, high-deductible health plans offer immediate costs savings, especially when coupled with a Health Savings Account (HSA). This option is especially attractive for generally healthy individuals who tend to spend less on healthcare, but still pay a high premium for more traditional plans. But with a higher deductible comes a caveat—people must pay out of pocket until it’s covered, which makes them take a closer look at how much doctor’s visits actually cost.

Enter telemedicine. A typical charge for a telemedicine visit is $40, compared to $125 for an office visit, and the best part is, it’s covered tax-free under an HSA. This is a substantial savings for people who haven’t yet met their deductible when they need a regular checkup or an emergency that doesn’t require an in-office visit. A recent survey from Mercer found 59% of large U.S. firms now cover a telemedicine program compared to just 30% in 2015. The usage numbers are only predicted to grow, and now that more insurers are embracing digital health services, we’re bound to see even more companies adopt telemedicine offerings.

Most fascinating about telemedicine is most people automatically assume it’s a millennial benefit, but the fact is, it’s incredibly useful for every generation. I’ve seen telemedicine act as a Medicare supplement for seniors who do not wish or are unable to leave their homes. Telehealth advocates and providers see senior telemedicine use as the next major market, especially for the 1 in 5 people older than 65 who live outside of a metropolitan area away from doctor’s offices. It’s opening a whole new door in healthcare where they can take wellness measures from the comfort of their own space.

The benefits of telemedicine go beyond cash-saving perks. By offering a telemedicine option, employers are sending the message that they care about workplace wellbeing. On the back of the recent “unsick day” trend, where employers give employees the day off to take preventative healthcare measures, it’s clear employers are realizing employees undergo a significant amount of stress when missing work. Since telemedicine is virtual, it’s more flexible—many providers even offer 24-hour access. It gives people the opportunity to check up on their health without the added time it takes to get to and from the doctor’s office, lessening the stress of using a sick day.

With telemedicine a generally new trend, how can employers convince employees to opt-in? To get employees to take advantage of this benefit, employers who offer telemedicine should consider educational tactics to communicate the availability and perks of using it, including video or health care transparency tools to show the potential savings. Think of it this way. Benefits are a language that most people don’t speak, and if they do, it’s only once a year for a few weeks during open enrollment. By offering year-round educational tools, employees are always in the know and can even bring home the “how-to” of telemedicine to their spouse or family members. This will encourage higher utilization and give people the full scope of what they can do with digital health.

Today, people expect more than just traditional healthcare, and furthermore, they expect it to be affordable. With telemedicine, employers can give their employees financial relief in the new HDHP landscape so they can worry less about hefty bills and more about taking care of themselves. Telemedicine exists in the same vein as Netflix and ATM banking.

Remember when we all went to Blockbuster to rent a video? Now we download entertainment digitally from Netflix. The analogy also holds true for the shift to more use of telehealth.

People are looking for a cost-effective, easily accessible platform to meet all their needs. Even though telemedicine is revered in its simplicity, it’s an incredibly comprehensive health care perk that’s likely to grow as more people uncover its benefits.

Jeff Oldham, is vice president of consumer strategy for Benefitfocus. He has worked in the benefits industry for 19 years, focusing on technology, medical and ancillary benefits management, along with wellness and disease management. He has been at Benefitfocus for over six years and leads the Benefitstore voluntary benefit consulting team.