Providers

As a second-year medical student at the University of Arizona College of Medicine – Tucson, I’ve been fortunate to interact with patients early in my training. Yet the experiences that left the deepest impact weren’t from structured classroom activities. They came from the time I chose to spend at the Crisis Response Center (CRC) at Banner University South, a 24-hour stabilization center for youth experiencing mental health crises.

Sitting in on patient interviews, I witnessed the wide range of stories and struggles that bring children and adolescents to the CRC. Despite their differences, one theme stood out: the lack of continuity in behavioral healthcare, especially for those in foster care. Given my research on telehealth since 2020, I kept asking myself, could telehealth be part of the solution?

We had the opportunity to speak with Dr. Amit Algotar, MD, PhD, MPH, FOMA, FACPM who leads a telehealth-based lifestyle weight loss clinic at Banner University Medical Center South. His innovative approach focuses on using lifestyle modifications as a primary treatment modality for managing and preventing chronic conditions like cardiovascular disease, diabetes, and even certain cancers. In this Q&A, Dr. Algotar shares the philosophy behind his work, the impact he’s seeing, and how telehealth is helping him reach more patients.

Telehealth measurement has recently received renewed attention as healthcare organizations rapidly adopted and deployed telehealth programs during the COVID-19 pandemic. Since the pandemic started, the need to measure utilization and its temporal variations accurately has increased as the rate and type of telehealth visits grew substantially and is now stabilizing. Measures that interact with utilization, like cost, have also not been effectively quantified to understand the financial impact of telehealth utilization variation during and since the pandemic and are only recently being rigorously assessed. This may be due to challenges accessing complete, reliable data, especially at the organizational level. As health services researchers who conduct evaluations in various areas of telehealth, these limitations restrict how health services researchers, who conduct evaluations in various areas of telehealth, define and measure telehealth among hospitals to inform accurate comparisons of utilization and care provision via telehealth.

As a geriatrician, I serve as a primary care physician for older adults. In my practice, there are patients across the continuum of medical complexity with all levels of physical and cognitive functioning. A universal theme I see in practice is that it’s hard to keep up with health, healthcare, and health insurance plans. It can be challenging for my patients to come into the office for an in-person visit. They may have to drive a long distance, their medical appointment may interfere with their routine, such as a weekly exercise class, or if they have limited mobility, leaving the house is a feat and getting into the clinic can be quite burdensome. 

The current and future potential impact of Artificial Intelligence (AI) on healthcare, particularly in relation to telemedicine, is huge. Presented here are just a few of the more exciting technologies and their potential for use and impact in telehealth applications.

With ambient clinical listening technologies (AI-based scribes), advanced, voice-enabled AI tools automatically document patient encounters and free-flowing conversation between physicians, patients, and families. An advantage of using AI scribes in a telemedicine setting is that providers can focus more continuously on their consultation with the patient, eliminating the need to divert their attention away from the patient for note taking. Using AI scribes can save providers significant amounts of time as the burden to create accurate notes or encounter summaries in the electronic health record is reduced as it can be done automatically with minimal editing. Some AI scribe products also include predictive tools that can analyze the conversations, provide feedback, and assist with order placement, future appointment scheduling, or prescriptions, which can help reduce provider burnout, save time, and help ensure that all topics discussed are properly coordinated.

On February 2, 2024, the Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), published a final rule that expands on, and makes permanent, certain opioid-related telehealth flexibilities initiated during the COVID-19 pandemic. Under the rule, authorized providers will be able to start patients on buprenorphine or methadone—medications used to treat opioid use disorders—pursuant to a telehealth visit and without needing an in-person visit.

In the ever-evolving landscape of Medicare coverage, the 2024 Medicare Physician Fee Schedule (MPFS) brings crucial updates to telehealth billing and reimbursement.

During a recent Southwest Telehealth Resource Center webinar presentation, “`Tis The Season: For The 2024 MPFS Telehealth Billing & Reimbursement Updates,” Carol Yarbrough, MBA, CCA, CPC, OCS, CHC, a healthcare compliance and reimbursement specialist, discussed the intricacies of the 2024 MPFS changes affecting telehealth along with their impact on providers and patients alike.

Virtual? In-person? Hybrid? These were the decisions faced by the officers and advisory committee of the Society for Education and the Advancement of Research in Connected Health (SEARCH) after three years of virtual events due to COVID. By 2023, the weariness of virtual meetings had taken its toll, so in-person it was. The outcome exceeded expectations. The National Telehealth Research Symposium in 2023 turned out to be a resounding success!

As in previous years, the meeting would not have succeeded without the support of collaborating organizations, and this year we had six partners return: the Medical University of South Carolina National Telehealth Center of Excellence, the National Consortium of Telehealth Resource Centers, SPROUT (Supporting Pediatric Research on Outcomes and Utilization of Telehealth), the University of Arkansas for Medical Sciences (UAMS) Institute for Digital Health & Innovation, the UAMS Translational Research Institute, and the University of Mississippi Medical Center National Telehealth Center of Excellence. New for 2023 was a collaboration with the American Heart Association (AHA).

Until earlier this year, newborn infants in the Four Corners region of New Mexico, born prematurely or with unique health problems requiring specialty care, were typically transported to neonatal intensive care units at larger hospitals hours from home.

According to Dr. Bradley Scoggins, the purchase of an Amwell telemedicine cart and a new telehealth partnership with Presbyterian Hospital’s Neonatal Intensive Care Unit (NICU) team in Albuquerque, NM has helped keep more infants at the San Juan Regional Medical Center in Farmington, NM.

Have you ever had patients say that virtual visits and technology are difficult? Have your patients avoided virtual visits due to their lack of comfort with virtual care? Have your patients ever asked for a resource center or for someone to practice virtual sessions with to overcome any challenges? The Veterans Health Administration has numerous approaches to help veterans with virtual care and technology adoption.