Q&A update with New Mexico Telehealth Alliance

Carol Yarbrough recognizes that compliance can be a scary avenue for many in the healthcare industry.
“When I was a compliance officer type person, people would avoid me on the street … they don't do that anymore,” Yarbrough joked during a recent webinar discussion on billing practices for hospital and clinic professionals.
Yarbrough, a specialist in federal and state regulatory billing and reimbursement guidelines, recently led the virtual webinar for the Southwest Telehealth Resource Center.
Telehealth services depend on quality broadband network communications. Recent legislation, executive orders, and agency funding commitments and grants are set to make a significant impact in terms of expanding and improving telehealth services and broadband availability and reliability in the southwest region and nationally.
For many Americans, their first personal experience of being a hospital patient quickly becomes a crash course in the importance and value of having a skilled and dedicated bedside nurse. At a higher level, this points to the importance of a sufficient nursing staff which impacts the entire workflow of the hospital. Without sufficient bedside nurses, patients in the Emergency Room and Intensive Care Units cannot be moved to the floors, resulting in longer waiting times for care for those newly arriving. Beds that cannot be staffed are beds that do not exist for all practical purposes. Unfortunately, a shortage of nurses has long been a problem for hospitals across the United States. The coronavirus pandemic has brought this challenge to an entirely new level, resulting in a request by the American Nurses Association that the U.S. Department of Health and Human Services declare the current nursing staffing shortage a national crisis.
The United States and the world have seen a dramatic increase in the use of telemedicine since the inception of the COVID-19 public health emergency due in most part to stay at home restrictions for both providers and patients. Prior to this, telemedicine was used in a wide variety of clinical and related patient care applications for at least 30 years, and had been seeing steady but not exponential growth. In many cases programs were initiated quite rapidly using readily available and often low-cost equipment and tools, unless there was already an existing program and platform in place. Further, the use of telemedicine was facilitated at the state and federal levels but widespread waivers and measures being put into place to reduce barriers that were previously in place such as changes in reimbursements, requirements regarding patient and provider locations, cross-state licensure and privacy/security requirements.
How can we make sure telehealth processes are making a difference that matters? Having led virtual care for Kaiser Permanente Colorado, what matters most to me is that we are finding ways to make care less expensive and/or with better clinical outcomes.
We have some proof that telehealth improves clinical outcomes. Video visits significantly decrease no-shows for mental health care. Remote patient monitoring significantly increases patient engagement in managing chronic disease. Most trust that no-shows and patient engagement are good surrogates for improved outcomes. However, the evidence that telehealth processes lead to decreased cost and/or improved clinical outcomes is less clear.
I’m not ready to jump on a plane anytime soon to get away from staying at home during COVID, but I am willing to jump in my car and take a road trip to do some hiking in National Parks on less popular trails and have done just that in the past couple of months. One was to Great Smokey Mountain National Park and the other to Shenandoah National Park and the Blue Ridge Parkway.