Accrediting telehealth and remote patient monitoring providers (US)

Another organization has a go at it. ClearHealth Quality Institute (CHQI) of Annapolis, Maryland, an independent health care accrediting body, is developing two new telemedicine accreditation modules that cover Telemedicine Outcomes and Remote Patient Monitoring. The CHQI has formed a committee to develop standards in these areas to add them to current accreditation modules in telemedicine delivery: Consumer-to-Provider (C2P), Provider-to Consumer (P2C), and Provider-to-Provider (P2P). 

The need for clinical training and accreditation was recognized in August’s National Quality Forum report, Creating a Framework to Support Measure Development for Telehealth. Four domains of measurement were identified in the NQF report for telemedicine and telehealth organizations: 1) access to care, 2) cost effectiveness, 3) experience, and 4) effectiveness.

CHQI started in the insurance accreditation and compliance areas, expanding to telehealth recently. It is the only telemedicine accreditation program recognized by the American Telemedicine Association (ATA) and with major telemedicine providers such as American Well, Doctor On Demand, and MDLive.

Our Readers will remember that back in 2014, then Intel-GE Care Innovations in conjunction with the Jefferson College of Population Health had started the Validation Institute to accredit both individuals and companies. By last July, Care Innovations had sold it off to the Health Value Institute and had some time back concentrated on companies only. ClearHealth release, PatientEngagementHIT

Want to know effectiveness of telehealth, interoperability? NQF reports take their measure.

There’s been an increase in doubt about the efficacy of telemedicine (virtual visits) and telehealth (vital signs monitoring) as a result of the publication of two recent long-term studies, one conducted by the University of Wisconsin and the other by CCHSC for Telemonitoring NI [TTA 13 Sep]. These follow studies that were directionally positive, and in a few cases like the VA studies conducted by Adam Darkins, very much so, but mostly flawed or incomplete (low N, short term, differing metrics). What’s missing is a framework for assessing the results of both. In an exceptionally well-timed announcement, the National Quality Forum (NQF) announced their development of a framework for assessing the quality and impact of telehealth services. 

In a wonder of clarity, the NQF defines telehealth’s scope as telemedicine (live patient-provider video), store-and-forward (e.g. radiology), remote patient monitoring (telehealth), and mobile health (smartphone apps). Measurement covers four categories: patients’ access to care, financial impact to patients and their care team, patient and clinician experience, and effectiveness of clinical and operational systems. Within these categories, NQF identified six areas as having the highest priority for measurement: travel, timeliness of care, actionable information, added value of telehealth to provide evidence-based practices, patient empowerment, and care coordination. Finally, the developing committee identified 16 measures that can be used to measure telehealth quality.

The NQF also issued a similar framework for interoperability, a bête noire that has led many a clinician and developer to the consumption of adult beverages. Again there are four categories: the exchange of electronic health information, its usability, its application, and its impact—on patient safety, costs, productivity, care coordination, processes and outcomes, and patients’ and caregivers’ experience and engagement. And it kept the committee very busy indeed with, from the release, “53 ideas for measures that would be useful in the short term (0-3 years), in the mid-term (3-5 years) and in the long-term (5+ years). It also identified 36 existing measures that serve as representative examples of these measure ideas (sic) and how they could be affected by interoperability.”

Both reports were commissioned and funded a year ago by the US Health & Human Services Department (HHS). We will see if these frameworks are extensively used by researchers.

NQF release, Creating a Framework-Telehealth (download link), Creating a Framework-Interoperability (download link), Mobihealthnews