Tender Alerts: Staffordshire’s £70m contract, Yorkshire and The Humber test

Susanne Woodman, our Eye on Tenders, alerts us to two tenders, the first which will definitely pique our UK Readers’ attention with its size and duration. The second is for a proposal using TECS and telemedicine as an alternative to emergency services.

  • Staffordshire: This is a huge seven-year contract to create the Support For Independent Living In Staffordshire (SILIS) Service to enable older and disabled adults to age in place in their current homes. “A key aim of the Service is to help Individuals to make changes to their home environment that will prevent the need for more costly interventions, such as admission to hospital or residential care, following life crises.” The Service will improve upon existing services in Assistive Technology (AT) including referral to telecare providers.

There are six borough and district councils involved, with the potential for use by nine more. The contract is valued at £70 million to start April 2018 with renewal points, ending in March 2025. Deadline is Wednesday 1 November at noon. Much more information (you’ll need it) on TED EU-Tenders Electronic Daily

  • NHS Greater Huddersfield & North Kirklees CCG: This tender is for the provision of a technology-assisted, rapid access service offering an alternative to hospital-based A&E services. Market test site is in Kirklees for residents of a care home. Requirements are:
    • A 24/7 clinical teleconsultation service delivered via secure video link into residential/ nursing homes, that is utilized instead of patients having to be taken to the local A&E department.
    • A service that provides clinical consultation not a logarithm based approach like 111.
    • A fully managed technical service utilizing bespoke laptops with HD cameras and with 4G SIM or broadband.

The CCG may also commission an accountable care organization (ACO) for this care in future, to which this contract would transfer. Deadline is 5pm on Friday 20 October to brenda.powell@greaterhuddersfieldccg.nhs.uk. More information on Gov.UK.

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 

Equivocal long term telemonitoring studies released by Telemonitoring NI, U. of Wisconsin

The HSC Public Health Agency for Northern Ireland and Queen’s University Belfast have released an evaluation of the six-year (2011 – 2017) Remote Telemonitoring Service for Northern Ireland (RTNI). The Centre for Connected Health and Social Care (CCHSC) launched the Telemonitoring NI project in 2011, which enrolled over 3,900 patients with COPD, diabetes, weight management, stroke, heart failure and kidney problems in both telehealth (vital sign) and telecare (behavioral) monitoring. The study period was through 2015, but the program continues to be implemented by all five NI Health and Social Care (HSC) Trusts across a range of chronic conditions. 

The Northern Ireland findings were at best equivocal. While the qualitative data gathered from patient, carer, and clinician focus groups and interviews were positive in terms of engagement and on reassurance–to be able to carry on with their lives as usual–the quantitative data did not confirm gains in effective care.

Although there were a number of testimonials from the participants in the patient focus groups regarding
reduced hospitalisations and a reduced need to attend outpatient clinics, this did not carry through to
the data obtained in the effectiveness aspect of the current evaluation. In general terms, the number
of hospitalisations, length of hospital stay and outpatient clinic attendance (and therefore overall cost
of healthcare provision) did not differ between the quasi-control ‘never installed’ group and any of the
groups who received some amount of telemonitoring. The results, where they were statistically
significant, were largely driven by an anomalous result for the heart failure ‘never installed’ group. (page 17)

The Executive Summary, Telehealth, and Telecare Reports are available for free download on the HSC R&D Division website. Many thanks to former TTA Ireland Editor Toni Bunting for the information, summary, and researching the previous TTA coverage below.

This is the second discouraging study on the long term effectiveness of patient monitoring released in the past month. A five-year, 140,000 patient/90 provider study conducted by the University of Wisconsin found that giving patients the option of telemedicine, instead of being more convenient for the provider, created new issues. It increased office visits by six percent, added 45 minutes per month of additional visit time to practices, and reduced the number of new patients seen each month by 15 percent. For the patient, the researchers found “no observable improvement in patient health between those utilizing e-visits and those who did not. In fact, the additional office visits appear to crowd out some care to those not using e-visits.” The study suggested that the telemedicine visits could be made more effective by structured questions prior to the visit. (This approach has been taken by telemedicine provider Zipnosis with adaptive online interviews and patient triage.) Mobihealthnews

Previous commentary by TTA’s Editor Emeritus Steve Hards on the procurement of the NI Remote Telemonitoring Service:

http://archive1.telecareaware.com/the-long-and-winding-road-that-leads-to-your-doorin-northern-ireland/
http://archive1.telecareaware.com/african-elephant-ecch/
http://archive1.telecareaware.com/remote-telemonitoring-northern-ireland-service-tender-long-list-mystery/
http://archive1.telecareaware.com/short-listed-companies-rtni-service/
http://archive1.telecareaware.com/northern-ireland-remote-monitoring-servicegoes-to-tf3/

 

Events: MEDICA App Competition 15 November (DE)–not too late to enter!

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/09/MAC_logo_474x133.jpg” thumb_width=”150″ /]Wednesday 15 November, Düsseldorf Exhibition Centre, Hall 15, 3-5pm

MEDICA 2017 (13-16 Nov) will be hosting the sixth annual MEDICA App Competition on the stage of the Connected Healthcare Forum. This is featured as the “the world’s largest live competition for the best App-based Medical Mobile Solution for use in the daily routine of a patient, a doctor or in the hospital.” 15 contestants will pitch on stage for three minutes each with an additional two minutes for the jury to submit questions. First place solution will be awarded €2,000, second €1,000 and third €500, along with the winner going to SXSW and the top three receiving Startupbootcamp (SBC) Digital Health awards.

Featured on the jury are Ashish Atreja from Mount Sinai in NYC and Ralf-Gordon Jahns of research2guidance.

Application submissions are being accepted through 30 September with notification early in October–scroll down the page for the link.

Can unused “TV white spaces” close the rural and urban broadband–and telehealth–gap?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/Radio-tower.jpg” thumb_width=”100″ /]The digital divide comes one step closer to closing. Microsoft’s release of its white paper proposing an alternative to the expensive build-out of the US broadband network deserved more attention than it received in July. The Rural Broadband Strategy combines TV white spaces spectrum (the unused UHV television band spectrum in the 600 MHz frequency range which can penetrate through walls, hilly topography, and other obstacles) with fixed wireless and satellite coverage to economically deliver coverage to un/under-served areas versus fiber cable (80 percent savings) and LTE fixed wireless (50 percent).

34 million Americans lack broadband connection to the internet. Some of these are voluntary opt-outs, but 23.4 million live in rural areas without access, with huge economic consequences estimated in the hundreds of billions. TV white spaces can also expand coverage in small cities and more densely populated areas, including usages such as within buildings. This effort also presses the FCC, which in turn has pressed for broadband for two decades, to ensure that at least three channels below 700 MHz are kept unlicensed in all markets in the US, with more TV white spaces for rural areas.

The first part, the Rural Airband Initiative, builds on Microsoft’s present 20 programs worldwide, and is planned to connect 2 million people in by July 4, 2022, with 12 projects across the US running in the next 12 months. Much of the connectivity is dedicated to nonprofit efforts like 4-H’s digital literacy program and ‘precision agriculture’ in New York State and Washington. Microsoft is also granting royalty-free access to 39 patents and sample source code related to white spaces spectrum use in rural areas.

A positive move for telehealth’s spread. Rural healthcare providers pay up to three times as much for broadband as their urban counterparts. Telemedicine increasingly connects for consults between hospitals in rural areas and city-based health systems for specialty coverage and to provide assistance in specialized medical procedures. Telemedicine and telehealth remote monitoring has difficulty spreading with poor internet coverage; this has already been a barrier to patients in rural ACOs who can be 1-2 hours from the doctor’s office and notably for the VA in providing rural veterans with home telehealth support. Paramedics increasingly rely on internet connections and dropped connections lead ambulances to go to hospitals at a greater distance. If the FCC cooperates and Microsoft’s partners can find a way to profitably execute, broadband can finally achieve that promise about closing the ‘digital divide’ made back in the Clinton Administration. A Rural Broadband Strategy: Connecting Rural America to New Opportunities  The Verge, mHealth Intelligence, Becker’s Hospital Review

Tender Alert: Scotland CAN DO Challenge, Bootle needs assistive tech

This Editor thought it would be quiet for the rest of the month, but our Eye on Tenders, Susanne Woodman, has alerted us to two freshly posted–and the first is major:

  • Scotland: The tender for the CAN DO Innovation Challenge Fund – Health & Social Care Challenges is so large it is in 10 lots which offer an initial market test, an evaluation by the fund, then a decision made on whether to pursue the potential project further with the public body. There are eight that directly involve healthcare technology:
    • Point of care lab testing
    • Adopting technology for care in the north of Scotland
    • Transforming nursing care processes for the 21st century
    • Creating and driving a clinically and cost effective pathway to improve recovery after critical illness enabled by data from hospital information systems
    • An IT system for care workers and patients for adherence to stroke management plans to enable real time monitoring
    • Transforming management of people with severe COPD to improve patient outcomes and quality of life and reduce healthcare costs
    • Glasgow TECS development to support care and digital cutover
    • Develop and integrate digital services that allow for consent-driven data sharing from patient records

There is no deadline listed. More information and required document links here on Public Contracts Scotland

  • Bootle (Merseyside) and Sovini Ltd are seeking assistive technology for about 1,000 residents of its local One Vision Housing with retirement and dispersed housing. Estimated value £180,000 over 24 months. Deadline is 18 Sept at noon. More information at Delta e-Sourcing and Tenders Electronic Daily.

Tender Alert: Torbay and South Devon NHS Foundation Trust for TECS

One more from our Eye on Tenders, Susanne Woodman, is from NHS South West which is reviewing their currently in-house delivery of TECS, including monitoring, in Torbay. The Torbay and South Devon NHS Foundation Trust is seeking a fresh look at innovative services from providers who are interested and able to provide the full service from equipment, installation and monitoring, as well as bench-marking information. To review their current services and equipment (Tunstall), they helpfully provided this linkThis was posted today (15 Aug) and closes 1 September, so there’s only a short window. Refer to the Gov.UK Contracts Finder page for contact information and (importantly) document attachments.

VA’s Shulkin: Cerner rollout start by mid-2019?

An interesting short (free) article on POLITICO Morning eHealth today was an interview with VA Secretary David Shulkin, MD on the Cerner transition, stating that if all went well with negotiations later this year, VA clinicians could be using the Cerner system by mid-2019. “There’s a lot of understandable concern about whether the Cerner EHR will have the same functionality as VistA, which has evolved to the physician’s needs over the past 35 years.” One of the problems with VistA was that it wasn’t one system, it was 130 systems, which is echoed in many EHRs. POLITICO goes on to quote Dr. Shulkin: “I don’t hear as many concerns about that as I do relief about finally making a decision because people felt this was the slow death of a system that they have poured their hearts and souls into. Knowing we’re committed to doing a transition as well as we can is reassuring to people.” Sadly, the rest of the interview is paywalled on POLITICO PRO. Earlier analysis: VA says goodbye to VistA, hello to Cerner. We wonder what the involvement and engagement of the four Home Telehealth winners of the 5-year contract will be.

Weekend Big Read: will telemedicine do to retail healthcare what Amazon did to retail?

Updated. Our past contributor and TelehealthWorks’ Bruce Judson (ATA 2017 coverage) has penned this weekend’s Big Read in the HuffPost. His hypothesis is that telemedicine specifically will disrupt location-based care, followed by other digitally based care–and that executives at health systems and payers are in denial. More and more states are recognizing both parity of treatment and (usually) payment. Telemedicine also appeals to three major needs: care at home or on the go, with a minimal wait; maldistribution of care, especially specialized care; and follow-up/post-acute care. His main points in the article:

  • Healthcare executives are being taken by surprise because present digital capabilities will not be future capabilities, and the shift to virtual will be a gradual process
  • Telemedicine will address doctor shortages and grow into coordinated care platforms embedding expertise (via connected diagnostics, analytics, machine learning, AI) and care teams
  • Telemedicine will eventually go up-market and directly compete with large providers in urban areas, displacing a significant amount of in-person care with virtual care
  • Telemedicine will start to incorporate continuous feedback loops to further optimize their services and move into virtual health coaching and chronic care management
  • Telemedicine platforms are also sub-specializing into stroke response, pediatrics, and neurology
  • Centers of expertise and expert platforms will become larger and fewer–centralizing into repositories of ‘the best’
  • Platforms will be successful if they are trusted through positive patient experiences. This is a consumer satisfaction model.

Mr. Judson draws an analogy of healthcare with internet services, an area where he has decades of expertise: “A general phenomenon associated with Internet services is that they break activities into their component parts, and then reconnect them in a digital chain.” Healthcare will undergo a similar deconstruction and reconstruction with a “new set of competitive dynamics.”

It’s certainly a provocative POV that at least gives a rationale for the sheer messiness and stop-n-start that this Editor has observed in Big Health since the early 2000s. A caution: the internet, communications, and retail do not endure the sheer volume of regulatory force imposed on healthcare, which tends to make the retail analogy inexact. Governments monitor and regulate health outcomes, not search results or video downloads (except when it comes to net neutrality). It’s hard to find an industry so regulated other than financial/banking and utilities. FierceHealthcare also found the premise intriguing, noting the VA’s ‘Anywhere’ programs [TTA 9 Aug] and citing two studies indicating 96 percent of large employers plan to make telemedicine, also with behavioral health services, available, and that 20 percent of employers are seeing over 8 percent employee utilization. (Under 10 percent utilization gave RAND the vapors earlier this year with both this Editor and Mr. Judson stinging RAND’s findings with separate analyses.)

Analyses of New Jersey’s new telemedicine regulations

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/New-Jersey-welcome.jpg” thumb_width=”150″ /]With New Jersey’s telemedicine regulations now signed into law by Governor Christie to be effective 21 July, both providers and payers are adjusting to what the expansion means for those covered by Medicaid, Medicaid managed care, commercial health plans, and NJ state-funded health insurance. Our 27 June article reviews key points, and they are largely positive for expanding telemedicine in the (now official) Garden State. However, the payment parity part was diluted in the final version, with the in-person reimbursement rate set as the maximum ceiling for telemedicine and telehealth reimbursement rates.

Unique parts of the NJ bill require:

  • Telemedicine or telehealth organizations operating in NJ to annually register with the Department of Health
  • Submit annual reports on activity and encounter data, which will include patient race and ethnicity, diagnostic and evaluation management codes, and the source of payment for the consult (final details determined by succeeding legislation)
  • A seven-member New Jersey Telemedicine and Telehealth Review Commission
  • Mental health screeners, screening services, and screening psychiatrists are not required to obtain a separate authorization in order to engage in telemedicine or telehealth for mental health screening purposes

Full reviews of the legislation are available from law firms Foley & Lardner and in the National Law Review by an attorney from NJ firm Giordano, Halleran & Ciesla.

VA unveils several ‘anywhere’ new telehealth services for veterans

The new Veterans Affairs Secretary, David Shulkin, has wasted no time since his appointment in introducing several technology and mobile-based services at the VA, all of which are long overdue in this Editor’s estimation:

  • Anywhere to Anywhere VA Health Care will authorize telehealth consults and cross-state care for veterans no matter their location and regardless of local telehealth restrictions. VA is already the largest provider of telemedicine services (called VA Telehealth) in 50 specialties to 700,000 veterans annually. This new regulation will enable VA to hire primary care and specialist doctors in metro areas to cover veterans in rural or underserved areas. 
  • Rolling out nationally over the next year is the VA Video Connect app where veterans can use their smartphones or home computers with video connections to consult with VA providers. At present 300 VA providers at 67 hospitals are using it.
  • The Veteran Appointment Request (VAR) app will also roll out from its test. It will enable veterans to use their smartphone, tablet or computer to schedule or modify appointments at VA facilities nationwide.

Dr. Shulkin advocated these programs while undersecretary, especially ‘Anywhere to Anywhere’, which required advice from the Justice Department. VA’s technology is also being supported by the American Office of Innovation to improve care transitions between the Defense Department and VA. 

President Trump participated in the announcement with Dr. Shulkin and sat in on between Albert Amescua, a 26-year Coast Guard veteran at a VA clinic in Grants Pass, Ore., and Brook Woods, a VA internist in Cleveland. VA announcement with videos, POLITICO Morning eHealth, HealthcareITNews

Charterhouse lost half its equity in Tunstall debt refinancing–Sunday Times report (updated)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Breaking News, even though it happened in March! See updates below. The Sunday Times (UK–sign up for limited access) broke news over the weekend that Charterhouse Capital Partners, the main investor in Tunstall Healthcare, along with other shareholders, have been forced to relinquish nearly half the equity in the company to senior lenders and management. According to their annual report on page 65, section 31**, this happened on 17 March after the close of the FY, but only now has come to light through the Sunday Times report.

The article is light on details, but our Readers who’ve followed Tunstall’s history since the Charterhouse purchase in 2008 for £530 million will not be surprised, only that this development took so long. The cold facts are that the company has been wrestling with a stunning debt burden that grew from £1.2bn in 2015 [TTA 15 Apr 16] to the Times report of £1.7bn at the end of last September, with £300m owed to lenders and £1.2bn to investors. Debt service drove their financials to a £391m pre-tax loss last year. 

The highlights of the deal as reported in the Sunday Times:

  • Senior lenders (not disclosed) received 24.9 percent of Tunstall’s shares. Management received 25 percent.
  • Charterhouse with other shareholders now have a razor-thin controlling balance of 50.1 percent. Prior to this, Charterhouse alone had 61 percent of Tunstall’s shares.
  • In return, the lenders agreed to relax covenants on their debt, termed a ‘covenant reset’.
  • Tunstall also spent £18.5m last year on an abortive attempt to sell itself for up to £700m. We noted reports in April 2016 that they rejected a £300 million (US$425 million at the time) buyout offer from private equity investment firm Triton Partners.

**For those who wish to dig deeper, Tunstall’s hard-to-find annual report through last September (but not filed until 29 March 2017)  is available through Companies House. Go to their index here and select the “Group of companies’ accounts made up to 30 September 2016” which currently is the first listing.

This will be updated as other sourced reports come in, if they do–for now, it appears that the Sunday Times has the exclusive ‘dig’. It is unfortunate since Tunstall is responsible for millions of customers and employs thousands worldwide, and has been aggressively investing in the company and technology while having a fair amount of churn in executive and director positions. Regrettably, they never capitalized on a established position in a big market when they bought AMAC in 2011, then estimated as the US’ third largest PERS company. But as this Editor closed her 2016 article, the whole category of healthcare tech, while becoming more accepted and with a few exceptions, regrettably is still mired in ‘too many players, too many segments with too many names, all chasing not enough money whether private or government.’ I will add to that equation ‘too few users’–still true among older adults and the disabled–and ‘technology that moves too fast’ to make it even more confusing and unsettled for potential buyers (obsolescence on steroids!). And ‘gadgets’, to use the Times’ wording, are among the worst culprits and victims of these factors.

Updated: Equity capital. A cautionary tale was Editor Emeritus and Founder Steve Hards’ prescient analysis of the risks that Tunstall and Charterhouse undertook in acquiring so much debt. After you read it, note the year it was published. More recent commentary on Tunstall’s financial deteriorata dating back to 2013 can be found here.

Tunstall pairing with Inhealthcare digital health for NHS remote monitoring

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]A digital link of hope for Tunstall’s future? Announced at The King’s Fund Digital Health & Care Conference but oddly not receiving much notice was the UK collaboration of Tunstall Healthcare and Inhealthcare. Inhealthcare builds infrastructure for digital health services, and currently works extensively with multiple NHS regions and programs, such as the North of England Regional Back Pain Programme, NHS England’s Sheffield City Region Test Bed and the Darlington Healthy New Town project. Their services include telehealth monitoring for INR, COPD, medication reminders, a smartphone app platform, chronic pain management, and a surprising one that addresses undernutrition in older adults. The Tunstall-Inhealthcare objective is to integrate health and social care with clinical care systems in six areas: LTC home monitoring, identifying vulnerable patients, involving family members, 24/7 clinical care coordination centers, post-discharge management, and digital health at home innovation. Also noted is that Inhealthcare has programming technology that can reduce the time to build out services and apps.

Inhealthcare Ltd is part of Intechnology plc, owned by Peter Wilkinson, who has developed several UK internet and technology companies at scale–Planet Online, Freeserve, and Sports Internet (now Sky Betting and Gaming). Tunstall release

Can Google Glass’ enterprise iteration solve the patient documentation crisis?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/07/Glass-EE.jpg” thumb_width=”200″ /]”Glass is a hands-free device, for hands-on workers.” What a marketing position! Google Glass finally arrives at where it should have started–not a techie toy or a social snooper banned from bars, but a tool for specific work needs that solve specific but important problems. This is not only ‘on trend’, but also the ‘professional case’ is steak on the grill as a powerful way to lend legitimacy to a new product (the classic is Tang ‘orange drink’ going into space in the early ’60s). The recent announcement of Glass Enterprise Edition (EE) marking its emergence from stealth mode was a refreshingly low-key (for Google and parent Alphabet) surprise. Even the revamped look is sturdy and utilitarian in full glass mode (left) or in clip-on (and also serves as eye protection). 

Their on-trend position for healthcare is to reduce the amount of time that doctors spend charting and documenting patients. Augmedix, a Glass partner, built the documentation automation platform for Sutter Health and for Dignity Health that captures the information from the interaction between patient and doctor via a ‘remote scribe’. Jay Kothari, the Glass project lead, quotes data from Dignity that it reduces clinician daily documentation time from 33 percent to less than 10 percent,  The Sutter Health estimate is two hours per day. Out of the gate this is extremely valuable because it improves the clinician-patient face-to-face (and presumably virtual) visit in eye contact, reduces the break in taking notes, and reduces time pressure generated by post-visit review. Netherlands-based swyMed concentrates on facilitating virtual visits, and is testing a home visit pilot with Loyola University Health System practitioners in Maywood, Illinois. Others, like John Nosta, have been continuing to use Glass in business. Our Readers may want to check out these partners as that is how Google is making the Glass available, not directly. SF/Boston-based partner Brain Power wasn’t mentioned in Mr. Kothari’s blog, but their AI/VR applications for brain conditions such as autism and TBI, as well as other uses such as clinical trials and care for older adults. mHealthIntelligence interviewed Augmedix’s CEO Ian Shakil, who notes that Glass still needs improvements in battery life for the hard work of documenting patient visits.

Update: An interesting comment on this via Twitter. The paper is from 2015 but the regulatory and privacy questions around recording patients and information remain. Augmedix does state on its website that it is HIPAA compliant.

 
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/07/Glass-Twitter.jpg” thumb_width=”250″ /]

Telemedicine, payment parity finally are ‘perfect together’ in New Jersey

The years-long telemedicine battle in the populous state of New Jersey–the ever-contradictory home of history, high taxes, ‘the Boss’, Newark Airport, and some of the world’s finest beaches and resorts–has finally concluded with a strong win. Last Thursday, the NJ Legislature unanimously passed two bills that set telemedicine practice and payment standards. The General Assembly passed A.1464 and then hours later, the State Senate passed its bill (S.291). Governor Chris Christie had already indicated his support and his signature is expected once both bills are formally reconciled. The new regulations will be effective immediately.

The bill defines telemedicine as doctor-patient two-way videoconferencing and store-and-forward technology, omitting audio-only, email, texting, and fax as usual on the consults. Telehealth is defined as communications technologies including remote patient monitoring and telephone to support clinical health care, provider consultations, and health-related education. No pre-qualifying in-person visits are required to establish a “proper provider-patient relationship” except for conditions requiring treatment with Schedule II controlled dangerous substances. Another exception is for unpaid consults in the wake of an emergency or disaster–something that NJ is experienced with, having been hit hard in the past by hurricanes.

Healthcare providers (inclusive of doctors, nurses and other healthcare professionals) must be licensed in the state and telemedicine/telehealth organizations must register with and submit reports to the Department of Health. A seven-member Telemedicine and Telehealth Review Commission will be set up within six months and will review DOH reports that contain de-identified data on usage, diagnostic code, and payment. These public reports could provide valuable insights on the efficacy of telemedicine and telehealth treatment.

The bill includes full parity of telemedicine payment with in-person visits for both public (Medicaid, state benefit plans) and private insurance plans. There is also parity of a different type affecting mental health providers, with mental health screeners, screening services, and screening psychiatrists not being required to obtain a prior authorization or a waiver prior to engaging in telemedicine and telehealth. (more…)

Tender Alert: Scotland Excel, Leeds, London/Manchester, Thurrock

Our Eye on Tenders, Susanne Woodman of BRE, has a new batch for your telehealth business consideration. (Thank you, Susanne!)

  • Scotland Excel: A Prior Information Notice (PIN) for suppliers of “digital dispersed alarm units that communicate information digitally between alarm unit and alarm centre”. They are invited to note interest to Scotland Excel and to demonstrate what digital equipment they can currently offer, including any relevant peripherals, such as alarm triggers. The estimated date for the contract notice is February 2018. More information on Public Contracts Scotland.
  • Leeds City Council: A £400k contract for telecare equipment is on offer for North East, Yorkshire and The Humber. This includes alarm units, fall detection, pendants, multiple sensors, and more. It is a 12 month framework with approval obtained to re-procure for the following two subsequent years, expiring 31st March 2020. Submit by 17 July. More information on Gov.UK.
  • General Medical Council, North West (Manchester) and London: An unusual tender for research comparing UK health regulators to counterparts in overseas countries (i.e. Canada, US, Australia, New Zealand or European member states). This covers the regulation of doctors, other healthcare providers (e.g. pharmacists) and healthcare services. Submit by 17 July. More information on Gov.UK.
  • Thurrock Council: This is for community alarm telecare monitoring and administration platforms, with all associated hardware required. Value stated is £100k – £500k, and contract ends 31 July 2021. Submit by 17 July. More information on Gov.UK.