28 minute read
INTERVIEW
Serving older adults and caregivers Dawn Simonson Metropolitan Area Agency on Aging
Please describe how the Metropolitan Area Agency on Aging (MAAA) was started.
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MAAA began in 1973 as a program of the Metropolitan Council in response to the Older Americans Act (OAA). The federal government created the OAA to address the nutritional and social needs of older adults that began to emerge with extended longevity. We became an independent nonprofit in 1994.
Please tell us about the Older Americans Act and how it informs your policies.
The Act was created in 1965 by Congress, the same year as Medicare. The two programs provide funding streams and policies to deliver social services and health care across the nation. Along with Social Security, the OAA and Medicare are our nation’s compact with older citizens for health and security in old age. OAA services and programs are aimed at helping older adults live independently in their homes and communities. This orientation has helped to spur a strong network of provider organizations that make it possible to be safe and cared for at home rather than in an institutional setting—which matches peoples’ desires and is the most cost-effective way to live.
How has your mission changed over time?
Our mission has expanded. We help people optimize health and well-being as they age, focusing on low-income older adults and those who face social inequities. Our work complements clinical health care, addressing the 80-plus percent of health that happens outside the clinic. We provide home-delivered meals, transportation, care management, chore services, evidence-based health promotion programs, and caregiver support through a network of service providers. We also provide consultations on Medicare, housing, and financial support and act as consultants to other organizations, helping them seek funds and design services.
How has the Minnesota Elder Care and Vulnerable Adult Protection Act impacted your work?
We report suspected abuse and neglect as directed under the provisions of this Act when we learn of it through our interactions with older adults and others. This reporting occurs primarily in our service as the state of Minnesota’s partner in providing Senior LinkAge Line services. Our staff—most of whom are social workers and human services professionals—are ultimately concerned with the health and safety of the older adults we serve.
What can you tell us about how MAAA works with state agencies serving older Minnesotans?
The Minnesota Board on Aging gives our nonprofit organization the designation of “Area Agency on Aging.” We partner with them to administer OAA and state funding. They guide MAAA’s Area Agency on Aging work and hold us accountable for the public funds we manage. We also work with the Minnesota Department of Health (MDH) to bring evidence-based healthy aging programs to people across Minnesota.
Please tell us about the Live Well at Home program.
Live Well at Home is a funding program of the Minnesota Department of Human Services (DHS) to encourage expansion of services to support older adults living in the community and their family caregivers. We help organizations in the Twin Cities prepare their proposals to align with the objectives of DHS.
What does the Juniper program do and how can physicians become involved?
Juniper offers classes across the state to help older adults take an active role in maintaining good health—something we all desire. We collaborate with the other six AAAs in Minnesota, 130-plus health care and community organizations, and health plans to deliver classes that help people manage chronic conditions, get fit, and prevent falls. People who take the classes report eating healthier, increasing physical activity, working more effectively with their health care professionals, and feeling better. They also form ties to other older adults and learn about community services that can boost their well-being. The classes are beneficial for people with diabetes, high blood pressure, heart disease, COPD, arthritis, depression, fall risk, and other health conditions.
In response to the COVID-19 pandemic, we now offer Juniper classes using HIPAAsecure video conferencing. People are changing their routines, are at increased risk for isolation, and many are skipping their regular medical appointments for fear of contracting the coronavirus. Chronic conditions can easily get out of control in this situation. Participants have found that online classes work well. In some cases, attendance has been higher and more consistent than with our in-person classes. People love that classes such as a Tai Ji Quan: Moving for Better Balance or Living Well with Diabetes are now available online for everyone, anywhere in the state. One participant in the Living Well with Chronic Pain class told the instructor how grateful he was that he could attend virtually.
We know that people are more likely to participate in a Juniper class if their physician recommends it. Physicians can help by referring patients to classes through our portal at yourjuniper.org or by giving their patients our web address (https://metroaging.org) or toll-free phone number (855-215-2174). Most classes are free or low cost, and some health plans also cover the cost. A second way to get involved is to consider becoming an advisor to Juniper. We welcome input from physicians.
Physicians serving older patients may not be aware of how your work can help their patients stay healthy. Please share some ways of improving this communication.
We’d love to have physicians think about us as their partner in keeping people healthy. Through our networks, we connect patients with services and programs that will help them maintain and follow treatment protocols. We are happy to provide information tailored for physicians, including webinars, short in-person presentations, and written materials, both for provider and patient use.
What are some of the biggest challenges to your work related to COVID-19?
As an administrator of federal funds, including over $6 million in the Families First Coronavirus Response Act and CARES Act funds, we need to stay tuned to the most pressing needs of older adults and their family caregivers and be highly responsive. It’s our job to maximize the investment of these resources for the greatest impact. We are seeing increased need for home-delivered meals, caregiver support, and alleviating isolation. We project that we will double the OAA dollars we provide to community partners this year for homedelivered meals compared to last year, and we do not expect the demand to diminish any time soon. When Adult Day Centers were ordered closed by the Governor in late March, we saw a spike in demand for caregiver services as family caregivers were called upon to provide full-time care. Our partners have stepped up to meet the changing needs, often by designing and delivering new services such as telephone reassurance or by expanding existing services. We have seen powerful new partnerships form, such as one between Metro Meals on Wheels and Afro Deli. Together they provided over 12,000 halal home-delivered meals during April, an option that was previously not available.
What final thoughts you would like to share with our readers?
Research published by Health Affairs in April 2020 attests that when health care providers partner with AAAs, older adults have improved health outcomes and reduced percapita health care spending. MAAA has the interest and capacity to engage in partnerships with physicians to address the health-related social needs of older adults. We’ve learned your language, meet requirements for data security as a HIPAA-covered entity, and can bring resources to the table that respect both data and what’s important to older adults. Connect with us to innovate together to improve the health of your patients and our communities.
Dawn Simonson is the executive director of the Metropolitan Area Agency on Aging, a nonprofit that serves both older adults and caregivers.
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3 Institutional racism in medicine from cover
article, including a handful of personal experiences. These world-class professionals join me in this commentary to address what remains America’s single biggest unsolved challenge. was a document with implications for African-Americans, leading to the closing of historically Black medical schools, leaving just two in the nation. African-Americans were excluded from the institution of medicine, leaving Blacks vulnerable to institutional abuses in health that facilitated distrust and disenfranchisement.
A historical perspective The lack of trust among Blacks for the Before the Civil War, very few Blacks graduated American health system was substantiated over from American medical schools—perhaps fewer time by unscrupulous research, such as the use of than two dozen. Most Black doctors at that time cervical cancer cells from Henrietta Lacks without learned through apprenticeship. Despite their permission after her death, the Tuskegee Study, scarcity, the benefits of Black doctors treating Black patients were already evident, both in terms Blacks were forced to form their own medical organizations. and many other projects that have treated Black Americans disrespectfully and even inhumanely. of Black doctors better understanding medical While the 14th Amendment presumably issues prevalent among Black Americans and in established racial equality in 1868, it did not their being more receptive to treating members of address discrimination, segregation, or many of the Black community. the fundamental seeds of racism. For instance,
After the war, opportunities began developing White medical schools had no directive to accept for Black students, almost exclusively male, to attend medical school. Black students, and few did. Established in 1867, the Howard University College of Medicine was the In 1896, the Supreme Court’s Plessy v. Ferguson decision upheld the racist first all-Black medical school. By 1910, a survey of medical schools known concept of “separate but equal.” Segregation of public schools was not found as “The Flexner Report” identified over 150 medical schools nationwide, unconstitutional for another half-century in the 1954 Brown v. Board of including Black-only medical schools. Education decision that itself took over 15 years to take full effect. These past
The Flexner Report was intended to standardize medical education and actions on society established institutional racism in every sector, and health increase physicians’ quality in the United States. Despite good intentions, it care was not immune.
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Blacks were forced to form their own medical organizations, such as the National Medical Association, when prevented from joining White organizations, namely the American Medical Association. The cover of the first journal of the National Medical Association, in 1909, clearly stated: “Conceived in no spirit of racial exclusiveness, fostering no ethnic antagonism, but born of the exigencies of the American environment.” Even today, the challenges that influence whether Black students matriculate or apply to a medical school program remain multifaceted. They include financial cost, bias and stereotypes, imagery and career attractiveness, and underperforming precursor schools. Statistical trends confirm our nation’s inability to attract and sustain a diverse physician workforce. When the Flexner Report was released in 1910, Black doctors’ proportion to the Black population in the United States was 2.5%. In 2019 it was 5.0%. The most current data at the University of Minnesota Medical School for 2020 shows 3% Black enrollment.
From institutional to personal—Dr. Zeke McKinney
For health care workers, discrimination is still prevalent. One thing in particular that remains a problem is placing Black or underrepresented professionals in positions of authority. While it is appreciated and admirable for employers to address issues of diversity and inclusion, it sends an inverted message when the time and energy required to manifest these intentions is not allocated.
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Unfortunately, this same degree of obtuseness can exist in terms of understanding the context in which underrepresented minorities can experience discrimination with respect to their workplace performance. Underrepresented individuals may be seen as “oppositional” in workplace interactions when speaking up, even when they do so appropriately. The latitude offered others—such as not being disciplined when frequently late—may not be offered to minority employees.
Even outside of workplace performance, social interactions for harassment, the message I communicated was loud and clear: my feelings underrepresented individuals that intersect with workplace culture can be and experience were not valued. challenging. For example, there is a common practice of workplace teams I continue to explain to well-meaning White colleagues that racism still going out for “happy hour” meetings. This can result in excluding those exists, is systemic, and impacts them. I have grown tired of justifying my with religious beliefs that include abstaining from alcohol. experience as a Black woman, as a mother of two Black men, and as a
Additionally, many underrepresented professional. There is no current or future cultural professionals (including myself) almost always competency course that will change someone’s dress extremely professionally, always wearing heart—and we need to change hearts. a tie or dress shoes. I had experienced several independent instances where workplace colleagues A systemic issue—Dr. Charles Crutchfield saw me outside of work, when I was dressed in Discrimination remains As a senior medical student, I did a surgical street clothes, and heard “Wow! I didn’t recognize a prevalent problem. rotation at a southern institution with a large you; you look like a thug (or hood or gangster).” hospital. On one occasion, I assisted on a
Lastly, a common challenge remains in how operating room, one of the nurses came up to me Blacks and other underrepresented populations abruptly. She wagged her finger in anger and said, fear or hesitate to engage institutional structures. “This is the last time I’m going to tell you this. This hesitation also exists in the area of bringing Pay attention to the corners!” about those concerns to leadership when they arise. A double-edged sword?—Dr. Dione Hart At the end of the case, the surgeon said everything had gone very well, telling My home is Chicago, one of the most segregated cities in the world, so I me, “Thank you for your help. Nice job.” I wondered, “Why would a nurse have personal experience with racism. Yet I honestly believed racism would criticize me when the surgeon did not?” Did parathyroidectomy involve not be overt in health care. “corners” that I didn’t do correctly?
That changed when my brother Michael died of complications from an aortic dissection. After collapsing at work, Michael waited for hours in an emergency department with classic signs. After an excruciating wait, he was sent home by providers who determined he likely had a kidney stone. While preparing for a follow-up primary care appointment, Michael died from cardiac tamponade. When his heart stopped, he fell with only a towel around him as if he’d just stepped out of the shower.
Michaels’ death led to me leave Chicago to train at the Mayo Clinic. I committed myself to becoming one of the best physicians, one who would never make such a serious misdiagnosis as the one that led to my brother’s untimely death.
Although my overall experience as a resident was outstanding, there were dark moments. For example, I would be mistaken for the interpreter or directed to leave a patient’s room because visitors were not permitted after hours.
I had also been told by a colleague that they felt threatened when I shared a critical statistic about an African American woman whose case was left out of a presentation. As an attending physician with authority, I have encountered other experiences that were not mere professional slights, but “blows to the gut” that made me feel helpless and hopeless.
On my first day on call as an attending physician, a nurse told me she was so happy I was on staff and “tickled pink” that I spoke English. I learned to live with such microaggressions to avoid retaliation until things got out of hand.
My supervisor threw objects at me during rounds, regularly yelled at me, and reportedly called me an n-word b**** in my absence, telling others she did not know how to “control” me. While the administration never told me directly what had happened, a union representative informed me of the incident. She was never again my supervisor, and although temporarily relocated to a different office, she was suddenly back working in the same building as me without notice. After years of dealing with constant parathyroidectomy, and as I was leaving the I had no idea what she was talking about, and I was utterly dumbfounded.
Institutional racism in medicine to page 124
3 Institutional racism in medicine from page 11 attending surgeon and I waited for drying towels. He was given a towel, but I was asked why I was just standing there and instructed that the garbage
Returning to the main locker room, I passed two more operating rooms, was in the corner. On another occasion, a woman at a restaurant assumed I one with a janitorial crew of two African American men and two Hispanic attended community college. When I said I did not, she told me that it was men, all wearing surgical scrub suits. One of them was methodically never too late to get an excellent education. I chose not to clarify that I was mopping the corners. It hit me like a brick: my skin already a medical doctor. color led the nurse to assume I could not have been I also painfully recall going for a second part of the surgical team. I became so enraged that opinion to a local facility with my mother-in-law, my face felt as if it was on fire. I went to find her to who had been recently diagnosed with mantle cell let her know that I was a medical student and part of lymphoma. The physician walked in, saw five family the surgical team. Thankfully, I did not find her, as I would have said something that would have gotten We need to change hearts. members, read an erroneous note on my motherin-law’s chart indicating she did not speak English, me in big trouble. and said, “Oh no, not another one to slow down my Racism is a culture shock—Dr. Inell Rosario day.” I reassured him that we all spoke English and Enrolling at Macalester College at age 16, I would translate for her. That was the only time I expected all the White people there would be ever threw out the “I’m a doctor” card, but it made wealthy, since many Whites in the Bahamas were no difference. He never apologized or changed his when I was growing up. I did not expect they attitude toward us. would judge my intelligence or even the propriety of who I chose to date Because of my upbringing and faith, these incidents have not rocked based on my complexion. my self-confidence or made me bitter. Even amid current racial unrest, I’m
Throughout my education, classroom professors often had a difficult confident we will move forward. There are many good people of all races, time distinguishing me from another Black female student, even though we and we need to create the narrative. Character, capability, and chemistry had no significant resemblance. I also did not expect the continuing parade have no color. of racially offensive encounters I would face over time, even as a medical Overall I see myself as a doctor who also happens to be a Black student. For instance, after scrubbing for a case during my residency, the woman. I want to treat patients of all ethnicities and see their differences only in a manner that allows me to connect with them to provide patientcentered care. I will continue to do my part in educating my colleagues so that we enable all physicians to take care of all patients irrespective celebrating 30 years of providing of color.
creative planning & design solutions for efficient, patientWhere are the black health care executives?—Dr. Tamiko Morgan
centered healthcare environments It is not for lack of capable and qualified individuals that so few African Americans hold positions as executives and on boards of health insurance companies, health systems, and hospitals. An unwelcoming and dismissive culture contributes to qualified professionals from underrepresented populations often hesitating to bring concerns to management or seek leadership positions within dysfunctional institutional structures. A culture that fails to address these systemic issues—which could be done in many simple ways—only perpetuates them.
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I remember it as if it were yesterday: “This is Dr. Morgan. She is my boss now.” These were the words of the company’s former chief medical officer, a White male who introduced me to the group of health care C-Suite executives I would be working with. His stern introduction appeared to be some sort of rite of passage.
As I took my seat at the table of White men, most at least 20 years my senior, the voices of welcome were drowned out by the daunting realization of loneliness that accompanies leadership as an African American. The reality of seeing and realizing how few people who looked like me in these leadership spaces was inevitable.
Disparities in health care leadership and governance opportunities have been attributed mainly to racial discrimination and bias. While African Americans and other non-Whites have increasingly gained a seat at the table in diversity and inclusion positions, their presence in top leadership positions
in health care organizations, such as the C-suite, boards of directors, and through actions that are intentional, measurable, sustainable, and reflect the senior management, is lacking. For the few who do attain such positions, institution’s visions, mission, and guiding principles. their voices are often silent due to fear of an unjust backlash that comes from failing to conform. They have the title without the power and the pressure to Changes to make a real change work twice as hard to be respected. To make real change the actions must be intentional, measurable, sustainable,
I had the painful experience of backlash from a and guiding principles. We must require health care trusted mentor after a promotion. The promotion corporate leaders and executives, as well as those in was not worth the daily microaggressions and academia, to take a deep look and dive on why and attempts at sabotage, but I stood strong. Others have how to implement systemic change. We must construct been passed up for promotions, commonly described My skin color led the nurse to health care systems and medical school policies, in the minority community as the classic case of assume I could not have been practice from an anti-racism lens, and implement “training and doing the work for the inexperienced part of the surgical team. accountable action. Some areas to address first include: White male colleague who received the promotion.” White privilege acts as a pass that grants those who Requiring Predominantly White Institutions are part of an informal network unique opportunities (PWI) to recruit, matriculate, hire, and retain Black but leaves others feeling left out. students, staff, and faculty and create safe spaces
During my career, several African American these environments. leaders have shared their stories of being labeled as “unsociable,” “unfriendly,” or “overly sensitive” when their participation in a Providing opportunities to mentor Blacks and offer role models. system that has been socialized as being right is questioned. It’s a heavy burden Investing in pipeline programs. to feel that your performance is judged at a microscopic level based on your Teaching about health disparities within the medical school curriculum. skin color. This is what White privilege and racism in the workplace looks like.
It’s disheartening to see organizational charts full of faces in leadership who don’t look like you. Recruitment and retention for African Americans Teaching future physicians on how to be culturally competent and anti-racist. and other non-Whites in these positions need to be strengthened. This Institutional racism in medicine to page 344 happens best through policies put in place and enforced rather than being left to chance. Like many, I felt confident in my ability to do the job when given the opportunity and the resources to succeed. Sadly, this opportunity is not granted for most due to the color of their skin.
An unprecedented moment?—Dr. David Hamlar and Mary Tate
Black men were counted as two-thirds of an American citizen under the Constitution. The Civil War nearly destroyed the Union. We endured the Jim Crow era, countless lynchings, and riots in the 1960s and the 1990s— and we continue to see racial inequality and disparities in all facets of American life. None of these events was considered “unprecedented,” so why is this moment any different?
We continue to struggle to enroll underrepresented students in our medical schools, to demand equal access to medical care through programs such as the Affordable Care Act, and to seek funding for clinics and hospitals in communities of color that are patient-centered and culturally sensitive. Despite all of the barriers, Minnesotans of color have managed to find a way to survive, but at the cost of nation-leading health disparities.
By any other name, this is systemic racism, which has led recently to street protests involving all demographics. Black people are underrepresented in the composition of CEOs of area hospitals, Fortune 500 companies, the state government, and within the police departments themselves. By holding them all accountable in this moment of recognition, admitting that systemic racism exists, and working toward the engagement of White America, we can make a real effort to change.
As a start, we must 1) construct health care systems and medical school policies, practices, and procedures from an anti-racism lens and implement accountable policies, practices, and procedures; and 2) make real change and embedded in the institution’s visions, mission, for Black individuals to be supported and thrive in Preparing all students to work in diverse health care systems and communities.
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3 The seeds of a revolution from cover
To support Medicare beneficiaries receiving telehealth services, the federal government in March announced expanded coverage. The Centers for Medicare and Medicaid Services (CMS) issued Medicare 1135 waivers intended to provide regulatory flexibility for providers and enhanced utilization by patients—but those waivers may not continue after the pandemic.
Key elements of the waiver
Under its 1135 waiver—the section of the Social Security Act that enables waivers during public health emergencies—CMS chose to enact the following key components:
• Expanded list of eligible telehealth practitioners that includes all those eligible to bill Medicare for professional services (includes physical therapy, occupational therapy, clinical social workers, etc.)
• Originating site of telehealth visit can be patient home or residence
• Expanded geography allowed for all telehealth visits including both rural and urban settings
• Use of expanded list of 80+ telehealth available procedural codes
• Payment parity for audio-only telephone visits
• Use of Place of Service (POS) billing code where patient would have been seen
• Provider licensure flexibility to practice in every state (subject to state licensure rules)
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• Audio-only virtual communications allowed for certain services
• Use of non-HIPAA compliant technology platforms
• Allowing critical access hospitals (CAH) and rural health clinics (RHC) to be originating sites
This massive, unexpected experiment in the use of technologies, processes, and role adaptations—sparked by the pandemic—removed barriers and accomplished in a few short months what otherwise would likely have taken years.
The future of waivers
In June, Stratis Health conducted a new survey of Minnesota health systems to prioritize components of the Medicare 1135 waiver that should be continued. Results in ranked order, along with benefits cited by respondents:
Maintain the expanded list of eligible telehealth practitioners that includes all those eligible to bill Medicare for professional services (includes physical therapy, occupational therapy, clinical social workers, and others). Benefit: broader set of practitioners can bill Medicare for telehealth.
Originating site of telehealth visit can be patient home or residence. Benefit: Ability to do telehealth visits in patient homes/residences.
Expanded geography allowed for all telehealth visits including rural and urban settings. Benefit: opens up urban settings for telehealth visits.
Use of expanded list of 80+ telehealth available procedural codes. Benefit: broader set of services and access allowed for telehealth visits.
Payment parity for audio-only telephone visits. Benefit: supports cases where telephone is the only option for remote visits.
Use of place of service (POS) billing code where patient would have been seen. Benefit: improves telehealth reimbursement for providers.
Provider licensure flexibility to practice in every state (subject to state licensure rules). Benefit: broader access to specialists across states.
Audio-only virtual communications allowed for certain services. Benefit: supports cases where audio is the only available method for remote visits.
Use of non-HIPAA compliant technology platforms. Benefit: allows for more options for patients/families to connect to providers.
Allowing CAHs and RHCs as originating sites. Benefit: broader access to telehealth in rural communities.
Survey respondents also suggested including pharmacies as eligible telehealth clinicians and allowing FQHCs and RHCs as eligible originating sites. These items had not been included in the Medicare 1135 waiver.
The results of the Stratis Health survey have been shared broadly across Minnesota, including with legislators, health care associations, the Minnesota Department of Health, Minnesota Department of Human Services, and health systems. Survey results were serendipitously underscored by a 3-page letter sent to the Senate and House of Representatives minority and majority leaders supporting permanent enactment of telehealth waivers and exceptions. This national letter was signed by 340 organizations including EMR vendors, health care associations, and integrated networks, as well as to payor organizations.
Legislation
The bipartisan Enhancing Preparedness through Telehealth Act—proposed by Minnesota Sen. Tina Smith and three other senators—requires an
inventory of telehealth readiness to anticipate and prepare for future needs (https://tinyurl.com/mp-legislation-01). The legislation recognizes that there are many lessons learned from the use of telehealth during the current pandemic, and seeks to put in place a five-year reporting cycle (conducted by the Department of Health and Human Services) to inform readiness steps for any future public health emergency. The recurring report will:
Conduct an inventory of telehealth initiatives in existence, including their capacity to handle increased volume during the response to a public health emergency;
Identify methods to expand and interconnect regional health information networks and state and regional broadband networks;
Evaluate ways to prepare for, monitor, respond rapidly to, or manage the events of a public health emergency through the enhanced use of telehealth technologies;
Promote greater coordination among existing federal interagency telehealth and health information technology initiatives; and
Make recommendations related to updates on the use of telehealth in public health emergencies in federal and state public health preparedness plans and any actions taken to implement such recommendations (https:// tinyurl.com/mp-legislation-02).
Other lessons
In response to COVID-19, health care organizations responded quickly with adapted workflows to make the sudden shift from in-person encounters to telehealth visits. The urgency of the pandemic did not allow for typical planning cycles, budgeting, or systematic implementation steps. Rapid implementation was essential. Some organizations that had telehealth
Suggested links
Great Plains Telehealth Resource and Assistance Center: gptrac.org/ Long-Term Care Telehealth Toolkit: tinyurl.com/mp-tele-02 National Consortium of Telehealth Resource Center Covid-19 Toolkit: tinyurl.com/mp-tele-03 Rural Telehealth Toolkit: tinyurl.com/mp-tele-04 Telehealth Toolkit for General Practitioners: tinyurl.com/mp-tele-05 Telehealth Toolkit for End-Stage Renal Disease Providers: tinyurl.com/mp-tele-06 President Trump expands telehealth benefits: tinyurl.com/mp-tele-07 Medicare—telemedicine fact sheet: tinyurl.com/mp-tele-08 Medicare telehealth FAQ’s: tinyurl.com/mp-tele-09 HRSA Telehealth Toolkit: tinyurl.com/mp-tele-10 CMS Medicare Telehealth Services: tinyurl.com/mp-tele-11 Center for Connected Health Care Policy: www.cchpca.org/ Rural Telehealth Research Center: tinyurl.com/mp-tele-12 NQF tele-behavioral health guide: tinyurl.com/mp-tele-13b
programs quickly scaled them up, while others new to telehealth had to learn and adapt to new ways of delivering patient care remotely.
Many organizations have now shifted from this hurried response to one of more deliberate planning, role redefinition, and longer-term visioning for the best use of telehealth tools. Health systems are now determining which patients are likely to benefit the most from long-term telehealth services. With provider and patient satisfaction high, telehealth options are likely to reshape health care long after the pandemic passes.
Before COVID-19 hit and the Medicare waivers were announced, Minnesota health systems identified their top challenges: educating staff and physicians on telehealth workflows; scaling up issues related to equipment availability and deployment; understanding coding/billing to obtain appropriate reimbursement; and facilitating/supporting telehealth encounters with patients.
Join the dialog
We recommend that you contact your state senator’s or representative’s offices to advocate or provide input on telehealth policy. To learn more, interested physicians can contact Sue Severson at Stratis Health.
Bill Sonterre, strategic account executive at Stratis Health, is a senior health information technology leader and business consultant.
Reid M. Haase, MHIM, is program manager and health IT consultant at Stratis Health.
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