Use Of Telemedicine For ED Physician Coverage In Critical Access Hospitals Increased After CMS Policy Clarification

Ward, Marcia M.; Merchant, Kimberly A S; Carter, Knute D.; Zhu, Xi; Ullrich, Fred; Wittrock, Amy; Bell, Amanda

doi:10.1377/hlthaff.2018.05103

Cited by 21 publications

(13 citation statements)

References 14 publications

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“…Therefore, less populated and more rural areas would need to rely on telehealth to cost-effectively bring needed services into hard to staff areas. 31 Furthermore, hospitals located in more competitive areas and those that received a greater percentage of reimbursement from private payers were associated with a higher level of hospital telehealth adoption. 4,22 Other hospital characteristics were found to significantly influence the provision of telehealth.…”

Section: Discussionmentioning

confidence: 99%

“…Although our research is in contrast to a previous study that found hospital competition was not associated with telehealth adoption, it did support other studies that hospitals located in less competitive areas were more likely to adopt telehealth. 3,31,32 Hospitals in less competitive markets are more likely to lack the specialist resources than that of more highly populated and competitive areas. Therefore, less populated and more rural areas would need to rely on telehealth to cost-effectively bring needed services into hard to staff areas.…”

Section: Discussionmentioning

confidence: 99%

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Telehealth: Advances in Alternative Payment Models

Zhao

Hamadi

Haley

et al. 2020

Telemedicine and e-Health

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Introduction: The hospital sector has shifted its focus to advanced information and communication technologies to facilitate health care delivery through telehealth services to alleviate the industry's most pressing challenges in quality care and access, especially under changing reimbursement payment approaches. The aim of this study was to examine the association between alternative payment models (APMs), market competition, and telehealth provisions in the hospital setting. Materials and Methods: A secondary cross-sectional design to analyze 2018 census data of nonfederal short-term acute care hospitals in the United States was used. Multilevel logistic regressions models were used to analyze data from 4,257 hospitals across 1,874 counties. Counties with less than one hospital were excluded. Results: Regarding APMs, we found that hospital participation in accountable care organizations and participation in a bundled payment risk arrangement are significantly associated with the provision of telehealth services. From the market perspective, competitive advantage was found to be statistically associated with hospitals providing telehealth services. In addition, other hospital characteristics such as ownership, part of a system, part of a network, and major teaching affiliation also have impact on the provision of telehealth. Conclusions: The increase uptake of telehealth-related capabilities and their strong integration into care-delivery systems under APMs present exciting opportunities to enhance the merit of clinical care, and challenges as clinical professionals are not adept to using such technologies. There is a need to provide comprehensive of evidence on telehealth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Telehealth: Advances in Alternative Payment Models

Zhao

Hamadi

Haley

et al. 2020

Telemedicine and e-Health

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“…[22][23][24] When traditional physician recruitment is insufficient, telemedicine has been reported to assist with rural physician coverage in an emergency setting. 25 In an era of digital diagnostics (e.g., photography, live video, lab results, audiogram, video otoscopy, tympanogram, endoscopy) evaluation by a remote otolaryngologist is becoming more practical. 26 Philips et al recently examined the financial feasibility of telemedicine in otolaryngology and found significant cost savings for both patients and the healthcare system.…”

Section: Discussionmentioning

confidence: 99%

Rural–Urban Disparities in Otolaryngology: The State of Illinois

Urban

Wojcik²,

Eggerstedt

et al. 2020

The Laryngoscope

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Objectives/Hypothesis To highlight rural–urban disparities in otolaryngology, and to quantify the disparities in access to otolaryngology specialist care across Illinois. Several studies across disciplines have shown increased prevalence and severity of disease in rural communities, relative to their urban counterparts. There is very little published quantifying a disparity in rural access to otolaryngologists. Study Design Population study. Methods Counties in Illinois were classified based on urbanization level on a scale from I (most urban) to VI (least urban) using the 2013 National Center for Health Statistics (NCHS) Urban–Rural Classification scheme. The six urbanization levels include four metropolitan (I–IV) and two nonmetropolitan levels (V and VI). The name and practice location of all registered otolaryngologists in Illinois were collected using the American Academy of Otolaryngology website (http://entnet.org). Population data were recorded from the most recent US Census (2010). Results Two hundred seventy‐eight academy‐registered otolaryngologists were identified in Illinois. One hundred fifty‐one of these providers were located in a single county categorized as a level I by the NCHS scheme. There are over 18,000 square miles and 600,000 persons living in NCHS level VI counties in Illinois with zero registered otolaryngologists. Overall, metropolitan counties (I–IV) averaged 1.32 otolaryngologists per 100,000 population, whereas nonmetropolitan counties (V and VI) averaged 0.46 otolaryngologists per 100,000 (P < .01). Conclusions There is a paucity of academy‐certified otolaryngologists with primary practice locations in rural counties of Illinois. There is a significant rural population and massive land area with limited spatial access to otolaryngologic specialist care. Level of Evidence NA Laryngoscope, 131:E70–E75, 2021

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“…However, there has been little exploration of ED adoption over time, the role of policy in ED adoption, characteristics of EDs that are using it, how it is used, and how it impacts patient care and outcomes. 23,24 It is important to acknowledge that the optimal rate of telemedicine receipt among US EDs is unknown. Many EDs have comprehensive resources and no need for telemedicine receipt; these EDs may even provide telemedicine services to others.…”

Section: Importancementioning

confidence: 99%

Factors associated with emergency department adoption of telemedicine: 2014 to 2018

et al. 2020

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Objective: Telemedicine is used by emergency departments (EDs) to connect patients with specialty consultation and resources not available locally. Despite its utility, uptake of telemedicine in EDs has varied. We studied characteristics associated with telemedicine adoption during a 4-year period. Methods: We analyzed data from the 2014 National Emergency Department Inventory (NEDI)-New England survey and follow-up data from 2016 and 2017 NEDI-USA and 2018 NEDI-New England surveys, with data from the Center for Connected Health Policy. Among EDs not using telemedicine in 2014, we examined characteristics associated with adoption by 2018. Results: Of the 159 New England EDs with available data, 80 (50%) and 125 (79%) reported telemedicine receipt in 2014 and 2018, respectively. Among the 79 EDs without telemedicine in 2014, academic EDs were less likely to adopt by 2018 (odds ratio, 0.12; 95% confidence interval, 0.03-0.46). State policy environment was not associated with likelihood of adoption. In 2018, all 7 freestanding EDs received telemedicine, whereas only 1 of 9 academic EDs (11%) did. Conclusions: Telemedicine use by EDs continues to grow rapidly and by 2018, >3 quarters of EDs in our sample were receiving telemedicine. From 2014 to 2018, the initiation of telemedicine receipt was less common among higher volume and academic EDs.

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Use Of Telemedicine For ED Physician Coverage In Critical Access Hospitals Increased After CMS Policy Clarification

Cited by 21 publications

References 14 publications

Telehealth: Advances in Alternative Payment Models

Telehealth: Advances in Alternative Payment Models

Rural–Urban Disparities in Otolaryngology: The State of Illinois

Factors associated with emergency department adoption of telemedicine: 2014 to 2018

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