Here's a link to a high quality webinar from AmericanWell about telehealth (see: A Guide to Integrating Cross-Continuum Telehealth into your Health System). Starting at about 11:00 minutes in the recording, the discussion turns to new CMS telehealth reimbursement guidelines for FY2019 that include new services such as remote patient monitoring (see: CMS to Reimburse Providers for Remote Patient Monitoring Services). Another new type of service that will be reimbursed is provider-to-provider consultations (see: CMS wants to expand telehealth coverage. Here's what that means for you). Here's the key passage from this latter article relating to provider-to-provider consults:
Internet-based inter-professional consultations: New reimbursement for provider-to-provider consultations via online messaging applications or portals. Both the initiating physician and the consulting physician would be eligible for reimbursement.
I have previously covered diagnostic management teams (DMTs) in Lab Soft News (see, for example: Deploying a DMT at the Front-End of Lab Orders for a Complex Patient). One of the challenges for DMT's in the past has been the lack of reimbursement.There is now a ray of light with CMS-approved reimbursement for provider-to-provider consultations which accurately describes the DMT process. A team of expert diagnosticians provides advice to a clinician caring for a patient about the ordering and interpretation of complex laboratory tests. There are, of course, additional benefits attributable to such consults such as decreased medical errors and decreased length of stay but at least some degree of reimbursement can provide an incentive for launching a DMT team in a health system.
Does a DMT consultation fall under the general rubric of telemedicine? First of all, I think that collaboration between the members of a DMT, even within the confines of a single hospital, will often take place via telephone or a video call. Secondly, discussion of the case between members of the team and with the consult-ordering clinician may often be more effective using video calls. Plans are now underway in collaboration with Sunquest and Epic to develop an app that will work in the following way after a DMT consult has been ordered: (1) enter the name of a patient into the LIS; (2) select the organ and/or disease state driving the DMT consultation; (3) the app will then interrogate the lab and EHR databases and generate a report with all of the relevant lab test results and clinical findings for the patient that will form the basis for the DMT report.
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