Telemedicine's Future: What PAs Need to Know Post-Pandemic

Co changed so many things in our society and tella health is definitely one of those things patients love it providers love it and it is something that could solve a lot of problems in healthcare but there are so many things that are still question marks so many policies that have to be worked out reimbursement licensing all of those things and I think a lot of providers like me have huge questions about where tell Health stands right now and also what is happening in the hiring landscape for Pas I've seen a lot of people talk about tele medicine jobs going exclusively to nurse practitioners so what is that all about and do Pas actually have a role in telea medicine and do we have opportunities all of those things I'm going to address with my guest today who is highly knowledgeable on this topic she's president of Pas in Virtual medicine and teleah health otherwise known as PMT and she is going to just Enlighten us about the state of teleah health and PAs in teleah health so if that interests you you're definitely going to want to stay tuned hi it's Michelle with the medicine couch thank you for joining me if you like this video please hit the like button share it with colleagues and people who may need this information and leave a comment down below tell us what your experience has been with telea medicine or telea health or maybe some of the challenges that you've been facing all right now let's hear from my very knowledgeable guest hi I'm Sarah Gallow I'm a PA in Denver Colorado and president of Pas in Virtual medicine tele medicine why don't we just kind of dive in and talk about what the current state of tella health is actually right now and and how it's been shaped going through the pandemic yeah so I think one of the biggest things that happened during the pandemic was the large adoption of teleah Health across the United States and the reimbursement of it because I think there is a lot of precursors to tellah health that's that came out before that but overall there was just a large push in order to give access to care best provider what would you say as the advantages of people working in telea health there's a sense of accomplishment that you can provide better access to care but I also think that's just flexibility for providers we really do feel I mean I personally felt limited making patients come in all the time when I felt like there was an established relationship I really wanted to just like throw some pointers out there but I also wanted it to be sustainable for my practice to be able to get paid I also think that overall it's more inclusive and especially rural providers Frontier providers or people seeing resilient populations it really allows for more contingency planning to make sure that they get their access and you can actually see more into their lifestyle and get to better understand what what exactly they're dealing with I mean sometimes it's just that you don't know know don't see kind of a lot of the other distractions or environmental impacts that happen at home knowing all of that stuff is really helpful to just tailor care and then on top of that I think tella Health that can be provided from anywhere as a provider you don't have to be in the state and so it allows for for providers to really expand the access to what their specialty is and allow them to work from home I especially think with the burden of the workforce being so limited out there right now you can definitely at least if you're sick but you just really just don't want to expose patients you can actually still see patients on tele health because you're still able to function and provide care it's just that you don't want to expose patients to that illness that you know again we're human to yeah I also think it reduces the no-show rate I mean a lot of times it's like just give them a call ask them to get on video that's a good point when you got somebody that is no showing and the the front desk calls them and and gives them the option and maybe they do hop on the call really quickly and then you've salvaged that appointment so yeah things like that are good tips to to bring to Administration right more ammunition of why this is this is a good thing to incorporate into the practice and and have it all set up so if you test positive for covid but you're not feeling bad you can still work from home and still see I think it incentivizes us doing what we kind of recommend patients which is don't bring it into the workplace right you know and if you're a provider that maybe is experiencing some kind of disability or having like an acute situation where you need to just adjust the way that you can work I think working from home is really a nice option to be able to provide to our clinicians and tell Health can be done so many ways like it can be your standard practice and you just incorporate a little teleah health or you could be completely 100% teleah Health but still work in an office or you could work from home or you can even start your own business so there's so many options with with teleah health and I think also it just requires less resources so you know you don't need a full staff to do it so you can offer it more outside the regular work hours there's just a lot more opportunity to really kind of practice in really interesting ways you know sometimes I feel very limited as a provider in the current traditional model of how we can actually see patients yeah tele health is definitely something I think that's needed and and wanted by by patients and providers alike yeah and one of the bigger things that I think really need to advance and and there's now a push to move towards more permanency is telea Health policy so licensing availability to be able to practice across the state lines more availability for Medicaid uh State kind of run government plans the PA compact will you just kind of tell people what a compact is and how that helps in health basically the PA compact allows for states that are participating to turn on a license if you have a compact license in their state so you would have a home state that you have your license in and then you have access to be able to add more states that are participating onto your PA I guess credentials to be able to see patients in other states but it's reciprocity so you're not going through the whole full licensing process for the other state it can be done very seamlessly and make it a lot easier for administrators to able to add states to your license especially if you're neighboring with other states that are participating yeah and then that's important in tellah health because as it stands right now you as the provider you have to be licensed in the state that the patient is in that you are seeing right yeah yeah and you can't necessarily see a patient in another state if you don't have that license unless there's specific carve outs for that state because the state has control over who gets to practice medicine in that state where the patient is standing so yeah the licenses are compact so I just want to make sure I understand if you get a a state license that from a state that's in the compact then you go through that whole application one time with the state you're in and then you don't have to go through the individual licenses in the other states they can just like you said be kind of added on I assume you have to pay the normal fees and stuff to get licensed in that state but it just basically cuts down the paperwork time right it standardizes the requirements upfront that are needed to be able to actually kind of get through most of the process but the one thing that um I would say is different from what you explained was that there is going to be a like basically an an agent that actually you apply through not through your state but through an agent as a compact agent and they are the ones that are working to kind of exchange that information with the states that are participating and there's a baseline requirement but there's like you know obviously certain things with you know training we need some CME and some kind of specific topic or you need like a supervising or collaborating agreement those are going to be that supplemental part that you probably will end up still having to do through the state that you also try to get a license in but the Baseline kind of requirements and process that you would do to get your license in a state would be streamlined and all held under one umbrella you also have the same deadline to renew and also it usually is does end up being a little cheaper because the resources on the state side are less that's fantastic I'd love to see all the states eventually you know participate in it do you know when it would go into effect there's about a 24mon kind of timeline you know it could happen sooner but generally that's what they've had in the past is it takes about 24 months to actually get it to the first PA to be able to register and get a license through the compact since the pandemic do you see any organizations medical facilities that are actually scaling back or does it seem like everyone's kind of moving full steam ahead on on implementing tah Health there's a lot that still needs to be done it was tellah Health was really introduced and practices were incentivized in a temporary way and also practices implemented T Health Services in a very temporary way as a means to an end and so I think a lot of those practices are pulling back because there's not a lot in place that's very cut and dry around reimbursement and how it should be documented what is under the scope of a telea health visit but I do see that there is a large amount of like kind of support from the federal government state governments and in general I think investors to really drive more solutions to be focused on access to care so I do think that there's going to be growth and stabilization of just what that telea Health reimbursement looks like because I think right now the fear is that it will be over utilized and it will actually end up being more cost so they're trying to find fee schedule models in order to kind of control those costs because there is overall a budget for Medicare so really trying to hone in on what is really appropriate what's not and then also making sure that programs are fully scaled and built for sustainability and to grow with the technology that comes out so I'm really excited to see what happens but I do think that there will be some inconsistencies for at least like the next two to three years is tahel still operating under like some special reimbursement rules from from covid yeah there's nothing permanently approved through Medicare which tends to be the kind of common denominator that sets the the scale of reimbursement for all the other commercial plans so there is now coming down the pipe which I think also will cause a lot of complexity is new codes that are specifically targeted to tracking those tella Health visits and can just create like maybe a different reimbursement fee that's associated with that a different rvu so the pH kind of waiver is still in place until the end of the year and what PMT and ATA and Center for connected Health policy and Alliance for Health Innovation I think it's called they all are a ating for adding that tella Health to the Medicare budget because that has to come from a federal legislative level and then CMS and the AMA coming up with appropriate codes and appropriate value units that are associated with those teleah Health to keep it going because there is this concern of if it gets undervalued then it's going to also still be Last Resort for most practices do you have concerns for people who are working in teleah health right now or do you think it's got so much momentum that it's that they're going to have jobs in 2025 I guess is what I'm saying yeah no I I definitely think there'll be jobs the one nice thing is that there is patient agency and there's patient patient empowerment and choice and there will always be choice and I think we will continue to innovate and create better patient experiences which also includes tella health I do think that there's an opportunity for providers to find either a place in their own practice where they can be the champion of making sure that teleah Health continues to stay concretely inside their practice ice as an option but I also think that everyone is just going to have to do it at some point because patients are going to expect it I've seen actually just recently some new platforms I mean they're new to me they other people may be aware of them but that make it so much easier to do virtual medicine even if you're like a solo practice or a very small practice like they're not that expensive and they're they meet all the hippoc things and they just make it easy they have the technology out do you envision a time where people go to like a drugstore and they buy a little kit that's got a blood pressure monitor and all these things that just plug into their computer and just sends all the information so we can get vitals and all those things do you see that being something that just everyone has eventually I think that patients appreciate the spectrum of connectivity that uh some of these devices that they would maybe even just have blood pressure cuff at home now they can get a blood pressure cuff that can now also transmit that information to a provider I also think like there's some really good benefits with these more lower Tech things but also then having that video and having that accessibility and engagement from patients is that you can actually watch them use their their device at home and teach them how to do it properly so you can get them reading the right things getting the right numbers and you're actually helping them to troubleshoot when they hit you know they know why it's maybe off I think the biggest barrier to all of it is just the Nuance of healthc care information how it is protected how it is consented to be exchanged and especially cyber security compliance there's just so much more Nuance when it comes to digital uh digital anything but especially digital health I think overall we're seeing just an improvement in technology we're seeing an improvement in in interest uh to get this care delivered and then also a prioritization on the reimbursement and policy side which doesn't always line up so I'm pretty I'm pretty happy to be first of all president of this organization where we can kind of advocate for patients at an industry level and really bring the voice of what Pas want and what Pas can speak from to drive really good policy that also includes us this is actually an opportunity because it is kind of the Wild West for us to stand up and and become a major player and tella Health do you see that for for Pas do you think that we have the opportunity to do that and what are some challenges that maybe we face in in moving in that direction yeah absolutely and I think Pas are part of the um tele Health movement they are stakeholders and they're also a large portion of the accessible Workforce that could provide tele health and I think that the industry given the workforce shortage uh there's been a lot of kind of understanding of what Pas are capable of how important they are to the the healthcare ecosystem and I think that now there's just more of an understanding that we need to actually update our policy and that's one of the challenges we face so you know having consistency across state lines on how things are licensed to practice our full scope and be utilized at the top of our license and I think that is the the key issue is a lot of these telea health organizations or even uh large Healthcare systems that operate in multiple States they're just really having a hard time operationalizing the hiring and the maintenance of Pas as clinicians versus nurse practitioners and Physicians where there's a little bit more clear lines and less administrative burden to maintain those license and to be able to help Pas practice at the top of their license and so there's a challenge there but last month we had 90 uh job postings that we found through our our own research that we post on our job board that included Pas as part of the hiring Workforce or even targeted towards Pas because there is a huge interest in hiring Pas because we do provide exemplary care and I think that the organizations understand that it just it needs to make sense that their bottom line of how much resources it takes to hire them yeah because some of the complexity and the problems that we face is that in Most states we still need a supervising physician but the the problem you can't just have a supervising physician that's going to cover you in all states unless that physician is also licensed in all the states so it it gets complicated we're not just dealing with one license we're dealing with two provids licenses so I'm hearing from people that when they apply to some of these jobs or they inquire why they're only hiring nurse practitioners they're being told it's because of the the licensing and because the nurse practitioners have independent practice in so many states now so it's kind of like I think compact licensure OTP and teleah health all of it is kind of coming to a head and maybe moving along together I think it's making sense with it all coming together for legislators to get behind it but I also realize like if this going to change I have to get involved I have to bring my situation to the table to explain to these legislators or legislators are just getting word of it because they're like why why can't you hire Pas I hear Pas saying that they can't find jobs and then the truth comes out that there's these restrictions that are extremely political when it comes to obviously uh the ability to practice based off our own experience and our own training as Pas as a precedent we've been restricted significantly and it's a lot harder to undo those things versus nurse practitioners they just get licensing approval through their own board Physicians have no control over it and so there's no competing incentives or or goals so I do agree and I think that a lot of organizations that are in control of these these jobs are realizing I get the dynamic now I need this to stop I just want patients to get access to the providers that we believe are the best providers to hire and then same thing I think that it it really puts a risk for the practice when it comes down to if you lose a physician you do you could lose a PA yeah and I I talked to a PA recently who owns a large company and he would love to hire Pas more they have some Pas but their Workforce is heavy in NPS and he says it's it's because they have to for the laws so yeah the the message is that Pas we need to advocate for ourselves we need to be involved with our state organizations and contact our legislators which I used to think was like some big thing like I wouldn't know know how to contact a legislator but if you're involved with your state organization they they spoon feed it to you yeah they give you the email addresses they tell you how to do it it's pretty straightforward so yeah and I think as constituents like any prepa sitting out there they can be part of the solution too to develop more opportunities for our career as well because you're a constituent of that legislator you know not a lot about what these barriers are you're looking to get into the workforce and you want an opportunity to stay in your state and tell your legislator that that needs to be changed in order for them to keep you I also think like one of the big things that we advocate in PMT is actually supporting the states that you hold a license in and speaking to the legislators or at least kind of you know participating in the campaigns in each individual state that you have a license in because you're caring for their constituents and so this is our way that we can advocate for patients and it's been extremely valuable I would also say that tah health is a huge buzzword that legislators really love to talk about it's like something not as political regarding like job opportunity but instead it's about like making sure that you're giving access to care and helping with the overall like generational health of your community and so we can bring in those two really big important factors Under the Umbrella of telea health because we'll have their ears perked they will be interested and then once they realize it's a lot more Nuance they'll be like well if I'm going to get telea health approved I need to know all this other stuff what advice do you have for PAs to to help them kind of push tele medicine forward in their organization maybe if their organization is holding back or if they're in a clinic and they want to kind of be The Driver to start teleah Health what what kind of advice do you have there clinicians in general just tend to be usually the barrier to adoption of any new things and changes into the practice especially when it regards how we deliver that care so I think developing some buyin among your colleagues to kind of really say we want to keep this how do we keep this have those conversations around what really concerns it administrators which is reimbursement um technology like implementing new technology understanding compliance and security and also just understanding the coding and billing that's what we offer to our members and then also within our community is really that guidance of really knowing okay I can really stand behind this recommendation of like these are the codes we use this is how much usually should be reimbursed this is how long it will be reimbursed for these are the rules around how we can deliver care this is the documentation we need to do and this is the technology that I've had other colleagues really like say are very easy what the cost is kind of cut down on some of that really large kind of rework you can make it a little easier to uh approach to feel confident that's it's a good decision and also to help with designing and implementing it for your practice and I really encourage any PA who really wants to push tele medicine that they get on our group they become a member and get access to all the tools that they're probably going to need to kind of overcome some of those concerns that will get in the way of it being implemented properly and expanding that access to care yeah so you're basically saying come come with the answers to break down the resistance that it certainly might have yeah have the solution when you bring up the problem yeah and so you said it it once you're a member of PMT you guys have that information like do you have information as detailed like by state or do you have what kind of information can they actually access once they're members that can help them yeah yeah yeah so we have actually a teleah health PA specific map where you can kind of hover over and you can get access to all the places where all that information sits some clarification around it with specific websites that have interpreted as Healthcare policy experts on what that means and also you can always contact us if you have questions I've had people contact us specifically about like very very particular unique scenarios either trying to undo some of this like kind of misinformation that some of the providers or practice administrators have gotten from other colleagues saying that they sh they can't be doing certain things and you know Pas being on our group like saying no I know this like how do I explain this to my employer or like they're trying to take away their teleah health role and make them come back into the office we certainly can give them the information they need so that's one of the resources that is accessible only to members another resource is the job board so we constant L every week post jobs all over the United States that offer jobs to Pas even if it's not necessarily on the headline we go through each one and kind of actually look through the listing and then we Post in there's a newsletter every week along with there's an entire set of webinars and CME um approved presentations regarding the history of teleah Health npas in it teleah Health billing and coding and uh talking about how to become a PA or open up your own PA practice as a tah Health PA so we have lots of resources that really I think cover the gamut of the questions that we often get as well as just having lots of subject matter experts in our leadership to be able to answer some of those Nuance questions about practicing and state related um practice questions so yeah I think there's a lot available yeah it sounds like it instead of having to hunt all that information yourself it's already curated in one place and then you said that there's a like a Facebook group or some kind of community where where people can Talk Amongst them M themselves other Pas and ask questions is that right yeah so that's how we first were kind of developed was through a Facebook group community and so basically that's a place where Pas really are only allowed to come in either students or are practicing Pas and they they just post like question specifics and we keep it moderated just so that there can be a way of creating a safe space to talk about these issues get really very direct information around reimbursement or like how you're getting paid or asking specifically about different employers and really navigating what do you need for malpractice what do you need to have as a business insurance you know how do I start my business what what does it mean to have a 1099 so we've had like a lot of entrepreneurial questions that come through that's awesome and I I assume that there's either in the group or on the actual members site as well like how to do how to do exams how to do tele medicine different things in it yeah yeah we have multiple Specialties specific how did you tell a health or what does that job look like what what kind of things do you manage I certainly really promote the membership because we also bring the lens of that access to care and digital Health perspective when the community is actually coming up with what aapa needs to stand for and and we make sure that first of all things aren't limiting and also we start to expand kind of the definition of what AAP would stand for regarding digital health and tele medicine and we also we became subject matter experts so we actually participated in the American tele medicine Association on behalf of AAP to make sure that we are engaged stakeholder in the conversation as far as get government relations and any kind of innovation coming through just really I strongly urge people to kind of think outside their little bubble of the PA world and say not everyone else especially legislators know how to practice medicine and what's the best thing for patients to priori ize there's many many stakeholders trying to get things um passed in healthcare policy and I think clinicians need to Advocate more as the expert to these legislators on what to to prioritize passing in bills so much stuff and it sounds like you guys really offer a lot of of value how much is a membership and how long do you get a membership for and how do they sign up for it so you can go to our website um we also have a discount code through medicine couch so happy to offer that also you'll be helping the support medicine catch which we fully advocate for we have a Fellow membership that gives you access to everything also you can be on a directory so that you can find other people in other parts of the field and that is $150 and it's a I think a 10% discount for those who use the code students there's membership and you get access to the same stuff you just don't get the CMEs um prepas can sign up we also have the availability for other Healthcare professionals to come in and as we see that training needs to be incorporated into the academic institutions that are training our future Pas we actually developed an entire separate membership for academic institutions many schools are members so that they give their students a module on telea health and also practice use cases where you can actually do a mock telea Health session so we we're really trying to Encompass pretty much all the aspects of how teleah health will really need to be full fully adopted is is empowering providers to really know how to do it be really good at it really stand behind it understand what needs to change in order for them to be able to incorporate it permanently into traditional Healthcare models because again I think that's what needs to happen Sarah you have shared so much great stuff thank you for being with us today yeah thank you so much now if you're interested in tah Health you might want to check out this video here it's another PA who shares a lot of tips and information about teleah health including some tips and tricks on how to do physical exam through a computer well thank you so much for joining me today and as always take care stay sane and I'll see you next time on the medicine couch bye

Channel: The Medicine Couch

Views: 281

Keywords: telemedicine, telehealth, working in telemedicine, pa jobs in telemedicine, PAs in telemedicine, pas in telehealth, telemedicine resources, PAs in virtual medicine and telemedicine, PAVMT, resources for telemedicine, resources for telehealth, how to do virtual physical exam, how to do telemedicine, telemedicine physical exam, PA licensure compact, PA compact, nurse practitioners in telemedicine, telemedicine video, telemedicine nurse practitioner, telehealth preneur, PA vs NP

Id: L_CW70_nWm0

Length: 29min 7sec (1747 seconds)

Published: Sun Jun 02 2024