With the recent change in policy around Medicare reimbursement for telehealth services, and the escalating pace of the spread of the coronavirus, seniors housing operators can use support for telehealth as a way to keep residents healthy to maintain census, and also as a sales tool for future move-ins. As a follow-on to the NIC Spring Conference panel discussion on telehealth, experts shared their thoughts on specific steps seniors housing communities can take both during the COVID-19 emergency and also on an ongoing basis.
Right Now: Support Physicians with Videoconferencing
In most seniors housing communities, residents can see any physician they choose. Since there are no standards for telehealth technology, according to Mei Kwong, executive director of the national Center for Connected Health Policy, this means operators must be ready to support whatever conferencing and monitoring technology their residents’ health providers have selected.
Yet Kwong said many health systems have recently started offering straightforward video visits as an emergency measure to keep patients away from offices and clinics where they might be exposed to the novel coronavirus, and in most states, there is no requirement that a person assisting a patient with telehealth technology hold medical credentials. This means any tech-savvy staff member with a camera- and microphone-equipped laptop could easily move from room to room to help residents connect with their doctors via videoconference during the current emergency – taking appropriate precautions such as wearing a mask and gloves and disinfecting the laptop after each visit, of course.
This is only possible if the seniors housing community has broadband throughout the community, Kwong pointed out. She also cautioned that while CMS has announced the policy change to allow for telehealth reimbursement, the companies that actually process claims “sometimes haven’t caught up yet,” so residents taking advantage of video doctor visits should watch their insurance statements carefully.
Medium Term: Support Specialists with Telemonitoring
Beyond virtual doctor visits, telehealth also encompasses various remote health monitoring technology, according to Kwong. While CMS’s current policy to reimburse for telehealth services is envisioned as an emergency measure, Kwong believes that many of its elements will become permanent. She suggests that once the pandemic ebbs and it is safe for residents to move freely throughout communities, operators might consider setting up a special room where they would host the various telehealth peripherals required by their local health systems, such as smart scales, internet-connected stethoscopes and blood pressure cuffs, or even higher-resolution imaging technology to allow specialists like dermatologists to examine patients remotely. Residents’ physicians could schedule consults or request regular monitoring of vital signs, and trained staff in the community could accompany residents to the special room where they could assist with any technology hurdles.
Long Term: Integrate Telehealth into the Community
For operators who want to equip their on-site nursing staff with specialist access, or who want to deliver more medical services within their communities, a tighter integration with a specialist telehealth service provider is an option, according to Michael Kurliand, director of telehealth and process improvement at West Health. West Health offers a free guide for seniors housing companies considering a move like this.
Joshua Hofmeyer, senior care officer at Avera E-Care, one such specialist provider, has a call center staffed by geriatricians and RNs with geriatric training. Client staff can call any time, day or night, and get immediate medical advice from specialists. Avera equips its seniors housing clients with mobile carts which hold all necessary peripherals to monitor health vitals or provide videoconferencing, and nursing staff can bring the carts to residents, either to deal with an emergency or on a regular basis to monitor chronic conditions. Avera does not aim to replace residents’ doctors, but rather, to work collaboratively with primary care providers and seniors housing staff, said Hofmeyer.
Even without Medicare reimbursement for these services, Hofmeyer calculates that his service is priced to offer positive ROI to any partner through census stabilization by avoiding unnecessary hospitalizations, as well as reduced turnover due to staff burnout. For skilled nursing operators who participate in risk-sharing networks, Avera clients see a reduction in both care costs and hospital readmissions, Hofmeyer adds.
Implementing services such as Avera E-Care typically requires support from IT staff, as well as specialist training for nurses and CNAs, and takes about 3-4 weeks, said Hofmeyer.