COVID-19 has taken the world by storm, infecting millions of people and causing thousands of deaths around the globe. The outbreak started in the Chinese province of Wuhan, where the first case was identified in late 2019. After then it spread globally, and ultimately the World Health Organization (WHO) labeled COVID-19 as a pandemic in March 2020. The virus causes a respiratory illness with effects in many other organs, including the heart, eyes, brain, and gastrointestinal system. The condition has stemmed chaos across the world, and there is no treatment or vaccine available. It has put people around the globe in a state of despair, but there is some light of hope as preliminary vaccine development has entered its first human trial.

COVID-19 Challenges

The COVID-19 pandemic brings with it a lot of challenging phases. It brought not only the healthcare crisis but also energy and economic crises. Apart from this, it leads to humanitarian crises even in the most developed parts of the world. Healthcare systems have collapsed around the globe due to the unpreparedness to tackle the pandemic. Although governments are trying their best to preserve an economic balance by reducing transmission and mortality rates, this pandemic could have lasting impacts on people and societies. The lockdowns, unemployment, and social distancing due to COVID-19 will affect mental health, societal cohesion, economic recovery, and consumer behaviors.

Technology is playing a significant role in dealing with COVID-19 challenges. But due to increased risk of misuse, it is also challenging the relationship between governance and technology, which again can have long-lasting effects on society. Technology is playing a part in stopping the spread of COVID-19 by enabling a contact-free economy, including online retail, social distancing deliveries (click and collect), telemedicine, and much more.

COVID-19 and Mental Health

The increase in the transference of infectious diseases, including COVID-19, is due to the rise in travel and international exchange. As COVID-19 got the status of a pandemic, it brought along with it a state of considerable fear, concern, and worry among the populations. This concern is mostly seen amongst healthcare professionals, the older population, and those with underlying medical conditions. The main psychological impacts seen in these people to date are an increase in anxiety and stress. With the implementation of lockdown and quarantine limiting people’s activities, routine, and livelihood, it was also expected to see the rise in other mental health conditions, including depression, feelings of loneliness, harmful drug and alcohol use, self-harm or suicidal thoughts. Other than these, patients with pre-existing mental conditions will see an exacerbation in their illness.

Healthcare workers are working on the frontline and managing the COVID-19 patients daily, seeing their condition aggravating, moving on to a ventilator, and then deaths. This whole working environment is putting them under extreme depression. They are already working under stressful situations, and due to this mental state of health, a suicidal rate among healthcare workers is seen. Not only healthcare workers but the patients who have recovered also have mental disturbances post-recovery, especially patients who improve after being on ventilatory support who have higher risks of post-traumatic stress disorder (PTSD). Mental health challenges due to COVID-19 are not only experienced by adults but also children who were kept out of school. These children are also facing a state of uncertainty and anxiety.

Mental Health Statistics in COVID-19 Phase

Multiple factors are leading to deteriorating mental health during this COVID-19 pandemic. All these stressors are taken into account by various researchers and surveyors to gather information showing how much an increase in mental health issues occurred due to pandemic. For instance, the factors include fear of becoming severely ill from COVID-19, fear of catching COVID-19, fear of losing job or unemployment, financial pressure, getting medical assistance to become ill, and boredom. National data collected from around the world confirmed the increase in mental vulnerability. The WHO’s Devora Kestel, based on surveys, said, “35% increase is seen in the prevalence of distress in Chinese population surveyed, 60% increase is seen in Iran, and 45% in the US.” Higher levels of anxiety and depression were also recorded in Ethiopia’s Amhara Regional State in April 2020, showing a 33% prevalence rate of symptoms, which is approximately three-fold as compared to pre-pandemic levels. The surveys done in Canada among healthcare workers showed that 47% of them reported needing psychological support. In America, the surveys showed a rise in distress from 3% (last year) to 37% in April 2020. The study completed in April 2020 showed that almost 70% of Americans are under moderate to severe distress.

A study was done by the University College of London focusing on the psychological and social experiences of the UK population during the COVID-19 pandemic. The study showed that depression and anxiety continued to rise from the start of lockdown along with feeling self-harm or suicidal thoughts, which rose from 10% (March 2020) to 20% (April 2020). The symptoms of these mental conditions are more pronounced in patients already who have a pre-existing mental illness.

Telehealth During COVID-19

The COVID-19 pandemic urges the hospitals to divert patients from in-patient and prevent emergency department visits beyond capacity. COVID-19 has put the hospitals in extreme crises with insufficient beds, equipment, and staff. Enter the role of telehealth, which has been an innovation in healthcare in recent years, and in this time of restricted movement, it is providing optimum patient care. Telehealth practice is generally feasible and appropriate for healthcare providers, patients, and their family members in this pandemic. The primary purpose of shifting to telehealth is to reduce the impact of the pandemic on the management of infections and mental health. This helps in slowing the transmission by keeping high-risk patients out of the hospital environment while enabling patients to receive care remotely without visiting a hospital. Telehealth also protects clinicians by allowing them to remotely monitor suspected or milder cases of COVID-19, which don’t require hospitalization. It will also spare hospital beds and equipment to be used by more severe cases.

The psychological impact of COVID-19 must be addressed along with physical symptoms that persist, even after recovery. With the implementation of isolations and lockdowns, the risk of psychological symptoms increases even in the non-infected population. Healthcare workers are at higher risk of distress as they have to work longer hours with exposure to the virus. It can lead to anxiety, stress, burnout, and depressive symptoms, which will harm their performance. Telehealth services through email, video conferencing, telephone, or smartphone applications are meant to provide psychological treatment helping affectees to maintain their psychological well being and cope with their mental health problems efficiently. Since the pandemic started, China has been providing telehealth services, and the services provided include counseling, supervision, monitoring, training, and psychoeducation through online platforms. Early surveys showed that these services are accessed by the people in isolation to address their mental health needs. Communication between doctor and patient is essential when the patient needs to be isolated, and telehealth is a valuable way to do this irrespective of geographical location. Information sharing via telehealth platforms about stress anxiety, PTSD, burnout can be enough to deal with minor symptoms of mental health. For COVID-19 patients, telehealth can be used to monitor symptoms and to provide support when needed. Shifting to telehealth and expanding them is perfect for this pandemic situation giving people access to essential health services without increasing risks of spreading or developing an infection.

CMS Updates Related to COVID-19 for Mental Health Therapy

The officials are relaxing the rules for telehealth services during the COVID-19 pandemic, allowing physical therapists and psychologists to provide telehealth services to Medicare patients at home. These rules will also enable the telehealth services providers to be reimbursed through Medicare. The Center for Medicare and Medicaid Services announced additional changes with the ongoing pandemic. The changes aim at allowing the healthcare industry to use tools and platforms for improving access to care. Here are some of the reforms issued by CMS regarding telehealth services (specifically related to mental health):

  • Medicare recipients can receive care in their homes. Previously the care can be accessed only at specific Medicare-approved sites. But new law makes it possible to receive telehealth services in their home at any time.
  • Telehealth providers are also free to provide services from anywhere. APA has contacted CMS to allow the psychologists to offer their services from homes during this emergency pandemic situation.
  • Practitioners can use audio and video-capable smartphones. Providers can use smartphones to provide telehealth services, but only if they use audio and video for communicating two ways in real-time. Psychologists providing telehealth services via landline phone will not be reimbursed, although these sessions are appropriate in many circumstances.
  • Temporary limiting the audits. Under the new law, telehealth services must be provided to returning patients, but CMS states that HHS will not conduct audits to check whether the patient is new or returning when the provider submits a claim.
  • Relaxation in HIPAA rules. The Department of Health and Human Services is waiving penalties for violations of HIPAA (Health Insurance Portability and Accountability Act) for providers who are providing telehealth services in this pandemic. It intends to provide necessary healthcare to Medicare patients using non-compliant telehealth platforms easily.
  • The new law does not make any changes in billing. The psychologists should reimburse telehealth services at the same amount as in-person visits before the pandemic.

Using Virtual Care to Address COVID-19 & Mental Health Challenges

cliexa is a Colorado-based digital health company connecting patients, physicians, and payers at a single platform. With ongoing pandemic, healthcare systems have gone into challenging situations, and it is essential to provide necessary care to patients, especially with chronic conditions. Such patients are at higher risk of contracting COVID-19, so there is an increasing demand to give them remote attention at their homes. cliexa is a digital healthcare platform providing tools to healthcare organizations for gathering patient’s data remotely and assessing their symptoms and risks. About half of the adults in the US are suffering from any chronic conditions, including asthma, arthritis, cardiovascular, COPD, depression, and chronic infectious diseases. These conditions need to be monitored even in this pandemic to prevent their progression into complications. cliexa provides a number of virtual tools to assess these patients and patients who have developed mental illnesses due to this pandemic.

Remote Patient Monitoring (RPM) is a method of remote healthcare delivery using technology in which patient data is collected outside the clinical setting. In this, the patients send their data through dedicated apps from their phones to the providers. cliexa utilizes RPM by providing assessments and automated disease activity scores allowing clinicians to tap into wearable devices for real-time data. Patients do not need to visit a clinician during the pandemic, and they can receive care and information via cliexa’s platform. It also monitors the patient with chronic conditions, and with questionnaires, disease activity can also be tracked.

This COVID-19 pandemic is challenging for every individual and organization. Everyone must try their best to maintain their mental health. Telehealth services offered by cliexa are better suited in this time to both clinicians and patients. It allows clinicians to monitor patients and provide them with the care they need without having them visit the clinic. Telehealth services address not only patients but also help normal people affected by psychological symptoms to come out of the mental stress caused by the pandemic. This remote healthcare delivery also has the benefits of limiting patients coming to the hospital, which is much needed to control COVID-19 spread.

References

  1. Covid-19 Risks Outlook: Current Challenges and Future Fallouts
  2. ‘Major’ mental health crisis looming from pandemic – UN
  3. UN leads call to protect most vulnerable from mental health crisis during and after COVID-19
  4. The Role of Telehealth in Reducing the Mental Health Burden from COVID-19 | Telemedicine, and e-Health
  5. How telehealth can help in the fight against COVID-19
  6. CMS Expands COVID-19 Telehealth Reimbursement to Therapists, Phone Services
  7. What the COVID-19 telehealth waiver means for psychology practitioners
  8. Chronic Care Management Platform, Patient-Reported Data

 

the role of digital health in quality reporting

The Importance of Quality Reporting

With constant access to the internet, consumers can shop around for the best product and services for almost every scenario. This even includes their healthcare. Patients no longer continue going to the same hospital because they were born there, their family does, or it is closest. Patients can pick and choose their doctor or hospital based on their quality reporting scores, patient outcomes, and cost. Various websites provide this service, as well as Centers for Medicare & Medicaid Services (CMS) or Merit-based Incentive Payment System (MIPS) public data.

Whether it is weak quality reports, lackluster patient outcomes, or high costs, patients will seek out other physicians to ultimately find the best care (See Your MIPS Score Stays with You). With the increase in healthcare locations across the country, some patients now have the option to choose their provider and institution at which to receive care. The rise of mobile technology is lending to patients receiving their care at home, saving time and effort on their end while improving the overall patient experience for the healthcare system. This newfound choice creates a greater emphasis on physicians and hospitals to pay attention to their quality reporting and patient outcomes.

The numbers of patients with multiple comorbidities are higher than ever before. These comorbidities and chronic conditions are extremely impactful to the care a physician gives to their patient. In addition, chronic conditions and comorbidities are impactful in understanding the way a patient responds to treatment and recovers from surgeries and other interventions. It is essential that physicians are collecting data, not only thorough past medical history for their patients, but also medications, and family health history.

The Role of Digital Health in Quality Reporting

For a practice to effectively collect this much data for each patient, it is incredibly time-consuming. A significant amount of time is required to not only have the patient read and sign consent forms, but also to complete intake forms for necessary information, and input all of this into the electronic medical record for the physician to read. Time and resources are precious in clinical and hospital settings, which is why it is so important to implement technology that aids clinical and hospital staff in completing this.

cliexa not only digitizes all consent forms and intake questions but discretely integrates each aspect of the clinical forms into the electronic medical record (EMR). Medical data now appears instantly in the EMR, just like a staff member or a medical assistant would have typed it. Medical staff and physicians can then review the information that is already in the EMR and proceed to treat the patient from a well-rounded point of view. cliexa allows the patient to complete their consent and intake forms while away from the clinic. Patients download the cliexa application and complete their paperwork, taking the time constraints away from the clinic or hospital, and allowing the patient to be more thorough in their information.

Receiving accurate and thorough past medical history, medications, and family history have huge effects on patients’ outcomes and quality reporting. A physician can use cliexa to identify a higher incidence of heart disease in a patient’s family and use this information to not only order tests and screen for heart disease in their patient but also discuss weight-loss strategies and lifestyle changes [1]. Our platform is designed to aid a physician in their foresight to catch an issue before it arises. This helps ensure physician’s patient outcomes and naturally improves quality reporting. Likewise, a surgeon can utilize cliexa and identify if their patient is a current smoker. They can use this information to assess the increased risk their patient has when consenting to elective surgery [2]. By including that data in their reporting, they are not only protecting themselves but can also start a conversation regarding smoking cessation with that patient.

In a time when quality reporting and patient outcomes not only influence your success as a physician but also how many patients you see and retain, it is more important than ever to partner with cliexa to help you achieve this. It is becoming more important to understand the needs and desires of patients to ensure your MIPS scores do not suffer, and virtual health is one way to address changing patient needs.  While patient experience is subject to change over time, quality reporting, patient outcomes, and physician ratings are only updated every two years. From the time you notice that your data is negative, it will take an additional two years to see if your outcomes have changed positively. Time is of the essence to enhance your data, receive more patients, and improve your quality reporting and patient outcomes.

[1] Moonesinghe, R., Yang, Q., Zhang, Z., & Khoury, M. J. (2019, July 16). Prevalence and Cardiovascular Health Impact of Family History of Premature Heart Disease in the United States: Analysis of the National Health and Nutrition Examination Survey, 2007-2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662130/

[2] Theadom, A., & Cropley, M. (2006, October). Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563647/

medical staff holding tablet conducting telehealth visit/remote care screening

FCC Telehealth Funds Overview

On March 27, 2020, President Trump signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act into law. As part of this new law, the Federal Communications Commission (FCC) was provided $200 million to fund telehealth services and devices for non-profit and public eligible healthcare providers. This $200 million will be used to streamline care delivery through the subsidization of telehealth programs across the country. Eligible hospitals and health centers are now able to apply for funding up to $1 million to cover the cost of implementing a telehealth program, including new devices, services, and medical personnel, into their clinical workflows.

So, what is telehealth? Telehealth is described as the delivery and facilitation of health care services through the use of remote, mobile technologies. These services include medical care, provider and patient education, health information tools, and self-care via telecommunication and digital communication technologies. Telehealth is comprised of four primary mechanisms that enable remote care delivery: mobile health, video conferencing, remote patient monitoring (RPM), and a “store and forward” electronic transmission of data, and documentation.

While the funding is directly tied to enabling telehealth for providers and their patients, additional measures can be taken to begin the implementation of digital health solutions. Digital health encompasses a range of categories that cover how technology can be implemented in healthcare to provide additional metrics and monitoring for at-risk patients. This includes wearable devices, telehealth and telemedicine, remote patient monitoring, and more. The cliexa platform offers the full suite of digital health solutions in one package and can be leveraged for the funding made available by the FCC in this release.

What Can the Telehealth Funds be Used for?

Funds may be applied to the implementation of telecommunications services, information services, and connected devices to connect providers with their patients in response to COVID-19. This includes freeing up time and resources for healthcare professionals to treat COVID-19. Monitoring devices (e.g., pulse-oximeters or blood pressure monitoring devices) and wearables that patients can use and then share the results with their healthcare provider will not be funded unless they are themselves connected. Funds also may not be used for administrative expenses related to the program (e.g., application costs and expenses) or other miscellaneous expenses. Your awarded funds can be used to implement an all-encompassing virtual health platform, such as cliexa.

Rather than replacing the solutions you have already found, cliexa complements them to increase your capabilities throughout this shift to remote care with digital intake, remote check-in, custom discrete data delivery, telehealth plug-ins, and more. With these new features, all registration and pre-screening can be done remotely for new and follow-up patients via their smartphones or tablets. If you decided to conduct telehealth visits, we also support plug-ins to provide all the necessary documentation upfront to the patient. The data will then discretely populate into a customizable format in the existing medical record flow. Whether you are looking to implement telehealth or a variety of digital health solutions, the FCC funds can be used for multiple aspects of the cliexa platform.

Eligibility & Criteria

According to the FCC report and order, for-profit hospitals will not be allowed to apply. The COVID-19 telehealth funding is limited to the following institutions:

  • Post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools
  • Community health centers or health centers providing healthcare to migrants
  • Local health departments or agencies
  • Community mental health centers
  • Not-for-profit hospitals
  • Rural health clinics
  • Skilled nursing facilities
  • Consortia of healthcare providers consisting of one or more entities falling into the first seven categories

The FCC has not specified a limit on how much it will award to applicants, but it does not expect to award more than $1 million to any applicant. The FCC will award support to eligible applicants based on the estimated costs they aim to purchase, outlined in the application process. Applicants that have exhausted initial funding may request further support. Applicants that are selected may apply to receive funding from the Connected Care Pilot Program but may not request funding for the same exact services from both programs.

How cliexa Can Help

Whether you exclusively enable telehealth or specific features of digital health, cliexa is the ideal partner to streamline the full-stack of virtual health for health systems and community-based health centers. With cliexa, patients can be remotely checked-in, pre-screened, and registered before entering the care facility. The data collected is then sent through the existing medical record or preferred format, limiting the steps taken by medical staff to on-board and treat patients. The platform is 100% customizable to fit the specific workflow already in place, enabling a tailored solution that seamlessly integrates with minimal disruptions.

With our availability as a digital health solution for this FCC grant, our team will provide assistance and guidance for the application process. As we are not permitted to apply, our platform can directly address the call for innovation across all eligible parties. Our team will work hand-in-hand with your staff to complete essential steps and apply for FCC funding. With the application, the cliexa team can address the “low hanging fruit” for your team to implement an effective digital health solution to enable remote care and virtual health throughout the COVID pandemic, and onwards.

For More Information

For questions regarding how cliexa can support you in the application process and implementation of digital health solutions, please Contact Us through our form submission or email info@cliexa.com.

What are the updates in Version 2?

cliexa now supports Digital Check-in, Remote Intake, Discrete Data Delivery, Telehealth Plug-ins, and Remote Patient Monitoring on the athenahealth More Disruption Please Marketplace!

With the overwhelming demand for clinicians to remotely care for their patients amidst the COVID-19 outbreak, our clinical partners have shared some of the newfound challenges they encounter with at-risk patients. While patients with chronic conditions require treatment and monitoring, they are at a higher risk of severe COVID-19 symptoms and complications. This has translated into a need for remote functionalities to treat and monitor chronic patients over the coming months, without requiring patients to come into the clinic.

After considering their input, the cliexa team prioritized a full-stack, virtual care experience for athenahealth customers. Over the past two months, our team has implemented new features that are now available on our athenahealth MDP Marketplace listing for remote registration, digital check-in, pre-screening, telehealth functionalities, and discrete data integration. This rollout not only addresses the current concerns with COVID but creates a customizable intake process to increase administrative and clinical efficiencies.

What does this mean?

Rather than patients traveling to their local healthcare setting, the entire registration process can now be completed remotely. Whether they are a new or follow-up patient, they will complete all registration information on a smartphone or tablet through our platform. The information provided by the patient discretely populates the appropriate fields and buckets in athenahealth for the medical staff, custom-tailored to the existing workflows. This process removes unnecessary encounters among at-risk patients and medical staff, thus resulting in a safer method to seek and receive medical care.

Check out our listing on the athenahealth MDP Marketplace and reach out to our team if you have any questions or would like to learn more!

Download The “Enabling Remote Care and Virtual Health” PDF


how is remote patient monitoring changing the game

Remote patient monitoring is a game changer during the COVID-19 outbreak.

Many questions have been brought up regarding the status of our current healthcare system. How can I get in touch with my physician? How are healthcare clinics handling social distancing and quarantine? Are they still able to meet with me? Do I have any symptoms of Coronavirus? How do I know whether I need to go to a hospital for testing?

Over the last few weeks, our healthcare environment has turned upside down by the emergence of Coronavirus in the United States. Serving patients during this time presents new challenges and has established a “new normal” for clinical workflows.

What exactly is Remote Patient Monitoring (RPM)?

Imagine you are experiencing some symptoms that you’d like your clinician to know about. Maybe you have some preexisting healthcare conditions that make you concerned. Remote patient monitoring allows your clinician to monitor your symptoms and reach out with any changes you should make to your current treatment plan. Most RPM platforms are online or through a mobile application that allow for secure communication with your healthcare provider from the comfort of your home.

cliexa utilizes Remote Patient Monitoring to improve patient care. The platform provides clinically validated assessments with automated disease activity scores, allowing clinicians to tap into wearable devices for real-time data. These wearables provide actionable data that otherwise could go undetected through general patient reported outcomes. This way of closely monitoring patients can lead to an improved patient satisfaction with overall care.

How can Remote Patient Monitoring help during the COVID-19 outbreak?

Remote patient monitoring with cliexa is changing the game in healthcare. Recently, many digital health companies have been working towards telehealth solutions for clinics. With cliexa’s remote patient monitoring, patients do not need to be physically present to onboard. Instead, they can receive care and information from a clinician with a fully remote platform. cliexa addresses the needs of each clinic’s specific Coronavirus response. cliexa enables remote check-in, customized clinical intake, secure transfer of medical history records, and remote patient monitoring. All of these functionalities in the platform seamlessly integrate into the existing EMR system. These functions allow patients to conduct all necessary actions from home on their mobile phones prior to telehealth or in-person visits.

Providers can leverage these services, along with cliexa’s COVID-19 screening, to triage patients with chronic conditions based on their risk level. The cliexa COVID-19 screening capabilities follow the CDC’s guidelines to assess risk factors for patients, including preexisting medical conditions. cliexa allows clinicians to utilize virtual health functionalities including remote monitoring and telemedicine visits.

How does Remote Patient Monitoring differ from Telehealth?

Telehealth allows for physicians to meet with their patients virtually – through video or audio communications. However, telehealth requires that patients have previously gone through an onboarding process with their specific clinic or physician. Many telehealth services still require patients to visit their healthcare provider’s office in-person for onboarding. During this initial office visit, the patient fills out onboarding documentation including waivers and past medical history documents. After all patient information is entered into the clinic’s EMR, only then can the patient enroll in telehealth functionalities.

This is where cliexa’s remote patient monitoring platform differs. Our platform eliminates this step completely. Clinics fully digitize the onboarding process and customize it to their specific clinic needs with cliexa. With remote check-in and customized clinical intake features, patients can enroll with a clinic of their choice and start using telehealth services safely from home. This eliminates the need for an initial in-person visit with a healthcare provider, reducing COVID-19 exposure in hospitals and clinics.

How can I learn more?

During this chaotic time, it’s important to stay informed with what’s happening in our current healthcare system. Using remote patient monitoring in healthcare today is outlined in online articles released almost daily. Participate in webinars to learn more about what digital healthcare companies are doing to help – and review materials like this on your own.

cliexa is determined to do all we can to help healthcare providers overcome challenges and promote better care for patients. To support our healthcare partners through this pandemic, we are waiving all implementation fees until further notice. COVID-19 has distanced us, but with the right tools the show can and must go on.

For more information, check out our brief explainer video or schedule a demo of the cliexa platform with our team here.