In a recent announcement, we teased our upcoming Adolescent Resiliency and Wellness Webinar with cliexa-OPTIONS. We are excited to announce this webinar is now live! Join Lisa Rue, PhD & Senior Advisor at cliexa, for Part I of our cliexa-OPTIONS Webinar Series featuring a discussion on assessing adolescent risk and resiliency in modern healthcare.

The Webinar Series

Part I of our cliexa-OPTIONS Webinar Series covers the impact of virtual screening tools in healthcare and how practitioners can leverage resiliency factors with their adolescent patients. More than ever, maintaining the continuum of mental health in adolescents is top priority for clinicians. Through proper utilization, digital health tools provide valuable insight into adolescents’ mindset and mental health.

In this webinar, Dr. Rue takes a deep dive into how promoting resiliency in adolescents can lead to improved mental health and prevention of risky behaviors. Our proprietary OPTIONS assessment, co-developed with the National Mental Health Institute of Colorado, quantifies this resiliency and provides clinicians a measurable insight into adolescent resiliency and wellness.

The cliexa-OPTIONS Platform

Our cliexa-OPTIONS solution assesses adolescent risk and resiliency to provide pediatric, primary, and family care practitioners a thorough view of their patient’s health. The OPTIONS Model is designed for youth and young adults and measures 6 dimensions of supportive factors through a set of 22 questions proven to increase supportive factors. With the continuum of care shifting to virtual interventions, having a digital tool to connect with adolescents in real-time is extremely important. One of our pilot site leads added onto this notion by stating, “[patients] feel safer disclosing more personal and relevant information about their mental health, sexual activity, and overall well-being.”

The modular application structure of cliexa-OPTIONS supports implementation across a wide variety of care settings. As one of our clinicians through the University of Northern Colorado shared, “when clients have the option to disclose information through a virtual platform this informs the counselor of various topics the client may feel uncomfortable bringing up in session.” We have seen great success in both family medicine practices and primary care locations, while venturing into non-clinical settings that have an immediate impact on adolescents.

Watch the Webinar

Tune in to learn more about how cliexa-OPTIONS solution assesses adolescent risk and resiliency! If you are interested in piloting cliexa-OPTIONS in your practice, Contact Us at the link provided for more information.

Click Here to register and download Part I of this Webinar Series!

Artificial Intelligence Model with UCDenver

With a team of Computer Science students from the University of Colorado Denver, cliexa built its’ first artificial intelligence software. This AI Model assesses the comparative impacts of behavioral health metrics on the risk of opioid addiction. The project is our initial AI model, contributing to our larger goal of unleashing the power of AI in healthcare.

The Senior Design Program

The Senior Design Program at the University of Colorado Denver partners with local companies to mentor students on a cumulative project for software development. Organized by Debra Parcheta and the School of Computer Science and Engineering, students in the Senior Design class use their prior learning and experiences to design and build working software for real-world problems. We’re proud to sponsor a project for the 2019-2020 academic year, which resulted in our first AI model.

The Initial Project Proposal

Tackling our first AI project was a daunting task, but we knew this would lead to opportunities across other subspecialties. Our initial brainstorming session produced the design of a convolutional neural network algorithm.  This method enables the algorithm to flag potential flareups, unplanned hospitalizations, and other risk factors. We recognized that if we could harness the power of AI to identify correlations within patient-reported data, our platform could revolutionize the personalization of healthcare.

This initial project proposal proved to be a larger concept than what was feasible in a 9-month project timeline. The idea behind this served as the driving factor in the development of our resulting AI model. We narrowed our focus on integrated pain management, where we developed something truly novel in digital health technology.

The Artificial Intelligence Model

Our team, led by Research & Development Lead, Ronald Berry III, consisted of three students: John Williams, Mengistu Shuma, and Uriah Moeller. Over the first semester, our project scope honed in on integrated pain management. After outlining technical specifications, we landed on the idea of improving the risk stratification of modern pain management to flag at-risk patients based on a myriad of behavioral and physical health assessments.

Throughout development, the students made the decision to pursue a convolutional neural network, rather than an alternative form called clustering. When the overarching architecture was decided on, the team went to work on their first-ever machine learning model. They structured the model with seven assessment inputs with an output structure of “low”, “medium,” and “high” risk for potential opioid misuse or addiction. Once the initial structure was defined, the students utilized 1,300 unique de-identified data points to test the model.

The final challenge was fine-tuning the algorithm to obtain an accurate output in relation to the Screener for Opiate Addiction in Patients with Pain (SOAPP-14). Widely used in pain management, the SOAPP-14 is the gold standard for identifying chronic pain patients’ risk of opioid addiction. Upon the final iteration, the AI model achieved a 96.3% accuracy when compared to the SOAPP-14.

Without a doubt, this project proved successful across all deliverables outline in the project specifications. While our model is accurate in comparison to the SOAPP-14, we plan to clinically validate our tool for pain management.

Applying AI in Healthcare

With a background in Computer Science, Mehmet Kazgan has a comprehensive understanding of machine learning and neural networks. This experience, in addition to his time as VP of Engineering at Aetna, establishes him as an expert in leveraging AI technology in modern healthcare as our CEO & Founder. Over the past year, Mehmet joined industry leaders to discuss the role of artificial intelligence in modern healthcare.

#AskTheCEO Podcast

Back in March, we joined the #AskTheCEO podcast with Avrohom Gottheil in a thorough conversation on how cliexa aims to implement machine learning on the Azure Marketplace. The two discuss the importance of utilizing innovative technology to stay at the forefront of patient care. With data collection and AI capabilities rapidly advancing, we hope to see this shift across healthcare.

Colorado Advanced Industries Grant

Fast forward to May, the Colorado Office of Economic Development and International Trade awarded our team the Advanced Industries Accelerator Grant with the purpose of developing a machine learning module for cardiovascular risk. The Colorado OEDIT Advanced Industries Early-Stage Capital and Retention Grant is designed to support early-stage start-ups with viable products that meet a market need and are established in Colorado. Our proposed project is to expand the cliexa-PULSE home-health monitoring platform and develop a predictive risk model for cardiovascular disease. This machine-learning algorithm would expand upon this model for opiate risk and reconfigure to analyze for risk of cardiovascular disease.

Who Would Have Thought Podcast

A few weeks ago, Robert Niichel and Sacha Heppell with SmartTab interviewed Mehmet on their podcast where they took a deep dive into the value of patient-reported data in AI models. In this episode, they discuss the value of patient-reported data and how cliexa leverages artificial intelligence (AI) in the platform. Some of the key topics include improving Crohn’s disease outcomes, patient-centered tools, data in healthcare, and the future of AI.

Featured Publication with CU Boulder’s CANLab

Most recently, our partners at the CU Boulder’s CANLab published their research on applications of AI in chronic back pain. Their focus on patients’ emotional health and its’ impacts on pain severity leverages machine learning to predict future episodes. For the full publication and more information on this fascinating research, check out our announcement!

The Future of AI in cliexa

So now what? Where are we going from here with our AI goals?

In short, the opportunities are endless. As a subspecialty agnostic platform, our long-term goals with AI will expand to other areas outside of integrated pain management. Already, partnering with the American College of Cardiology, our focus shifts to an interventional AI risk model for cardiovascular diseases. As our experience with machine learning expands, we aim to find institutional partners to enter the world of AI with. To get in touch with our team, reach out via our Contact Us page.

Our Next Steps

Although COVID-19 changes the outlook of this upcoming academic year, we are proud to sponsor another project with UCDenver. We look forward to working with our 2020-21 cohort of students on a new project exploring the workflows for claims verification.

Congratulations to John, Mengistu, and Uriah on graduating this past May and best of luck to you all on your future endeavors!

Rural Patient Access Digital Health Tools

Introduction

It is well known that with COVID-19 cases on the rise in much of America, extra stress has been put on healthcare workers and departments. One specific area of great focus includes rural areas, where hospitals were financially ill-prepared for the onset of COVID-19. Rural hospitals are finding themselves in vulnerable positions as they consider how to manage both the extreme loss in revenue due to canceled elective surgeries and the costly nature of acquiring ventilators. 

Due to the precarious situation rural hospitals have encountered (only having an average of 21.3 days of cash on hand for Rural PPS Hospitals 26-50 beds), multiple rural hospitals across the US have been forced to close and many more are under threat of closure. These increasing closures in many rural areas cause residents to grapple with overall decreased access to care. With restricted access to care and hefty provider costs, healthcare workers are scrambling to find adaptive, modern solutions. 

However, access to care in rural settings has always been a critical issue in the US as there has been much need for the development of medical infrastructure providing affordable and high-quality care to 20% of the population. In fact, of the 170 rural hospitals that have closed in the US since 2005, only 11 have shut down in 2020. With this context, it is important to understand what barriers to healthcare are still present for rural patients today, as well as what potential modern solutions will help increase overall access to care in the US. 

Distance and Transportation

One of the main barriers to healthcare in rural areas is transportation. Since rural areas tend to be less densely populated, patients often travel long distances to see their medical providers. In a study by the Pew Research Center, the average urban travel time to a hospital was 10 minutes, while the average rural travel time was 17 minutes, with the top 25 percentile over 35 minutes.

Uninsured Individuals in Rural Settings

While urban residents benefit from public transportation and the relative proximity of their providers, for rural residents large travel times can be a serious problem for those who require immediate care. However, they can also act as an obstacle for more mild cases, deterring patients from reporting symptoms, completing patient onboarding, or seeking primary care. The significant increase in travel time introduces a myriad of other burdens for rural residents. When a patient travels to seek medical attention, they may suffer from lost wages, time away from home, and transportation fees. Patients should not have to weigh these costs in their consideration of receiving healthcare. 

cliexa’s solutions in Remote Patient Monitoring alleviate these difficulties in transportation by lowering the number of unnecessary hospital visits. Through a focus on patient engagement, wearables integration, and self-reported patient outcomes, providers can deliver high-quality care to patients exclusively through mobile devices. Also, patient intake and registration forms can be completed remotely, saving time for patients and clinicians. With the ability to receive care from the comfort of their home, patients no longer have to face the barrier of transportation. 

Workforce Issues

Healthcare Professional Shortage by Area United States

 Source: https://www.ruralhealthinfo.org/rural-maps 

Health Professional Shortage Areas (HPSA’s) are more abundant in rural locations. While many countries regulate the geographic distribution of healthcare providers, the US does not.Instead, physicians have complete discretion on where to work, leading to unequal health professional coverage across the country. According to the Bureau of Health Workforce, 61% of the country’s HPSA’s are located in rural areas. As a result, rural patients are less likely to have regular access to care. 

Healthcare workforce shortages present a dangerous situation to rural residents who may have difficulty finding an appropriate provider. In urban areas, there are about 84 physicians per 100,000 people; however, in rural areas this number drops to 68. cliexa alleviates stress on HPSA’s by virtually connecting patients and their providers. By eliminating travel times and automating digital intake, telehealth solutions dramatically increase efficiency, allowing health professionals to reach more patients. 

Poor Health Literacy

Health literacy is an important topic in modern day healthcare as new developments in the field, including new forms of treatment, can sometimes confuse patients or leave them feeling like they are not an important part of their own care decisions. According to the Rural Health Information Hub, poor health literacy can negatively impact “a patient’s ability to understand health information and instructions from their healthcare providers.” The bottom line is, poor health literacy can deter patients from taking a major role in their health journey and, in some cases, from even pursuing care in the first place. 

This is a real problem especially in some rural areas where there may not be an interpreter on the staff to help non-native English speakers understand health information and services related to their care. Even aside from that case, according to the US Department of Education, only “12 percent of adults had proficient health literacy,” and “adults living below the poverty level had lower average health literacy than adults living above the poverty threshold.”Furthermore, this plays a significant role in rural areas given that The United States Department of Agriculture reports that “the large majority (301 or 85.3 percent) of the persistent-poverty counties are nonmetro… ”

However, cliexa helps patients be engaged and educated in regards to their care. All of our services have at least some features built into them to support patient education so they can be proficient in the subspecialty of care that is most relevant to them. From the Office of Disease Prevention and Health promotion, studies have shown that “adequate health literacy may increase a person’s capacity to take responsibility for their health and their family’s health,”further promoting their access to care 

Another way that cliexa supports improving health literacy is through our telehealth services. Telehealth is the “delivery and facilitation of health care services through the use of remote mobile technologies.” We know that our telehealth services help patients be more connected and active in their care. With remote access to care, rural residents can utilize our telehealth services to improve their poor health literacy and find easier solutions to their barriers to care.

Health Insurance Coverage

Health insurance coverage plays a crucial role in determining access to healthcare. Rural areas tend to have consistently less coverage than metropolitan areas. According to a U.S. Census report, 9.1% of rural populations live without any health insurance compared to 8.4% of urban populations. Additionally, an article from ACA Implementation reveals that premiums are higher in rural areas and “on average, $39 more per month (10% higher) than those in urban areas”.

Distance to Nearest Provider Rural Settings

A higher percentage of uninsured individuals can lead to significant gaps in healthcare in rural areas. A report from the Office of the Assistant Secretary for Planning and Evaluation found that more than 25% of uninsured individuals withheld from receiving healthcare due to costs. This issue has become even more prevalent in the last few months as 5.4 million Americans have become uninsured due to Covid-related job losses.

cliexa combats sparse health insurance coverage in rural areas with innovations in telehealth. Telehealth allows patients to receive health care at lower costs than in-person visits. Virtual visits also provide a safer alternative to access care under the current conditions of COVID-19 in America, potentially saving thousands of dollars for vulnerable, uninsured individuals.

Social Stigma and Privacy Issues

A common trend across rural areas is the lack of anonymity associated with living there. This plays an important role in healthcare as some rural residents may avoid seeking necessary care as a result of social embarrassment or privacy concerns. The main avenues of care that this directly impacts includes substance abuse, mental health, sexual health, and chronic illness. 

In fact, a report from the US National Library of Medicine National Institutes of Health reports that although HIV cases in rural areas have been on the rise since before 2005, “HIV-related stigma can significantly impact care utilization and health outcomes including quality of life and medication adherence and people living in rural regions often experience high levels of HIV-related stigma.” Not only is HIV-related stigma a prevalent factor in rural social settings, mental health is not regarded as much in rural areas as in urban areas. The CDC reports that “children in rural areas with mental, behavioral, and developmental disorders face more community and family challenges than children in urban areas with the same disorders.”

Although “rural adults have higher rates of alcohol abuse, tobacco use, and methamphetamine use, [and] prescription drug abuse and heroin use has grown in towns of every size… rural areas often lack options for specialty substance abuse treatment programs… which may discourage treatment utilization among vulnerable, underserved populations.” Learn more about how cliexa is taking part in Combating the Opioid Crisis with Pain Management Technology

cliexa’s platform is perfectly geared towards helping rural residents receive care without social stigma or fear of privacy issues. Our Remote Patient Monitoring Platform lets patients report their symptoms and update their care providers securely and privately. Furthermore, our forms and assessments, such as the Fagerström Test for Nicotine Dependence (NIDE), offered on our Behavioral Health Platform, help providers have easy, reliable access to information about multiple patients coming from a wide range of areas. Finally, our Adolescent Resiliency Platform is perfectly geared towards users at risk for a number of personal health issues including sexual health, depression, and anxiety. Overall, it is clear that cliexa’s options will greatly help improve access to care for rural residents, by providing ways to circumnavigate social stigma and privacy concerns.  

Conclusion

Rural health is in a critical state in the modern day healthcare world due to rural hospitals being financially at risk, rural residents at risk for a variety of serious conditions (including substance abuse outcomes and chronic illnesses), as well as physical and organizational barriers that limit patients’ access to care. As Georgetown University’s Health Policy Institute cleanly states, “the rural population is consistently less well-off than the urban population with respect to health.”

cliexa, however, is a virtual health platform that is set on improving access to care for rural residents via remote patient onboarding, remote patient monitoring, telehealth, secure and private form access, and patient education models. One of our fundamental goals is improving outcomes, a goal which is greatly limited due to access to care being restricted for a variety of reasons in the rural world. We are confident that our host of solutions are perfectly suited to resolving these issues and improving outcomes in one of the most critical areas of the modern healthcare world. 

References

[1] UNC Rural Health Research Program; Findings Brief: Most Rural Hospitals Have Little Cash Going into COVID, May 2020. https://www.shepscenter.unc.edu/programs-projects/rural-health/projects/north-carolina-rural-health-research-and-policy-analysis-center/publications/

[2] UNC Rural Health Research Program: 170 Hospital Closures: 2005 – Present. https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/

[3]https://www.pewresearch.org/fact-tank/2018/12/12/how-far-americans-live-from-the-closest-hospital-differs-by-community-type/

[4]https://www.graham-center.org/rgc/publications-reports/publications/one-pagers/unequal-distribution-2013.html

[5]Designated Health Professional Shortage Areas Statistics, Bureau of Health Workforce Health Resources and Services Administration (HRSA) U.S. Department of Health & Human Services, June 30, 2020.

[6]https://www.graham-center.org/rgc/publications-reports/publications/one-pagers/unequal-distribution-2013.html

[7] https://nces.ed.gov/pubs2006/2006483.pdf

[8]https://www.ers.usda.gov/topics/rural-economy-population/rural-poverty-well-being/#demographics

[9]https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/health-literacy#5

[10] https://www.cliexa.com/solutions/telehealth/

[11]https://www.rwjf.org/en/library/research/2018/11/are-marketplace-premiums-higher-in-rural-than-in-urban-areas.html

[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169533/

[13] https://www.cdc.gov/ruralhealth/about.html

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995852/

[15] https://hpi.georgetown.edu/rural/

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/