Practice Guidelines for Teledermatology.

Previous American Telemedicine Association (ATA) Teledermatology Practice Guidelines were issued in 2007. This updated version reflects new knowledge in the field, new technologies, and the need to incorporate teledermatology practice in a variety of settings, including hospitals, urgent care centers, Federally Qualified Health Centers, school-based clinics, public health facilities, and patient homes.

Private payer telehealth reimbursement in the United States.

BACKGROUND: Significant information is available about government-reimbursed telehealth services such as Medicare and Medicaid across the United States. Although currently 20 states mandate reimbursement for telehealth services and some private insurers have voluntarily covered those services in other states, relatively little is known about telehealth provider experiences with reimbursement from private insurance payers. MATERIALS AND METHODS: To investigate this, the American Telemedicine Association's (ATA's) Telemental Health Special Interest Group (SIG), the Policy Group, and the Business and Finance SIG, with the help of ATA staff, conducted a national private payer reimbursement online survey in 2012 using Survey Monkey™ (Palo Alto, CA) ( www.surveymonkey.com/ ). RESULTS: Survey responses were received from respondents in 46 of the 50 states. The survey found that telehealth services are being reimbursed by private payers but that progress in reimbursement has been relatively slow compared with earlier surveys. CONCLUSIONS: Key findings from this study were that government payers as well as several major private payers are highly influential in payment policies for telehealth private payers, that private payers have administrative rules regarding telehealth reimbursement that are barriers to services and reimbursement, and that some providers would benefit from being better informed about billing and coding for telehealth services and how to advocate for telehealth services reimbursement.

Telemedicine--an efficient and cost-effective approach in parathyroid surgery.

OBJECTIVES/HYPOTHESIS: To demonstrate the effectiveness and cost benefit of using telemedicine for the postoperative visit in patients undergoing parathyroidectomy for primary hyperparathyroidism. STUDY DESIGN: Prospective noncontrolled study at a tertiary medical center of a cohort of 39 patients undergoing postoperative care after parathyroidectomy through TeleHealth at a number of sites at various distances from the primary surgical facility. METHODS: From October 2006 through January 2010, 149 patients underwent parathyroidectomy for primary hyperparathyroidism at one tertiary medical center by a single surgeon. Age, sex, distance from the patient's home to the surgical center and to the TeleHealth site, effective completion of the TeleHealth visit, and postoperative complications were recorded. RESULTS: Of the 149 patients who underwent parathyroidectomy, 39 had their postoperative visit using TeleHealth (26%). There were 26 females (67%) and 13 (33%) males. Mean age was 64 years. All visits were effectively carried out and completed with a nurse and the patient at a remote TeleHealth site and the surgeon at the surgical center site. There were no postoperative surgical complications noted with the visits. Average round-distance travel saved was 119 miles. The travel distance saved translated into an average savings of $357.00 per patient (which included estimations of transportation costs and lost work time), with further immeasurable benefits to the patient and healthcare system. CONCLUSIONS: TeleHealth is a cost-effective and efficient way to follow-up with patients who have undergone parathyroidectomy, with significant convenience and financial benefits for the patient and healthcare system.

The technology-privacy conundrum. HIPAA perspectives for telehome care providers.

The implementation of Health Insurance Portability and Accountability Act privacy and security provisions does not need to be a cause for panic among health care organizations. A common sense approach that stresses documentation of policies and procedures for communication using technology, such as in the case of providing telehome care, takes agencies a long way towards HIPAA compliance.