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When on deadline she fuels herself almost exclusively on chocolate chips.\r\n\r\n ","avatar":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g","twitter":"lesleywmcclurg","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["editor"]},{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["author"]}],"headData":{"title":"Lesley McClurg | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lesleymcclurg"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"futureofyou_437827":{"type":"posts","id":"futureofyou_437827","meta":{"index":"posts_1591205157","site":"futureofyou","id":"437827","score":null,"sort":[1513771312000]},"guestAuthors":[],"slug":"telemedicine-for-addiction-treatment-sounds-great-but-its-effectiveness-isnt-clear","title":"Telemedicine For Addiction Treatment Sounds Great, But Its Effectiveness Isn't Clear","publishDate":1513771312,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>When President Donald Trump declared the opioid epidemic a public health emergency, it came with a regulatory change intended to make it easier for people to get care. The declaration allows for doctors to prescribe addiction medicine virtually, without ever seeing the patient in person.\u003c/p>\n\u003cp>In Indiana, this kind of virtual visit has been legal since early 2017. But among a dozen addiction specialists in Indiana contacted by a reporter, just one had heard of doctors using telemedicine for opioid addiction treatment: Dr. Jay Joshi.\u003c/p>\n\u003cp>[contextly_sidebar id=\"HTWa6DDHbA3jbwATNMZV5X1BLHSB9M0O\"]At Joshi’s practice, \u003ca href=\"http://prestigepatient.com/\" target=\"_blank\" rel=\"noopener\">Prestige Clinics\u003c/a> in Munster, Ind., a telemedicine consultation takes place in what looks like a standard exam room with a computer. On Tuesdays, Joshi’s patients have video chats with a psychologist who lives 140 miles away.\u003c/p>\n\u003cp>Elizabeth Hall is one of those patients. “The only issue I really had with it was [that] it would freeze, which is kind of inconvenient and a little bit awkward,” she said. “When it freezes you’re like, ‘What do I do? Just sit here and stare at the lady?'”\u003c/p>\n\u003cp>But she said she appreciates the counseling. She’s a former nurse’s assistant and has been going to Joshi for back pain and to treat a heroin addiction for about a year.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I’m in a good place, you know?” she said. “I’m not doing nothing I shouldn’t be doing. I’m not lying to nobody. I’m not sneaking around. Plus, I have a baby. I’m really busy!”\u003c/p>\n\u003cp>To get her insurer to cover her addiction medicine, Hall has to prove she’s engaged in counseling. Local counselors are hard to find. By having a telepsychologist available, Joshi helps patients clear that hurdle.\u003c/p>\n\u003cp>Hall’s insurance also requires urine tests for drug use to keep covering her medication. But she failed her latest urine test — she had used drugs the previous week. Joshi asked Hall to talk to the telepsychologist about the relapse.\u003c/p>\n\u003cp>“I know you know that I haven’t done anything since last week, and I told them I’m not doing nothing no more. I can’t screw up my life,” Hall said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"SEwDMDxgBXjgSpzLw5kL4C8gZO5SgWlc\"]Because of the failed test, her insurance may refuse to pay for Suboxone, her addiction medication. Joshi’s staff may need to intervene with the insurer by phone to keep Hall’s treatment covered. “It’s one of those situations where she’s not taking any other controlled substance,” Joshi said. “We’re seeing her every two weeks. She’s participating in the counseling. It’s just one thing.”\u003c/p>\n\u003cp>Hall said, “I’ve been doing really good, it’s just, you know, it’s hard.”\u003c/p>\n\u003cp>This is why Joshi requires in-person visits — to begin and maintain his patients’ Suboxone prescriptions. He prefers to see these patients every two weeks and will even arrange transportation before going too long without seeing them.\u003c/p>\n\u003cp>Occasionally he’ll prescribe Suboxone remotely, but typically only for a refill once or twice during a patient’s treatment. Seeing the patient in person is critical to their treatment, he said.\u003c/p>\n\u003cp>“You’re not going to get a good system of health care for primary care in these high-risk areas unless you invest time and energy into these patients,” he said.\u003c/p>\n\u003cp>The face-to-face interaction establishes trust, allows him to pick up on body language. Plus, it’s hard to do a urine drug test screen remotely and be sure that the sample actually belongs to the patient. A proper screen lets him know if his patients are taking their medication, instead of selling it.\u003c/p>\n\u003cp>He asked Hall if she mentioned her recent drug use to the counselor.\u003c/p>\n\u003cp>“I really don’t remember if I talked to her about it or not,” she said. Joshi said to make sure she comes in for her next counseling session.\u003c/p>\n\u003cp>Joshi said he has a lot of conversations that aren’t billable.\u003c/p>\n\u003cp>[contextly_sidebar id=\"2CUFegfbIEou2wrq8oAFahU0vF2tkX89\"]That’s partly why there is a shortage of addiction treatment doctors, said Dr. Emily Zarse. She runs the addiction treatment program at Eskenazi Health in Indianapolis.\u003c/p>\n\u003cp>“Telemedicine is a great idea in theory, but it doesn’t fix the workforce shortage problem,” she said.\u003c/p>\n\u003cp>Insurance billing takes up a lot of time and so do the complexities of addiction treatment, she said.\u003c/p>\n\u003cp>There is one area where Zarse thinks telemedicine would be helpful — as a tool to train providers. “That takes one expert’s time for a couple of hours a week, maybe, and you can reach 10, 15, 20 people all at one time,” she said.\u003c/p>\n\u003cp>In fact, Zarse plans to launch a course to train Indiana doctors to treat addiction. In January, she’ll learn more about how to do it, from \u003ca href=\"https://echo.unm.edu/\" target=\"_blank\" rel=\"noopener\">Project Echo\u003c/a>, a resource for clinicians seeking virtual training tools. Zarse envisions a place where doctors from around the state can call in to video chat and walk through cases with trained psychiatrists like herself.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of a partnership that includes \u003ca href=\"https://www.wfyi.org/\" target=\"_blank\" rel=\"noopener\">WFYI\u003c/a>, \u003ca href=\"http://www.sideeffectspublicmedia.org/\" target=\"_blank\" rel=\"noopener\">Side Effects Public Media\u003c/a>, \u003ca href=\"http://www.npr.org/sections/news/\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a> and \u003ca href=\"https://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"One Indiana addiction specialist doesn’t shy away from telemedicine, but he still requires in-person visits to begin and maintain his patients’ Suboxone prescriptions.","status":"publish","parent":0,"modified":1513874310,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":924},"headData":{"title":"Telemedicine For Addiction Treatment Sounds Great, But Its Effectiveness Isn't Clear | KQED","description":"One Indiana addiction specialist doesn’t shy away from telemedicine, but he still requires in-person visits to begin and maintain his patients’ Suboxone prescriptions.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Telemedicine For Addiction Treatment Sounds Great, But Its Effectiveness Isn't Clear","datePublished":"2017-12-20T12:01:52.000Z","dateModified":"2017-12-21T16:38:30.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"437827 https://ww2.kqed.org/futureofyou/?p=437827","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/20/telemedicine-for-addiction-treatment-sounds-great-but-its-effectiveness-isnt-clear/","disqusTitle":"Telemedicine For Addiction Treatment Sounds Great, But Its Effectiveness Isn't Clear","nprByline":"Emily Forman\u003c/br>Side Effects Public Media","path":"/futureofyou/437827/telemedicine-for-addiction-treatment-sounds-great-but-its-effectiveness-isnt-clear","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When President Donald Trump declared the opioid epidemic a public health emergency, it came with a regulatory change intended to make it easier for people to get care. The declaration allows for doctors to prescribe addiction medicine virtually, without ever seeing the patient in person.\u003c/p>\n\u003cp>In Indiana, this kind of virtual visit has been legal since early 2017. But among a dozen addiction specialists in Indiana contacted by a reporter, just one had heard of doctors using telemedicine for opioid addiction treatment: Dr. Jay Joshi.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>At Joshi’s practice, \u003ca href=\"http://prestigepatient.com/\" target=\"_blank\" rel=\"noopener\">Prestige Clinics\u003c/a> in Munster, Ind., a telemedicine consultation takes place in what looks like a standard exam room with a computer. On Tuesdays, Joshi’s patients have video chats with a psychologist who lives 140 miles away.\u003c/p>\n\u003cp>Elizabeth Hall is one of those patients. “The only issue I really had with it was [that] it would freeze, which is kind of inconvenient and a little bit awkward,” she said. “When it freezes you’re like, ‘What do I do? Just sit here and stare at the lady?'”\u003c/p>\n\u003cp>But she said she appreciates the counseling. She’s a former nurse’s assistant and has been going to Joshi for back pain and to treat a heroin addiction for about a year.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I’m in a good place, you know?” she said. “I’m not doing nothing I shouldn’t be doing. I’m not lying to nobody. I’m not sneaking around. Plus, I have a baby. I’m really busy!”\u003c/p>\n\u003cp>To get her insurer to cover her addiction medicine, Hall has to prove she’s engaged in counseling. Local counselors are hard to find. By having a telepsychologist available, Joshi helps patients clear that hurdle.\u003c/p>\n\u003cp>Hall’s insurance also requires urine tests for drug use to keep covering her medication. But she failed her latest urine test — she had used drugs the previous week. Joshi asked Hall to talk to the telepsychologist about the relapse.\u003c/p>\n\u003cp>“I know you know that I haven’t done anything since last week, and I told them I’m not doing nothing no more. I can’t screw up my life,” Hall said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Because of the failed test, her insurance may refuse to pay for Suboxone, her addiction medication. Joshi’s staff may need to intervene with the insurer by phone to keep Hall’s treatment covered. “It’s one of those situations where she’s not taking any other controlled substance,” Joshi said. “We’re seeing her every two weeks. She’s participating in the counseling. It’s just one thing.”\u003c/p>\n\u003cp>Hall said, “I’ve been doing really good, it’s just, you know, it’s hard.”\u003c/p>\n\u003cp>This is why Joshi requires in-person visits — to begin and maintain his patients’ Suboxone prescriptions. He prefers to see these patients every two weeks and will even arrange transportation before going too long without seeing them.\u003c/p>\n\u003cp>Occasionally he’ll prescribe Suboxone remotely, but typically only for a refill once or twice during a patient’s treatment. Seeing the patient in person is critical to their treatment, he said.\u003c/p>\n\u003cp>“You’re not going to get a good system of health care for primary care in these high-risk areas unless you invest time and energy into these patients,” he said.\u003c/p>\n\u003cp>The face-to-face interaction establishes trust, allows him to pick up on body language. Plus, it’s hard to do a urine drug test screen remotely and be sure that the sample actually belongs to the patient. A proper screen lets him know if his patients are taking their medication, instead of selling it.\u003c/p>\n\u003cp>He asked Hall if she mentioned her recent drug use to the counselor.\u003c/p>\n\u003cp>“I really don’t remember if I talked to her about it or not,” she said. Joshi said to make sure she comes in for her next counseling session.\u003c/p>\n\u003cp>Joshi said he has a lot of conversations that aren’t billable.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>That’s partly why there is a shortage of addiction treatment doctors, said Dr. Emily Zarse. She runs the addiction treatment program at Eskenazi Health in Indianapolis.\u003c/p>\n\u003cp>“Telemedicine is a great idea in theory, but it doesn’t fix the workforce shortage problem,” she said.\u003c/p>\n\u003cp>Insurance billing takes up a lot of time and so do the complexities of addiction treatment, she said.\u003c/p>\n\u003cp>There is one area where Zarse thinks telemedicine would be helpful — as a tool to train providers. “That takes one expert’s time for a couple of hours a week, maybe, and you can reach 10, 15, 20 people all at one time,” she said.\u003c/p>\n\u003cp>In fact, Zarse plans to launch a course to train Indiana doctors to treat addiction. In January, she’ll learn more about how to do it, from \u003ca href=\"https://echo.unm.edu/\" target=\"_blank\" rel=\"noopener\">Project Echo\u003c/a>, a resource for clinicians seeking virtual training tools. Zarse envisions a place where doctors from around the state can call in to video chat and walk through cases with trained psychiatrists like herself.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of a partnership that includes \u003ca href=\"https://www.wfyi.org/\" target=\"_blank\" rel=\"noopener\">WFYI\u003c/a>, \u003ca href=\"http://www.sideeffectspublicmedia.org/\" target=\"_blank\" rel=\"noopener\">Side Effects Public Media\u003c/a>, \u003ca href=\"http://www.npr.org/sections/news/\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a> and \u003ca href=\"https://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437827/telemedicine-for-addiction-treatment-sounds-great-but-its-effectiveness-isnt-clear","authors":["byline_futureofyou_437827"],"categories":["futureofyou_1"],"tags":["futureofyou_828","futureofyou_708","futureofyou_344"],"featImg":"futureofyou_437834","label":"futureofyou"},"futureofyou_188522":{"type":"posts","id":"futureofyou_188522","meta":{"index":"posts_1591205157","site":"futureofyou","id":"188522","score":null,"sort":[1466525231000]},"guestAuthors":[],"slug":"employees-getting-health-care-through-telemedicine-kiosks-at-work","title":"Employees Getting Health Care Through Telemedicine Kiosks at Work","publishDate":1466525231,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>On the day abdominal pain and nausea struck Jessica Christianson at the office, she discovered how far telemedicine has come.\u003c/p>\n\u003caside class=\"pullquote alignright\">Kiosks are replacing in-person doctor visits for maladies like colds, sore throats and earaches.\u003c/aside>\n\u003cp>Rushing to a large kiosk in th the Palm Beach County School District’s administrative building where she works, Christianson, 29, consulted a nurse practitioner in Miami via two-way video. The nurse examined her remotely, using a stethoscope and other instruments connected to the computer station. Then, she recommended Christianson seek an ultrasound elsewhere to check for a possible liver problem stemming from an intestinal infection.\u003c/p>\n\u003cp>The cost: $15. She might have paid $50 at an urgent care center.\u003c/p>\n\u003cp>The ultrasound Christianson got later that day confirmed the nurse practitioner’s diagnosis.\u003c/p>\n\u003cp>“Without the kiosk I probably would have waited to get care and that could have made things worse,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Endorsements like Christianson’s demonstrate how technology and positive consumer experiences are lending momentum to telemedicine’s adoption in the workplace.\u003c/p>\n\u003cp>Less than a decade ago, telemedicine was mainly used by hospitals and clinics for secure doctor-to-doctor consultations. But today, telemedicine has become a more common method for patients to receive routine care at home or wherever they are — often on their cellphones or personal computers.\u003c/p>\n\u003cp>In the past several years, a growing number of employers have provided insurance coverage for telemedicine services enabling employees to connect with a doctor by phone using both voice and video. One limitation of such phone-based services is physicians cannot always obtain basic vital signs such as blood pressure and heart rate.\u003c/p>\n\u003cp>That’s where telemedicine kiosks offer an advantage. Hundreds of employers — often supported by their health insurers — now have them installed in the workplaces, according to consultants and two telemedicine companies that make kiosks, American Well and Computerized Screening, Inc.\u003c/p>\n\u003cp>Employers and insurers see the kiosks as a pathway to delivering quality care, reducing lost productivity due to time spent traveling and waiting for care, and saving money by avoiding costlier visits to emergency rooms and urgent care facilities.\u003c/p>\n\u003cp>Jet Blue Airways is adding a kiosk later this year for its employees at John F. Kennedy International Airport in New York. Other big employers providing kiosks in the workplace include the city of Kansas City, Missouri.\u003c/p>\n\u003cp>Large health insurers such as Anthem and UnitedHealthcare are promoting telemedicine’s next wave by testing the kiosks at worksites where they have contracts.\u003c/p>\n\u003cp>Anthem has installed 34 kiosks at 20 employers in the past 18 months. John Jesser, an Anthem vice president, said kiosks are a good option for employers too small or disinclined to invest hundreds of thousands of dollars in creating an on-site clinic with doctors and nurses on standby.\u003c/p>\n\u003cp>“This technology should make it more affordable for employers of many sizes,” Jesser said.\u003c/p>\n\u003cp>Kiosks are typically used for the same maladies that lead people to see a doctor or seek urgent care — colds, sore throats, upper respiratory problems, earaches and pink eye. Telemedicine doctors or nurse practitioners can email prescriptions to clients’ local pharmacies. Employees often pay either nothing or no more than $15 per session, far less than they would pay with insurance at a doctor’s office, an urgent care clinic or an emergency room.\u003c/p>\n\u003cp>Despite kiosks’ growing use in telemedicine, it’s unclear whether they will be supplanted as smartphones, personal computers and tablets enable people to access health care anywhere with a Wi-Fi connection or cell service. Some employers already offer kiosk and personal device options, including MBS Textbook Exchange in Columbia, Missouri, which has 1,000 workers.\u003c/p>\n\u003cp>Workplace kiosks’ appeal is they are quiet, private spaces to seek care. Consumers can get their ailments diagnosed remotely because the kiosks are equipped with familiar doctors’ office instruments such as blood pressure cuffs, thermometers, pulse oximeters and other tools that peer into eyes, ears and mouths. The instrument readings, pictures and sounds are seen and heard immediately by a doctor or nurse practitioner.\u003c/p>\n\u003cp>“The kiosk gives the doctor more tools to diagnose a wider range of conditions,” Anthem’s Jesser said.\u003c/p>\n\u003cp>The downside is that the machines cost $15,000 to $60,000 apiece, which may still be too much for some employers.\u003c/p>\n\u003cp>“Telemedicine kiosks look promising and may still take off, but I don’t see explosive growth,” said Victor Camlek, principal analyst with Frost & Sullivan, a research firm.\u003c/p>\n\u003cp>While kiosks are now found in more workplaces, usage is still relatively low because employees are not sure how they work, said Allan Khoury, a senior consultant with Willis Towers Watson.\u003c/p>\n\u003cp>Employers’ experiences are mixed.\u003c/p>\n\u003cp>Officials in Kansas City, Missouri, estimate the kiosk placed in city hall almost a year ago has saved the local government at least $28,000. That’s what Kansas City hasn’t spent because employees and dependents chose the telemedicine option instead of an in-person doctor visit. The city also estimates it has gained hundreds of productive work hours — that’s the time employees saved by not leaving work to see a doctor.\u003c/p>\n\u003cp>In contrast, fewer than 175 of the 2,000 employees at the Palm Beach County School District headquarters have used the kiosk there in its first year, said Dianne Howard, director of risk management.\u003c/p>\n\u003cp>Howard remains hopeful: “This is the future of health care.”\u003c/p>\n\u003cp>The district’s kiosk was supplied at no cost by UnitedHealthcare, as part of a test also involving two other employers in Florida.\u003c/p>\n\u003cp>Those kiosks connect employees to nurse practitioners at Nicklaus Children’s Hospital in Miami. The hospital employs an attendant at each kiosk location to help workers register and use some of the instruments, such as the stethoscope.\u003c/p>\n\u003cp>Other telemedicine kiosks, such as those made by America Well, are designed to be totally self-service for employees. They also offer users immediate access to a health care provider. American Well has deployed about 200 kiosks and is in midst of rolling out 500 more, mostly to employers, the company said. It also places kiosks in retail outlets and hospitals.\u003c/p>\n\u003cp>Telemedicine’s increasing sophistication is winning over some traditional-minded physicians.\u003c/p>\n\u003cp>The WEA Trust in Madison, Wisconsin, a nonprofit that offers health coverage to public employers, installed a kiosk for the benefit of its 250 workers last fall.\u003c/p>\n\u003cp>Dr. Tim Bartholow, a family doctor by training and chief medical officer for the trust, said he was cautious about physicians treating patients they haven’t seen in person. After observing employees using it, Bartholow is convinced it can help them get good care.\u003c/p>\n\u003cp>“I don’t think telemedicine is making a doctor being on site quite agnostic, but it is certainly reducing the premium on being in the same space as the patient,” Bartholow said.\u003c/p>\n\u003cp>Insurers declare they are moving carefully, too, recognizing that telemedicine has its limits and they must depend on practitioners to tell patients when they have to see a doctor — in person.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We have to rely on their experience and judgment,” Jesser said.\u003c/p>\n\n","blocks":[],"excerpt":"Hundreds of employers have installed medical kiosks at workplaces. Large insurance companies are also promoting this next wave of telemedicine.","status":"publish","parent":0,"modified":1466525684,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":36,"wordCount":1212},"headData":{"title":"Employees Getting Health Care Through Telemedicine Kiosks at Work | KQED","description":"Hundreds of employers have installed medical kiosks at workplaces. Large insurance companies are also promoting this next wave of telemedicine.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Employees Getting Health Care Through Telemedicine Kiosks at Work","datePublished":"2016-06-21T16:07:11.000Z","dateModified":"2016-06-21T16:14:44.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"188522 http://ww2.kqed.org/futureofyou/?p=188522","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/06/21/employees-getting-health-care-through-telemedicine-kiosks-at-work/","disqusTitle":"Employees Getting Health Care Through Telemedicine Kiosks at Work","nprByline":"Phil Galewitz\u003cbr />Kaiser Health News","path":"/futureofyou/188522/employees-getting-health-care-through-telemedicine-kiosks-at-work","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>On the day abdominal pain and nausea struck Jessica Christianson at the office, she discovered how far telemedicine has come.\u003c/p>\n\u003caside class=\"pullquote alignright\">Kiosks are replacing in-person doctor visits for maladies like colds, sore throats and earaches.\u003c/aside>\n\u003cp>Rushing to a large kiosk in th the Palm Beach County School District’s administrative building where she works, Christianson, 29, consulted a nurse practitioner in Miami via two-way video. The nurse examined her remotely, using a stethoscope and other instruments connected to the computer station. Then, she recommended Christianson seek an ultrasound elsewhere to check for a possible liver problem stemming from an intestinal infection.\u003c/p>\n\u003cp>The cost: $15. She might have paid $50 at an urgent care center.\u003c/p>\n\u003cp>The ultrasound Christianson got later that day confirmed the nurse practitioner’s diagnosis.\u003c/p>\n\u003cp>“Without the kiosk I probably would have waited to get care and that could have made things worse,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Endorsements like Christianson’s demonstrate how technology and positive consumer experiences are lending momentum to telemedicine’s adoption in the workplace.\u003c/p>\n\u003cp>Less than a decade ago, telemedicine was mainly used by hospitals and clinics for secure doctor-to-doctor consultations. But today, telemedicine has become a more common method for patients to receive routine care at home or wherever they are — often on their cellphones or personal computers.\u003c/p>\n\u003cp>In the past several years, a growing number of employers have provided insurance coverage for telemedicine services enabling employees to connect with a doctor by phone using both voice and video. One limitation of such phone-based services is physicians cannot always obtain basic vital signs such as blood pressure and heart rate.\u003c/p>\n\u003cp>That’s where telemedicine kiosks offer an advantage. Hundreds of employers — often supported by their health insurers — now have them installed in the workplaces, according to consultants and two telemedicine companies that make kiosks, American Well and Computerized Screening, Inc.\u003c/p>\n\u003cp>Employers and insurers see the kiosks as a pathway to delivering quality care, reducing lost productivity due to time spent traveling and waiting for care, and saving money by avoiding costlier visits to emergency rooms and urgent care facilities.\u003c/p>\n\u003cp>Jet Blue Airways is adding a kiosk later this year for its employees at John F. Kennedy International Airport in New York. Other big employers providing kiosks in the workplace include the city of Kansas City, Missouri.\u003c/p>\n\u003cp>Large health insurers such as Anthem and UnitedHealthcare are promoting telemedicine’s next wave by testing the kiosks at worksites where they have contracts.\u003c/p>\n\u003cp>Anthem has installed 34 kiosks at 20 employers in the past 18 months. John Jesser, an Anthem vice president, said kiosks are a good option for employers too small or disinclined to invest hundreds of thousands of dollars in creating an on-site clinic with doctors and nurses on standby.\u003c/p>\n\u003cp>“This technology should make it more affordable for employers of many sizes,” Jesser said.\u003c/p>\n\u003cp>Kiosks are typically used for the same maladies that lead people to see a doctor or seek urgent care — colds, sore throats, upper respiratory problems, earaches and pink eye. Telemedicine doctors or nurse practitioners can email prescriptions to clients’ local pharmacies. Employees often pay either nothing or no more than $15 per session, far less than they would pay with insurance at a doctor’s office, an urgent care clinic or an emergency room.\u003c/p>\n\u003cp>Despite kiosks’ growing use in telemedicine, it’s unclear whether they will be supplanted as smartphones, personal computers and tablets enable people to access health care anywhere with a Wi-Fi connection or cell service. Some employers already offer kiosk and personal device options, including MBS Textbook Exchange in Columbia, Missouri, which has 1,000 workers.\u003c/p>\n\u003cp>Workplace kiosks’ appeal is they are quiet, private spaces to seek care. Consumers can get their ailments diagnosed remotely because the kiosks are equipped with familiar doctors’ office instruments such as blood pressure cuffs, thermometers, pulse oximeters and other tools that peer into eyes, ears and mouths. The instrument readings, pictures and sounds are seen and heard immediately by a doctor or nurse practitioner.\u003c/p>\n\u003cp>“The kiosk gives the doctor more tools to diagnose a wider range of conditions,” Anthem’s Jesser said.\u003c/p>\n\u003cp>The downside is that the machines cost $15,000 to $60,000 apiece, which may still be too much for some employers.\u003c/p>\n\u003cp>“Telemedicine kiosks look promising and may still take off, but I don’t see explosive growth,” said Victor Camlek, principal analyst with Frost & Sullivan, a research firm.\u003c/p>\n\u003cp>While kiosks are now found in more workplaces, usage is still relatively low because employees are not sure how they work, said Allan Khoury, a senior consultant with Willis Towers Watson.\u003c/p>\n\u003cp>Employers’ experiences are mixed.\u003c/p>\n\u003cp>Officials in Kansas City, Missouri, estimate the kiosk placed in city hall almost a year ago has saved the local government at least $28,000. That’s what Kansas City hasn’t spent because employees and dependents chose the telemedicine option instead of an in-person doctor visit. The city also estimates it has gained hundreds of productive work hours — that’s the time employees saved by not leaving work to see a doctor.\u003c/p>\n\u003cp>In contrast, fewer than 175 of the 2,000 employees at the Palm Beach County School District headquarters have used the kiosk there in its first year, said Dianne Howard, director of risk management.\u003c/p>\n\u003cp>Howard remains hopeful: “This is the future of health care.”\u003c/p>\n\u003cp>The district’s kiosk was supplied at no cost by UnitedHealthcare, as part of a test also involving two other employers in Florida.\u003c/p>\n\u003cp>Those kiosks connect employees to nurse practitioners at Nicklaus Children’s Hospital in Miami. The hospital employs an attendant at each kiosk location to help workers register and use some of the instruments, such as the stethoscope.\u003c/p>\n\u003cp>Other telemedicine kiosks, such as those made by America Well, are designed to be totally self-service for employees. They also offer users immediate access to a health care provider. American Well has deployed about 200 kiosks and is in midst of rolling out 500 more, mostly to employers, the company said. It also places kiosks in retail outlets and hospitals.\u003c/p>\n\u003cp>Telemedicine’s increasing sophistication is winning over some traditional-minded physicians.\u003c/p>\n\u003cp>The WEA Trust in Madison, Wisconsin, a nonprofit that offers health coverage to public employers, installed a kiosk for the benefit of its 250 workers last fall.\u003c/p>\n\u003cp>Dr. Tim Bartholow, a family doctor by training and chief medical officer for the trust, said he was cautious about physicians treating patients they haven’t seen in person. After observing employees using it, Bartholow is convinced it can help them get good care.\u003c/p>\n\u003cp>“I don’t think telemedicine is making a doctor being on site quite agnostic, but it is certainly reducing the premium on being in the same space as the patient,” Bartholow said.\u003c/p>\n\u003cp>Insurers declare they are moving carefully, too, recognizing that telemedicine has its limits and they must depend on practitioners to tell patients when they have to see a doctor — in person.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have to rely on their experience and judgment,” Jesser said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/188522/employees-getting-health-care-through-telemedicine-kiosks-at-work","authors":["byline_futureofyou_188522"],"categories":["futureofyou_1"],"tags":["futureofyou_344"],"featImg":"futureofyou_188525","label":"futureofyou"},"futureofyou_179237":{"type":"posts","id":"futureofyou_179237","meta":{"index":"posts_1591205157","site":"futureofyou","id":"179237","score":null,"sort":[1465417836000]},"guestAuthors":[],"slug":"5-trends-to-watch-in-digital-health-for-people-over-50","title":"5 Trends to Watch in Digital Health for People Over 50","publishDate":1465417836,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Medical companies shouldn’t overlook older people when they design wearables or apps, according to new \u003ca href=\"http://www.aarp.org/technology/innovations/innovation-50-plus/research/#frontiers\" target=\"_blank\">findings\u003c/a> from AARP, the advocacy group for seniors.\u003c/p>\n\u003cp>Consumers 50 and over are moving away from traditional health care models that require face-to-face clinical appointments and extensive hospital tests, in favor of digital health care solutions like smart sensors and video appointments. AARP's \u003ca href=\"http://www.aarp.org/content/dam/aarp/home-and-family/personal-technology/2016/05/2016-Health-Innovation-Frontiers-Infographics-AARP.pdf\" target=\"_blank\">revenue forecast\u003c/a> for digital health care for the over-50 market is $34 Billion between 2015 and 2020.\u003c/p>\n\u003cp>Jody Holtzman, AARP's senior vice President for market innovation, spoke at this week's \u003ca href=\"https://summersummit.digitalhealthsummit.com/\" target=\"_blank\">Digital Health Summer Summit\u003c/a>, in downtown San Francisco. Here are five digital health trends he sees emerging in the over-50 market.\u003c/p>\n\u003cp style=\"text-align: left\">\u003cb>Trend No. 1: Ease of Hiring Caregivers \u003c/b>\u003c/p>\n\u003cp>Traditionally patients have contacted an agency to find a caregiver, but companies are disrupting this model by removing the middle man. A growing number of startups like \u003ca href=\"https://www.joinhonor.com/\" target=\"_blank\">Honor\u003c/a> and \u003ca href=\"https://www.carelinx.com/\" target=\"_blank\">CareLinx\u003c/a> offer online marketplaces connecting patients directly with service providers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cb>Trend No. 2: Technophobia Declines\u003c/b>\u003c/p>\n\u003cp>The data shows older people are no longer resisting screens -- in fact they're adopting technology in increasing numbers. \u003ca href=\"http://www.pewinternet.org/2014/04/03/older-adults-and-technology-use/\" target=\"_blank\">Pew Research Center\u003c/a> reports 79 percent of people between 50 and 64 go online every day. The rate for people 65 and older is 71 percent. That's up from 58 percent in \u003ca href=\"http://www.pewinternet.org/2010/12/16/generations-2010/\">2010\u003c/a>.\u003c/p>\n\u003cp>Holtzman says pedometers, which measure the number of steps people take, have always been popular with the elderly, who are now adopting digital devices like Fitbits, Jawbones and Misfit Shines. The most successful products will be designed for those who have less than perfect vision, he says. Think user friendly products with big font and simple visuals.\u003c/p>\n\u003cp>\u003cb>Trend No. 3: Siri and Alexa are the Future\u003c/b>\u003c/p>\n\u003cp>Even though older people are becoming more tech savvy, Holtzman says hands-free voice recognition devices like \u003ca href=\"http://www.apple.com/ios/siri/\" target=\"_blank\">Apple’s Siri\u003c/a> and \u003ca href=\"http://www.amazon.com/Amazon-Echo-Bluetooth-Speaker-with-WiFi-Alexa/dp/B00X4WHP5E\" target=\"_blank\">Amazon Echo’s Alexa\u003c/a> will be the real killer health apps for seniors.\u003c/p>\n\u003cp>“When you can just say, ‘Computer I took my medication,' or, ‘Computer order my meds.’ Imagine a day when you can order an autonomous vehicle that takes you to and from your doctor appointment. ... You are going to see exponential development and ease of use.”\u003c/p>\n\u003cp>\u003cb>Trend No. 4: Technology Plus Humans\u003c/b>\u003c/p>\n\u003cp>Patient behavior is more likely to change if a human being is involved. Holtzman cites \u003ca href=\"https://www.omadahealth.com/\" target=\"_blank\">Omada Health’s\u003c/a> diabetes management program, in which a patient receives a health \u003ca href=\"https://go.omadahealth.com/health-coaches\" target=\"_blank\">coach\u003c/a> who works in tandem with digital tracking systems like wireless scales, pedometers and apps to monitor diet, exercise and medicines. As the patient tracks daily habits, the coach offers support and recommendations.\u003c/p>\n\u003cp>\u003cb>Trend No. 5: Telemedicine \u003c/b>\u003c/p>\n\u003cp>An increasing number of physicians are offering patients remote care through online video appointments or email consultations. Not surprisingly, Holtzman predicts telemedicine will expand in rural communities and among patients who have physical limitations that make it difficult to travel.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"People over 50 are a ripe market for digital health companies according to new findings from AARP.","status":"publish","parent":0,"modified":1475120958,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":524},"headData":{"title":"5 Trends to Watch in Digital Health for People Over 50 | KQED","description":"People over 50 are a ripe market for digital health companies according to new findings from AARP.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"5 Trends to Watch in Digital Health for People Over 50","datePublished":"2016-06-08T20:30:36.000Z","dateModified":"2016-09-29T03:49:18.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"179237 http://ww2.kqed.org/futureofyou/?p=179237","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/06/08/5-trends-to-watch-in-digital-health-for-people-over-50/","disqusTitle":"5 Trends to Watch in Digital Health for People Over 50","path":"/futureofyou/179237/5-trends-to-watch-in-digital-health-for-people-over-50","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Medical companies shouldn’t overlook older people when they design wearables or apps, according to new \u003ca href=\"http://www.aarp.org/technology/innovations/innovation-50-plus/research/#frontiers\" target=\"_blank\">findings\u003c/a> from AARP, the advocacy group for seniors.\u003c/p>\n\u003cp>Consumers 50 and over are moving away from traditional health care models that require face-to-face clinical appointments and extensive hospital tests, in favor of digital health care solutions like smart sensors and video appointments. AARP's \u003ca href=\"http://www.aarp.org/content/dam/aarp/home-and-family/personal-technology/2016/05/2016-Health-Innovation-Frontiers-Infographics-AARP.pdf\" target=\"_blank\">revenue forecast\u003c/a> for digital health care for the over-50 market is $34 Billion between 2015 and 2020.\u003c/p>\n\u003cp>Jody Holtzman, AARP's senior vice President for market innovation, spoke at this week's \u003ca href=\"https://summersummit.digitalhealthsummit.com/\" target=\"_blank\">Digital Health Summer Summit\u003c/a>, in downtown San Francisco. Here are five digital health trends he sees emerging in the over-50 market.\u003c/p>\n\u003cp style=\"text-align: left\">\u003cb>Trend No. 1: Ease of Hiring Caregivers \u003c/b>\u003c/p>\n\u003cp>Traditionally patients have contacted an agency to find a caregiver, but companies are disrupting this model by removing the middle man. A growing number of startups like \u003ca href=\"https://www.joinhonor.com/\" target=\"_blank\">Honor\u003c/a> and \u003ca href=\"https://www.carelinx.com/\" target=\"_blank\">CareLinx\u003c/a> offer online marketplaces connecting patients directly with service providers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>Trend No. 2: Technophobia Declines\u003c/b>\u003c/p>\n\u003cp>The data shows older people are no longer resisting screens -- in fact they're adopting technology in increasing numbers. \u003ca href=\"http://www.pewinternet.org/2014/04/03/older-adults-and-technology-use/\" target=\"_blank\">Pew Research Center\u003c/a> reports 79 percent of people between 50 and 64 go online every day. The rate for people 65 and older is 71 percent. That's up from 58 percent in \u003ca href=\"http://www.pewinternet.org/2010/12/16/generations-2010/\">2010\u003c/a>.\u003c/p>\n\u003cp>Holtzman says pedometers, which measure the number of steps people take, have always been popular with the elderly, who are now adopting digital devices like Fitbits, Jawbones and Misfit Shines. The most successful products will be designed for those who have less than perfect vision, he says. Think user friendly products with big font and simple visuals.\u003c/p>\n\u003cp>\u003cb>Trend No. 3: Siri and Alexa are the Future\u003c/b>\u003c/p>\n\u003cp>Even though older people are becoming more tech savvy, Holtzman says hands-free voice recognition devices like \u003ca href=\"http://www.apple.com/ios/siri/\" target=\"_blank\">Apple’s Siri\u003c/a> and \u003ca href=\"http://www.amazon.com/Amazon-Echo-Bluetooth-Speaker-with-WiFi-Alexa/dp/B00X4WHP5E\" target=\"_blank\">Amazon Echo’s Alexa\u003c/a> will be the real killer health apps for seniors.\u003c/p>\n\u003cp>“When you can just say, ‘Computer I took my medication,' or, ‘Computer order my meds.’ Imagine a day when you can order an autonomous vehicle that takes you to and from your doctor appointment. ... You are going to see exponential development and ease of use.”\u003c/p>\n\u003cp>\u003cb>Trend No. 4: Technology Plus Humans\u003c/b>\u003c/p>\n\u003cp>Patient behavior is more likely to change if a human being is involved. Holtzman cites \u003ca href=\"https://www.omadahealth.com/\" target=\"_blank\">Omada Health’s\u003c/a> diabetes management program, in which a patient receives a health \u003ca href=\"https://go.omadahealth.com/health-coaches\" target=\"_blank\">coach\u003c/a> who works in tandem with digital tracking systems like wireless scales, pedometers and apps to monitor diet, exercise and medicines. As the patient tracks daily habits, the coach offers support and recommendations.\u003c/p>\n\u003cp>\u003cb>Trend No. 5: Telemedicine \u003c/b>\u003c/p>\n\u003cp>An increasing number of physicians are offering patients remote care through online video appointments or email consultations. Not surprisingly, Holtzman predicts telemedicine will expand in rural communities and among patients who have physical limitations that make it difficult to travel.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/179237/5-trends-to-watch-in-digital-health-for-people-over-50","authors":["11229"],"categories":["futureofyou_1060"],"tags":["futureofyou_950","futureofyou_26","futureofyou_951","futureofyou_643","futureofyou_344"],"featImg":"futureofyou_179728","label":"futureofyou"},"futureofyou_7055":{"type":"posts","id":"futureofyou_7055","meta":{"index":"posts_1591205157","site":"futureofyou","id":"7055","score":null,"sort":[1435345792000]},"guestAuthors":[],"slug":"why-medicare-has-been-slow-to-adopt-telemedicine","title":"Why Medicare Has Been Slow to Adopt Telemedicine","publishDate":1435345792,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Donna Miles didn’t feel like getting dressed and driving to her physician’s office or to a retailer’s health clinic near her Cincinnati home.\u003c/p>\n\u003cp>For several days, she had thought she had thrush, a mouth infection that made her tongue sore and discolored with raised white spots. When Miles, 68, awoke on a wintry February morning and the pain had not subsided, she decided to see a doctor. So she turned on her computer and logged on to \u003ca href=\"https://livehealthonline.com/\" target=\"_blank\">www.livehealth.com\u003c/a>, a service offered by her Medicare Advantage plan, Anthem BlueCross BlueShield of Ohio. She spoke to a physician, who used her computer’s camera to peer into her mouth and who then sent a prescription to her pharmacy.\u003c/p>\n\u003cp>“This was so easy,” Miles said.\u003c/p>\n\u003cp>For Medicare patients, it’s also incredibly rare.\u003c/p>\n\u003cp>Nearly 20 years after such videoconferencing technology has been available for health services, fewer than one percent of Medicare beneficiaries use it. Anthem and a University of Pittsburgh Medical Center health plan in western Pennsylvania are the only two Medicare Advantage insurers offering the virtual visits, and the traditional Medicare program has tightly limited telemedicine payments to certain rural areas. And even there, the beneficiary must already be at a clinic, a rule that often defeats the goal of making care more convenient.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Congress has maintained such restrictions out of concern that the service might increase Medicare expenses. The Congressional Budget Office and other analysts have said giving seniors access to doctors online will encourage them to use more services, not replace costly visits to emergency rooms and urgent care centers.\u003c/p>\n\u003cp>In 2012, the latest year for which data are available, Medicare paid about $5 million for telemedicine services — barely a blip compared with the program’s total spending of $466 billion, according to a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25839672\" target=\"_blank\">study\u003c/a> in the journal Telemedicine.\u003c/p>\n\u003cp>“The very advantage of telehealth, its ability to make care convenient, is also potentially its Achilles’ heel,” Ateev Mehrotra, a Rand Corp. analyst, told a House Energy and Commerce subcommittee \u003ca href=\"http://docs.house.gov/meetings/IF/IF14/20140501/102173/HHRG-113-IF14-Wstate-MehrotraA-20140501.pdf\" target=\"_blank\">last year\u003c/a>. “Telehealth may be ‘too convenient.’ ”\u003c/p>\n\u003cp>But the telemedicine industry says letting more beneficiaries get care online would reduce doctor visits and emergency care. Industry officials as well as the American Medical Association, the American Hospital Association and other health experts say it’s time for Congress to expand use of telemedicine in Medicare.\u003c/p>\n\u003cp>\u003cstrong>Popular Outside Medicare\u003c/strong>\u003c/p>\n\u003cp>“There is no question that telemedicine is going to be an increasingly important portal for doctors and other providers to stay connected with patients,” former Surgeon General Richard Carmona said in an interview.\u003c/p>\n\u003cp>Some health experts say it’s disappointing that most seniors can’t take advantage of the benefit that many of their children have.\u003c/p>\n\u003cp>“Medicare beneficiaries are paying a huge price” for not having this benefit, said Jay Wolfson, a professor of public health, medicine and pharmacy at the University of South Florida in Tampa. For example, he said, telemedicine could help seniors with follow-up appointments that might be missed because of transportation problems.\u003c/p>\n\u003cp>Aetna and UnitedHealthcare cover telemedicine services for members younger than 65, regardless of whether enrollees live in the city or in the country. About 37 percent of large employers said that they expect to offer their employees a telemedicine benefit this year, according to a \u003ca href=\"http://www.towerswatson.com/en-US/Press/2014/08/current-telemedicine-technology-could-mean-big-savings\" target=\"_blank\">survey\u003c/a> last year by Towers Watson, an employee benefits firm. About 800,000 online medical consultations will be done in 2015, according to the American Telemedicine Association, a trade group.\u003c/p>\n\u003cp>Medicare’s tight lid on telemedicine is showing signs of changing.\u003c/p>\n\u003cp>In addition to Medicare Advantage plans, several Medicare accountable care organizations, or ACOs — groups of doctors and hospitals that coordinate patient care for at least 5,000 enrollees — have begun using the service. Medicare Advantage plans have the option to offer telemedicine without the tight restrictions in the traditional Medicare program because they are paid a fixed amount by the federal government to care for seniors. As a result, Medicare is not directly paying for the telemedicine services; instead, the services are paid for through plan revenue.\u003c/p>\n\u003cp>Republicans and Democrats in Congress are also considering broadening the use of telemedicine; some of them tried unsuccessfully to add such provisions to the recent law that revamped Medicare doctor payment rules and to the House bill that seeks to streamline drug approvals.\u003c/p>\n\u003cp>\u003cstrong>‘Changing This Dynamic’\u003c/strong>\u003c/p>\n\u003cp>This year, Medicare expanded telemedicine coverage for mental health services and annual wellness visits — when done in certain rural areas and when the patient is at a doctor’s office or health clinic.\u003c/p>\n\u003cp>“Medicare . . . is still laboring under a number of limitations that disincentivize telemedicine use,” said Jonathan Neufeld, clinical director of the Upper Midwest Telehealth Resource Center, an Indiana-based consortium of organizations involved in telemedicine. “But ACOs and other alternative payment methods have the possibility of changing this dynamic.”\u003c/p>\n\u003cp>AARP wants Congress to allow all Medicare beneficiaries to have coverage for telemedicine services, said Andrew Scholnick, a senior legislative representative for the lobbying group. “We would like to see a broader use of this service,” he said. He stressed that AARP prefers that Medicare patients use telemedicine in conjunction with seeing their regular doctor.\u003c/p>\n\u003cp>The American Medical Association has \u003ca href=\"https://kaiserhealthnews.files.wordpress.com/2015/06/2015-february-23-ama-20th-cures-comment-letter_v2.pdf\" target=\"_blank\">endorsed\u003c/a> congressional efforts to change Medicare’s policy on telemedicine, as has the \u003ca href=\"http://www.aafp.org/dam/AAFP/documents/advocacy/health_it/interoperability/LT-EC-Telemedicine-061614.pdf\" target=\"_blank\">American Academy of Family Physicians\u003c/a>. “We see the potential for it . . . to improve quality and lower costs,” said Robert Wergin, president of the academy and a family doctor in Milford, Neb. He said such technology can help patients who are disabled or don’t have easy transportation to the doctor’s office.\u003c/p>\n\u003cp>Anthem, which provides its telemedicine option to about 350,000 Medicare Advantage members in 12 states, expects the system to improve care and make it more affordable. “It’s also about the consumer experience and giving consumers convenience to be able to be face to face with a doctor in less than 10 minutes, 365 days a year,” said John Jesser, an Anthem vice president. Anthem provides the service at no extra charge to its Medicare Advantage members.\u003c/p>\n\u003cp>While seniors are more likely to have more complicated health issues, telemedicine for them is no riskier than for younger patients, said Mia Finkelston, a family physician in Leonardtown, Md., who works with American Well, a firm that provides the technology behind Livehealth.com. That’s because the online doctors know when they can handle health issues and know when to advise people to seek an in-person visit or head to the emergency room, she said.\u003c/p>\n\u003cp>“Our intent is not to replace their primary care physician, but to augment their care,” she said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story originally ran on\u003ca href=\"http://www.kaiserhealthnews.org/\"> Kaiser Health News\u003c/a> (KHN), a nonprofit national health policy news service. \u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Nearly 20 years after such videoconferencing technology has been available for health services, fewer than one percent of Medicare beneficiaries use it. ","status":"publish","parent":0,"modified":1435345813,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":1165},"headData":{"title":"Why Medicare Has Been Slow to Adopt Telemedicine | KQED","description":"Nearly 20 years after such videoconferencing technology has been available for health services, fewer than one percent of Medicare beneficiaries use it. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why Medicare Has Been Slow to Adopt Telemedicine","datePublished":"2015-06-26T19:09:52.000Z","dateModified":"2015-06-26T19:10:13.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"7055 http://ww2.kqed.org/futureofyou/?p=7055","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/06/26/why-medicare-has-been-slow-to-adopt-telemedicine/","disqusTitle":"Why Medicare Has Been Slow to Adopt Telemedicine","nprByline":"Phil Galewitz, Kaiser Health News","path":"/futureofyou/7055/why-medicare-has-been-slow-to-adopt-telemedicine","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Donna Miles didn’t feel like getting dressed and driving to her physician’s office or to a retailer’s health clinic near her Cincinnati home.\u003c/p>\n\u003cp>For several days, she had thought she had thrush, a mouth infection that made her tongue sore and discolored with raised white spots. When Miles, 68, awoke on a wintry February morning and the pain had not subsided, she decided to see a doctor. So she turned on her computer and logged on to \u003ca href=\"https://livehealthonline.com/\" target=\"_blank\">www.livehealth.com\u003c/a>, a service offered by her Medicare Advantage plan, Anthem BlueCross BlueShield of Ohio. She spoke to a physician, who used her computer’s camera to peer into her mouth and who then sent a prescription to her pharmacy.\u003c/p>\n\u003cp>“This was so easy,” Miles said.\u003c/p>\n\u003cp>For Medicare patients, it’s also incredibly rare.\u003c/p>\n\u003cp>Nearly 20 years after such videoconferencing technology has been available for health services, fewer than one percent of Medicare beneficiaries use it. Anthem and a University of Pittsburgh Medical Center health plan in western Pennsylvania are the only two Medicare Advantage insurers offering the virtual visits, and the traditional Medicare program has tightly limited telemedicine payments to certain rural areas. And even there, the beneficiary must already be at a clinic, a rule that often defeats the goal of making care more convenient.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Congress has maintained such restrictions out of concern that the service might increase Medicare expenses. The Congressional Budget Office and other analysts have said giving seniors access to doctors online will encourage them to use more services, not replace costly visits to emergency rooms and urgent care centers.\u003c/p>\n\u003cp>In 2012, the latest year for which data are available, Medicare paid about $5 million for telemedicine services — barely a blip compared with the program’s total spending of $466 billion, according to a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25839672\" target=\"_blank\">study\u003c/a> in the journal Telemedicine.\u003c/p>\n\u003cp>“The very advantage of telehealth, its ability to make care convenient, is also potentially its Achilles’ heel,” Ateev Mehrotra, a Rand Corp. analyst, told a House Energy and Commerce subcommittee \u003ca href=\"http://docs.house.gov/meetings/IF/IF14/20140501/102173/HHRG-113-IF14-Wstate-MehrotraA-20140501.pdf\" target=\"_blank\">last year\u003c/a>. “Telehealth may be ‘too convenient.’ ”\u003c/p>\n\u003cp>But the telemedicine industry says letting more beneficiaries get care online would reduce doctor visits and emergency care. Industry officials as well as the American Medical Association, the American Hospital Association and other health experts say it’s time for Congress to expand use of telemedicine in Medicare.\u003c/p>\n\u003cp>\u003cstrong>Popular Outside Medicare\u003c/strong>\u003c/p>\n\u003cp>“There is no question that telemedicine is going to be an increasingly important portal for doctors and other providers to stay connected with patients,” former Surgeon General Richard Carmona said in an interview.\u003c/p>\n\u003cp>Some health experts say it’s disappointing that most seniors can’t take advantage of the benefit that many of their children have.\u003c/p>\n\u003cp>“Medicare beneficiaries are paying a huge price” for not having this benefit, said Jay Wolfson, a professor of public health, medicine and pharmacy at the University of South Florida in Tampa. For example, he said, telemedicine could help seniors with follow-up appointments that might be missed because of transportation problems.\u003c/p>\n\u003cp>Aetna and UnitedHealthcare cover telemedicine services for members younger than 65, regardless of whether enrollees live in the city or in the country. About 37 percent of large employers said that they expect to offer their employees a telemedicine benefit this year, according to a \u003ca href=\"http://www.towerswatson.com/en-US/Press/2014/08/current-telemedicine-technology-could-mean-big-savings\" target=\"_blank\">survey\u003c/a> last year by Towers Watson, an employee benefits firm. About 800,000 online medical consultations will be done in 2015, according to the American Telemedicine Association, a trade group.\u003c/p>\n\u003cp>Medicare’s tight lid on telemedicine is showing signs of changing.\u003c/p>\n\u003cp>In addition to Medicare Advantage plans, several Medicare accountable care organizations, or ACOs — groups of doctors and hospitals that coordinate patient care for at least 5,000 enrollees — have begun using the service. Medicare Advantage plans have the option to offer telemedicine without the tight restrictions in the traditional Medicare program because they are paid a fixed amount by the federal government to care for seniors. As a result, Medicare is not directly paying for the telemedicine services; instead, the services are paid for through plan revenue.\u003c/p>\n\u003cp>Republicans and Democrats in Congress are also considering broadening the use of telemedicine; some of them tried unsuccessfully to add such provisions to the recent law that revamped Medicare doctor payment rules and to the House bill that seeks to streamline drug approvals.\u003c/p>\n\u003cp>\u003cstrong>‘Changing This Dynamic’\u003c/strong>\u003c/p>\n\u003cp>This year, Medicare expanded telemedicine coverage for mental health services and annual wellness visits — when done in certain rural areas and when the patient is at a doctor’s office or health clinic.\u003c/p>\n\u003cp>“Medicare . . . is still laboring under a number of limitations that disincentivize telemedicine use,” said Jonathan Neufeld, clinical director of the Upper Midwest Telehealth Resource Center, an Indiana-based consortium of organizations involved in telemedicine. “But ACOs and other alternative payment methods have the possibility of changing this dynamic.”\u003c/p>\n\u003cp>AARP wants Congress to allow all Medicare beneficiaries to have coverage for telemedicine services, said Andrew Scholnick, a senior legislative representative for the lobbying group. “We would like to see a broader use of this service,” he said. He stressed that AARP prefers that Medicare patients use telemedicine in conjunction with seeing their regular doctor.\u003c/p>\n\u003cp>The American Medical Association has \u003ca href=\"https://kaiserhealthnews.files.wordpress.com/2015/06/2015-february-23-ama-20th-cures-comment-letter_v2.pdf\" target=\"_blank\">endorsed\u003c/a> congressional efforts to change Medicare’s policy on telemedicine, as has the \u003ca href=\"http://www.aafp.org/dam/AAFP/documents/advocacy/health_it/interoperability/LT-EC-Telemedicine-061614.pdf\" target=\"_blank\">American Academy of Family Physicians\u003c/a>. “We see the potential for it . . . to improve quality and lower costs,” said Robert Wergin, president of the academy and a family doctor in Milford, Neb. He said such technology can help patients who are disabled or don’t have easy transportation to the doctor’s office.\u003c/p>\n\u003cp>Anthem, which provides its telemedicine option to about 350,000 Medicare Advantage members in 12 states, expects the system to improve care and make it more affordable. “It’s also about the consumer experience and giving consumers convenience to be able to be face to face with a doctor in less than 10 minutes, 365 days a year,” said John Jesser, an Anthem vice president. Anthem provides the service at no extra charge to its Medicare Advantage members.\u003c/p>\n\u003cp>While seniors are more likely to have more complicated health issues, telemedicine for them is no riskier than for younger patients, said Mia Finkelston, a family physician in Leonardtown, Md., who works with American Well, a firm that provides the technology behind Livehealth.com. That’s because the online doctors know when they can handle health issues and know when to advise people to seek an in-person visit or head to the emergency room, she said.\u003c/p>\n\u003cp>“Our intent is not to replace their primary care physician, but to augment their care,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story originally ran on\u003ca href=\"http://www.kaiserhealthnews.org/\"> Kaiser Health News\u003c/a> (KHN), a nonprofit national health policy news service. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/7055/why-medicare-has-been-slow-to-adopt-telemedicine","authors":["byline_futureofyou_7055"],"categories":["futureofyou_1"],"tags":["futureofyou_230","futureofyou_475","futureofyou_476","futureofyou_344"],"featImg":"futureofyou_7087","label":"futureofyou"},"futureofyou_3240":{"type":"posts","id":"futureofyou_3240","meta":{"index":"posts_1591205157","site":"futureofyou","id":"3240","score":null,"sort":[1432143022000]},"guestAuthors":[],"slug":"telemedicine-abortions-under-attack-as-a-new-option-for-women","title":"Telemedicine Abortions Under Attack as a New Option for Women","publishDate":1432143022,"format":"standard","headTitle":"Contributor | KQED Future of You | KQED Science","labelTerm":{"term":172,"site":"futureofyou"},"content":"\u003cp>The House of Representatives’ approval last week of a bill to ban abortions after 20 weeks brings into sharp focus the issue of early access to abortion. Abortion rights supporters say more than a dozen states have banned one option that could improve early access: telemedicine.\u003c/p>\n\u003cp>Iowa and Minnesota are the only states that offer so-called “telemed” abortions. Women who choose this option confer with a doctor through an Internet video connection and can then be prescribed two drugs, mifepristone and misoprostol, which when taken in sequence induce an abortion. Women who opt for a medication abortion can be no more than nine weeks into their pregnancy.\u003c/p>\n\u003cp>Supporters of telemed abortions say it increases the odds that a woman will be able to get an abortion earlier in her pregnancy, when the procedure is safer and cheaper, and in areas where providers are stretched thin. In 2011, \u003ca href=\"http://www.guttmacher.org/pubs/journals/psrh.46e0414.pdf\">89 percent of counties nationwide had no clinics that provided abortion services\u003c/a>, according to the Guttmacher Institute, and more than a third of women of childbearing age lived in those counties.\u003c/p>\n\u003cp>Opponents say that “webcam” abortions are unsafe and suggest that clinics are using them as moneymakers to boost the number of abortions they can provide.\u003c/p>\n\u003cp>“We believe it’s too dangerous for women,” says Cheryl Sullenger, a senior policy adviser at Operation Rescue, a group that opposes abortion. “There’s no physical exam ahead of time, and there are a lot of cues a doctor gets from a medical exam.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Planned Parenthood of the Heartland provides surgical and medication abortion at two of its 13 sites in Iowa and telemed medication abortions at six sites. The organization began offering telemed services in 2008.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The woman essentially goes home and labors and delivers a fetus. It’s very bloody. It’s painful.\"\u003cbr>\n\u003ccite>Greg Hoversten, an Iowa City physician\u003c/cite>\u003c/aside>\n\u003cp>If a woman opts for a medication abortion through that group, she’ll go to the clinic and meet with a member of the staff who will explain the procedure and answer questions, get her informed consent, check her blood type and take a brief medical history. She’ll have an ultrasound to ensure she’s not more than nine weeks pregnant.\u003c/p>\n\u003cp>Then the staff member will connect her via videoconference with the doctor, who will review the ultrasound and any other relevant medical information, and talk with the patient to ensure she’s comfortable with her decision.\u003c/p>\n\u003cp>At that point, the doctor will use a computer to unlock a drawer in the clinic that contains the pills. While the doctor and staff member observe, the patient will take the first pill, then bring the second pill home to take 24 to 48 hours later. A follow-up visit is scheduled two weeks later to make sure the abortion was successful.\u003c/p>\n\u003cp>\u003cb>A Safer Option for Women? \u003c/b>\u003c/p>\n\u003cp>Penny Dickey, chief clinical officer at Planned Parenthood of the Heartland, says patients get exactly the same care in person or in the telemedicine appointments.\u003c/p>\n\u003cp>The overall rate of abortion has \u003ca href=\"http://www.guttmacher.org/media/nr/2014/02/03/\">decreased in Iowa, as it has nationally since 1981\u003c/a>. Medication abortions, whether provided telemedically or face to face, accounted for nearly a quarter of abortions in 2011, up from 17 percent in 2008.\u003c/p>\n\u003cp>Meanwhile, a study comparing the two-year periods before and after telemed abortions were introduced found that the proportion of medication abortions increased from 46 percent to 54 percent at the Iowa Planned Parenthood clinics. The study published in the American Journal of Public Health in 2012 also \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518368/\">found that women were 46 percent more likely to have an abortion during their first trimester\u003c/a> after telemed abortions were introduced.\u003c/p>\n\u003cp>“From a public health perspective, even though there was a relatively small decline in second trimester abortions, it’s significant,” says Daniel Grossman, lead author of the study and vice president for research at Ibis Reproductive Health, an organization focused on women’s reproductive health. “Second trimester abortions have higher complications and are more expensive for women.”\u003c/p>\n\u003cp>Cost is an issue, since only about 12 percent of abortions are paid for by private insurance, \u003ca href=\"http://www.guttmacher.org/media/inthenews/2011/01/19/index.html\">a study\u003c/a> by the Guttmacher Institute found.\u003c/p>\n\u003cp>The median cost of a first-trimester abortion, whether surgical or medication, \u003ca href=\"http://www.guttmacher.org/pubs/journals/j.whi.2014.05.002.pdf\">was approximately $500 in 2012\u003c/a>, compared with a median cost of $1,350 for a surgical abortion at 20 weeks, according to Guttmacher.\u003c/p>\n\u003cp>The Iowa telemed operation may be on borrowed time, however. In 2013, the state Board of Medicine adopted a new rule that requires a physician to be physically present for a medication abortion. Planned Parenthood of the Heartland sued, and the group is awaiting a decision by the state’s Supreme Court, expected “anytime,” according to Mike Falkstrom, the group’s general counsel.\u003c/p>\n\u003cp>After an emotionally charged hearing, the board chairman said his group acted because of concerns that women’s health was not being protected in the telemed abortions. Greg Hoversten, an Iowa City physician, said at the hearing that complications could be serious, \u003ca href=\"http://www.usatoday.com/story/news/nation/2013/08/30/iowa-board-bans-telemedicine-abortions/2750185/\">according to quotes in the Des Moines Register\u003c/a>.\u003c/p>\n\u003cp>“The woman essentially goes home and labors and delivers a fetus. It’s very bloody. It’s painful,” he said when explaining why he thought a physician should be close by.\u003c/p>\n\u003cp>The Iowa rule is similar to actions in 16\u003ca href=\"http://www.guttmacher.org/statecenter/spibs/spib_MA.pdf\"> other states that require physicians to be in the room to provide medication abortions\u003c/a>.\u003c/p>\n\u003cp>Supporters of telemed abortions argue that the procedure is safe and having a doctor physically present is unnecessary.\u003c/p>\n\u003cp>In a 2011 study published in Obstetrics & Gynecology, Grossman compared the results for patients who received medication abortions telemedically in Iowa versus those who were in the room with the doctor. \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21775845\">The results were almost identical\u003c/a>: 99 percent of telemedicine patients had a successful abortion compared with 97 percent of those who were face-to-face with the doctor.\u003c/p>\n\u003cp>“Adverse events are no higher with telemedicine,” says Grossman. “We have looked at this and we have some data that shows it’s just as safe as medication abortions provided in person.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story originally ran on \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN), a nonprofit national health policy news service. \u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Abortion rights supporters say more than a dozen states have banned one option that could improve early access: telemedicine.","status":"publish","parent":0,"modified":1434048237,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":1075},"headData":{"title":"Telemedicine Abortions Under Attack as a New Option for Women | KQED","description":"Abortion rights supporters say more than a dozen states have banned one option that could improve early access: telemedicine.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Telemedicine Abortions Under Attack as a New Option for Women","datePublished":"2015-05-20T17:30:22.000Z","dateModified":"2015-06-11T18:43:57.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"3240 http://ww2.kqed.org/futureofyou/?p=3240","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/05/20/telemedicine-abortions-under-attack-as-a-new-option-for-women/","disqusTitle":"Telemedicine Abortions Under Attack as a New Option for Women","nprByline":"Michelle Andrews, Kaiser Health News","path":"/futureofyou/3240/telemedicine-abortions-under-attack-as-a-new-option-for-women","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The House of Representatives’ approval last week of a bill to ban abortions after 20 weeks brings into sharp focus the issue of early access to abortion. Abortion rights supporters say more than a dozen states have banned one option that could improve early access: telemedicine.\u003c/p>\n\u003cp>Iowa and Minnesota are the only states that offer so-called “telemed” abortions. Women who choose this option confer with a doctor through an Internet video connection and can then be prescribed two drugs, mifepristone and misoprostol, which when taken in sequence induce an abortion. Women who opt for a medication abortion can be no more than nine weeks into their pregnancy.\u003c/p>\n\u003cp>Supporters of telemed abortions say it increases the odds that a woman will be able to get an abortion earlier in her pregnancy, when the procedure is safer and cheaper, and in areas where providers are stretched thin. In 2011, \u003ca href=\"http://www.guttmacher.org/pubs/journals/psrh.46e0414.pdf\">89 percent of counties nationwide had no clinics that provided abortion services\u003c/a>, according to the Guttmacher Institute, and more than a third of women of childbearing age lived in those counties.\u003c/p>\n\u003cp>Opponents say that “webcam” abortions are unsafe and suggest that clinics are using them as moneymakers to boost the number of abortions they can provide.\u003c/p>\n\u003cp>“We believe it’s too dangerous for women,” says Cheryl Sullenger, a senior policy adviser at Operation Rescue, a group that opposes abortion. “There’s no physical exam ahead of time, and there are a lot of cues a doctor gets from a medical exam.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Planned Parenthood of the Heartland provides surgical and medication abortion at two of its 13 sites in Iowa and telemed medication abortions at six sites. The organization began offering telemed services in 2008.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The woman essentially goes home and labors and delivers a fetus. It’s very bloody. It’s painful.\"\u003cbr>\n\u003ccite>Greg Hoversten, an Iowa City physician\u003c/cite>\u003c/aside>\n\u003cp>If a woman opts for a medication abortion through that group, she’ll go to the clinic and meet with a member of the staff who will explain the procedure and answer questions, get her informed consent, check her blood type and take a brief medical history. She’ll have an ultrasound to ensure she’s not more than nine weeks pregnant.\u003c/p>\n\u003cp>Then the staff member will connect her via videoconference with the doctor, who will review the ultrasound and any other relevant medical information, and talk with the patient to ensure she’s comfortable with her decision.\u003c/p>\n\u003cp>At that point, the doctor will use a computer to unlock a drawer in the clinic that contains the pills. While the doctor and staff member observe, the patient will take the first pill, then bring the second pill home to take 24 to 48 hours later. A follow-up visit is scheduled two weeks later to make sure the abortion was successful.\u003c/p>\n\u003cp>\u003cb>A Safer Option for Women? \u003c/b>\u003c/p>\n\u003cp>Penny Dickey, chief clinical officer at Planned Parenthood of the Heartland, says patients get exactly the same care in person or in the telemedicine appointments.\u003c/p>\n\u003cp>The overall rate of abortion has \u003ca href=\"http://www.guttmacher.org/media/nr/2014/02/03/\">decreased in Iowa, as it has nationally since 1981\u003c/a>. Medication abortions, whether provided telemedically or face to face, accounted for nearly a quarter of abortions in 2011, up from 17 percent in 2008.\u003c/p>\n\u003cp>Meanwhile, a study comparing the two-year periods before and after telemed abortions were introduced found that the proportion of medication abortions increased from 46 percent to 54 percent at the Iowa Planned Parenthood clinics. The study published in the American Journal of Public Health in 2012 also \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518368/\">found that women were 46 percent more likely to have an abortion during their first trimester\u003c/a> after telemed abortions were introduced.\u003c/p>\n\u003cp>“From a public health perspective, even though there was a relatively small decline in second trimester abortions, it’s significant,” says Daniel Grossman, lead author of the study and vice president for research at Ibis Reproductive Health, an organization focused on women’s reproductive health. “Second trimester abortions have higher complications and are more expensive for women.”\u003c/p>\n\u003cp>Cost is an issue, since only about 12 percent of abortions are paid for by private insurance, \u003ca href=\"http://www.guttmacher.org/media/inthenews/2011/01/19/index.html\">a study\u003c/a> by the Guttmacher Institute found.\u003c/p>\n\u003cp>The median cost of a first-trimester abortion, whether surgical or medication, \u003ca href=\"http://www.guttmacher.org/pubs/journals/j.whi.2014.05.002.pdf\">was approximately $500 in 2012\u003c/a>, compared with a median cost of $1,350 for a surgical abortion at 20 weeks, according to Guttmacher.\u003c/p>\n\u003cp>The Iowa telemed operation may be on borrowed time, however. In 2013, the state Board of Medicine adopted a new rule that requires a physician to be physically present for a medication abortion. Planned Parenthood of the Heartland sued, and the group is awaiting a decision by the state’s Supreme Court, expected “anytime,” according to Mike Falkstrom, the group’s general counsel.\u003c/p>\n\u003cp>After an emotionally charged hearing, the board chairman said his group acted because of concerns that women’s health was not being protected in the telemed abortions. Greg Hoversten, an Iowa City physician, said at the hearing that complications could be serious, \u003ca href=\"http://www.usatoday.com/story/news/nation/2013/08/30/iowa-board-bans-telemedicine-abortions/2750185/\">according to quotes in the Des Moines Register\u003c/a>.\u003c/p>\n\u003cp>“The woman essentially goes home and labors and delivers a fetus. It’s very bloody. It’s painful,” he said when explaining why he thought a physician should be close by.\u003c/p>\n\u003cp>The Iowa rule is similar to actions in 16\u003ca href=\"http://www.guttmacher.org/statecenter/spibs/spib_MA.pdf\"> other states that require physicians to be in the room to provide medication abortions\u003c/a>.\u003c/p>\n\u003cp>Supporters of telemed abortions argue that the procedure is safe and having a doctor physically present is unnecessary.\u003c/p>\n\u003cp>In a 2011 study published in Obstetrics & Gynecology, Grossman compared the results for patients who received medication abortions telemedically in Iowa versus those who were in the room with the doctor. \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21775845\">The results were almost identical\u003c/a>: 99 percent of telemedicine patients had a successful abortion compared with 97 percent of those who were face-to-face with the doctor.\u003c/p>\n\u003cp>“Adverse events are no higher with telemedicine,” says Grossman. “We have looked at this and we have some data that shows it’s just as safe as medication abortions provided in person.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story originally ran on \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN), a nonprofit national health policy news service. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/3240/telemedicine-abortions-under-attack-as-a-new-option-for-women","authors":["byline_futureofyou_3240"],"series":["futureofyou_172"],"categories":["futureofyou_1"],"tags":["futureofyou_342","futureofyou_346","futureofyou_348","futureofyou_138","futureofyou_270","futureofyou_80","futureofyou_347","futureofyou_349","futureofyou_345","futureofyou_344","futureofyou_343"],"featImg":"futureofyou_3241","label":"futureofyou_172"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. 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No other part of the globe has experienced such dynamic political and social change in recent years.","airtime":"SAT 3am-4am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Inside-Europe-Podcast-Tile-300x300-1.jpg","meta":{"site":"news","source":"Deutsche Welle"},"link":"/radio/program/inside-europe","subscribe":{"apple":"https://itunes.apple.com/us/podcast/inside-europe/id80106806?mt=2","tuneIn":"https://tunein.com/radio/Inside-Europe-p731/","rss":"https://partner.dw.com/xml/podcast_inside-europe"}},"latino-usa":{"id":"latino-usa","title":"Latino USA","airtime":"MON 1am-2am, SUN 6pm-7pm","info":"Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg","officialWebsiteLink":"http://latinousa.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/latino-usa","subscribe":{"npr":"https://rpb3r.app.goo.gl/xtTd","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/Latino-USA-p621/","rss":"https://feeds.npr.org/510016/podcast.xml"}},"live-from-here-highlights":{"id":"live-from-here-highlights","title":"Live from Here Highlights","info":"Chris Thile steps to the mic as the host of Live from Here (formerly A Prairie Home Companion), a live public radio variety show. 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Updated Monday through Friday at about 3:30 p.m. PT.","airtime":"MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.marketplace.org/","meta":{"site":"news","source":"American Public Media"},"link":"/radio/program/marketplace","subscribe":{"apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=201853034&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/APM-Marketplace-p88/","rss":"https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"}},"mindshift":{"id":"mindshift","title":"MindShift","tagline":"A podcast about the future of learning and how we raise our kids","info":"The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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