Hoʻopilikia ʻia ke kulekele kīwila ma 2020
Inā ʻoe i haʻi mai iaʻu i ka hoʻomaka o ka makahiki i hala e hoʻonui ana ka loaʻa kālā makahiki o ka kīwī ma kahi o $ 3 biliona a $ 250 biliona paha i ka makahiki 2020, manaʻo wau ua noi wau ua nānā ʻia kou poʻo, ʻaʻole wau manaʻo ma luna o ke wikiō! Akā me ka maʻi maʻi COVID-19, ua ʻike mākou i ka neʻe ʻana o ka telehealth mai ke koho ʻana i kahi lawelawe lawelawe olakino peripheral i ke koho i makemake ʻia no nā miliona o ʻAmelika e loaʻa i kā lākou mālama i kēia manawa paʻakikī. Ua ʻae ʻo Telehealth i ka hoʻomau ʻana o ka mālama olakino i ka wā o ka maʻi ahulau, a ua hoʻonui ʻia hoʻi ka telehealth i nā ala like ʻole e maʻalahi ai i nā poʻe e loaʻa nā lawelawe lawelawe kūikawā e like me ke olakino olakino, me ka ʻole o ke kipa ʻana i ke keʻena o ke kauka. ʻOiai ma kahi o mau makahiki he nui ka telehealth, e ʻōlelo i ka telehealth i catapult i loko o ke kahua mokulele i ka makahiki 2020 ʻaʻole ia he mea haʻahaʻa.
Ma ke ʻano he kanaka i noho ma ke kahua kīwī no nā makahiki ʻehā i hala, ua pūʻiwa wau i ka nui o ka loli o ka ʻāina i ka hoʻololi i kēia makahiki, a me ka paʻakikī i lilo ai. Me ka hoʻomaka ʻana o COVID-19, nā ʻōnaehana mālama olakino a me nā hana i hana ʻia i loko o kekahi mau lā he aha i hala he mau pule, mahina, a i ʻole mau makahiki, ʻoiai he mau kaukani a me nā luna hoʻomalu i aʻo ʻia i ka hoʻokō ʻana i ka telehealth a me ka hoʻokumu ʻana a me ke aʻo ʻana i nā hana hou. , nā kuʻina, a me nā kaʻina hana e kākoʻo i kā adopter telehealth hikiwawe loa. Ua uku ʻia kēia hana nui e like me ka hōʻike a ka CDC ua hoʻonui nā kipa telephealth i ka 154% i loko o ka pule hope o Malaki 2020, i hoʻohālikelike ʻia me ka wā like i ka makahiki 2019. Ma ʻApelila, ua kipa aku nā kānaka i nā keʻena kauka a me nā hana mālama olakino ʻē aʻe 60%, ʻoiai e kipa ʻia ka telehealth kokoke i ka 69% o ka nui o nā hālāwai mālama ola. Ke hāʻawi nei nā mea lawelawe olakino ma kahi o 50-175 mau manawa o ke kipa kelepona ʻana ma mua o kā COVID-19 i hala. ʻAe, ʻo ka "maʻamau hou" no ka telehealth aia ma aneʻi, akā he aha ke ʻano o ia manaʻo?
ʻĀ, paʻakikī. E haʻi wau e wehewehe. ʻO ke kumu nui i hiki ai i ka telehealth ke neʻe i mua o ka mālama olakino ʻana i kēia makahiki ʻaʻole no ka maʻi maʻi COVID-19 ponoʻī, akā ma muli o ka hoʻololi ʻana o nā kulekele telehealth i loaʻa ma muli o ke ahulau. Ma hope o Malaki, i ka manawa i hoʻolaha mua ʻia ai kahi pilikia kūloko, ua hāʻawi ʻia kahi ala hou i nā keʻena pekelala a me nā mokuʻāina e pane i ka pilikia, a ua hana lākou pēlā. Ua hoʻonui nui nā Kikowaena no Medicare a me Medicaid Services (CMS) i nā pono kīwī o Medicare, no ka manawa mua e ʻae ana i nā mea kōkua Medicare e loaʻa nā lawelawe he nui ma o ke wikiō a me ke kelepona, e haʻalele ana i ka pono no kahi pilina ma mua, a ʻae ʻia e loaʻa nā lawelawe telehealth pololei i ka home o ka mea maʻi. Ua ʻōlelo pū ʻo Medicare hiki i nā mea hoʻolako ke uku no ka kipa ʻana i ka telehealth ma ka helu like me nā kipa ʻana o ka poʻe, i ʻike ʻia ʻo "parity." Ma Malaki pū kekahi, ua hoʻomaha ke Keʻena no nā Pono Kivila (OCR) i kāna kulekele hoʻokō a ua ʻōlelo ʻia e haʻalele lākou i nā hana hoʻopaʻi hoʻopaʻi HIPAA inā hoʻohana ʻia nā polokalamu wikiō ʻole e like me FaceTime a me Skype, e lawe i ka telehealth. ʻOiaʻiʻo, ua nui nā hoʻololi hou ʻana i ke kulekele kelepona i hoʻokō ʻia ma ka pae pekelala, he nui loa e papa inoa ma aneʻi, akā ʻo kekahi o kēia mau mea, a me kekahi o nā hoʻololi a mākou i nānā ai, he manawa pōkole ia a pili ʻia i ka pilikia olakino lehulehu (PHE ). Ua hoʻopuka ʻo CMS i kā lākou hoʻoponopono hou 2021 i ka Papa Kuhikuhi Uku Kauka (PFS), e hana ana i kekahi o nā hoʻololi kūlohelohe i paʻa mau, akā aia nō kekahi mau lawelawe i kau ʻia e pau i ka hopena o ka makahiki a pau ka PHE. E ʻike i kaʻu manaʻo? Hoʻopilikia.
Ke inaina nei wau e hoʻopīpī hou i nā mea, akā ke kūkākūkā mākou i nā kulekele telehealth i loli i ka pae mokuʻāina, makaʻu wau i ka hiki ʻole ke pale ʻia. ʻO kekahi o nā mea hoihoi, a hoʻonāukiuki hoʻi, e pili ana i ka telehealth ka wehewehe ʻana a me ka ʻahaʻāina ʻana i nā ʻano ʻokoʻa i kēlā me kēia mokuʻāina. ʻO kēia ke ʻano, ma ka pae mokuʻāina, a no ka nui o nā heluna Medicaid, ʻokoʻa ke ʻano o ke kulekele telehealth a me ka uku hou ʻana, a ʻo nā ʻano o nā lawelawe telehealth i uhi ʻia hiki ke loli nui mai kekahi mokuʻāina a i kekahi. ʻO mua ʻo Colorado ma mua o ka hana ʻana i kekahi o kēia mau kulekele telehealth kūlohelohe e kū mau ana i ke kau ʻana o ke kiaʻāina ʻo Polis Polis i ka bila Senate 20-212 i kānāwai ma Iulai 6, 2020. Pāpā ʻia ka pila i nā papa olakino e pili ana i ka ʻinikua mai:
- Ke kau nei i nā koi kikoʻī a i ʻole nā palena ma nā ʻenehana hoʻokō HIPAA i hoʻohana ʻia e lawe i nā lawelawe telehealth.
- Ke koi nei i kahi kanaka e loaʻa kahi pilina paʻa me kahi mea hoʻolako i mea e loaʻa ai nā lawelawe kelepona telehealth e pono ai mai kēlā mea hāʻawi.
- Ke kauoha ʻana i nā hōʻoia hou aʻe, kahi, a i ʻole nā koi hoʻomaʻamaʻa ma ke ʻano he uku no ka lawelawe telehealth.
No ka Polokalamu Medicaid ʻo Colorado, ka Bila Senate 20-212, e paʻa mau ai i nā kulekele ʻelua. ʻO ka mea mua, koi ia i ka mokuʻāina e uku i nā kaukapila olakino kaiāulu, ka Federal Health Health Service, a me nā keʻena olakino laulā ʻo Federally Qualified no nā lawelawe telehealth i hāʻawi ʻia i nā mea e loaʻa ana iā Medicaid i ka helu like me ka manawa i hāʻawi ʻia ai kēlā mau lawelawe i ke kino. ʻO kēia kahi hoʻololi nui loa no Colorado Medicaid, ma mua o ka maʻi ahulau, ʻaʻole i uku ʻia kēia mau mea e ka mokuʻāina no ka hāʻawi ʻana i nā lawelawe telehealth. ʻO ka lua, ua kikoʻī ka pila e hiki i nā lawelawe olakino olakino a me nā lawelawe olakino noʻonoʻo ma Colorado ke komo pū me ka haʻiʻōlelo ʻōlelo, ka hoʻōla kino, ka hoʻomaʻamaʻa hana, ka mālama hale maʻi, ka mālama olakino home, a me ka mālama ola kino pediatric Inā ʻaʻole i hoʻoholo ʻia kēia pila, ʻaʻole paha i ʻike kēia mau loea inā hiki iā lākou ke hoʻomau i ka hāʻawi ʻana i kā lākou mālama ma ke kelepona ke pau ka maʻi ahulau.
ʻĀ, ua kūkākūkā mākou e pili ana i nā loli o ka politika a me ka mokuʻāina, akā pehea e pili ana i ke kulekele telehealth no nā mea uku pilikino, e like me Aetna a me Cigna ʻĀnō, i kēia manawa, aia he 43 mau mokuʻāina a me Wakinekona DC i loaʻa nā kānāwai pili kaulhe uku uku pilikino pilikino, i manaʻo ʻia aia ma kēia mau mokuʻāina, e pili pū ana me Colorado, koi ʻia nā mea ʻinikua e uku hou i ka telehealth ma ka helu like me ka mālama pono ʻana i loko o ke kanaka. , a koi kēia mau kānāwai i ka like no ka telehealth i ka uhi ʻana a me nā lawelawe. ʻOiai paʻakikī ʻole kēia, ua heluhelu wau i kekahi o kēia mau kānāwai parity o ka mokuʻāina a ʻike ʻole kekahi o ka ʻōlelo e hāʻawi i ka poʻe uku pilikino i ka manaʻo e hana i kā lākou iho, a ʻoi paha nā kulekele telehealth ʻoi aku ka nui. Pili pū nā hoʻolālā uku pilikino i ka kulekele, ʻo ia hoʻi hiki iā lākou ke kāpae i ka telehealth no ka uku hou ʻana ma lalo o kekahi mau kulekele. ʻO ka mea nui, ʻo ke kulekele telehealth no nā mea uku pilikino e pili ana i ka mea uku, ka mokuʻāina, a me ke kulekele hoʻolālā olakino kikoʻī. ʻAe, paʻakikī.
He aha ka manaʻo o kēia a pau no ka wā e hiki mai ana o ka telehealth? ʻĀ, ma ke kumu, e ʻike mākou. Me he mea lā e hoʻomau ka hoʻonui ʻana o ka telehealth i ka hoʻohana a me ke kaulana, ʻoiai ma hope o ka maʻi ahulau. Ua ʻike ʻia kahi noiʻi ma kahi o McKinsey ma kahi o 74% o nā mea hoʻohana telehealth i ka wā o ke ahulau e hōʻike ana i ka ʻoluʻolu kiʻekiʻe me ka mālama i loaʻa iā lākou, e hōʻike ana ke koi ʻia nei nā lawelawe telehealth ma aneʻi e noho. Pono nā keʻena olakino olakino āpau a me kēlā me kēia mokuʻāina e nānā i kā lākou mau kulekele kelepona i ke kokoke ʻana o ka hopena o ka PHE, a na lākou e hoʻoholo i nā kulekele e waiho a i nā mea e pono e hoʻololi a hoʻopau ʻia paha.
Ma muli o ke kelepona e koi ai i ka poʻe maʻi e loaʻa i ka ʻenehana a me ka pūnaewele, a me kekahi pae o ka ʻike ʻenehana, kekahi o nā mea e pono ai e kamaʻilio ʻia, ʻo ia ka "digital digital," ka mea e pono ʻole ai nā kānaka ʻeleʻele a me Latinx, nā ʻelemakule, nā heluna kaiāulu, a me ka poʻe me ka mākaukau Pelekane palena ʻole. ʻAʻole hiki i ka poʻe he nui ma ʻAmelika ke kiʻi i kahi kelepona paʻalima, kamepiula, papapihi, a i ʻole pūnaewele puni honua, a ʻo nā haneli miliona mau kālā i hoʻokaʻawale ʻia e hōʻemi i kēia mau mea like ʻole ʻaʻole lawa paha e lanakila ai i nā pale ʻōnaehana ma kahi. hiki iā ia ke ālai i ka holomua. No nā poʻe ʻAmelika āpau e hiki ke komo i ka telehealth a me ka pōmaikaʻi mai kāna mau lawelawe āpau i ka wā a ma hope o ka pau ʻana o ka maʻi ahulau e koi ana i nā hana nui i ka pae mokuʻāina a me ke aupuni pekelala e hoʻoholo i ka hui pū ʻana o nā hana hoʻomalu a me nā kānāwai e pono ai. I kēia manawa ʻaʻole paʻakikī kēlā, ʻeā?
Ke makemake nei iā ʻoe i ka telehealth maikaʻi!
https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0123
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768771
Ke kikowaena no ke kulekele olakino pili. https://www.cchpca.org
https://www.healthcareitnews.com/blog/telehealth-one-size-wont-fit-all