Telehealth Policy Got Yakaomeswa mu2020
Dai iwe wakandiudza pakutanga kwegore rapfuura kuti mari yegore rose yeUS telehealth yaizokwira kubva pamadhora mazana matatu emadhora kusvika pamamirioni mazana maviri nemazana mashanu emadhora muna3, ndinofunga ndingadai ndakabvunza kuti wakaongororwa musoro, zvinoreva pamusoro pevhidhiyo! Asi nedenda re COVID-250, takaona telehealth ichisimuka kubva pakuva nzira yekuchengetedza hutano kuita sarudzo yekusarudzika yemamiriyoni eAmerica kuti vagamuchire panguva ino yakaoma. Telehealth yakabvumidza kuenderera mberi kwekurapwa panguva yechirwere, uye telehealth yakawedzerawo munzira dzakasiyana siyana kuitira kuti zvive nyore kuvanhu kuti vawane rubatsiro rwehutano hwakadai sehunhu hwekuita, pasina chikonzero chekushanyira hofisi yechiremba. Kunyangwe telehealth yanga iriko kwemakumi emakore, kutaura kuti telehealth yakakwenenzverwa munzvimbo inoonekera yenyika muna 2020 yaisazove iri pasi.
Semunhu anga arimumunda wehehehealth kwemakore mana apfuura, ndakashamiswa nekushanduka kwakaita nzvimbo yeterehealth gore rino, uye nekuoma kwayakaita. Nekutanga kwe COVID-19, masisitimu ehutano uye maitiro anoitwa mukati memazuva mashoma izvo zvingadai zvakatora vhiki, mwedzi, kana kunyangwe makore, sezvo zviuru zvevashandi vezvekurapa nevatungamiriri vakadzidziswa kuita telehealth nekugadzira nekudzidza mabasa matsva. , maprotocol, uye mafashama ekutsigira kutorwa kweterehealth nekukurumidza sezvazvinogona. Iri basa rakaomarara rakabhadharwa sezvo CDC yakazivisa kuti kushanya kweterehealth kwakawedzera 154% muvhiki rekupedzisira raKurume 2020, zvichienzaniswa nenguva imwecheteyo muna 2019. Pakazosvika Kubvumbi, kushanyira-munhu kumahofisi echiremba uye mamwe maitiro ehutano akadonha 60%, nepo telehealth kushanya kwakaverengerwa kungangoita 69% yehuwandu hwehutano hwekusangana. Vanoona nezvehutano vari kuendesa kanenge ka50-175 kakapetwa kakawanda kushanyirwa kweterehealth kupfuura zvavaiita pre-COVID-19. Hongu, iyo "nyowani yakasarudzika" ye telehealth iri pano, asi zvinonyatsorevei izvozvo?
Zvakanaka, zvakaoma. Regai nditsanangure. Chikonzero chikuru chekuti telehealth yakakwanisa kuenda kumberi kwekutarisirwa kwehutano gore rino kwaisave nekuda kwechirwere cheCOVID-19 pachayo, asi zvaive nekuda kweshanduko yemitemo yeterehealth yakauya nekuda kwehosha. Kudzoka munaKurume, pakaitika emergency yenyika yose, imwe nzira yakapihwa kumasangano ehurumende kuti vapindure padambudziko, uye vakaita saizvozvo. ICentre yeMedicare neMedicaid Services (CMS) yakawedzera zvakanyanya mabhenefiti eMedare, kwenguva yekutanga kubvumidza vanobatsirwa veMedare kuti vagamuchire mabasa mazhinji kuburikidza nevhidhiyo nefoni, vachisiya kudiwa kwehukama hwatovepo, uye vachibvumidza kuti telehealth services igamuchire. zvakananga mumba memurwere. Medicare yakatsanangudza zvakare kuti vanopa mari vanogona kubhadharira kushanya kwehehehehehe panguva imwechete seye-munhu-kushanya, kunozivikanwa sekuti telehealth "parity." Zvakare munaKurume, Iyo Hofisi yeHurumende Kodzero (OCR) yakarerutsa mutemo wayo wekumanikidza uye ikati yaizoregedza zvingangoitika kutyorwa kweHIPAA chirango kana zvaimbove zvisingateedzere vhidhiyo maapplication, saFaceTime uye Skype, aishandiswa kuendesa telehealth. Ehezve, kwaive neakawanda akawanda telehealth mutemo shanduko inoitwa padanho remubatanidzwa, nzira yakawandisa kunyora pano, asi zvimwe zveizvi, pamwe nedzimwe shanduko dzatichangobva kuongorora, ndezvenguva pfupi uye dzakasungirirwa kune yeruzhinji hutano emergency (PHE ). CMS ichangobva kuburitsa yavo 2021 kudzokororwa kuFizikisi Fee Chirongwa (PFS), ichiita dzimwe shanduko dzechinguva dzive dzechigarire, asi kuchine masevhisi akamisikidzwa kupera pakupera kwegore iyo PHE inoguma. Munoona zvandiri kureva? Zvakaoma.
Ini ndinovenga kuomesa zvinhu zvakanyanya, asi apo patinokurukura shanduko yeterehealth inoshanduka padanho rehurumende, ndinotya kuti zvinogona kudzivirirwa. Chimwe chezvinhu zvinonyanya kufadza, uye zvinoshungurudza, nezve telehealth ndechekuti inotsanangurwa uye inogadzwa zvakasiyana mumatunhu ese. Izvi zvinoreva kuti, padanho rehurumende, uye kunyanya kune vanhu veMedicaid, mutemo wezve telehealth uye kudzoreredza zvinotaridzika zvakasiyana, uye mhando dzema telehealth services dzinovharwa dzinogona kusiyana zvakanyanya kubva kune imwe nyika kuenda kune imwe. Colorado yanga iri pamberi mukuita mamwe emitemo yenguva pfupi yethehealth inoshanduka zvachose sezvo Gavhuna Polis akasaina Senate Bill 20-212 kuita mutemo muna Chikunguru 6, 2020. Bhiri iri rinorambidza Chikamu cheInishuwarenzi-chinotarisirwa zvirongwa zvehutano kubva:
- Kuisa zvakatarwa zvinodiwa kana kutadza pane HIPAA-inoenderana tekinoroji inoshandiswa kuendesa telehealth services.
- Zvinoda kuti munhu ave nehukama hwakasimbiswa nemupi kuitira kuti agamuchire zvokurapa zvinodikanwa zvehutano kubva kune iye mupi.
- Kuraira kumwe kuwedzera chitupa, nzvimbo, kana zvekudzidziswa zvinodiwa semamiriro ekubhadhariswa kweaterehealth services.
YeColorado Medicaid Chirongwa, Seneti Bhiri 20-212, inogadzira marongero mashoma akakosha zvachose. Kutanga, zvinoda kuti dhipatimendi renyika ribhadhare makiriniki ehutano ekumaruwa, iyo Federal Indian Health Service, uye Federally Qualified Hutano Nzvimbo dzekushandira telehealth masevhisi anopiwa kune vanogamuchira veMedicaid pamwero wakaenzana neuyo masevhisi acho anopiwa mumunhu. Uku ndiko kuchinja kukuru kweColorado Medicaid, sepamberi pehosha, aya masangano haana kubhadharirwa nenyika nekupa masevhisi eruzivo. Chechipiri, bhiri rinotsanangura kuti hutano uye hutano hwepfungwa masevhisi muColorado anokwanisa kusanganisira kurapwa kwekutaura, kurapa kwemuviri, kurapwa kwenyaya, kuchengetedza varwere, kuchengetwa kwehutano hwepamba, uye hutano hwevana hunhu. Dai bhiri iri risina kupasiswa, hunyanzvi uhu hungadai husina kuziva kana vaizokwanisa kuenderera vachiendesa tarisiro yavo pamusoro pezvehutano kana denda rapera.
Zvakanaka, takurukura shanduko yenyika nehurumende telehealth shanduko, asi ko mutemo wezve telehealth kune vanobhadhara vega, saAetna naCigna? Zvakanaka, parizvino, kune makumi mana nematatu nyika neWashington DC iyo ine yakazvimiririra inobhadhara telehealth mitemo yeparity, iyo inofanirwa kureva kuti mumatunhu aya, anosanganisira Colorado, mainishuwarenzi anodikanwa kubhadhara telehealth pamutengo mumwechetewo weye-munhu kuchengetwa , uye mitemo iyi inodawo kuenzana kweye telehealth mukuvhara uye masevhisi. Kunyangwe izvi zvichinzwika sezvisinganetsi, ndakaverenga yakati wandei yeiyi mitemo yenyika uye mimwe yemitauro haina kujeka zvinopa vanobhadhara vega kungwara kuti vagadzire yavo vega, pamwe inodzvinyirira mitemo yemahehehealth. Zvirongwa zvekubhadhara zvega zvakavanzika zvinoenderana nemitemo, zvichireva kuti vanogona kusasanganisa runhare rwekubhadhara pasi pemamwe marongero. Chaizvoizvo, telehealth mutemo kune vanobhadhara vega zvinoenderana nemubhadhari, nyika, uye nehurongwa hwehutano chaihwo. Yup, zvakaoma.
Izvi zvinorevei kune ramangwana rezvehutano? Zvakanaka, chaizvo, isu tichaona. Izvo zvinoita sekunge telehealth icharamba ichiwedzera mukushandiswa uye mukurumbira, kunyangwe mushure mekupararira kwedenda. Ongororo ichangoburwa yaMcKinsey yakawana kuti 74% yevanoshandisa telehealth panguva yedenda vakataura kugutsikana kukuru nechengetedzo yavakagashira, zvichiratidza kuti kudiwa kwemasevhisi yethehehefu kungangogara pano. Masangano emunyika ehutano wezvehutano nedunhu rega rega vanofanirwa kuongorora marongero avo ezvehutano sezvo kupera kwePHE kwaswedera, uye vanofanirwa kuona kuti ndeapi marongero achasara uye ndeapi anofanira kuchinjwa kana kugumiswa.
Sezvo telehealth inoda kuti varwere vawane hunyanzvi uye neinternet, pamwe nehumwe hunyanzvi hwehunyanzvi hwekuverenga, chimwe chezvinhu zvinodawo kugadziriswa i "dhijitari kukamura," izvo zvinokanganisa zvisingaenzaniswi vanhu veVatema neveLatinx, vanhu vakura, vanhu vekumaruwa, uye vanhu vane hushoma hunyanzvi hweChirungu. Vanhu vazhinji muAmerica vachiri vasina mukana weiyo smartphone, komputa, piritsi, kana Broadband internet, uye kunyangwe mazana emamirioni emadhora akapihwa kudzikisira aya mutsauko anogona kunge asingakwanise kukurira akawanda ezvipingaidzo munzvimbo. izvo zvinogona kutadzisa kufambira mberi kwakadaro. Kuti vese maAmerican vakwanise kuwana telehealth uye vabatsirwe nesevhisi dzayo panguva uye mushure mekuguma kwedenda zvinoda kuedza kwakasimba kuhurumende nemubatanidzwa kuti vaone musanganiswa wezviito zvekutonga nemitemo zvinodiwa kuzviita. Zvino izvo hazvinzwika zvakanyanya kuomarara, handizvo here?
Kuda iwe telehealth yakanaka!
https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0123
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768771
Center for Yakabatanidzwa Hutano Policy: https://www.cchpca.org
https://www.healthcareitnews.com/blog/telehealth-one-size-wont-fit-all