Siyaasadda Telehealth waxay adkaatay 2020
Haddii aad ii sheegi laheyd bilowgii sanadkii hore in wadarta dakhliga sanadlaha ah ee telehealth-ka Mareykanka uu ka kici doono illaa $ 3 bilyan oo laga yaabo inuu gaaro $ 250 bilyan sannadka 2020, waxaan u maleynayaa inaan weydiisan lahaa in madaxaaga la baaro, mana sameyn doono macnaheedu waa fiidiyoow! Laakiin cudurka faafa ee 'COVID-19', waxaan aragnay in telehealth ay ka guureyso inay noqoto ikhtiyaarka adeegga daryeelka caafimaadka oo ay noqoto xulashada la doorbido ee malaayiin Mareykan ah inay helaan daryeelkooda xilligan adag. Telehealth waxay u oggolaatay sii wadista daryeelka caafimaad inta lagu jiro aafada, iyo telehealth waxay kaloo ballaarisay siyaabo kala duwan si ay ugu fududaato dadka inay helaan adeegyo daryeel gaar ah sida caafimaadka habdhaqanka, iyadoon loo baahnayn inay booqdaan xafiiska dhakhtarka. In kasta oo telehealth ay jirtay tobanaan sano, in la yiraahdo telehealth-ka ayaa lagu dhex shubay iftiinka qaranka sannadka 2020-ka ma noqon doono wax laga dhigto.
Aniga oo ah qof ku jiray qaybta telehealth afartii sano ee la soo dhaafay, waxaan la yaabay sida ay u badashay muuqaalka taleefanka sannadkan, iyo sida uu u adkaaday. Bilawga COVID-19, nidaamyada daryeelka caafimaadka iyo dhaqammada ayaa lagu dhammeeyaa maalmo gudahood wixii kale haddii ay qaadan lahayd toddobaadyo, bilo, ama xitaa sannado, maaddaama kumanaan shaqaale caafimaad iyo maamuleyaal lagu tababaray hirgelinta telehealth iyo abuurista iyo barashada hawlaha cusub , hab maamuus, iyo socodsiinta shaqada si loo taageero korsashada telehealth sida ugu dhakhsaha badan. Shaqadan adag waxay bixisay sida CDC-du u soo warisay in booqashooyinka telehealth-ka ay kordheen 154% intii lagu jiray usbuucii ugu dambeeyay ee Maarso 2020, marka la barbardhigo isla muddadaa 2019. Bishii Abriil, booqashooyinka shaqsi ahaaneed ee xafiisyada dhakhtarka iyo dhaqamada kale ee daryeelka caafimaadka ayaa hoos u dhacay 60%, halka booqashooyinka telehealth-ka ay noqdeen ku dhowaad 69% wadarta la kulanka daryeelka caafimaadka. Bixiyeyaasha daryeelka caafimaadka ayaa keenaya ku dhowaad 50-175 jeer booqashooyinka telehealth-ka intii ay bixiyeen kahor-COVID-19. Haa, "caadiga cusub" ee telehealth-ka ayaa runtii halkan jooga, laakiin maxay dhab ahaan taasi macnaheedu tahay?
Hagaag, way adagtahay. Aan sharaxo. Sababta ugu weyn ee telehealth u awooday inay udhaqaaqdo safka hore ee bixinta daryeelka caafimaadka sanadkaan daruuri maahan sababtoo ah COVID-19 faafa laftiisa lafteeda, laakiin taa badalkeeda waxay aheyd isbadalka siyaasada telehealth ee ku yimid natiijada cudurka. Dib ugu laabo bishii Maarso, markii ugu horreysay ee lagu dhawaaqay xaalad deg-deg ah, xorriyad dheeri ah ayaa la siiyay hay'adaha federaalka iyo kuwa gobolka si ay uga jawaabaan dhibaatada, waana ay sameeyeen. Xarumaha Medicare iyo Adeegyada Medicaid (CMS) waxay si weyn u ballaarisay faa'iidooyinka caafimaadka ee Medicare, markii ugu horreysay waxay u oggolaatay ka-faa'iideystayaasha Medicare in ay ku helaan adeegyo badan fiidiyow iyo taleefan, kana tanaasulaan baahida xiriir hore u jiray, iyo u oggolaanshaha in adeegyada telehealth la helo toos bukaan socodka gurigiisa. Medicare ayaa sidoo kale qeexday in adeeg bixiyayaashu ay biil ku bixin karaan booqashooyinka telehealth-ka si la mid ah booqashooyinka shaqsi ahaaneed, taas oo loo yaqaan telehealth “parity” Sidoo kale bishii Maarso, Xafiiska Xuquuqda Madaniga (OCR) wuxuu dabciyay siyaasadiisa fulinta wuxuuna sheegay inuu ka dhaafi doono xadgudubyada ciqaabta ee HIPAA haddii barnaamijyada fiidiyowga ee aan horay loo aqbali karin, sida FaceTime iyo Skype, loo adeegsaday gudbinta telehealth. Dabcan, waxaa jiray isbadalo badan oo siyaasadeed oo telehealth ah oo laga hirgaliyay heer federaal, waa qaab aad u tiro badan oo halkaan lagu qoro, laakiin qaar ka mid ah kuwan, oo ay weheliyaan qaar ka mid ah isbeddelada aan hadda dib u eegnay, waa ku meel gaar waxayna ku xiran yihiin xaaladaha degdegga ah ee caafimaadka bulshada (PHE ). CMS waxay dhowaan daabacday dib-u-eegidoodii 2021 ee Jadwalka Khidmadda Dhakhaatiirta (PFS), iyagoo ka dhigaya qaar ka mid ah isbeddelada ku-meel-gaarka ah kuwo joogto ah, laakiin weli waxaa jira adeegyo loo qoondeeyay inay dhacaan dhammaadka sannadka PHE uu dhammaado. Eeg waxa aan ula jeedo? Dhib badan.
Waan necbahay inaan sii adkeeyo waxyaabaha, laakiin markaan ka hadlayno isbedelada siyaasadeed ee telehealth ee heer gobol, waxaan ka baqayaa inay taasi lama huraan noqon karto. Mid ka mid ah waxyaabaha xiisaha badan, jahwareerka leh, ee ku saabsan telehealth-ga waa in lagu qeexo oo sharci looga dejiyo gobol kasta. Tan macnaheedu waa, heer gobol, iyo gaar ahaan dadweynaha Medicaid, siyaasadda telehealth iyo lacag celinta waxay u muuqdaan kuwo kala duwan, iyo noocyada adeegyada telehealth ee la daboolay aad ayey ugu kala duwanaan karaan gobol kale. Colorado waxay safka hore kaga jirtay sameynta qaar ka mid ah isbedeladaan siyaasadeed ee kumeelgaarka ah ee joogtada ah sida Badhasaabka Polis uu u saxiixay Golaha Guurtida Hindisaha 20-212 sharci ahaan July 6, 2020. Sharciga ayaa mamnuucaya Qaybta Qorshayaasha caafimaadka ee nidaamsan Caymiska:
- Ku dhejinta shuruudo gaar ah ama xaddidan teknoolojiyada waafaqsan HIPAA ee loo adeegsado bixinta adeegyada telehealth.
- Qofka oo looga baahan yahay inuu xiriir dhow la yeesho adeeg bixiyaha si uu adeeg caafimaad uga helo adeegyo caafimaad oo caafimaad.
- U xilsaarid shahaado dheeri ah, goob, ama shuruudaha tababarka oo ah shuruud dib loogu soo celinayo adeegyada telehealth.
Wixii ku saabsan Barnaamijka 'Medicaid Colorado', Golaha Guurtida Hindise sharciyeed 20-212, wuxuu ka dhigayaa dhowr siyaasadood oo muhiim ah joogto. Marka hore, waxay ubaahantahay in waaxda gobolka ay dib ubixiso bukaan socod eegtada caafimaadka miyiga, Adeegga Caafimaadka ee Dowladda Federaalka ee Hindida, iyo Xarumaha Caafimaadka ee Fidralka Takhasuska leh ee adeegyada telehealth ee lasiiyo dadka qaata Medicaid isla heerka ay tahay marka adeegyadaas qof ahaan loo bixiyo. Tani waa isbeddel weyn oo loogu talagay Colorado Medicaid, maadaama faafka ka hor, hay'adahaas aysan dowladdu dib ugu soo celin lacag bixinta adeegyada telehealth. Tan labaad, biilku wuxuu qeexayaa in daryeelka caafimaadka iyo adeegyada daryeelka caafimaadka maskaxda ee Colorado ay ku jiri karaan daaweynta hadalka, daaweynta jireed, daaweynta shaqada, daryeelka isbitaalka, daryeelka caafimaadka guriga, iyo daryeelka caafimaadka habdhaqanka carruurta. Haddii biilkan aan la gudbin, takhasusyadan ayaa laga yaabaa inaysan ogeyn haddii ay awoodi doonaan inay sii wadaan bixinta daryeelkooda telehealth markii masiibadu dhammaatay.
Hagaag, waxaan ka wada hadalnay qaar ka mid ah isbadalada siyaasadeed ee telehealth-ka qaranka iyo gobolka, laakiin ka waran siyaasada telehealth ee bixiyaasha gaarka loo leeyahay, sida Aetna iyo Cigna? Hagaag, hadda, waxaa jira 43 gobol iyo Washington DC oo leh sharci-bixiyeyaal lacag-bixineed oo gaar loo leeyahay, oo loo malaynayo inay ka dhigan tahay in gobolladan, oo ay ku jiraan Colorado, caymiyayaashu looga baahan yahay inay dib-ugu-celiyaan telehealth-ka lacag la mid ah tan daryeelka qofka , iyo sharciyadan sidoo kale waxay u baahan yihiin sinnaanta telehealth ee caymiska iyo adeegyada. In kasta oo tani u muuqato mid aan dhib badnayn, haddana waxaan aqriyay in yar oo ka mid ah sharciyadan sinnaanta gobolka iyo luqadda qaarkeed oo aan caddayn waxay siineysaa bixiyayaasha gaarka loo leeyahay ikhtiyaar ay ku abuuraan iyaga u gaar ah, laga yaabee in ay aad u xaddidan yihiin siyaasadaha telehealth. Qorshayaasha bixiyaha gaarka loo leeyahay sidoo kale waa kuwo siyaasad ku tiirsan, taasoo macnaheedu yahay inay ka reebi karaan telehealth lacag-celinta siyaasadaha qaarkood. Asal ahaan, siyaasada telehealth ee bixiyaasha gaarka loo leeyahay waxay kuxirantahay bixiyaha, gobolka, iyo siyaasada qorshaha caafimaadka gaarka ah. Yup, dhib badan
Maxay tan oo dhami uga dhigan tahay mustaqbalka telehealth? Hagaag, asal ahaan, waan arki doonaa. Xaqiiqdii waxay umuuqataa in telehealth ay sii wadi doonto ballaarinta adeegsiga iyo caannimada, xitaa kadib faafida. Sahamintii ugu dambaysay ee McKinsey waxay ogaatay in 74% dadka isticmaala telehealth intii lagu jiray aafada ay sheegeen inay ku qanacsan yihiin daryeelka ay heleen, taas oo muujinaysa in baahida adeegyada telehealth ay u badan tahay inay halkan sii joogaan. Hay'adaha sharci dejinta ee caafimaadka qaranka iyo dowlad goboleed kasta waxay u baahan doonaan inay baaraan siyaasadooda telehealth maadaama dhamaadka PHE uu soo dhowaanayo, waana inay go'aamiyaan siyaasadaha sii jiraya iyo kuwa la badalayo ama la joojinayo.
Maaddaama telehealth ay u baahan tahay in bukaanku helaan helitaanka tiknoolajiyadda iyo internetka, iyo sidoo kale heer waxbaris farsamo, mid ka mid ah arrimaha sidoo kale u baahan in wax laga qabto ayaa ah "kala qaybsanaanta dhijitaalka ah," taas oo si aan dheellitirnayn u waxyeeleysa shakhsiyaadka Madow iyo Latinx, dadka da'da ah, dadka reer miyiga ah, iyo dadka ay ku yartahay aqoonta Ingiriisiga. Dad badan oo ku nool Ameerika wali ma helaan marin taleefan casri ah, kumbuyuutar, kumbuyuutar, ama internet ballaadhan, xitaa boqolaal milyan oo doolar oo loo qoondeeyey in lagu yareeyo kala duwanaanshahan ayaan ku filnayn in laga gudbo in badan oo ka mid ah caqabadaha nidaam ee meesha yaal. taas oo carqaladeyn karta horumarkaas. Dhamaan dadka Mareykanka ah inay si cadaalad ah awood ugu yeeshaan inay helaan telehealth isla markaana ay ka faa'iideystaan dhamaan adeegyadooda inta lagu gudajiro iyo kadib dhamaadka safka faafa waxay u baahan doonaan dadaal xoog leh oo heer gobol iyo heer federaal ah si loo go'aamiyo isku dhafka ficillada maamul iyo sharci dejinta ee loo baahan yahay in sidaas la sameeyo. Hadda taasi uma muuqato mid aad u adag, ma?
Waxaan kuu rajaynayaa caafimaad wanaagsan!
https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0123
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768771
Xarunta Siyaasadda Caafimaadka Isku Xidhan: https://www.cchpca.org
https://www.healthcareitnews.com/blog/telehealth-one-size-wont-fit-all