Umgaqo-nkqubo weTelehealth Unzima kwi-2020
Ukuba ubundixelele ekuqaleni konyaka ophelileyo ukuba ingeniso yonyaka ye-telehealth yase-US iya kunyuka isuka kwi-3 yezigidigidi ukuya kwi-250 yezigidigidi zeedola ngo-2020, ndicinga ukuba ngendikubuzile ukuba intloko yakho ihlolwe, kwaye Ndithetha ividiyo! Kodwa ngobhubhane we-COVID-19, siyibonile impilo ye-telehealth isuka ekubeni yinkonzo yokhathalelo lwempilo ukuba ibe lukhetho olukhethwayo kwizigidi zabantu baseMelika ukufumana ukhathalelo lwabo ngeli xesha linzima. I-Telehealth ivumele ukuqhubeka kononophelo lonyango ngexesha lobhubhane, kwaye i-telehealth iye yanda ngeendlela ezahlukeneyo ukwenza kube lula kubantu ukuba bafumane iinkonzo zononophelo ezikhethekileyo njengempilo yokuziphatha, ngaphandle kwesidingo sokundwendwela iofisi kagqirha. Nangona i-telehealth sele ikho amashumi eminyaka, ukutsho ukuba ubuchwephesha obukhathalelwe kukukhanya kwesizwe ngo-2020 ngekhe kube yinto ephantsi.
Njengomntu obekwisikhundla se-telehealth kule minyaka mine idlulileyo, bendimangalisiwe yindlela otshintshe ngayo umhlaba we-telehealth kulo nyaka, kwaye nokuba ubunzima kangakanani. Ngokuqala kwe-COVID-19, iinkqubo zokhathalelo lwempilo kunye nezenzo ezifezekisiweyo kwimihla yeentsuku enye into eyayinokuthatha iiveki, iinyanga, okanye neminyaka, njengamawaka abasebenzi bezonyango kunye nabalawuli abaqeqeshiweyo ekuphumezeni ubuchwephesha bokwenza kunye nokwenza imisebenzi emitsha , iiprotocol, kunye nokuhamba komsebenzi ukuxhasa ukwamkelwa kwe-telehealth ngokukhawuleza. Lo msebenzi unzima uhlawule njengoko i-CDC ixele ukuba ukutyelelwa kwe-telehealth kunyuke nge-154% kwiveki ephelileyo ka-Matshi 2020, xa kuthelekiswa nexesha elifanayo ngo-2019. Ngo-Epreli, ukutyelelwa ngabantu kwii-ofisi zoogqirha nakwezinye iindlela zokhathalelo lwempilo kwehle ngama-60%, ngelixa ukutyelelwa kwezobuchwephesha kubalwa phantse iipesenti ezingama-69 zokuhlangana kwezempilo. Ababoneleli ngononophelo lwempilo bahambisa malunga namaxesha angama-50-175 ngaphezulu kotyelelo lwe-telehealth kunokuba babenzile ngaphambi kwe-COVID-19. Ewe, "okuqhelekileyo okutsha" kwe-telehealth kulapha ngokwenene, kodwa oko kuthetha ntoni kanye?
Ewe, inzima. Makhe ndikucacisele. Esona sizathu siphambili sokuba i-telehealth ikwazi ukuhambela phambili ekunikezelweni kokhathalelo lwempilo kulo nyaka ibingeyonto ibangelwa sisibetho se-COVID-19 uqobo, kodwa kungenxa yotshintsho lomgaqo-nkqubo we-telehealth oza ngenxa yesifo. Emuva ngo-Matshi, xa imeko kaxakeka yesizwe yabhengezwa okokuqala, indlela ethe yongezwa yanikwa iiarhente zombuso kunye nezaseburhulumenteni ukuba ziphendule kule ngxaki, kwaye benza njalo. Amaziko e-Medicare kunye neeNkonzo zeMedicaid (i-CMS) andise kakhulu izibonelelo ze-Medicare ze-telehealth, ngokokuqala ngqa evumela abaxhamli be-Medicare ukuba bafumane iinkonzo ezininzi ngevidiyo kunye nefowuni, beshenxisa isidingo sobudlelwane obukhoyo ngaphambili, kunye nokuvumela iinkonzo ze-telehealth ukuba zamkelwe. ngqo kwikhaya lomguli. I-Medicare ikwacacisile ukuba ababoneleli banokubhatala imali yokundwendwela nge-telehealth kwinqanaba elifanayo nokutyelelwa ngabantu, okwaziwa ngokuba yi-telehealth "parity". Kwakhona ngo-Matshi, iOfisi yamaLungelo oLuntu (i-OCR) yathambisa umgaqo-nkqubo wayo wokunyanzeliswa kwaye yathi iyakuphelisa ukwaphulwa kwesohlwayo esinokubakho xa ii -apps zangaphambili ezingathobeliyo, ezinje ngeFaceTime kunye ne-Skype, bezisetyenziselwa ukuhambisa ubuchwephesha. Ewe, bekukho uninzi lomgaqo-nkqubo wotshintsho kumgaqo-nkqubo ophunyezwe kwinqanaba lomdibaniso, indlela ezininzi kakhulu ukuba zingadweliswa apha, kodwa ezinye zazo, kunye nolunye utshintsho esivele silijongile, zezokwexeshana kwaye zibotshelelwe ngxamisekileyo kwezempilo yoluntu (PHE ). I-CMS kutshanje ipapashe uhlaziyo lwazo lowama-2021 kwiShedyuli yeeNtlawulo zeGqirha (PFS), isenza ezinye zotshintsho lwethutyana lube sisigxina, kodwa kusekho iinkonzo ezimiselwe ukuba ziphele ekupheleni konyaka i-PHE iphela. Uyabona ukuba ndithetha ukuthini? Kunzima.
Ndiyakucaphukela ukwenza izinto nzima nangakumbi, kodwa njengoko sixoxa ngomgaqo-nkqubo we-telehealth otshintsha kwinqanaba likarhulumente, ndiyoyika oko kunokuba yinto engenakuphepheka. Enye yezona zinto zinomdla, kwaye ziyakhathaza, malunga ne-telehealth kukuba ichaziwe kwaye iwisiswe ngokomthetho ngokwahlukeneyo kuwo onke amazwe. Oku kuthetha ukuba, kwinqanaba likarhulumente, kwaye ngakumbi kubantu beMedicaid, umgaqo-nkqubo we-telehealth kunye nokubuyiselwa kwemali kubonakala ngokungafaniyo, kwaye iintlobo zeenkonzo ze-telehealth ezigutyungelweyo zingahluka kakhulu ukusuka kwelinye ilizwe ukuya kwelinye. IColorado ibiphambili ekwenzeni ezinye zeenguqu zomgaqo-nkqubo we-telehealth ngokusisigxina njengoko iRhuluneli Polis ityikitye i-Senate Bill 20-212 ukuba ibe ngumthetho ngoJulayi 6, 2020. Umthetho oyilwayo uthintela iCandelo lezicwangciso ezilawulwa yi-Inshurensi kwezempilo:
- Ukubeka iimfuno ezithile okanye umda kwitekhnoloji ehambelana neHIPAA esetyenziselwa ukuhambisa iinkonzo zetelehealth.
- Ukufuna ukuba umntu abe nobudlelwane obumiselweyo kunye nomboneleli ukuze afumane iinkonzo zempilo zempilo eziyimfuneko zivela kuloo mboneleli.
- Ukugunyazisa ukongezwa kwesatifikethi, indawo, okanye uqeqesho njengemeko yokubuyiselwa kweenkonzo zetelehealth.
Inkqubo ye-Colorado Medicaid, i-Senate Bill 20-212, yenza imigaqo-nkqubo emibini ebalulekileyo esisigxina. Okokuqala, kufuna ukuba isebe likarhulumente libuyisele iiklinikhi zasemaphandleni, iNkonzo yezeMpilo yaseIndiya, kunye neZiko lezeMpilo eliQinisekisiweyo lezeMpilo kwiinkonzo zetelehealth ezinikezelwa kubamkeli beMedicaid ngenqanaba elifanayo njengoko ezo nkonzo zinikezelwa buqu. Olu lutshintsho olukhulu kwiColorado Medicaid, njengaphambi kobhubhane, ezi zinto azibuyiswanga ngurhulumente ngokubonelela ngeenkonzo zononophelo lwempilo. Okwesibini, umthetho oyilwayo ucacisa ukuba ukhathalelo lwempilo kunye neenkonzo zokhathalelo lwempilo yengqondo eColorado kunokubandakanya unyango lwentetho, unyango lomzimba, unyango lomsebenzi, ukhathalelo lwe-hospice, ukhathalelo lwempilo yasekhaya, kunye nokhathalelo lwempilo yabantwana. Ukuba lo mthetho usayilwayo awuzange upasiswe, ezi zinto bezingazukukwazi ukuba ziya kuba nakho ukuqhubeka nokuhambisa ukhathalelo lwabo ngaphezulu kwe-telehealth xa ubhubhane uphela.
Ewe, sixoxe ngotshintsho lomgaqo-nkqubo wesizwe noworhulumente, kodwa kuthekani ngomgaqo-nkqubo we-telehealth wababhatala babucala, njengo-Aetna noCigna? Ewe, okwangoku, kukho amazwe angama-43 kunye neWashington DC enemithetho yokuhlawula imali yabucala yabucala, ekumele ukuba ithetha ukuba kula mazwe, aquka iColorado, abaxhasi beinshurensi bayacelwa ukuba babuyisele imali yezobuchwephetsha kwinqanaba elifanayo nelokunakekelwa kwabantu , kwaye le mithetho ikwafuna ukulingana kwe-telehealth ekugubungeleni nakwiinkonzo. Ngelixa oku kuvakala kungangqinelani, ndiyifundile embalwa le mithetho yobunye belizwe kwaye olunye ulwimi alucacanga kunika abantu babucala ilungelo lokuziqambela eyabo imigaqo-nkqubo enokubanqanda. Izicwangciso zabahlawuli babucala zikwaxhomekeke kumgaqo-nkqubo, oko kuthetha ukuba banokungabandakanyi ubuchwephesha bokubuyiselwa kwemali phantsi kwemigaqo-nkqubo ethile. Ngokusisiseko, umgaqo-nkqubo we-telehealth wabahlawuli babucala uxhomekeke kumhlawuli, kurhulumente, kunye nomgaqo-nkqubo othile wezicwangciso zezempilo. Yup, inzima.
Oku kuthetha ntoni ngekamva le-telehealth? Ewe, ngokusisiseko, siza kubona. Ngokuqinisekileyo kubonakala ukuba i-telehealth iya kuqhubeka nokwanda ekusebenziseni nasekuthandeni, kwanasemva kwesifo. Uphando lwakutsha nje lukaMcKinsey lufumanise ukuba iipesenti ezingama-74 zabasebenzisi be-telehealth ngexesha lobhubhane baxele ukwaneliseka okuphezulu ngenkathalo abayifumeneyo, bebonisa ukuba ibango leenkonzo zetelehealth kungenzeka ukuba zihlale apha. Iiarhente zowiso-mthetho kuzwelonke kunye nelizwe ngalinye kuya kufuneka ukuba zivavanye imigaqo-nkqubo yabo yezempilo njengoko ukuphela kwe-PHE kusondela, kwaye kuya kufuneka babone ukuba yeyiphi imigaqo-nkqubo eza kuhlala kwaye yeyiphi ekufuneka itshintshiwe okanye ipheliswe.
Kuba umnxeba ufuna ukuba izigulana zifikelele kubuchwephesha nakwi-intanethi, kunye nenqanaba elithile lokufunda ngezobuchwephesha, enye yezinto ezifuna ukujongiwa "kukuhlukana kwedijithali," okungahambisani ngokungafaniyo nabantu abaMnyama nabaseLatinx, abantu abadala, abantu basemaphandleni, kunye nabantu abanolwazi oluncinci lwesiNgesi Abantu abaninzi eMelika abakabi nakho ukufikelela kwi-smartphone, ikhompyuter, ithebhulethi, okanye ibroadband ye-intanethi, kwaye namakhulu ezigidi zeedola ezabiweyo ukunciphisa oku kungalingani zinokwanela ukoyisa uninzi lwezithintelo zenkqubo ezikhoyo endaweni. Ingathintela inkqubela phambili enjalo. Kubo bonke abantu baseMelika ngokulingeneyo ukuba banakho ukufikelela kwezobuchwephesha kwaye baxhamle kuzo zonke iinkonzo zayo ngexesha nasemva kokuphela kwesifo kuya kufuna iinzame ezijolise kwinqanaba likarhulumente nakwimanyano ukumisela indibaniselwano yezenzo zolawulo nezomthetho ezifunekayo ukwenza oko. Ngoku ayizwakali inzima kakhulu, andibi kunjalo?
Ndikunqwenelela ukuba nempilo elungileyo!
https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0123
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768771
Iziko loMgaqo-nkqubo weMpilo eliDibeneyo: https://www.cchpca.org
https://www.healthcareitnews.com/blog/telehealth-one-size-wont-fit-all