Inqubomgomo yeTelehealth Ithole Inkinga ngo-2020
Ukube wangitshela ekuqaleni konyaka odlule ukuthi imali engenayo yonyaka ye-telehealth yase-US izokhuphuka isuka ezigidini eziyizinkulungwane ezintathu zamaRandi iye cishe ezigidigidini ezingama-3 zamaRandi ngo-250, ngicabanga ukuthi bengizobuza ukuthi uhlolwe ikhanda lakho, futhi angikwenzi lokho. kusho ngaphezu kwevidiyo! Kepha ngobhubhane lwe-COVID-2020, sibonile i-telehealth isuka ekubeni inketho yenkonzo yokunakekelwa kwezempilo yasendaweni ibe inketho ekhethwayo yezigidi zabantu baseMelika ukuthola ukunakekelwa kwabo ngalesi sikhathi esiyinselele. I-Telehealth ivumele ukuqhubeka kokunakekelwa kwezempilo phakathi nalolu bhubhane, kanti i-telehealth nayo yanda ngezindlela ezahlukahlukene ukwenza kube lula ukuthi abantu bathole izinsizakalo zokunakekelwa okukhethekile njengezempilo yokuziphatha, ngaphandle kwesidingo sokuvakashela ihhovisi likadokotela. Yize i-telehealth isineminyaka engamashumi eminyaka ikhona, ukusho ukuthi i-telehealth yangena endaweni yezwe ngo-19 ngeke kube yinto ephansi.
Njengomuntu obe semkhakheni wezempilo eminyakeni emine edlule, ngimangele ukuthi ishintshe kangakanani indawo yezempilo kulo nyaka, nokuthi isibe nzima kangakanani. Ngokuqala kwe-COVID-19, izinhlelo zokunakekelwa kwezempilo kanye nezinqubo ezifezwe ngezinsuku ezimbalwa obekungathatha amasonto, izinyanga, noma ngisho neminyaka, njengoba izinkulungwane zabasebenzi bezokwelapha nabaphathi beziqeqeshelwa ukusebenzisa i-telehealth kanye nokudala nokufunda imisebenzi emisha. , amaphrothokholi, nokugeleza komsebenzi ukusekela ukwamukelwa kwe-telehealth ngokushesha okukhulu. Lo msebenzi onzima waba nezithelo njengoba i-CDC ibike ukuthi ukuvakasha ngocingo kukhuphuke ngo-154% phakathi nesonto eledlule likaMashi 2020, uma kuqhathaniswa nesikhathi esifanayo ngo-2019. Ngo-April, ukuvakashela mathupha emahhovisi odokotela nezinye izindlela zokunakekelwa kwezempilo kwehle ngo-60%, kuyilapho ukuvakasha ngocingo kubalele cishe u-69% wengqikithi yokunakekelwa kwezempilo. Abahlinzeki bokunakekelwa kwezempilo baletha ukuvakasha kocingo okuphindwe izikhathi ezingama-50-175 kunangaphambi kwe-COVID-19. Yebo, "okujwayelekile okusha" kwe-telehealth kukhona ngempela, kodwa lokho kusho ukuthini ngempela?
Hhayi-ke, kuyinkimbinkimbi. Ake ngichaze. Isizathu esikhulu esenza ukuthi i-telehealth ikwazi ukuqhubekela phambili ekulethweni kokunakekelwa kwezempilo kulo nyaka bekungengenxa yobhubhane lwe-COVID-19 uqobo, kodwa bekungenxa yezinguquko zenqubomgomo yezempilo eza ngenxa yalolu bhubhane. Emuva ngoMashi, lapho kumenyezelwa isimo esiphuthumayo kuzwelonke, kwanikezwa inkululeko eyengeziwe ezikhungweni zikahulumeni nezombuso ukuze ziphendule kule nkinga, futhi zenza kanjalo. I-Centers for Medicare and Medicaid Services (CMS) yandise kakhulu izinzuzo ze-Medicare ze-telehealth, okokuqala ngqa ivumela abahlomuli beMedicare ukuthi bathole izinsiza eziningi ngevidiyo nangocingo, isusa isidingo sobudlelwano obabukhona ngaphambilini, nokuvumela izinsiza zezempilo ukuthi zamukelwe. ngqo endlini yesiguli. I-Medicare iphinde yacacisa ukuthi abahlinzeki bangakhokhisa ukuvakasha kwezempilo ngenani elifanayo nokuvakashela mathupha, okwaziwa ngokuthi "ukulingana" kwe-telehealth. Futhi ngoMashi, iHhovisi Lamalungelo Oluntu (OCR) laxegisa inqubomgomo yalo yokuphoqelela futhi lathi lizohoxisa ukwephulwa kwenhlawulo ye-HIPAA okungenzeka ukuthi ngabe izinhlelo zokusebenza zevidiyo ezazingathobeli ngaphambilini, njenge-FaceTime ne-Skype, zisetshenziswa ukuletha i-telehealth. Vele, kube nezinguquko eziningi ezengeziwe zenqubomgomo yezempilo esetshenziswa ezingeni likahulumeni, eziningi kakhulu ukuthi zingafakwa ohlwini lapha, kodwa ezinye zazo, kanye nezinye zezinguquko esisanda kuzibuyekeza, zingezesikhashana futhi zixhumene nesimo esiphuthumayo sezempilo yomphakathi (PHE ). I-CMS isanda kushicilela izibuyekezo zayo zango-2021 kuHlelo Lokukhokhelwa Odokotela (i-PFS), okwenza ezinye zezinguquko zesikhashana zibe unomphela, kodwa kusenezinsizakalo ezizophelelwa yisikhathi ekupheleni konyaka i-PHE ephela. Niyabona ukuthi ngiqonde ukuthini? Inkimbinkimbi.
Ngiyakuzonda ukwenza izinto zibe nzima nakakhulu, kodwa njengoba sixoxa ngezinguquko zenqubomgomo ye-telehealth ezingeni likahulumeni, nginovalo lokuthi lokho kungase kungenakugwemeka. Enye yezinto ezithakazelisa kakhulu, futhi ezikhungathekisayo, mayelana ne-telehealth ukuthi ichazwa futhi ishaywa umthetho ngokwehlukile kuzo zonke izifundazwe. Lokhu kusho ukuthi, ezingeni likahulumeni, futhi ikakhulukazi kubantu be-Medicaid, inqubomgomo ye-telehealth kanye nembuyiselo ibonakala ihlukile, futhi izinhlobo zezinsizakalo ze-telehealth ezimboziwe zingahluka kakhulu kusuka kwesinye isifunda kuya kwesinye. I-Colorado ibihamba phambili ekwenzeni ezinye zalezi zinguquko zenqubomgomo yezempilo yesikhashana zibe unomphela njengoba uMbusi u-Polis esayine uMthethosivivinywa weSigele 20-212 ukuba ube umthetho ngoJulayi 6, 2020. Umthethosivivinywa uvimbela izinhlelo zezempilo ezilawulwa yiDivision of Insurance kusukela:
- Ukubeka izidingo ezithile noma imikhawulo kubuchwepheshe obuvumelana ne-HIPAA obusetshenziselwa ukuletha izinsiza zezempilo ngocingo.
- Ukudinga umuntu ukuthi abe nobudlelwano obumisiwe nomhlinzeki ukuze athole izinsiza zezempilo ezidingekayo kulowo mhlinzeki.
- Ukugunyaza izitifiketi ezengeziwe, indawo, noma izimfuneko zokuqeqeshwa njengombandela wokubuyisela izinsiza zezempilo ngocingo.
Ohlelweni lweColorado Medicaid, uMthethosivivinywa weSenethi 20-212, wenza izinqubomgomo ezimbalwa ezibalulekile zibe unomphela. Okokuqala, kudinga ukuthi umnyango wezwe ubuyisele imitholampilo yezempilo yasemaphandleni, i-Federal Indian Health Service, kanye ne-Federally Qualified Health Centers ngezinsizakalo ze-telehealth ezinikezwa abamukeli be-Medicaid ngenani elifanayo lapho lezo zinsizakalo zinikezwa mathupha. Lolu wushintsho olukhulu lweColorado Medicaid, njengoba ngaphambi kwalolu bhubhane, lezi zinhlangano azizange zibuyiselwe nguhulumeni ngokuhlinzeka ngezinsizakalo zezempilo. Okwesibili, lo mthethosivivinywa ucacisa ukuthi ukunakekelwa kwezempilo kanye nezinsizakalo zokunakekelwa kwezempilo yengqondo eColorado zingabandakanya ukwelapha ngenkulumo, ukwelapha ngokomzimba, ukwelapha emsebenzini, ukunakekelwa kwabagulela ukufa, ukunakekelwa kwezempilo kwasekhaya, nokunakekelwa kwezempilo kokuziphatha kwezingane. Ukube lo mthethosivivinywa awuzange uphasiswe, lezi zici ezikhethekile zazingeke zazi ukuthi zizokwazi yini ukuqhubeka nokuletha ukunakekelwa kwazo ngocingo lapho ubhubhane seluphelile.
Hhayi-ke, sixoxile ngezinguquko zenqubomgomo yezempilo kazwelonke neyezwe, kodwa kuthiwani ngenqubomgomo ye-telehealth yabakhokhi abazimele, njengo-Aetna noCigna? Nokho, okwamanje, kunezifundazwe ezingama-43 kanye neWashington DC ezinemithetho yokulinganisa inkokhelo ye-telehealth yabakhokhi bangasese, okufanele kusho ukuthi kulezi zifundazwe, ezihlanganisa iColorado, abadayisi bomshwalense kudingeka babuyisele i-telehealth ngenani elifanayo nelokunakekelwa komuntu siqu. , futhi le mithetho futhi idinga ukulingana kwezempilo ngocingo ekusakazweni nasezinsizeni. Nakuba lokhu kuzwakala kungenangqondo, ngifunde embalwa yale mithetho yokulinganisa yezwe futhi olunye ulimi alucacile kangangokuthi lunikeza abakhokhi abazimele ukuhlakanipha kokuzakhela ezabo, izinqubomgomo zocingo okungenzeka zibe nemingcele. Izinhlelo zabakhokhi abazimele nazo zincike kwinqubomgomo, okusho ukuthi zingase zingafaki i-telehealth ukuze ibuyiselwe ngaphansi kwezinqubomgomo ezithile. Empeleni, inqubomgomo yezempilo yocingo yabakhokhi abazimele incike kumkhokhi, umbuso, kanye nenqubomgomo yohlelo lwezempilo oluthile. Yebo, kuyinkimbinkimbi.
Kusho ukuthini konke lokhu ngekusasa le-telehealth? Yebo, ngokuyisisekelo, sizobona. Kubukeka sengathi i-telehealth izoqhubeka nokukhula ekusetshenzisweni nasekudumeni, ngisho nangemva kwalolu bhubhane. Inhlolovo yakamuva kaMcKinsey ithole ukuthi u-74% wabasebenzisi bezingcingo ngesikhathi sodlame babike ukwaneliseka okuphezulu ngokunakekelwa abakuthola, okukhombisa ukuthi isidingo sezinsiza zezempilo kungenzeka sihlale lapha. Ama-ejensi kazwelonke womthetho wezempilo kanye nombuso ngamunye kuzodingeka ukuthi bahlole izinqubomgomo zabo zokuxhumana ngocingo njengoba ukuphela kwe-PHE kusondela, futhi kuzodingeka banqume ukuthi yiziphi izinqubomgomo ezizosala nokuthi yiziphi okufanele zishintshwe noma ziqedwe.
Njengoba i-telehealth idinga ukuthi iziguli zibe nokufinyelela kwezobuchwepheshe kanye ne-inthanethi, kanye nezinga elithile lokufunda nokubhala kwezobuchwepheshe, enye yezinto okufanele zibhekwe futhi "ukuhlukaniswa kwedijithali," okulimaza ngokulinganayo abantu abamnyama nabaLatinx, abantu asebekhulile, abantu basemaphandleni, kanye nabantu abanolwazi olulinganiselwe lwesiNgisi. Abantu abaningi eMelika abakakwazi ukufinyelela ku-smartphone, ikhompuyutha, ithebhulethi, noma i-inthanethi ye-broadband, futhi ngisho namakhulu ezigidi zamaRandi abelwe ukunciphisa lokhu kuhlukana kungenzeka anganeli ukunqoba izithiyo eziningi zesistimu ezikhona. lokho kungakhinyabeza intuthuko enjalo. Ukuze bonke abantu baseMelika bakwazi ngokulinganayo ukuthola i-telehealth futhi bazuze kuzo zonke izinsiza zabo ngesikhathi nangemuva kokuphela kobhubhane kuzodinga imizamo eqinile ezingeni lombuso kanye nelenhlangano ukuthola inhlanganisela yezenzo zokuphatha nezomthetho ezidingekayo ukwenza lokho. Manje lokho akuzwakali kuyinkimbinkimbi kakhulu, akunjalo?
Ngikufisela i-telehealth enhle!
https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0123
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768771
Isikhungo Senqubomgomo Yezempilo Exhunyiwe: https://www.cchpca.org
https://www.healthcareitnews.com/blog/telehealth-one-size-wont-fit-all