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Telemedicine Transition: Legal & Operational Issues

Telemedicine Transition: Legal & Operational Issues. Jennifer Baron, Telemedicine Program Director Clarian Health Valita Fredland, Associate General Counsel Clarian Health. Telemedicine Defined.

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Telemedicine Transition: Legal & Operational Issues

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  1. Telemedicine Transition: Legal & Operational Issues Jennifer Baron, Telemedicine Program Director Clarian Health Valita Fredland, Associate General Counsel Clarian Health

  2. Telemedicine Defined Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. Closely associated with telemedicine is the term "telehealth," which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth. Telemedicine is not a separate medical specialty. Products and services related to telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. Telemedicine encompasses different types of programs and services provided for the patient. Each component involves different providers and consumers. 

  3. History of Clarian Telemedicine 2004 Began at Riley Hospital for Children • Grant Funded - HRSA OAT 2006 Became a Clarian Department • Largest/most comprehensive program in Indiana • Only program in Indiana functioning as a fully operational department • 3 FTEs Facilitate Live/Interactive clinical consults and Distance Learning activities

  4. Program Highlights • Grown from 3 spoke sites to 19 spoke sites in three years • Facilitated nearly 2000 clinical consults • Facilitated nearly 1000 distance learning educational events (CME)

  5. Transitioning from Grant Funding to Operational Sustainability • Know industry legal and regulatory issues • Contractual Agreements/MOU’s • Service Assessment

  6. Transitioning from Grant Funding to Operational Sustainability • Ongoing Data • Business Planning • Organizational Strategy • Marketing

  7. http://www.thirdage.com/ebsco/files/13621.html

  8. Legal Issues • Licensure Certificate of Need (varying State laws) Physician/Provider licensure • Accreditation State law and Private credentialing standards • JCAHO Standards MS 4.120 MS 4.130 LD 3.50 MS 13.01.01 (effective July 15, 2010)

  9. Legal Issues (cont.) • Malpractice Liability • e-health Website 844 IAC 5-3 • Electronic Medical Record • Privacy (HIPAA) / Security • Intellectual Property • Center for Devices and Radiological Health (FDA)

  10. Legal Issues (cont.) • EMTALA • Antitrust • Antikickback / Stark • Reimbursement

  11. Telemedicine evolves… • Client initiated projects • Ad hoc video platforms (e.g. Skype) • Off-the-shelf technology • Internet social networking

  12. Questions/Answers

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