Day 1 | Michyla Greene
On this day I learned new things that are relevant to task shifting and the reimbursement process throughout the duration of the meeting with the various congressmen from North Carolina as well as the final session of the America’s Health Insurance Plans (AHIP). I was informed that a ‘list’ exists, mandated by Centers for Medicare and Medicaid (CMS), on which medical professionals are allowed to conduct certain tasks and be reimbursed for it. This list has not been updated in a significant amount of time and does align with the roles and responsibilities of general physicians and other non-physician medical professionals such as nurse practitioners and physician assistants. This may pose a problem when attempting to shift a task usually reserved for a specialist upstream to primary care.
I also was informed that many medical technology companies are making strides to make medical care through various web applications a viable option. This is in the hopes that individuals in more rural areas can receive expertise from doctors located in places with large medical institutions, as well as to lower costs. A major issue with this is lack of broadband internet in some areas, which makes access to these applications very difficult.
Day 2 (Thursday)
Thursday’s meetings as a whole really put into perspective how the team’s means of thinking about implementing the Pocket was missing the mark on considerations that are significant when changing the methods of practice in the medical field. We were informed that we need to take more of a business-minded approach by asking the questions for providers:
Will they get paid?
Will they get sued?
Does it work?
We also learned the reimbursement factor of telemedicine and new medical devices is a driving force behind its success, as profitability enhances the allure of product to its many stakeholders. It was also made aware that changing the billing codes on procedures is a possibility. This is accompanied by diligent work in proving that the medical professional in question expertise is sufficient enough to perform the task successfully and without causing harm to the patient. An additional point made with coding is that colposcopy can be placed into two different categories, preventative and diagnostic. Preventative screenings are completely covered by insurance whereas diagnostic screenings are not.
We also discussed another consideration when working with telemedicine is the limitations that doctors have with their state licensure. There is a possibility that multiple states can make agreement with one another to resolve issue associated with interacting with patients over state lines.
Day 3 (Friday)
On this day the team met with many individuals and organizations who do similar work and share similar goals with us. Additionally, we were informed of a conference, Dialogue for Action, that discusses telemedicine. The most memorable takeaway of the day was the fact artificial intelligence is considered to be a medical device and would be put through a rigorous approval process. This trip as a whole has been very informative and the conclusions we have made will be integrated very nicely into our policy framework.