The Executive Innovation Show

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Welcome to today's special edition Knowledge Knugget during Mental Health Awareness Month. During this week's segment, Carrie Chitsey answers the questions, what is telepsychiatry and why is there a rising demand pre and post COVID. 

What is Telepsychiatry? 

Telepsychiatry is normally referred to when talking about the psychiatric assessment and/or evaluation of a patient via telehealth. This can be in the form of a psychiatrist to the patient, regardless of the location.

It can also be referred to the psychiatry consultation in regards to medication management, either prescribing medication or ongoing the continuum of care.

You may have also heard it being referred to as provider to provider. We are seeing more and more where you have a facility, primary care physician, or an ER doctor that is doing consultations with psychiatry or a telepsych consult. 

Where is The Need for Telepsychiatry? 

With the shortage of rural access to mental health, there's been an increase in the need for telepsychiatry in: 

• Skilled Nursing Facilities
• Long-Term Care
• Senior Living Facilities
• Clinics 
• Youth Mental Health 
• Hospital Systems

Youth Mental Health 

As we look at youth, child protective services, and the foster care system, there is a growing need for telepsychiatry. With this vulnerable population, psych evaluations need to be done in a very timely fashion, 24 to 48 hours. The problem that arises is that it is very hard to transport youth and get to them, they need to be with a case manager or social worker. So to be able to do that remotely for mental health needs during COVID, this has increased dramatically. 

What Are The Benefits of Telepsychiatry? 

Improve Access to Care

For rural areas where time is a sensitivity and there's a shortage, it will allow mental health care to be done remotely. This could be psych evaluations, assessments, and/or appointments . This will also give the psychiatrist a broader reach. By cutting down driving time. 

Reduce Admissions to ER 

It is critical to have instant access to care to reduce the need for ER admissions. With the shortages right now in the US, being able to get HIPAA compliant evaluations done instantaneously through telepsychiatry will truly play a role in accomplishing that. 

Ongoing Continuum of Care 

When talking about medication management, ongoing care, and moving away from site evaluations to therapy and medication, telepsych can play a huge role in a patient's treatment plan. By being part of that continuum of care, this can reduce no show rates, readmission, and relapse rates. 

That's today's healthcare Knowledge Knugget, part of The Executive Innovation Show. Feel free to submit questions or be featured on the Knowledge Knugget. Subscribe to our YouTube, Vimeo, and the podcast channels to get your Knowledge Knugget on Thursdays.

Download our latest mental health white paper "Telemental Health & The Impact on the Future of Behavioral Health" and listen to the healthcare podcasts where we talk about all the use cases for telehealth.

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Welcome to this week’s healthcare Knowledge Knugget! As a part of “The Executive Innovation Show” podcast, we’re bringing you the hot topics, questions we receive each week, and game-changing ideas, best practices, and tips. During today’s topic, Dr. Shikha Jain, MD talks about how telehealth is being used in oncology during COVID-19. 

Dr. Shikha Jain, MD is an assistant professor of medicine in the Division of Hematology and Oncology and the physician director of social media and communication at the Rush University Cancer Center.

Dr. Shikha Jain, MD goes through some great use cases that they're doing during COVID and really what is the future of telehealth for cancer care post-pandemic.

As we look at this patient population who's highly prone with low immune systems, it really is critical to keep them at home. We should use telehealth as follow-ups to their chemo, to the radiation. Allowing the oncologist to be able to prioritize who they actually need to physically see and who they need to be touching base with. 

There are two sides to this. There's the preventative testing, which has been kind of put on hold during COVID. Then there are actual cancer patients who are going through the process of chemoradiation that oncologists really are keeping a very close eye on this patient population. 

How Has COVID-19 Impacted Cancer Care Across The Country? 

We have found that COVID-19 is a very easily transmissible disease, meaning it's very easy to pass between people, even in some people who don't have any symptoms. And so the challenge for Dr. Jain’s cancer patients has been how to continue their treatment without putting them at unnecessary risk. Providers are doing what they can without exposing them to potential patients who do have coronavirus.

Practices across the country have done a variety of things in order to help prevent the spread and protect our patients. One thing that has been done pretty much globally at this point in the United States is telemedicine. So many patients who don't need to be physically seen are able to access their physicians and their care teams over the phone and through video visits. 

Telehealth has been found to be very effective because patients are able to have a clinic visit when they don't necessarily need to come in. This way they won't have to visit the hospital or the clinic and be unnecessarily exposed. Patients seem to enjoy this type of visit because they're able to do it from their own home.

Has Cancer Care Become More Personalized?

One thing that has happened with COVID-19 is cancer care has become even more personalized. we have found that the patients who really need to be seen are actually coming in to be seen. Those who may benefit from televisits will also be using the benefit of telehealth in the future. 

It is likely that telemedicine will continue to be incorporated in cancer care and that is hopefully one silver lining and one positive that comes out of this global pandemic. We will be able to incorporate these more convenient ways of seeing patients and providing patient care in the future. 

Learn more about One Touch Telehealth and how telehealth can help providers improve quality care for oncology patients. Register for the “COVID Telehealth Adoption: Why Simple Patient & Physician Experience is Critical” webinar here. 

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Welcome to the Executive Innovation Show Podcast, brought to you by One Touch Telehealth. During this podcast, host Carrie Chitsey talks with Dr. Tim Ihrig and Kim Kuebler. 

Timothy Ihrig, M.D., M.A. is Chief Medical Officer at Crossroads Hospice and Palliative Care. He is the founder and CEO of Ihrig MD & Associates. 

Dr. Kim Kuebler is the Founder and Director of the Multiple Chronic Conditions Resource Center, highlighted by the U.S. Dept of Health and Human Services for providing interdisciplinary resources to improve care for the largest and fastest-growing U.S. patient populations. 

Listen to this episode of The Executive Innovation Show Podcast as we discuss: 

• Today we talk with two doctors who are on the front lines of palliative and hospice care, Dr. Tim Ihrig and Dr. Kim Kuebler. With more seniors looking to age at home, how has this changed the industry? Listen to this in-depth conversation about the future of palliative care and how virtual care is making a huge impact. 
• Should we be thinking about the end of life palliative and hospice care as separate or the same? What’s the difference? 
• Listen as Dr. Tim Ihrig of  Crossroads Hospice and Palliative Care details his sentiments on “stealing hope” from patients. 
• Are we selling false dreams to patients? How can doctors do a better job of helping a patient receive a higher quality of life other than aggressive treatments that will hinder their ability to live? 
• What question should doctors be asking to make sure that the patient has a good quality of life? Dr. Ihrig states that “We should stop focusing so much on that endpoint and shift it and say, how do you want to live?". 
• He expresses that we should be moving away from healthcare reform and talk about how we can reform care. Dr. Ihrig believes that it starts with honest conversations, empowering people to ask questions, shifting the narrative. 
• Dr. Kim Kuebler has worked both on the chronic disease and pain management sides of healthcare. How does pain management fit in with palliative care? She breaks down some insightful statistics about chronic pain management across the country today.
• What is the difference between palliative care and hospice care? 
• Should palliative care start when the patient has been diagnosed with a chronic disease?
• Can technology help transform pain management programs in the future? How can primary care physicians implement remote monitoring plans with technology like telehealth that helps decrease overall health care costs and improve patient care?
• As more patients get access to their health information, how is the conversation changing with their doctors?
• As always, we ask these healthcare executives what is keeping them up at night. Listen to their answers here. 

Keep up with Dr. Tim Ihrig by connecting on LinkedIn. 

Get more resources on pain management from Dr. Kim Klueber and Multiple Chronic Conditions Resource Center. 

Learn more about One Touch Telehealth and how telehealth can help providers improve access to care for patients with chronic conditions. Download our “What Is Telehealth?" White Paper to learn more. 

Welcome to the Executive Innovation Show Podcast, brought to you by One Touch Telehealth. During this podcast hear host, Carrie Chitsey, with Chantell Preston. 

Chantell Preston is the Chief Executive Officer and a founding partner of Facilities Management Group who operates multiple freestanding emergency rooms and hospitals located in Texas and Nevada. Chantell is also an avid investor in technology based healthcare companies as well as a Lead Partner for The Active Aging and Longevity Fund for Portfolia Venture Capital. 

Listen to this episode of The Executive Innovation Show Podcast as we discuss: 

• How has the coronavirus shifted ERs around the country to not only keep patients safe but also their employees? Listen as Chantell Preston details the steps taken to transform the ER from brick and mortar to adding telehealth for virtual care. While COVID-19 has led to an increase in emergency room visits, Preston reminds us that other patients will still have emergencies. How can your ER accommodate these patients and reduce the potential exposure to the virus?
• Are you letting the community know that your doors are still open? With a rise in patients not wanting to come into waiting rooms where potential COVID-19 patients could be, how do you sustain the business? Listen to Chantell Prestons’ talk about ways to supplement the walk in traffic.  
• What are executives going to be thinking in the future, post-COVID-19, about virtual visits and telehealth? With such a shakeup to everyday life, how will this change the way healthcare executives think about physical locations and expanding beyond the four walls of a hospital? 
• One big change in healthcare we will see post-coronavirus is innovation. Chantell believes healthcare executives will take a look at technology and how it will help us prepare for the future. She states that we will see more proactive healthcare versus reactive healthcare.  
• Some healthcare systems and companies will be laying off employees and reevaluating their business plans for the future. As an avid investor and lead partner in Portfolia Venture Capital , does Chantell Preston’s healthcare investment strategy change? Listen as Carrie and Chantell talk about the necessities a healthcare company will need to succeed post COVID.
• Chantell Preston details what other physicians and healthcare CEOs can do to keep their business afloat and keep their staff and patients safe. From efficiency to looking at other sources of revenue, she gives her advice here. 
• As always, we ask Chantell what’s keeping her up at night. 

Keep up with Chantell Preston as she makes waves through healthcare by connecting with her on LinkedIn. 

Learn more about One Touch Telehealth and how telehealth can help your ER or urgent care provide virtual care through telehealth keeping employees and patients safe. Download our “What Is Telehealth?" White Paper to learn more.

Welcome to the Executive Innovation Show Podcast, brought to you by One Touch Telehealth. During this podcast hear host, Carrie Chitsey,  with Dr. Brian Bluth (Bluth Medical Associates, LLC). 

Dr. Brian Bluth is trained and board-certified in family medicine. He is the owner and sole-practitioner in private practice since 2009 in rural Oklahoma. He gained interest in rural medicine while in residency in Des Moines Iowa. He especially loved the aspect of full-spectrum medicine the rural setting allows for, including traditional outpatient care, inpatient care, ER coverage, Obstetrics, pediatrics, geriatrics including nursing home director, and surgical procedures including colonoscopy, EGD and laparoscopic surgeries.

Listen to this episode of The Executive Innovation Show Podcast as we discuss: 

• As the Coronavirus becomes more widespread across the country, we talk with Dr. Brian Bluth, a family medicine doctor, about the changes he's seen across the healthcare ecosystem this past week and a half. With the emergence of COVID-19, more practices are seeking to utilize telehealth for virtual visits. 
• Dr. Bluth talks about how previously they hadn't used telemedicine in a major fashion but now it has become 70 to 80% of their appointments. Telehealth appointments have become a necessity for patients, nurses, and doctors to keep them safe from the potential spread of the virus. 
• While people around the country are being placed on Stay-At-Home orders, they still need their medications and check-ups. Seniors will need the help, management, and medical care direction that home health provides. As an at-risk population to the coronavirus,  telehealth is needed to provide proper care. 
• As the cancellation of appointments mounts, revenue is being lost. For practices that had telehealth or telemedicine on the roadmap for the future, they are now looking to implement it instantly. Hear Dr. Bluth talk about what providers need to be doing in this time to reduce cancellations and increase revenue? 
• Since Dr. Brian Bluth and staff had a telehealth platform in place, moving to virtual appointments was more seamless than those practices implementing telehealth for the first time. Listen as Dr. Bluth details what your practice needs to do to set up procedures and a system to accommodate potential coronavirus patients. 
• CMS has lifted restrictions on HIPAA compliance to allow things like Zoom, FaceTime and other video tools during this crisis. Should providers and physicians of small and mid-sized practices avoid previous HIPAA compliant standards now? Hear Dr. Bluth's advice on using tools like FaceTime. 
• "It's not just the encryption of the video, but it's the encryption of the information." Carrie and Dr. Bluth talk about why even in this time of crisis, it's important to be HIPAA compliant not only the video but also the information of the patient. 
• How will this change in telehealth affect healthcare long term? As more patients and doctors begin using telehealth and seeing a spike in satisfaction, telehealth will be here to stay. 

How is Dr. Brian Bluth making sure his community gets the care they need? Visit his website to find out. 

Learn more about One Touch Telehealth and how telehealth can help your practice provide better patient care via our “What Is Telehealth?" White Paper. 

Read the blog here.

Welcome to the Executive Innovation Show Podcast, brought to you by One Touch Telehealth. During this podcast, the host, Carrie Chitsey, has a round table with five Generation Z students from Anderson High School, here in Austin, Texas to hear directly from these Gen Z’s about all things healthcare! We dive deeper into their healthcare preferences for PCPs, how they like to be communicated with and more. 

Listen to “Understanding Gen Z: Healthcare Preferences (Part 3)” as we discuss the following: 

• A lot is going on in healthcare right now. There has been a noticeable shift from going to your primary doctor with more urgent care and retail clinics popping up. You can even go to your local pharmacy to be seen for a cold, sinus issues, etc. And now with healthcare technology like telehealth being accepted by private insurance, the landscape has truly changed. 
• What is Gen Z’s preference for seeing a doctor for minor ailments such as the cold or flu? Would they rather make an appointment with their local doctor and go to them? Or would they rather run into a retail clinic? Listen to their answers here. Are you losing patients to consumer-facing telehealth companies? 
• Where does these Gen Zs' relationship stand with primary care physicians? Do they have one? We talk with these Austin, Texas Gen Zers and they discuss what they are looking for in a PCP. As digital natives, they are looking for online patient scheduling to telehealth.
• During the live in-person recording, we discuss the healthcare preferences of Gen Z when it comes to after-hours. If given the option, they would rather communicate via telehealth with their PCP then going to local retail clinics and third-party apps. 
• What does Gen Z think about mental health? How should it be taught to students? Who should be the one guiding them on things like depression, anxiety, and dealing with suicidal thoughts? As a generation directly caught in the social media highlight reel era, how are they seeing mental health being handled? 
• Are schools teaching mental health to Generation Z students in the right way? Listen as we discuss how they feel. “I feel like if the school were to [teach about mental health], they themselves need to get educated.” How can we bridge the mental health condition education gap? 
• How can we understand Gen Z’s preferences for therapists? Is there too much of a stigma behind going to see a mental health professional? We get their sentiments on peer-to-peer video counseling. 
• Dive deeper into their thought process when it comes to peer-to-peer video support. How would they like to start the communication channel? Listen as they describe their ability to identify bots for real people. 

That brings us to the end of this awesome three-part series, ``Understanding Gen Z.” Take a listen to both part one (Communication and Hiring) and part two (Banking)! Subscribe to the podcast now. 

Download our playbook where we define "What is Telehealth?". We’ll cover use cases, benefits, top implementation areas and why Telehealth is NOT video conferencing. Learn why you need to implement to not lose any Gen Z patients. 

A special thanks to Anderson High School. 

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Welcome to this week’s healthcare Knowledge Knugget! As a part of “The Executive Innovation Show” podcast, we’re bringing you the hot topics, questions we receive each week and game-changing ideas, best practices and tips. Today’s topic is one you’ve seen all over the news, the coronavirus. 

We have gotten tons of requests and it has truly been a floodgate in the telehealth business since Trump’s 8.3 Billion bill that was passed on Friday. This bill lifts the previous telehealth restrictions in Medicare for the Coronavirus. Everyone is going full-court press and trying to figure out how to keep seniors at home and safe in lieu of coming into the ER, clinics and to doctor’s offices waiting rooms. 

So what does that mean? As you know there have been a lot of positive changes for the telehealth reimbursement in 2019 with payer support. In addition, to Medicare Advantage that went into effect in January of 2020. But what does that mean with these new restrictions lifted?

If you are a practice group, hospital, clinic and you’re serving senior patients in nursing homes, skilled nursing facilities, OR with chronic care conditions, you need to have a telehealth solution in place. By doing those routine appointments via telehealth, you are keeping these folks and others safe and at home. 

In addition, people that don’t want to go into the ER or urgent care to try and limit their exposure. There's been a huge surge in consumer-facing telehealth and telehealth in general. Obviously, if someone has symptoms of the Coronavirus, you’re not going to be able to do those tests through telehealth but you can use telehealth to determine who needs to come in and who doesn’t. 

Looking at the appointment types that you have today, such as people who have had surgeries that need to do a post-surgical follow up that are high risk because of infection and wound care. If you are a practice, a hospital or clinic and telehealth has been on your roadmap, with these restrictions lifted, this has opened up the ability to reach this patient safely and at home. 

So if your business on the healthcare side is being affected by a surge of people coming in and having symptoms but also normal patient interactions, you need to think about how not to cancel those appointments. 

If you have any questions on what that means to your healthcare organization with those Medicare restrictions being lifted or the billable codes that are available today, we are here to help.

Stay tuned to the Knowledge Knugget of The Executive Innovation Show. every Thursday as we provide more detail and answer the questions you may be having. We’ll continue to update on the Medicare restrictions lifted on our social channels so be sure to follow us on Twitter and LinkedIn. You’ve seen a lot of officials from the American Hospital Association, American Telehealth Association and as well as President Trump promoting telehealth. 

Download our playbook where we define "What is Telehealth?". We’ll cover use cases, benefits, top implementation areas and why Telehealth is NOT video conferencing. This white paper will be useful to you or someone on your team if you like others trying to figure out telehealth for the Coronavirus quickly. 

Read the blog here.

Welcome to the Executive Innovation Show Podcast, brought to you by One Touch Video Chat. During this podcast, the host, Carrie Chitsey, has a round table with five Generation Z students from Anderson High School, here in Austin, Texas to hear directly from these Gen Z’s about all things banking! What are these Gen Z’s banking preferences and what are they truly looking for in a banking relationship? 

Listen to “Understanding Gen Z: Banking Preferences (Part 2)” as we discuss the following: 

• We kick off the show by understanding these Gen Zs’ banking preferences and why. We get answers on when they first got their checking accounts and debit cards. Do they prefer big traditional banks or would they rather use a community bank or a local credit union? 
• What draws Gen Zs to become bank customers? While a mobile app is table stakes across the industry what other technologies does this generation find necessary? Listen to find out what your bank needs to have to attract these Gen Z customers.
• Security is a huge factor for these Gen Zers. One of the buzzwords with their mobile banking and personal finances was Face ID. Learn how this security feature plays into their decision making with financial institutions. 
• As bank branches continue to close down, we get to the root of the problem. Gen Z isn’t visiting the branch as often anymore. When was the last time they stepped into the branch? Why aren’t branch visits a necessity for these young consumers vs. other generations? 
• Growing up with the power of the internet, members of Gen Z are searching for authenticity! When searching for financial advice on investing, they want unbiased opinions. Do they trust big banks or do they believe they have their own “secret agenda”?
• Skipping the branch and using in-app features to apply for financial services such as car loans are becoming the new norm. How will banks still keep the trust of customers without their visits to the branch? 
• What’s the deal with 1-800 numbers? How is this generation utilizing them or are they even using them at all? Do they prefer a call center or branch when they need to talk to someone?  

This is part two of our three-part series, “Understanding Gen Z”. Subscribe to the podcast now to get notified for part 3, where we’ll talk about healthcare next week.

To learn more on The Future of Banking, Virtual Banking Beyond Four Walls, download our latest White Paper or watch our webinar on demand. 

A special thanks to Anderson High School for allowing the students to participate. 

Welcome to this week’s healthcare Knowledge Knugget! As a part of “The Executive Innovation Show” podcast, we’re bringing you the hot topics, questions we receive each week and game-changing ideas, best practices and tips. Today’s topic comes from Carol Ermis.

Carol Ermis is the Revenue Cycle Director for Orthopaedic Specialist of Austin in Austin, Texas. She has worked in the field of medical billing and coding for 20 years with the last 14 years being dedicated to the revenue cycle of orthopedic surgery.

Hear her answers to the following questions:

What are the patient types that make the most sense to use telehealth for consultations in orthopedics?

It makes sense to use telehealth for patients who live far away from the office and patients who live in rural areas where there's often a shortage of specialists. It may also make sense for patients who live out of the state or for patients who don't have transportation available to them to come to the office. 

Patients who are in a nursing home or who have been admitted to the hospital and can't medically be safely or easily transported to the office. 

What appointment types in orthopedics do not require a physical exam and can they be converted to telehealth to free up waiting rooms?

Surgical follow-ups, wound checks that don't require a suture removal or staple removal can be done via telehealth.

Also, appointments that are basically the doctor delivering diagnostic information to the patient. So if the patient has had an MRI or a CT scan done and the doctor has reviewed the films and is delivering information to the patient about their diagnosis, about their treatment options and answering the patient's questions.

What are the most common billable codes in orthopedics with the GT modifier for telehealth? 

Right now, most commercial payers will cover telemedicine visit services and they're advising healthcare providers to bill an evaluation and management code for telemedicine appointments. That's 99201 - 99205 which is your standard outpatient office visit codes for new or established patients. 

Ask which specific billing codes you should use and whether they recognize the GT modifier. If they have a published policy about their coverage of telemedicine, review it before you call and be armed with that information about their coverage policies when you contact them. 

That has been today's Knowledge Knugget with Carol Ermis. If you have any additional questions, you can find her on LinkedIn. 

That's today's healthcare Knowledge Knugget, part of The Executive Innovation Show. Feel free to submit questions or be featured on the Knowledge Knugget. Subscribe to our YouTube, Vimeo, and the podcast channels to get your Knowledge Knugget on Thursdays.

Download our playbook where we define "What is Telehealth?". We go over top implementation areas for telehealth such as post and pre-surgery consults in orthopedics. We also layout the top benefits of telehealth and even more use cases. 

Read the blog here.

Welcome to the Executive Innovation Show Podcast, brought to you by Live Video Interviews and One Touch Video Chat.  During this podcast, the host, Carrie Chitsey, has a round table with five Generation Z students from Anderson High School, here in Austin, Texas to hear directly from these Gen Z’s how they like to communicate, think about college and what they are looking for in an employer.

Listen to “Understanding Gen Z: Communication and Hiring Trends (Part 1)” as we discuss the following: 

• During our live studio recording, we ask these Gen Zs about their communication preferences, how they use the internet and mobile phone today. Do they prefer to download apps for one time use or just visit the mobile website? With storage space on their cell phones being a premium, does every companies' app get a download? 
• When did they get their first cell phones? At a much younger age than you or I, our teen guests discuss the grade they got their first phone and why. 
• Listen to the podcast as we discover if this generation prefers a text, call or FaceTime? From video homework help to maintaining relationships from far distances, hear just how Gen Z is making the most of video calls. 
• Are college gap years the new normal for this younger generation? We discuss the next steps for these upperclassmen. Is a college degree still seen as the end goal? After seeing millennials strapped with debt, it’s something Gen Z is thinking about even more. Hear their sentiments on college and the factors that play into the next steps of their lives. 
• How are job boards looked at by Gen Z? Do they find them helpful or daunting? Is there a disconnect between experience needed and the current experience gained by this young generation? 
• What is this generation looking for in a job? Is it culture, company values, career path advancement or pay? Their answers differ from Millennial generations. Find out how by listening. 

This is part one of our three-part series, “Understanding Gen Z”. Subscribe to the podcast now to get notified for parts 2 and 3, where we’ll talk banking and healthcare for the next two weeks.

Download the White Paper, “Reach & Recruit a Passive Front-Line Talent Pool” to learn more about how you can connect to the next generation’s top talent. 

A special thanks to Anderson High School for allowing the students to participate.