DOCSLIB.ORG

Immunology Position Paper on the Use of Telemedicine for Allergists

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Immunology Position Paper on the Use of Telemedicine for Allergists Ann Allergy Asthma Immunol xxx (2017) 1e6 Contents lists available at ScienceDirect 1 Position Paper 58 2 59 3 American College of Allergy, Asthma & Immunology Position Paper on 60 4 61 5 the Use of Telemedicine for Allergists 62 6 63 Q12 Tania Elliott, MD; Jennifer Shih, MD; Chitra Dinakar, MD; Jay Portnoy, MD; Stanley Fineman, MD 7Q1 64 8 Q2 --- 65 9 66 10 67 ARTICLE INFO 68 11 The integration of telecommunications and information systems in health care first began 4 decades ago 12 69 Article history: with 500 patient consultations performed via interactive television. The use of telemedicine services and 13 70 Received for publication September 7, 2017. technology to deliver health care at a distance is increasing exponentially. Concomitant with this rapid 14 71 Accepted for publication September 8, 2017. expansion is the exciting ability to provide enhancements in quality and safety of care. Telemedicine enables 15 72 increased access to care, improvement in health outcomes, reduction in medical costs, better resource use, 16 73 expanded educational opportunities, and enhanced collaboration between patients and physicians. These 17 74 potential benefits should be weighed against the risks and challenges of using telemedicine. The American 18 75 College of Allergy, Asthma, and Immunology advocates for incorporation of meaningful and sustained use of 19 76 telemedicine in allergy and immunology practice. This article serves to offer policy and position statements 20 77 of the use of telemedicine pertinent to the allergy and immunology subspecialty. 21 78 Ó 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. 22 79 23 80 24 81 25 Introduction The sustainability of health care systems is a matter of continued 82 26 concern.3 According to projections by the Association of American 83 In 1972, Murphy and Bird1 conducted 500 patient consultations 27 Medical Colleges, the nation will be short more than 90,000 total 84 via interactive television, and the first formal definition of tele- 28 physicians by 2020 and 130,000 physicians by 2025.4 With 85 medicine was born. In 1974, Bird defined telemedicine as “the 29 approximately only 3000 active allergists nationwide (adapted 86 practice of medicine via an interactive audio-video communication 30 from American Academy of Allergy, Asthma, and Immunology Report 87 system.”1 Federal health programs and rural communities were 31 on the Allergy and Immunology Physician Workforce, 1999-2009/10 5), 88 some of the first to adopt telemedicine as a means to improve 32 telemedicine offers the opportunity to provide scalable, longitudi- 89 access to patient care. However, telemedicine has traditionally not 33 nal, high-quality care to patients. 90 been considered part of mainstream medical practice largely 34 Telemedicine technologies have been proven to work and are 91 because of a combination of technology limitations and federal 35 considered a viable option for health care delivery.6 With the 92 regulations. With the advent of the internet and widespread 36 availability of low-cost computing and digital telecommunications 93 computer and smartphone use, telemedicine can support high- 37 in the 1980s, telemedicine became practical and feasible.7 Unfor- 94 quality at-a-distance health care delivery. Variations in regula- 38 tunately, since then, adoption of widespread telemedicine practice 95 tions, including discrepancies between state and federal laws and 39 has been slow. Holistic implementation approaches are therefore 96 questions around the quality of care delivery, still exist. Despite 40 urgently needed.8 97 41 this, most health plans offer some reimbursement for telemedicine 98 42 services. According to the American Telemedicine Association, 99 43 more than 15 million Americans received some form of medical 100 Methods 44 care remotely in 2015, with a projected increase to 158.4 million by 101 2 45 2020. The American College of Allergy, Asthma, and Immunology 102 46 appointed a telemedicine task force, composed of allergists with 103 fi 47 Drs Elliott and Shih are primary authors and contributed equally. telemedicine experience, dedicated to de ning the scope and 104 48 Reprints: Michael Blaiss, MD, Department of Pediatrics and Medicine, University of practice of telemedicine for allergists. A PubMed literature search 105 49 Tennessee Health Science Center, 1090 Windfaire Place, Roswell, TN 30076; E-mail: using the keywords telemedicine and telehealth was performed 106 50 [email protected]. and articles reviewed from publication dates of 1990 to 2017. 107 51 Q3 Disclosures: Authors have nothing to disclose Position papers from other medical specialties were additionally 108 Disclaimer: This White Paper is intended for informational purposes only and reviewed and analyzed for relevance to the use of telemedicine 52 nothing in it should be construed as constituting legal advice. The information 109 53 presented here is current as of the date of issuance; however, the American College in allergy and immunology practice. For the purposes of this 110 54 of Allergy, Asthma, and Immunology assumes no obligation to update it in response position paper, the terms telemedicine and telehealth will be used 111 55 to new developments. interchangeably. 112 56 113 https://doi.org/10.1016/j.anai.2017.09.052 57 1081-1206/Ó 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. 114 PGL 5.5.0 DTD ANAI2312_proof 3 October 2017 11:09 pm ce 2 T. Elliott et al. / Ann Allergy Asthma Immunol xxx (2017) 1e6 115 Definition of Telemedicine costs by $1,436 and gained 0.02 years of quality-adjusted life-years 181 116 during a lifetime compared with the patient receiving care at a rural 182 Telemedicine is defined as the use of technology to deliver 117 community hospital.15 183 health care, health information, or health education at a distance. 118 Telehealth technologies used by the Veterans Health Adminis- 184 The American Medical Association (AMA) further defines this to 119 tration have shown greater efficiency and patient satisfaction in the 185 include face-to-face evaluations, either in person or virtually 120 management of chronic disease. The Veterans Health Administra- 186 through real-time audio and video technology.9 According to the 121 tion’s care coordination/home telehealth program saw a 25% 187 Federation of State Medical Boards, “generally, telemedicine is not 122 reduction in the number of bed days, a 19% reduction in the number 188 an audio-only, telephone conversation . it typically involves the 123 of hospital readmissions, and a mean increase in patient satisfac- 189 application of secure videoconferencing or store-and-forward 124 tion scores of 86%.16 190 technology to provide or support healthcare delivery by 125 191 replicating the interaction of a traditional encounter in person 126 192 between a provider and a patient.”10 Access 127 193 128 Access to health care is also improved with telemedicine. Ac- 194 Types of Telemedicine 129 cording to a 2015 study, the mean no-show rate for physician ap- 195 130 Store and Forward (Asynchronous) pointments was upwards of 20%, with a mean cost per patient of 196 131 approximately $200.17 Telemedicine technologies can connect pa- 197 Asynchronous telemedicine is communication with a patient 132 tients with the clinician without having to incur long travel times 198 that is separated by distance and time. The Department of Veteran 133 and associated expenses, particularly if they do not have ready 199 Affairs defines this as “the acquisition and storing of clinical infor- 134 access or are unwilling to travel. Beyond the rural setting, 200 mation e.g. data, image, sound, video, that is then forwarded to (or 135 telemedicine may aid in facilitating care for underserved patients in 201 retrieved by) another site for clinical evaluation.” Examples include 136 Q4 rural and urban settings.18 Sites located in the prison environment 202 e-messaging with a patient, e-consultations (where another 137 or school environment offer immediate access to health care. 203 physician may request a second opinion or formal consultation 138 Democratic State Representative Kip Kendrick, who helped pass a 204 through a secure portal to send and receive patient medical records 139 Missouri law that allows Medicaid payments for telemedicine in 205 for review), and the use of peripheral devices (eg, otoscope, 140 schools, stated that school telehealth will be significant in terms of 206 stethoscope) that record images and/or sounds and transmit them 141 children’s health, keeping them in school and improving educa- 207 to the treating physician. Considerations for the practice of asyn- 142 tional outcomes.19 208 chronous telemedicine include establishment of the physician- 143 Although patients with Parkinson disease do better under the 209 patient relationship and the use of Health Insurance Portability 144 treatment of a neurologist, research indicates that fewer than half 210 and Accountability Act (HIPAA)ecompliant, secure modes of 145 of Medicare patients with Parkinson disease see a neurologist 211 communication. 146 because of lack of access.20 Telemedicine could offer improved 212 147 access to care. A national randomized clinical trial of virtual house 213 Real-Time Video (Synchronous) 148 calls for people with Parkinson disease found great interest in 214 149 Synchronous telemedicine consultations use video- virtual access, with 11,734 individuals visiting the study’s website 215 150 conferencing to connect the physician and patient. The location of and 927 individuals submitting electronic interest forms.21 216 151 the patient is defined as the originating site and can be at a satellite Quicker access has also been found with forms of telemedicine 217 152 office with a telefacilitator or from the patient’s home directly in the Indian health service. A comparison study of patients waiting 218 153 through the patient’s smartphone, tablet, or computer.
Load more

Recommended publications
  • Interventional Chronic Pain Treatment in Mature Theaters of Operation
    28. INTERVENTIONAL CHRONIC PAIN pain, nonradicular arm pain, groin pain, noncardiac spinal and myofascial pain); and anticonvulsants TREATMENT IN MATURE THEATERS chest pain, and neck pain. The most common diag- and tricyclic antidepressants (usually prescribed for OF OPERATION noses conferred on these patients were lumbosacral radicular and other forms of neuropathic pain). The radiculopathy, recurrence of postsurgical pain, large majority of patients received at least one inter- IMPACT OF NONBATTLE-RELATED INJURIES lumbar facetogenic pain, myofascial pain, neuro- ventional procedure. The most frequently employed AND TREATMENT pathic pain, and lumbar degenerative disc disease. nerve blocks were lumbar transforaminal epidural The most common noninterventional treatments steroid injections (ESIs), trigger point injections, Acute nonbattle injuries (NBIs) and chronic pain have been nonsteroidal antiinflammatory drugs cervical ESIs, lumbar facet blocks, various groin conditions that recur during war have been termed (NSAIDs; > 90%); physical therapy referral (for back blocks, and plantar fascia injections. Table 28-1 lists the “hidden epidemic” by the former surgeon pain, neck pain, and leg pain); muscle relaxants (for procedures for common nerve blocks conducted in general of the US Army, James Peake. Since statistics have been kept, the impact of NBIs on unit readiness TABLE 28-1 has increased. In World War I, NBI was the fourth leading cause of soldier attrition. In World War II PROCEDURES FOR COMMON NERVE BLOCKS CONDUCTED IN THEATER and the Korean conflict, NBIs were the third leading cause of morbidity. By the Vietnam War, NBIs had Injection Injectate Need for Comments become the leading cause of hospital admissions, Volume* (mL) Fluoroscopy? where they have remained ever since.
    [Show full text]
  • Study Guide Medical Terminology by Thea Liza Batan About the Author
    Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails ­proficiency­in­communicating­with­healthcare­professionals­such­as­physicians,­nurses,­ or dentists.
    [Show full text]
  • CMA Psychiatry Profile, 2018
    Psychiatry Profile Updated December 2019 1 Table of Contents Slide . General Information 3-7 . Total number & number/100,000 population by province, 2019 8 . Number/100,000 population, 1995-2019 9 . Number by gender & year, 1995-2019 10 . Percentage by gender & age, 2019 11 . Number by gender & age, 2019 12 . Percentage by main work setting, 2019 13 . Percentage by practice organization, 2017 14 . Hours worked per week (excluding on-call), 2019 15 . On-call duty hours per month, 2019 16 . Percentage by remuneration method 17 . Professional & work-life balance satisfaction, 2019 18 . Number of retirees during the three year period of 2016-2018 19 . Employment situation, 2017 20 . Links to additional resources 21 2 General information Psychiatry is the medical specialty that deals with the diseases of the mind. Psychiatric patients manifest illnesses and problems that require a comprehensive biological, psychological and social evaluation to understand their illnesses and their needs. Central to the psychiatrist’s role is a comprehensive assessment, leading to a diagnosis and a treatment plan for the care and rehabilitation of patients with mental illness, and emotional and behavioural disorders. Psychiatrists use a combination of biological, psychological and social treatment modalities. They must be comfortable in working with the patient, as opposed to working on the patient. To do this successfully, they must possess the skills and comfort level to work and lead a team that includes the patient, their family and other mental health professionals and agencies. Source: Pathway evaluation program 3 General information Most psychiatrists work in multiple settings and their role may vary somewhat in these different settings, including: .
    [Show full text]
  • 2019‐2020 Internal Medicine Residency Handbook Table of Contents Contacts
    2019‐2020 Internal Medicine Residency Handbook Table of Contents Contacts ............................................................................................................................................ 1 Introduction ...................................................................................................................................... 2 Compact ............................................................................................................................................ 2 Core Tenets of Residency ……………………………………………………………………………………………………………3 Program Requirements ……………………………………………………………………………………………………………….6 Resident Recruitment/Appointments .............................................................................................. 9 Background Check Policy ................................................................................................................ 10 New Innovations ............................................................................................................................. 11 Social Networking Guidelines ......................................................................................................... 11 Dress Code ...................................................................................................................................... 12 Resident’s Well Being ...................................................................................................................... 13 Academic Conference Attendance ................................................................................................
    [Show full text]
  • Your Path to Becoming a Medical Doctor at the University of Iowa Types of Doctors Medicine Offers a Lot of Career Choices
    Your Path to Becoming a Medical Doctor at the university of iowa Types of Doctors Medicine offers a lot of career choices. Many doctors treat patients full-time, while others also teach, conduct research, manage hospitals and clinics, or help develop health policy. There is no single road to becoming a doctor, but most our mission is simple: changing medicine. changing lives. at the carver college medical career paths share key characteristics. of medicine, we do that by inspiring and educating students to become Doctors fall into two main groups: primary care world-class health care providers and scientists for iowa and the world. doctors and specialists. Primary Care Doctors The term “primary care” refers to the medical What Makes Us Different? fields that treat most common health problems: family medicine, general internal medicine, Our Curriculum pediatrics (children’s health), and in some cases obstetrics and gynecology (women’s health). As a medical student at Iowa, you’ll get a lot of hands-on experience, including opportunities to learn from real doctors—and real patients—in hospital or clinic setting. Specialists Specialists concentrate on diseases or problems Our Distinction Tracks that affect specific parts of the body. They may Six distinction tracks allow you to follow your own personal interests and career goals. treat patients with complicated illnesses who are sent to them by primary care doctors or other We’re an Academic Medical Center specialists. Being an academic medical center means that we teach and train future doctors and scientists, take care of patients, and do Types of Degrees medical research.
    [Show full text]
  • Tips on Choosing the Specialty That's Right For
    page 1 of 2 Tips on Choosing the Specialty That’s Right for You • Where should you be in the specialty to work in? How many patients will you see in a selection process right now? Careers in day? As you go through the rotation, reconcile your Medicine (http://www.aamc.org/students/cim/) expectations with what you actually experience. is a valuable resource. It divides specialty Also use your journal to keep track of your feelings. choice into four phases corresponding with At the end of the rotation, summarize the things the four years of medical school. Designed by you learned about yourself. What challenged you the Association of American Medical Colleges the most? What were your biggest strengths and (AAMC) and the American Medical Association weaknesses? What did you enjoy the most? The (AMA), this program is implemented on many answers will help you focus on the specialties that medical school campuses. suit you best. • What if you haven’t narrowed your specialty • Identify a resident, attending physician and choices at all? The first step is self-assessment. community physician from each rotation who Go to the Careers in Medicine Web site inspire you. To gain an insider’s perspective of (http://www.aamc.org/students/cim/). Phase 1 the specialty, ask these individuals the following includes self-evaluation tools to help you define questions: What do you like most about your your personality, values and goals. Once you’ve specialty? What do you like least? What is your completed the exercises, you can begin thinking typical daily schedule? What skills or talents are about which specialties complement your most important for someone in your specialty? interests and goals.
    [Show full text]
  • Pathology: a Career in Medicine the Study of the Nature of Disease, Its Causes, Processes, Development, and Consequences
    PATHOLOGY A Career in Medicine The Intersociety Council for Pathology Information (ICPI) www.pathologytraining.org 2015 Pathology: A Career in Medicine The study of the nature of disease, its causes, processes, development, and consequences. Pathology is the medical specialty that provides a scientific foundation for medical practice The pathologist is a physician who specializes in the diagnosis and management of human disease by laboratory methods. Pathologists function in three broad areas: as diagnosticians, as teachers, and as investigators. Fundamental to the discipline of pathology is the need to integrate clinical information with physiological, biochemical and molecular laboratory studies, together with observations of tissue alterations. Pathologists in hospital and clinical laboratories practice as consultant physicians, developing and applying knowledge of tissue and laboratory analyses to assist in the diagnosis and treatment of individual patients. As teachers, they impart this knowledge of disease to their medical colleagues, to medical students, and to trainees at all levels. As scientists, they use the tools of laboratory science in clinical studies, disease models, and other experimental systems, to advance the understanding and treatment of disease. Pathology has a special appeal to those who enjoy solving disease-related problems, using technologies based upon fundamental sciences ranging from biophysics to molecular genetics, as well as tools from the more traditional disciplines of anatomy, biochemistry, pharmacology, physiology and microbiology. The Pathologist in Patient Care The pathologist uses diagnostic and screening tests to identify and interpret the changes that characterize different diseases in the cells, tissues, and fluids of the body. Anatomic pathology involves the analysis of the A biosample robot prepares specimens for gross and microscopic structural changes caused by testing disease in tissues and cells removed during biopsy procedures, in surgery, or at autopsy.
    [Show full text]
  • 14 Glossary of Healthcare Terms
    Premera Reference Manual Premera Blue Cross 1144 GGlloossssaarryy ooff HHeeaalltthhccaarree TTeerrmmss A Accreditation: Health plan accreditation is a rigorous, comprehensive and transparent evaluation process through which the quality of the systems, processes and results that define a health plan are assessed. Acute: A condition that begins suddenly and does not last very long (e.g., broken arm). ‘acute” is the opposite of “chronic.” Acute Care: Treatment for a short-term or episodic illness or health problem. Adequacy: The extent to which a network offers the appropriate types and numbers of providers in a designated geographic distribution according to the relative availability of such providers in the area and the needs of the plan's members. Adjudication: The process of handling and paying claims. Also see Claim. Admission Notification: Hospitals routinely notify Premera of all inpatient admissions that link members to other care coordination programs, such as readmission prevention. The process includes verification of benefits and assesses any need for case management. Advance Directives: Written instructions that describe a member’s healthcare decision regarding treatment in the event of a serious medical condition which prevents the member from communicating with his/her physician; also called Living Wills. Allied Health Personnel: Specially trained and licensed (when necessary) healthcare workers other than physicians, optometrists, dentists, chiropractors, podiatrists, and nurses. Allowable: An amount agreed upon by the carrier and the practitioner as payment for covered services. Alpha Prefix: Three characters preceding the subscriber identification number on Blue Cross and/or Blue Shield plan ID cards. The alpha prefix identifies the member’s Blue Cross and/or Blue Shield plan or national account and is required for routing claims.
    [Show full text]
  • A Medical-Legal Guide to Spinal Surgery
    169 Journal of Health & Biomedical Law, XVII (2021): 169-208 © 2021 Journal of Health & Biomedical Law Suffolk University Law School A Medical-Legal Guide to Spinal Surgery By Samuel D. Hodge, Jr.* “You only really discover the strength of your spine when your back is against the wall.” ---James Geary Patricia Jones, a 56-year-old payroll manager, suffered from neck discomfort and radiating pain because of a herniated disc. She underwent a laminectomy but complications arose during the procedure. A small fragment of the vertebra broke off and became embedded in the protective covering surrounding the spinal cord.1 The neurosurgeon forged ahead despite the complication and wrote in the post-operative note that no adverse events had occurred during the surgery. The patient’s blood pressure plummeted the next day and she developed paralysis. A computed tomography scan (“CT scan”) was not ordered until three hours later and it revealed an epidural hematoma.2 The neurosurgeon dismissed this finding and said that no accumulation of blood was present that was pressing on the spinal cord. If a proper diagnosis had been made, the hematoma could have been promptly evacuated. Instead, the mistake rendered Ms. Jones a quadriplegic.3 At trial, the defense argued that the patient suffered a spinal cord infarction, nothing could have been done to prevent it, and the informed consent document covered the problem.4 Following a five-month jury trial, Mrs. Jones and her husband were awarded $55.9 million in damages.5 I. Introduction Many legal and insurance professionals do not understand the indications and limitations of spinal surgery.
    [Show full text]
  • Roadmap to Choosing a Medical Specialty Questions to Consider
    Roadmap to Choosing a Medical Specialty Questions to Consider Question Explanation Examples What are your areas of What organ system or group of diseases do you Pharmacology & Physiology à Anesthesia scientific/clinical interest? find most exciting? Which clinical questions do Anatomy à Surgical Specialty, Radiology you find most intriguing? Neuroscience à Neurology, Neurosurgery Do you prefer a surgical, Do you prefer a specialty that is more Surgical à Orthopedics, Plastics, Neurosurgery medical, or a mixed procedure-oriented or one that emphasizes Mixed à ENT, Ob/Gyn, EMed, Anesthesia specialty? patient relationships and clinical reasoning? Medical à Internal Medicine, Neurology, Psychiatry See more on the academic advising website. What types of activities do Choose a specialty that will allow you to pursue Your activity options will be determined by your practice you want to engage in? your non-medical interests, like research, setting & the time constraints of your specialty. Look at teaching or policy work. the activities physicians from each specialty engage in. How much patient contact Do you like talking to patients & forming Internal & Family Medicine mean long-term patient and continuity do you relationships with them? What type of physical relationships. Radiology & Pathology have basically no prefer? interaction do you want with your patients? patient contact. Anesthesiologists & EMed docs have brief and efficient patient interactions. What type of patient Look at the typical patient populations in each Oncologists have patients with life-threatening diseases. population would you like specialty you’re considering. What type of Pediatricians may deal with demanding parents as well as to work with? physician-patient relationship do you want? sick infants and children.
    [Show full text]
  • National Imaging Associates, Inc. (NIA) Medical Specialty Solutions Frequently Asked Questions (FAQ's) for Home State Health P
    National Imaging Associates, Inc. (NIA) Medical Specialty Solutions Frequently Asked Questions (FAQ’s) For Home State Health Providers Question Answer GENERAL Why did Home State Health We implemented a Medical Specialty Solutions implement a Medical Program to improve quality and manage the Specialty Solutions utilization of the following non-emergent Program? procedures. • CT/CTA • MRI/MRA • PET Scan • CCTA • Myocardial Perfusion Imaging (MPI) • Echocardiography • Stress Echocardiography Why did Home State Health A subsidiary of Magellan Health, NIA was selected select NIA to manage its to partner with Home State Health because of Medical Specialty Solutions their clinically driven program designed to Program? effectively manage quality and patient safety, while ensuring appropriate utilization of resources for Home State Health membership. Which Home State Health NIA manages diagnostic imaging services members will be covered (MR/CT/PET) for all Home State Health members under this relationship and through its contractual relationships with free what networks will be used? standing facilities. Cardiology services are managed through Home State Health’s contractual relationships. PRIOR AUTHORIZATION What was the Implementation Implementation date was July 1, 2012. Date for the Medical Specialty Solutions Program? 1 – Home State Health – Frequently Asked Questions Solutions Program - Frequently Asked Questions What Medical Specialty The following non-emergent, outpatient, Medical Solutions Services require Specialty Solutions services require prior providers to obtain a prior authorization through NIA: authorization? • Diagnostic Imaging (MRI/MRA, CT/CTA, PET Scan, CCTA, Myocardial Perfusion Imaging (MPI), Stress Echocardiography, and Echocardiography) Emergency room, observation and inpatient procedures do not require prior authorization from NIA. If an urgent/emergent clinical situation exists outside of a hospital emergency room, please contact NIA immediately with the appropriate clinical information for an expedited review.
    [Show full text]
  • Interventional Pain Management and Spine Surgery
    NIA Magellan1 Medical Specialty Solutions Tufts Health Plan Spine Management- Provider Training Presented by: April J. Sidwa Manager, Provider Relations 1NIA Magellan refers to National Imaging Associates, Inc. NIA Training Program 2 NIA Program Agenda •Our Program 1. Authorization Process 2. Provider Tools and Contact Information •RadMD Demo •Questions and Answers Magellan Today and Building for the Future Behavioral • • Behavioral Health Health • • Substance Abuse Solutions • • Integrated Medical & Behavioral Care • • EAP and Health and Wellness Magellan BH • • Psychotropic Drug Management Multiple Solutions One Magellan Pharmacy • • Total Drug Management Solutions • • Medical Pharmacy As the nation’s leading • • Specialty Pharmacy specialty health care Magellan Rx • • Pharmacy Benefits management company, we deliver comprehensive and • Advanced Diagnostic imaging • Cardiac Solutions innovative solutions to • Radiation Oncology improve quality Medical • OB Ultrasound Specialty • Genetic Testing outcomes and • Musculoskeletal Management (Spine Surgery/IPM) Solutions (Chiropractic Care, Speech, Physical and optimize cost of care. Occupational Therapies) NIA Magellan • Sleep Management • Emergency Department • Provider Profiling & Practice Management Analysis 4 NIA Magellan Highlights NIA Magellan Industry Presence Product Portfolio Facts Clinical Leadership • Providing Client Solutions • 76 Health Plan Clients • Strong panel of internal • Advanced Diagnostic since 1995 serving 25.7M National Clinical leaders – client Imaging • Magellan
    [Show full text]