A presentation at Latest CMS and TJC Standards for Telemedicine in in California, USA by Conference Panel
Telemedicine CMS and TJC Standards
Speaker ▪ Darlene Evans ▪ MSN, RN, CPHQ, NEA-BC ▪ Senior Consultant ▪ 678-326-1219 ▪ Email questions to CMS: Critical Access Hospitals: qsog_CAH@cms.hhs.gov. Acute hospitals: qsog_hospital@cms.hhs.gov. https://nashhealthcareconsulting.com/contact-us 2
Overview ▪ COVID-19 gave telemedicine a larger role in diagnosis ▪ Communicating remotely protects clinicians and patients from transmission of viruses including COVID-19 ▪ Federal government, some states and health insurers quickly suspended regulations that limited telemedicine ▪ Is anticipated telemedicine boom will outlive the coronavirus. 3
The Joint Commission (TJC) Telemedicine Standards 4
TJC Telemedicine Standards ▪ Has telemedicine standards in two separate chapters – LD & MS ▪ LD.04.03.09, EP23 (contract management) ▪ MS.13.01.01 – licensed practitioners who are responsible for the care and treatment of patients via telemedicine link are subject to the credentialing and privileging process of the originating site ▪ MS.13.01.03 – medical staff must recommend which clinical services may be delivered by licensed practitioner through telemedicine ▪ TJC made changes to align with the CMS CoP requirements 5
CMS Telemedicine Standards 6
CAH Telemedicine and EMTALA ▪ June 2013 memo ▪ Some CAH do not have a physician in the ED ▪ May be staffed with NP or PA with emergency care training in states that allow this scope of practice ▪ CoPs: Must have physician (MD/DO) immediately available by phone or radio contact ▪ Requirement can be met using telemedicine ▪ As well as by the MD/DO who practices on site in the CAH 7
Credentialing ▪ Two ways a hospital can use for credentialing and to grant physicians privileges ▪ Proxy credentialing with a Medicare certified hospital – “Distant-site hospital” ▪ Proxy credentialing with another telemedicine entity – “Distant-site telemedicine entity” 8
Definition of Telemedicine ▪ Telemedicine: ▪ Provision of clinical services to patients ▪ By practitioners from a distance ▪ Via electronic communications ▪ Can be simultaneously – tele-ICU services ▪ Can be non-simultaneously – teleradiology 9
Additional Information ▪ CMS discussed in the comment section the written agreement/contract should also allow the CAH ▪ Access to the complete credentialing and privileging file with exceptions – Include in the contract ▪ Upon request for each practitioner who is covered by the agreement 10 138
CMS Telemedicine Standards ▪ Board decides what categories of practitioners are eligible candidates for appointment to the MS (45) ▪ Such as physicians, podiatrist, dentist, CRNA, PA, NP, CNS, clinical social worker, clinical psychologist, dietician, etc. ▪ Must be consistent with any state laws and within the person’s state scope of practice ▪ Surveyor will ask to see a copy of the written telemedicine agreement ▪ Will look for documentation indicating that privileges have been granted to each telemedicine practitioner 11 138
Thank You Register Now ▪ Darlene Evans, ▪ MSN, RN, CPHQ, NEA-BC ▪ Senior Consultant ▪ 678-326-1219 ▪ Email questions to CMS: Critical Access Hospitals: qsog_CAH@cms.hhs.gov. Acute hospitals: qsog_hospital@cms.hhs.gov. https://nashhealthcareconsulting.com/contact-us 12 138
The standards established by CMS and TJC for telemedicine aim to ensure that patients receive high-quality care through remote communication technology while maintaining patient safety and privacy. These standards ensure that telemedicine services are provided by qualified professionals, that patient information is protected, and that telemedicine services are accessible and appropriately billed.
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