‘Telehealth is here to stay’: AHA launches its first individual telehealth certification
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Key takeaways:
- The American Heart Association launched a certification that demonstrates commitment to telehealth care.
- The online program includes research, hands-on experiences and best practices.
The American Heart Association recently launched its first individual certification for telehealth, part of an effort to improve standards of care for a delivery model that grew exponentially — and unevenly — during the COVID-19 pandemic.
Telehealth services have become increasingly popular since many clinicians incorporated some form of virtual care into practice during the pandemic, when in-person visits for routine care were considered risky and discouraged. According to the AHA, telehealth utilization has stabilized at levels 38 times higher than before the pandemic. It is estimated that 20% of all Medicare, Medicaid and commercial payer outpatient, clinic and home health spending could potentially shift to virtual care.
“One of the largest changes for cardiologists and other physicians during the last 3 years has been the remarkable shift to virtual care,” Andrew Watson, MD, volunteer chair of the AHA’s telehealth certification development workgroup and a practicing surgeon at the University of Pittsburgh Medical Center, told Healio. “We thought about this shift before, but we did not have the pressure to do it. Then with COVID-19, what seemed like something nice to have suddenly became our only way to practice medicine. This change brought into question the whole idea of where health care takes place. Traditionally, that place was an office. But for cardiology — and for all physicians — the point of care is unclear.”
Certification details
The new telehealth individual certification is available through the AHA’s professional education hub. It is an offering of the AHA Center for Telehealth, formerly the American Board of Telehealth. The certification aims to standardize training for health care providers in telehealth care delivery, increase skills and competencies in telehealth care delivery and help improve patient outcomes though telehealth integration.
“Telehealth as an option for care has become an expectation of patients, rather than a convenience,” Keith Churchwell, MD, FAHA, president of Yale New Haven Hospital and an AHA board member, told Healio. “That is true of cardiology and across all specialties, and it has shifted the conversation within health systems away from whether to offer telehealth services and toward how to best integrate telehealth services with our in-person care provision.”
Watson said certification is important throughout all aspects of medicine, and telehealth as part of care delivery is no different.
“It is important we have vehicles to certify people and assess competency,” Watson said during an interview. “As telemedicine grows, there will be areas where certification will become more important. The people that buy and pay for health care are going to start looking at competency around telehealth and some of the guardrails around it.”
The certification program will include online telehealth education that combines research, hands-on experiences and best practices, an assessment delivery via live remote-proctoring and individual promotional opportunities by display of a personalized certificate award and credentials, which are good for 3 years.
“The Zoom call or the video platform is just the technology,” Watson said. “That is the ‘room’ where it happens. There are ways to examine a patient that are different in telehealth. There are some different rules with a telehealth visit. If people ask if telehealth is here to stay, I will ask rhetorically, ‘When was the last time you left your cellphone at home?’ It is here forever.”
Telehealth ‘not a singular modality’
In a commentary published in Circulation in June, Churchwell and Brooke Yeager McSwain, MSc, MA, noted that telehealth approaches before the pandemic were primarily geared toward stand-alone services that replaced, rather than augmented, traditional in-person services.
Such models failed to recognize the many ways in which telehealth could enhance and expand existing health care services, the researchers wrote.
“Prior to the pandemic, the telehealth service that came to mind for most when the topic was raised, including for policymakers, was the direct-to-consumer (DTC) model,” Churchwell told Healio. “Many of the policy and payment decisions about telehealth were made with that model in mind, and the result was that other means of augmenting traditional health care through virtual care were stymied due to lack of payment. It also led to a tendency for DTC service providers to bill patients out of pocket, rather than submitting claims for payment. That led to these services being less accessible for economically disadvantaged populations.”
In addition to DTC telehealth services, there are many other types of telehealth care available, Churchwell said, including cardiology and stroke services and subspecialty care, as well as services ranging from emergency and critical care to school-based nursing, second opinion services and smoking cessation.
“Telehealth interventions can continuously monitor patients with CVD and may include anything from structured telephone or video support to remote monitoring of wearable or implantable devices,” Churchwell told Healio. “An advantage of the latter is that they can favorably affect CVD burden, such as significantly reducing BP, progression of disease and health care expenditures. Additionally, telehealth is useful for risk factor modification, medication adherence and symptom monitoring in both coronary artery disease and congestive HF.”
Churchwell said providers should focus on two key points: Telehealth is not a singular modality, and telehealth services are most effective when integrated with in-person care.
“Cardiologists themselves have also developed a wealth of experience with the provision of services through telehealth, and they understand much better what works well through a virtual modality and what is still best provided in-person,” Churchwell told Healio. “That understanding is critical to evolve our services toward an approach that provides the highest quality of care in a way that streamlines the experience for both patients and providers.”
Reference:
For more information:
Keith Churchwell, MD, FAHA, can be reached at keith.churchwell@yale.edu.
Andrew Watson, MD, can be reached at watsar@upmc.edu.
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