Page numbers followed by b refer to boxes, f to figures, and t to tables.
access to care
metrics, 104, 104t, 110–11
self-reported barriers to leveraging telethealth, 120–21, 121b
workflow and, 38
access to technology, 4, 20–21, 37–38, 156
Accountable Care Organizations (ACOs), 84
Accreditation Council for Pharmacy Education (ACPE), 127, 128, 129, 135–36, 147
advanced pharmacy practice experiences (APPEs), 128, 143, 151–54, 158
adverse event metrics. See medication safety indicators and metrics
Affordable Care Act. See Patient Protection and Accountable Care Act
Agency for Healthcare Research and Quality (AHRQ), 85, 91, 92t–93t, 93, 121
American Association of Colleges of Pharmacy (AACP), 144
American College of Clinical Pharmacy (ACCP), 128, 129
American Diabetes Association (ADA), 77
American Society of Health-System Pharmacists (ASHP), 13, 128–29
Annual Wellness Visits, 36, 67, 76–77
anticoagulation management, 7, 35, 111. See also chronic care management
Association of Diabetes Care and Education Specialists (ADCES), 77
asthma care, 7
asynchronous telehealth, 13–14
automated reporting, 116, 120
billing
basics, 57–58
challenges, 21
general and specific rules of, 67–68
modifiers, 67
payer types, 58–62
process quality, 80
terminology, 65
value-based payments, 83–85
See also codes, billing
Brigham Health of Boston, 17
Brunisholz et al. study of team-based care quality, 110–11, 113
bundled payments, 84
Carbone Cancer Center, 45
care flow models, 151–57
care gaps in telehealth, 38–39
care team management, 39–41, 46, 79–80
Center for the Advancement of Pharmacy Education (CAPE), 144
Centers for Disease Control and Prevention (CDC), 14
Centers for Medicare and Medicaid Services (CMS), 36, 59–60, 61, 67–68
Chan et al. study of pediatric asthma patients, 7
chat features, software, 136
chronic care management
billing codes, 73–74, 87
clinical outcomes evaluation of, 49
clinical vignette, 53
learning experience in, 152–54, 155
Medicare reimbursement for, 21
metrics for, 112, 113
telehealth role in, 3
clinical care, patient consent for, 138–39
clinical episode payments, 84
clinical experience for learners, 146–48
clinical metrics, 106
clinical outcomes, 5–8, 49, 96–97, 97f
clinical video telehealth (CVT), 7, 47–48, 112
clinical vignettes
billing codes, 87
learner integration, 158
metrics, 122–23
workflow, 53–54
clinic workflow. See workflow
codes, billing
billing structure, 66f
categories, 66t
clinical vignette, 87
evaluation and management codes, CPT, 72–75
facility fee billing, 72
fee-for-service, 69
incident-to services, 69–70, 70t
language of billing, 65–66
medicine codes, CPT, 75–76
summary of, 71t, 78–80
collaborative care, 43
comment cards, 112–13
commercial payers, 57, 58, 69, 73, 84
communication
C-suite, 115, 117–18
learners’ skills in, 135–36, 148
methods of, 139
virtual communication and mannerisms, 46
Community Health Network, 37
complex chronic care management codes, 73–74
comprehensive medication management (CMM)
care delivery process for, 45–46
components, tenets, and functions, 43–44
evaluation of, 46–51
multidisciplinary care team management, 46
organizational support for, 44–45
See also medication therapy management
comprehensive medication reviews (CMRs), 21
conducting the appointment, 30–34
consent, 138–39, 140
Consumer Assessment of Healthcare Providers and Systems (CAHPS), 49–50
Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) survey, 94, 95t
Continuous Glucose Monitoring (CGM) codes, 75–76
continuous quality improvement (CQI) projects, 140
core competency areas for residency training, 129–30
costs. See financial issues
counseling, patient, 157
COVID-19 pandemic
billing rule changes after, 68
changes in telehealth due to, 5
Medicare Annual Wellness visits, 36
privacy law relaxation during, 19
student experience requirements and, 128
telehealth services expansion during, 17
V-safe program, 14
critical skills in pharmacy telehealth practice, 129–30
C-suite, communication with the, 115, 117–18
Current Procedural Terminology (CPT) codes
evaluation and management codes, 72–75
Level 1 and Level 2, 65–66, 66t, 67
medicine codes, 75–76
customer service. See patient experience
dashboards for sharing metrics, 115–17, 116f
data retrieval, 50, 109–13, 117b
definitions and terminology
billing terms, 65
eConsults, 14
mobile health, 14
remote patient monitoring, 12–13
synchronous vs. asynchronous telehealth, 13–14
telehealth and telemedicine, 3, 11–12
telepharmacy, 13
value, 83
web-based services, 14–15
DeNicola et al. review of telehealth literature, 6
device compatibility of software, 136
diabetes care
billing codes for, 65, 75–76, 77–78
clinical vignettes, 122–23
learner integration in, 151–52
patient experience evaluation of, 50
review of clinical outcomes in, 6, 7–8, 49, 110–11, 113
telehealth clinic for, 35–36
direct patient care learning experience, 128, 141, 145
direct reimbursement, 57, 58, 65
eConsults, 14
educational outcomes, 143–45
effectiveness metrics, 105–6, 106t, 113
e-learning tools, 136, 137t–38t
electronic health records
metrics tracking and, 119
patient education and, 32
platform comparisons and, 18, 19
electronic reminders, 31
Entrustable Professional Activities (EPAs), 144
established patient codes, 72–73
evaluation and management codes, CPT, 72–75
evaluation metrics. See metrics;
quality indicators
evaluation of comprehensive medication management, 46–49, 47f
evaluations, learner, 143–45
expectations, establishing, 40–41
experience, patient. See patient experience
experiential requirements for learners, 127–30, 147
facility fee billing, 72
Family Educational Rights and Privacy Act (FERPA), 135
federally qualified health centers (FQHCs), 71t, 77, 151
federal medical assistance percentages (FMAPs), 58
fee-for-service. See codes, billing
financial issues
data retrieval for tracking, 111, 111f
financial impact metrics, 48, 104, 105t, 120
platform adoption costs, 44–45
reimbursement challenges, 4
software costs, 135
telehealth for cost reduction, 3
See also billing
formal learner evaluations, 143–45
formative learner evaluations, 143
forms, billing, 67
Funk et al. study of provider satisfaction, 50
geographic billing adjustments, 67
global payments, 84
goals and objectives of the learning experience, 141–42
group telehealth visits, 36
Hatton et al. study of patient satisfaction, 45, 112
Hawes et al. study of financial outcomes, 111
Healthcare Common Procedure Coding System (HCPCS) codes, 65–66, 66t, 76–78
Healthcare Cost and Utilization Project (HCUP), 91
healthcare definition, 11
Health Care Finance Administration (HCFA), 91
healthcare professional shortage areas (HPSAs), 110
healthcare providers
pharmacists as, 57
satisfaction of, 50
shortages of, 110
unwillingness to adopt telehealth, 4
Healthcare providers. See also Current Procedural Terminology (CPT) codes
Health Insurance Portability and Accountability Act (HIPAA), 17, 19, 67, 79, 135
health maintenance and value-based care contracts, 39
heart failure telehealth, 34–35
home-based encounters, 32, 49, 50
Hospital Outpatient Prospective Payment System (HOPPS), 61, 72
hospitals, telehealth use by, 3
hospital services, Medicare coverage for. See Medicare
hypertension care, 49, 50, 110–11, 113
incident-to services, 21, 69–70, 72, 73, 74, 75
information system resources, leveraging, 119–20
Institutional Review Boards (IRBs), 140
International Classification of Disease, 10th edition (ICD-10) codes, 66
International Normalized Ratio Monitoring (INR) codes, 76
Internet. See Access to technology;
web-based services
interpreter services, 21
interprofessional consults. See eConsults
introductory pharmacy practice experiences (IPPEs), 127–28, 144, 151–52
Joint Commission of Pharmacy Practitioners, 129
key performance indicators (KPIs), 103, 107
laboratory data and value-based care contracts, 38–39
language issues, 21
layered learning experiences, 152
learner integration
barriers in, 146–48
care flow models, 151–57
clinical vignette, 158
evaluations, of, 143–45
goals and objectives of the learning experience, 141–42
learning experience types, 127–30
in the patient care environment, 134f
preparing the learner for telehealth pharmacy practice, 145–46
research projects and quality assessment, 139–41
site preparation for, 133–39
technology orientations process, 142–43
workflow for, 142
Likert Scale, 50
limited English proficiency patients, 21
Litke et al. study of chronic disease management for rural veterans, 113
managed care, 61
manual data collection, 50, 117
Maxwell et al. study of patient satisfaction with clinical video telehealth, 112
McFarland et al. study of provider satisfaction, 50
Medicaid, 58–59, 59t
billing codes, 69, 73, 76
billing rules, 68
reimbursement from, 4, 79
Medicare
Annual Wellness Visits, 36, 67, 76
benefit plans under, 59–61, 60t
billing rules, 67–68
Diabetes Prevention Program codes, 77–78
quality indicators, 93
reimbursement from, 4, 17, 21
See also codes, billing
Medicare Access and CHIP Reauthorization Act (MACRA), 93
Medicare Administrative Contractors (MACs), 62, 62f
Medicare Advantage plans, 61
Medicare Diabetes Prevention Program (MDPP) codes, 77–78
Medicare Improvement for Patients and Providers Act (MIPPA), 93
medication safety indicators and metrics, 97–99, 98t, 121
medication therapy management (MTM)
billing codes, 76
in history of telehealth services, 17
Medicare reimbursement for, 21, 61
value-based payments and, 85
See also comprehensive medication management
Merit-based Incentive Payment System, 93, 94t
metrics
barriers to, 119–21
clinical vignette, 122–23
for comprehensive medication management evaluation, 49, 50
data retrieval methods for tracking, 109–13
for evaluating telehealth, 103–7
financial impact, 104
process measures, 47–48
productivity measures, 48
sharing methods, 115–18
See also quality indicators
mobile health (mHealth), 14
Model Rules of the National Association of Boards of Pharmacy, 13
Model State Pharmacy Act, 13
multidisciplinary care team management, 46
multimedia learning tools, 136, 137t–38t
National Association of Boards of Pharmacy (NABP), 13
National Provider Identifier (NPI), 67
National Quality Forum quality indicator recommendations, 95t, 99
Nebraska Psychiatric Institute, 3
Niznik et al. study of clinical phamacist-led telemedicine interventions, 8
Norfolk State Hospital, 3
note template development for learners, 147
obstetrics and gynecology, 6
Office of the National Coordinator for Health Information Technology (ONC), 14, 15
oncology services, 45
operating system compatibility, 136
operational metrics, 106
organizational support, 44–45
orientation, student, 145–46, 151–52, 153, 156
outpatient services, Medicare coverage for, 60–61
patient assessment, 31, 32
patient care barriers in learning integration, 146–48
The Patient Care Process (American College of Clinical Pharmacy), 47
Patient-Centered Medical Home (PCMH) model, 84
Patient-Centered Outcomes Research Institute (PCORI), 93
patient education, 32–33, 36, 152, 157
patient experience
comprehensive medication management and, 45, 49–50
data retrieval for tracking metrics of, 112–13
metrics for, 104–5, 105t
quality indicators, 94–96, 95t
self-reported barriers to leveraging telethealth, 120–21, 121b
patient portals, 21, 32, 33
Patient Protection and Affordable Care Act, 58, 83, 93
patient-reported data, 32, 87
patients
communication methods for, 139
electronic reminders, 31
established patient codes, 72–73
expectations of, 40–41
resistance to telehealth pharmacy practice, 147
rooming of, 31–32
unwillingness to adopt telehealth, 4
workflow considerations and factors relating to, 37–38
Patient Safety Net (PSN), 98
patient selection, 34, 35
patient stories, 117–18
pay for performance (P4P) model, 84
pay-for-reporting system, 93
per member per month (PMPM) expenses, 111
permissions, patient, 138–39
Pharmacists’ Patient Care Process, 129, 129f
pharmacy benefit managers (PBMs), 21
pharmacy practice experiential learning, 127–30
pharmacy-specific research outcomes, 7–8
physician fee schedule (PFS), 61
Physician Quality Reporting Initiative (PQRI), 93
platforms
adoption costs, 44–45
billing and, 79
comparisons of, 17–19, 18t
portals, patient, 21, 32, 33
Porter, M. E., 83
post-discharge medication reviews, 37
postgraduate residencies, 128–30, 136, 154–56
post-visit workflow, 30, 33
practice management system, 19, 44–51
preparing for appointments, 27–30
preparing the learner for telehealth pharmacy practice, 145–46
Prescription Drug Plans (PDPs), 61
Press Ganey patient satisfaction surveys, 94, 95
pre-visit workflow, 29–30
Primary Care Management (PCM) codes, 74
privacy laws. See Health Insurance Portability and Accountability Act
private health insurance. See commercial payers
process measures, 47–48
productivity, 48, 118
pulse checks of learners, 143
quality assessment of learner involvement, 139–41
quality indicators
Agency for Healthcare Research and Quality, 91, 92t–93t
of clinical outcomes, 96–97, 97f
of medication safety, 97–99, 98t
Merit-based Incentive Payment System, 94t
of patient experience, 94–96, 95t
See also metrics
questionnaires, patient experience, 45, 94–96, 95t
reimbursement issues, 4, 21, 45. See also billing; codes, billing
relative value units (RVUs), 67
reminders, electronic, 31
remote learning, 135, 143, 144, 147
remote patient monitoring, 7–8
remote physiologic monitoring, 75
reporting metrics. See sharing metrics
research projects, learner involvement in, 139–40
residents. See learner integration
Resource-Based Relative Value Scale (RBRVS), 67
return on investment (ROI) metrics, 111
revenue issues. See billing;
financial issues
rooming of patients, 31–32
rotations, student. See learner integration
Rubric for E-Learning Tool Evaluation (Anstey and Watson), 137–38
Satisfaction with Pharmacists (SWiP) scale, 50
scaling work within organizations, 118
screening tools and Annual Wellness visits, 36
screen-sharing capabilities of software, 136
Seamon et al. study of rural diabetes patient reduction in HbA1c, 8
security of health information, 19
self-reported barriers to leveraging telethealth, 120–21, 121b
self-reported data, 32, 87
Shane-McWhorter et al. study of diabetes patient telemonitoring, 7–8
sharing metrics, 50, 115–18
Shigekawa et al. review of telehealth literature, 6
simultaneous multi-user software capabilities, 136
Singh et al. study of clinical video telehealth use, 7
site preparation for learners, 133–40, 134t
social determinants of health, 38
software, 135–36
spreadsheets, financial metrics, 111, 111f
staff management. See care team management
Star Ratings, Medicare, 61
state rules
in-person requirements, 73
Medicaid reimbursement, 58–59, 59t
reimbursement criteria, 57
telehealth utilization and, 4
students. See learner integration
Supervising providers. See Current Procedural Terminology (CPT) codes
supervision of pharmacist telehealth billing, 69–71, 78–80
surveys, patient, 94–96, 95t, 112–13
synchronous telehealth, definition of, 13
system metrics, 106
Tax Identification Number (TIN), 67
Tax Relief and Health Care Act (TRHCA), 93
teach-back methods, 157
team management. See care team management
technology, access to. See Access to technology
technology difficulties and learner integration, 156–57
technology literacy, 20
telecommunications technology types, 12
telehealth
barriers to, 4, 20–21
definition, 3, 11–12
meta-analysis of literature on, 6
platform comparisons, 17–19, 18t
synchronous vs. asynchronous, 13–14
Telehealth Usability Questionnaire (TUQ), 96
telemedicine definition, 3, 12
Telemedicine Satisfaction and Usefulness Questionnaire, 96
telemonitoring. See remote patient monitoring
telepharmacy definition, 13
telephone conferencing
Annual Wellness Visits and, 36
challenges in, 32, 33, 37
effectiveness studies, 113
learner experiences with, 151–52, 153, 156
software capabilities for, 135
telephone surveys, 113
time management for learners, 147
training
for quality of care, 51
in virtual communication and website manner, 46
See also learner integration
transitional care management (TCM), 37, 74
triage, 12–13, 34
universal billing forms, 67
University of Wisconsin Health, 45
utilization metrics, 106, 106t, 113
vaccinations, 14, 39
value-based care contracts, 38–39
value-based payments, 83–85, 93
video conferencing
barriers to, 4, 20
comprehensive medication management, 45–46
effectiveness studies, 113
learner experiences with, 151–52, 153, 155–56
outcome studies of, 7
patient assessment, 32–33
patient experience metrics, 112
patient-related factors and, 37–38
pharmacist-patient visits, 17
post-discharge medication reviews, 37
privacy laws and, 19
remote patient monitoring, 12
software capabilities for, 135
store-and-forward, 14
for transition of care, 37
Virginia Maryland healthcare system, 7
visit workflow, 30–33, 34t
vitals, 32, 39
V-safe program, 14
wearable medical devices, 5
web-based services, 14–15
workflow
anticoagulation telehealth clinic, 35
closing care gaps and, 38–39
diabetes telehealth clinic, 35–36
group telehealth visits, 36
heart failure telehealth, 34–35
for learning engagement, 142
learning integration and, 151–57
managing care team relationships and, 39–41
mapping, 27–29, 28f, 28t, 29t, 30, 41
patient-related factors, 37–38
transitional care management, 37
visit flow, 30–33, 34t
See also comprehensive medication management
World Health Organization (WHO), 14, 66
Wu et al. review of telehealth literature, 6
Zoom. See video conferencing