Page numbers followed by b refer to boxes, f to figures, and t to tables.

A

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

B

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

C

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

D

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

E

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

F

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

G

geographic billing adjustments, 67

global payments, 84

goals and objectives of the learning experience, 141–42

group telehealth visits, 36

H

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

I

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

J

Joint Commission of Pharmacy Practitioners, 129

K

key performance indicators (KPIs), 103, 107

L

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

M

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

N

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

O

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

P

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

Q

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

R

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

S

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

T

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

U

universal billing forms, 67

University of Wisconsin Health, 45

utilization metrics, 106, 106t, 113

V

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

W

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

Z

Zoom. See video conferencing