It’s about to get much easier for mortgage loan originators to switch jobs and continue originating mortgages without any license-related delays.

Under the current rules of the Secure and Fair Enforcement for Mortgage Licensing Act, an LO who moves between states or from a bank to a nonbank is required to wait for a new license before they can begin originating at their new job.

But after a years-long push from the mortgage industry, those rules are about to change.

Later this year, new LO licensing rules will take effect that will allow originators to move from a bank to a nonbank or to a new state and keep originating new mortgages without having to wait for a new license.

The changes to the LO licensing rules were part of the Economic Growth, Regulatory Relief and Consumer Protection Act, which President Donald Trump signed into law last year.

In addition to rolling back many Dodd-Frank Act regulations, the bill also included changes to the LO rules, which the mortgage industry has lobbied several years for.

Beginning Nov. 24, 2019, LOs who change corporate affiliation from a federally insured institution to a nonbank lender, or move across state lines, will be granted “transitional authority” that will allow them originate mortgages while they work to meet the SAFE Act’s licensing and testing requirements.

LOs will then have 120 days to complete the SAFE Act licensing requirements.

As with these types of regulations, the rules are much more complicated than that, but luckily the Nationwide Multistate Licensing System & Registry recently published an “FAQ” that provides answers to many relevant questions about the new rules.

For example: Who is eligible for the temporary licensing authority?

The answer: LOs must be: 1) employed and sponsored through NMLS by a state-licensed mortgage company, and 2) either: A. registered in NMLS as an MLO during the one year preceding the application submission; or B. licensed as an MLO during the 30-day period preceding the date of application.

Compliance provider MQMR also recently published a bulletin on the matter, which sheds additional light on the new LO rules.

From MQMR’s bulletin, which references the NMLS FAQ:

Importantly, the FAQs explain that a MLO will not have to submit a separate application for temporary authority. Rather, an MLO applies for a MLO license through NMLS and, if eligible, will automatically receive temporary authority as the applicable state processes the license application. NMLS will be programmed to check certain eligibility requirements, such as criminal history and whether an applicant has had an MLO license application denied, revoked, or suspended. Before a licensing decision is made by the applicable state, an individual with temporary authority will show as being “authorized to conduct business” in the state – the actual license status will not be updated until the state makes a decision with regard to the license application.

An individual with temporary authority may originate loans as if he/she possesses a license in that state. The individual and the loans originated by that individual will be subject to the same rules and regulations as applicable to a licensed MLO.

One important piece of these new rules to note is that lenders “must monitor” the status of their LOs’ licensing status and temporary authority to originate. If an LO’s application is denied, the lender “must reassign any active loans in the pipeline originated by that MLO to a licensed MLO in that state.”

Additionally, if the lender “knew or should have known” of a “disqualifying event” that would cause the LO’s application to be denied, the lender may face enforcement action from their state.

For the full FAQ on the new LO licensing rules from the NMLS, click here.

Source: Loan originator licensing rules are about to change: Here’s what you need to know | 2019-04-09 | HousingWire

If you are like most leaders, you waste plenty of your own and others’ time. There is some good news about how to do more with the time you have left: BJ Fogg, the Stanford scientist who founded Stanford University’s Behavior Design Lab, has discovered that people want more than anything to get more productive.

What’s more, after three decades of study, he’s come away with a simple and powerful insight: People can get more productive by making tiny improvements to their daily routines that will stick if they reward themselves after making the changes.

As CNBC reports, Fogg encourages people to insert the tiny habits into their normal routines–for instance, after they brush their teeth in the morning. If someone can’t stick with the new habit, she will feel little disappointment because her expectations were already low. Once she has added the new habit, she should give herself “a fist-bump,” Fogg told CNBC.

I’ve reviewed 12 of Fogg’s little habits and selected four that I believe are most useful for leaders like you. Each habit is connected with an anchor or prompt to help you remember to complete it. Read on for an explanation of why I picked each, why it’s important to entrepreneurs, and why the habit will boost productivity.

1. Sit down at your desk, then put your phone on do-not-disturb mode.

Successful entrepreneurs have great demands on their time from their team, customers, and investors. If you give in to their urgent desire to talk, you lose control of your time–which could make it more difficult for your company to reach its goals.

To keep these people motivated, make a plan each day and stick to it. Ironically, that means you must keep these people from pulling you away from your plan. That’s why you must not to answer every call that comes into your phone by putting it on do-not-disturb mode.

This habit will keep you focused on your key tasks and give you back the time you would have spent talking with the person, thinking about the call afterwards, and doing something to solve the caller’s problem.

2. Don’t browse social media for distraction. But if you do, log out.

Someone in your company–possibly in marketing or customer service–should be keeping an eye on social media.

I think founders should not spend time on social media during work hours. Yet some leaders cannot resist looking at Twitter or LinkedIn during work–possibly justifying it with the thought that they might receive an important business insight.

If you make that mistake, cut your losses by logging out. This will keep you from wasting more time. And if you feel the need for getting away from the grind, take a brisk walk around the building.

3. After you sit down in a meeting, write the title, the date, and the attendees at the top of your notes.

Leaders spend lots of time in meetings–say with potential customers or investors. If you’re like me, you take notes in those meetings so you can remember key details–such as who said what.

The notes help you follow up more effectively with the right people when you have time to think about the topics discussed in the meeting. This is why it’s particularly important for you to write down the date and the name and title of each attendee.

By doing this, you will save yourself the time and embarrassment of going back to the attendees and asking them for this information. That time will be better spent using what happened in that meeting to win new customers or raise needed capital.

4. After reading a time-sensitive email, reply with something like: “Got it. I will review it in detail and get back in touch soon.”

Leaders receive lots of email from their executive team, employees, customers, and others. Many of the emails are time sensitive to the sender but less so to the entrepreneur–who ignores the message.

This failure to respond reduces the sender’s productivity by putting the related task on hold, which aggravates the sender. The simple remedy for this productivity-sapping inaction is to get in the habit of sending a quick note that you received the email and will respond by a particular time.

Adopt these four tiny habits and you’ll get more done.

Source: 4 Small Habits That Can Make Any Business Owner More Productive | Inc.com

A southeast Iowa hospital is taking patient care to a new level by utilizing telehealth.

The Avera E-Care system officially went live Wednesday at Van Buren County Hospital in Keosauqua.

Dr. William Felegi, emergency medicine physician, says this system will support the hospital with specialized doctors and nurses that can help in emergency situations.

He says Avera E-Care will play a vital role because the rural Van Buren County Hospital is considered a critical access hospital, meaning it sometimes has difficulty recruiting providers.

“I’m a board certified physician, I only work a 48-hour shift and therefore, the other shifts are covered by an advanced practitioner, whether that’s a PA or a nurse practitioner. What the Avera system allows us to do, is it allows any provider to immediately have telemedicine hook up with both audio and visual to be able to evaluate a patient with the provider, but the person on the other end is also a board certified emergency physician.”

The Avera E-Care Emergency team has implemented secure, interactive, high-definition video and audio equipment and software in the emergency department.

With just the push of a button, ER staff have immediate, virtual access to a team of physicians and nurses who specialize in emergency medicine.

Once the button is pressed, the E-Care team will activate a camera, which has the capability to zoom in and out and view all areas of the room, including the monitors that show patient vital signs.

Felegi says a microphone will allow Van Buren County Hospital staff to speak with the E-Care team and vice versa.

“What it allows us to do, it allows our community to have the care that they would receive at a more urbanized or suburban hospital.”

Teresa Johnson, service line manager for E-Emergency at Avera E-Care, says Van Buren County Hospital staff can connect with the virtual hospital hub, 24/7, 365 days a year.

“It’s a benefit to the bedside team members to have kind of that extra person in the room with them. To have an extra nurse to assist with nursing questions, nursing documentation, providers have an additional colleague that they can consult with.”

Felegi adds that he hopes the E-Care system is something other rural hospitals will consider implementing down the road.

“I think this is just a program where our leadership here and our medical staff are very forward thinkers, and I think this is a model for many other rural hospitals to be able to use to really be able to keep a board certified physician for supervision, but yet when not around, have that backup that they need.”

The Avera E-Care system is currently up in running at 190 sites in 13 different states.

Source: Van Buren County Hospital taking patient care to next level, utilizing telehealth | KTVO

Teladoc (TDOC) to Post Q4 Earnings: What's in the Cards?Teladoc Health, Inc. TDOC, the global leader in virtual care, will release fourth-quarter 2019 results on Jan 26, 2020, after market close.

The Zacks Consensus Estimate stands at a loss of 32 cents per share. The company had reported loss of 39 cents in the year-ago quarter. The consensus mark for revenues is pegged at $153.79 million, indicating 25.3% increase from the year-ago period reported figure.

Factors at Play

Teladoc is likely to have witnessed higher visit fee revenue driven by increase in U.S. paid membership visits as well as individuals with visit-fee-only access in the fourth quarter. The U.S. paid membership visits include revenues from general medical visits as well as other specialty visits primarily comprised of expert medical and commercial behavioral health services. The balance of visit fee revenue is primarily comprised of the company’s visit-fee-only access.

Higher visit revenues, which are attributable to increased adoption of virtual care and benefits, are likely to have aided the company’s fourth-quarter performance.

The acquisition of Advance Medical, made last year, is likely to have benefited the company’s revenues by increasing membership in the quarter under review.

Teladoc’s Behavioral Health business is likely to have been one of the strongest drivers of visit growth in the fourth quarter. The company might have witnessed increased engagement in its business-to-business service in terms of increased number of visits.

In its Health Plan business, the company is likely to have witnessed growth in terms of new distribution and penetration of existing relationships in the to-be-reported quarter. This area continues to diversify with wins in new lines of business, population and geographies both commercial and government programs.

Teladoc recently expanded its relationship with a major Blues plan and continued to increase penetration into its largest client’s books of business, where its sales velocity is healthy and on track with expectations.

This is likely to have benefited the company’s performance in the to-be-reported quarter.

Operating expenses are likely to have increased in the fourth quarter as the company continued to gain from operating leverage.

Company’s Guidance

For full-year 2019, revenues are expected between $552 million and $553 million, and total visits are anticipated to be more than 4.1 million.
For the fourth quarter of 2019, Teldoc estimates revenues between $155 million and $156 million. It expects visits to be more than 1.2 million.

Earnings Surprise History

The company surpassed estimates in two of the four reported quarters, the positive surprise being 0.6%, on average. It missed estimates by 2.5% in one quarter and matched the same in the other quarter. This is depicted in the graph below:

What Our Model Says

Our proven model does not predict an earnings beat for Teladoc this season. The combination of a positive Earnings ESP and a Zacks Rank #1 (Strong Buy), 2 (Buy) or 3 (Hold) increases the odds of an earnings beat. But that’s not the case here.

Earnings ESP: Earnings ESP, which represents the difference between the Most Accurate Estimate and the Zacks Consensus Estimate, is -2.86%. You can uncover the best stocks to buy or sell before they’re reported with our Earnings ESP Filter.

Source: Teladoc (TDOC) to Post Q4 Earnings: What’s in the Cards?

Summary

Teladoc has doubled in valuation since our previous article around six months ago and has surpassed our optimistic expectations.

The company continues to exhibit strong growth and has multiple growth vectors at its disposal.

We have a very favorable view of the industry and TDOC’s leadership position, however today’s valuation appears to be a bit rich.

We think the stock may have limited upside at today’s valuation and recommend value investors to monitor from the sidelines and look for a more reasonable entry point.

Investment Thesis

In our previous article, we presented a a detailed view on Teladoc’s (TDOC) business and growth prospects. We theorized that the market was not fully appreciating the growth opportunity ahead for the company and the stock price was undervalued. Fast forward to today and our theory has panned out faster than we anticipated with the stock price almost doubling and in fact surpassing our expectations. In this article we will aim to provide an update on the company with a focus on any changes to its fundamental value. We also provide an updated forecast and valuation for the stock. Ultimately, we theorize the view that although the company still has significant growth prospects to tap into, the stock appears fully valued at today’s price and investors should wait for a better entry point to establish a long position.

Stock price since last article (Source: Yahoo Finance)

Company Overview

TDOC provides a software that allows users to access a scaled network of medical professionals over their mobile phones from anywhere with an internet connection. The company also provides access to doctors over a traditional land-line. A key point to note is that the company’s competitive advantage doesn’t come from its software (which is actually not difficult to develop), instead the competitive advantage lies in the vast network of medical professionals that readily provide services on TDOC’s platform. Majority of the company’s consultations fall in the general medicine category however the company has been increasing its mix of services including mental health, dermatology, sexual health, wellness etc. These additional services provide a compelling up-sell opportunity for the company to its already significant subscriber base especially mental health and wellness services which are gaining increasing awareness in North America. In recent months, TDOC has entered into the virtual consultation space for hospitals by acquiring InTouch Health (to be discussed later in the article). Furthermore, the company has been expanding its global footprint with presence across several different countries.

Source: TDOC investor presentation

Updates Since Last Article

Q3-2019 Earnings Release

The company released its Q3 results October and we believe this has been the main catalyst for the aggressive stock price increase since. The key stat here was the significant increase in subscriber base to 35M (from 27M in Q2 2019). YoY, this constitutes an increase of 55% and really exhibits the leadership position of TDOC in this market. The growth was driven by continued increase in notable insurance plan clients (e.g UNH) and increases in the behavioral health business as adoption of mental health and wellness increases across North America. Revenue growth beat analyst consensus and the company increased its guidance for Q4 2019. Management indicated that RFP volume is up 25% YoY and bookings are up 30%, which should translate into strong organic growth in 2020. Management remains confident in the 20-30% long-term organic growth targets which is a very positive sign for investors.

Quarterly revenue and adj. EBITDA trends. Note that our adj. EBITDA calculation only excludes stock compensation and does not take into account other adjustments that the company includes in its own calculations (Source: company disclosures)

Acquisition of InTouch Health

In January, TDOC acquired InTouch Health, a provider of enterprise telehealth solutions for hospitals and health systems, for $600M. The deal was valued at 7.5x TTM revenue which is well below TDOC’s current valuation of ~15x revenue. The deal consideration included $450M of TDOC’s stock which shows the seller’s confidence in TDOC’s business and the company’s use of a high valuation to invest it the business. InTouch’s platform allows hospitals to provide specialist coverage in smaller communities for specialties like cardiology and critical care. This helps smaller hospitals reduce overheads by leveraging virtual consultations. TDOC’s current offering helps hospitals provide virtual access to outpatient visits (ex: pre-admission, post-discharge) and is synergistic to InTouch. This acquisition further expands TDOC’s set of products that it can cross sell to its established base.

Growth Vectors

  • Capture unpenetrated commercial insurance market – Despite the aggressive adoption of telehealth, only ~25% – 30% of the US population covered by commercial health insurance is currently subscribed to telemedicine services leaving a fairly large untapped market to grow into.
  • Higher use by existing subscribers – The use of telehealth is becoming more popular as patients look to save time and the health ecosystem looks for ways to cut costs. Higher use by subscribers leads to higher revenues for TDOC.
  • Add new services to the platform – The company has continuously added new services to the platform such as mental health and wellness and now hospital specialist capabilities via InTouch. This again leads to higher utilization of the platform along with a higher per employee per month (PEPM) rate.
  • New Market (Medicare Advantage) – Medicare is expected to cover telemedicine services starting in 2020 and this could open up a significant new market for TDOC (20 million potential users).
  • New Market (International expansion) – Adoption of telehealth in international markets is much lower than the US and TDOC has started to expand its footprint outside North America.
  • License software – There will likely be physician offices that can utilize the software to reduce costs and provide convenience to their customers, without the need for the physician network available via TDOC. For example, a high-touch family practice may want to provide its regular customers access to telemedicine to generate additional revenue. These physicians would pay a licensing fee to the telemedicine company providing the software.
  • Industry Consolidation (M&A) – As adoption increases, we will see more consolidation in the telemedicine market which should provide TDOC another avenue for expansion. Acquisition of InTouch is a prime example of this.

Valuation

Despite our optimism on the business side, the significant increase in the stock price makes us a bit cautious at today’s valuation. We have updated our forecast for the business below which now shows more aggressive increase to subscriber base and higher increase to PEPM as new services are added. We have kept EBITDA margins consistent as our previous article however note that this is likely an aggressive assumption given that advertising and market spend will likely increase as the company looks to expand. Overall, we think the forecast below is fairly aggressive and value investors should be cautious.

What does this mean in terms of market adoption?

Essentially, over the next 5 years adoption would have to increase significantly for this valuation model to come to fruition. While this is an aggressive assumption, we note that our forecast may not fully take into account cross selling opportunities into the established customer base which could provide additional upside

Risks

  • Increased competition from new entrants could temporarily hinder growth and apply downward pressure on pricing
  • Increasing physician shortage leading to higher cost of revenue
  • Regulatory changes leading to cuts in reimbursement rates
  • Change in regulations resulting in restrictions upon cross state physicians treating patients; this will impact ability to scale profitably
  • General market downturn stemming from fears of a global recession

Conclusion

TDOC has exhibited very strong growth on the backs of industry tailwinds and development of new services. The company has many growth vectors at its disposal however today’s valuation make us a bit cautious. We recommend value investors to monitor from the sidelines for now.

Source: Teladoc: Growth Prospects Still Intact, But Upside Limited On Valuation – Teladoc Health, Inc. (NYSE:TDOC) | Seeking Alpha

In an ideal world, closing deals would be easy.

And with the right approach, it sometimes is.

Before sitting down at the table next time, take these five negotiation steps to increase the chances you get the outcomes you’re aiming for.

1. Prepare an Accusation Audit

Out of all the negotiation steps, this one may be the most important.

First things first: You’ve got to prepare an accusation audit before you engage with the other side. There’s no way around it.

The accusation audit is a great way to set the stage up front. The stage you’re trying to set is not so much an agenda you want to talk about as it is a need to mitigate any negatives they may have brought to the table.

Keep in mind that you don’t need to be 100 percent certain that the negatives you address in your accusation audit are actually at the forefront of your counterpart’s mind. The attempt to verbalize an understanding is always more important than its accuracy.

Putting any negatives you can think of on your list and addressing them at the beginning of the conversation will help create a collaborative environment—which is the precursor to the end goal of trust-based influence.

Remember, at the end of the day, in the world of negotiation, people give you things because they feel like it. You want to get the other side to trust you enough to feel like moving in your direction.

The accusation audit is a great way to start the process of just general collaboration and trust-building up front—while skipping over all of the run-of-the-mill common ground stuff.

Would it hurt to increase your influence? Read this guide to become a more effective salesperson »

2. Don’t Answer Questions Until You Know Why They’ve Been Asked

Before you respond to a question, make sure you understand why your counterpart asked it in the first place.

You can put yourself in a tough spot if you answer a question poorly. You don’t want to leave yourself naked by answering a question in a way that doesn’t necessarily address the motivation for why they’ve asked it.

Most people are bad at asking questions in general. So before you answer, you need to understand the dynamics that caused the other side to ask in the first place.

Worried that that might be difficult to do? It’s not.

Phrases like What makes you ask? and Seems like you have a reason for asking that will help you understand the reasons behind the questions.

3. Fire off a One-Liner Before Your Ask

Before you make an ask of any sort—e.g., there’s a term in the contract that needs to be taken out—have a couple of one-liners ready to go.

Spend some time thinking about some of the potential ways that the other side can react to your ask that might not be in your favor. If it’s something they are probably not going to like—which is a pretty good bet, considering that you’re at the table in the first place—greasing the skids for your ask with a one-liner is going to be a huge help.

Before diving in, set the table with something like this: This is really going to catch you off guard. 

The other side will respect your upfront approach—and the fact that you’re practicing tactical empathy by seeing things from their perspective.

4. Expect to Be Caught Off Guard

At the same time, you need to be aware that you yourself are going to be caught off guard.

Many people go into a negotiation with a mindset wherein they hope that the other side will move in their direction, but decide to just see what happens. This is not a horrible mindset to have, mind you. But it is a mindset that means you’re less equipped for when unexpected things happen.

On the other hand, if you go to the table with the mindset that your counterpart is going to say something that’s going to throw you off your game, you’ll be in a much better spot to prepare for whatever comes your way.

5. Allow the Other Side to Have the Floor

Every now and again—at the very least—you’ll run into a situation wherein you sense a lot of discomfort at the table. If the other side seems standoffish or restless, that’s often a telltale sign that your approach is not in a good place.

When you sense an impasse, say something like, It seems like I said something that offended you or, It seems like I said something that made you uncomfortable.

Otherwise, when you let it linger, they’ll spend more time listening to the voice in their head than whatever it is you’re saying. When that happens, they’re not soaking anything up. They’re just waiting for their turn to speak.

In these situations, address their discomfort immediately and allow them to take the floor. Their behavior is probably an indicator that you’re speaking too much anyway.

Source: 5 Negotiation Steps That Will Close Your Next Deal

AUSTIN, Texas — The St. David’s Women’s Center of Texas is now at the cutting edge of reducing maternal mortality rates.

  • Hospital researching maternal mortality rates
  • 1 of 3 facilities in Texas to participate
  • First phase of trials targets premature birth

Reva Goujon became a patient there during her second pregnancy, when she was told she was at a high risk of developing a condition called placenta accreta.

“It was definitely deeply unsettling to know this risk was always looming,” Goujon said.

“Think of it as akin to the layers of an onion,” Dr. Jasbir Singh, Maternal Fetal Medicine Physician at St. David’s Women’s Center said. “After you deliver a baby you would expect the placenta to peel away from the wall of the uterus, if it’s grown into the wall of the uterus it attaches and it doesn’t detach.”

The condition can lead to excess bleeding, and can be life-threatening for the mother. Luckily, Dr. Haeri and Dr. Singh at St. David’s Women’s Center of Texas, are experts at treating it.

“It’s reassuring when the medical papers you’re reading also have the names of the doctors you’re seeing at the top because they were the specialists in this condition,” Goujon said. “In our first consultation with him, he looked me straight in the eye and said, ‘You are not going to die.’ And he repeated that with so much conviction every single meeting thereafter, and I’ve never had that level of confidence, or assurance from any other doctor. And his care his expertise, proved to be exceptional.” ​

“Reva is one of our favorites,” Singh said. “She was very scared, but that was also because she’s a really intelligent woman and knew what challenges lay ahead, and I think she felt comfortable because she knew that we had a well-oiled team that could handle her care, and that we were prepared.”

The St. David’s Women’s Center of Texas is now part of a national research network working to reduce maternal and fetal mortality rates. It is one of only three facilities in Texas to participate in the research done by the National Institute of Child Health and Human Development’s Maternal-Fetal Medicine Unit Network.

“It’s, in our specialty, considered the echelon of research. The top echelon,” Dr. Sina Haeri, Medical Director at the St. David’s Women’s Center said. “When you’re part of it, you’re basically at the forefront of perinatal medicine, doing research that truly impacts everyday disease.”

This week the Women’s Center at St. David’s began its first phase of trials, targeting a specific method of reducing premature birth. In the coming months they plan to roll out two more phases of trials, addressing hemorrhage and hypertension in mothers.

“It is heartwarming to see something you had a hand in change the practice of obstetrics across the world,” Haeri said. “It’s always good to be at the forefront of this so when your patients come in, every single intervention that might be available to them, is available to them.”

The research will benefit millions of mothers across the country, but St. David’s participation will directly impact mothers in Texas.

“If you go back to the whole maternal mortality morbidity issue that we talk about, one of the fundamental reasons behind the numbers being as high as they are is poor access to care, poor access to expertise,” Haeri said. “And we’re hoping to alleviate that.”

“The research component is critical, the funding to do that research is critical,” Goujon said. “So I think everyone can be reassured that that money is being well spent when you have experts who are really driven by their intellectual pursuit and finding answers and finding the best practices to deal with this condition, and Austin should be proud to have that here.”

Source: St. David’s Women’s Center Begins Maternal Health Research

“There’s just not enough mental health coverage across the state, but the rural areas are particularly hit hard,” said one doctor.

patient using telemedicine for doctor's visit

ID 137028483 © Piotr Adamowicz | Dreamstime.com

People living in rural areas face challenges that can take a toll on their mental health, including low wages, limited job opportunities and a lack of social capital. All of that is compounded by the fact that it can be harder to access mental health care in rural America.

From Months To Days

Now, telemedicine is helping to close the gap in treatments available in rural areas. At Meridian Health Services in Indiana, integrating telemedicine has reduced the wait time for new patient visits with a psychologist from months to days, according to NPR.

That makes a big difference for patient outcomes, said Meridian’s chief medical officer Dr. Sarfraz Khan.

“In my opinion, it’s lifesaving,” he said. Meridian was having trouble delivering mental health services because the organization couldn’t find doctors who were willing to work in rural areas.

“There was a time when we were seriously considering: Would it be viable for us to provide psychiatric services because nobody would like to come to small towns?” Khan said.

Now, doctors don’t need to come to small towns to work. They work out of a central location in Indianapolis. Patients, meanwhile, visit rural clinics for their appointments. There, a nurse takes their vitals and sets them up with a two-way computer screen, where they teleconference with a doctor from the city.

Patients Share Their Experiences

Some patients might balk at the idea of receiving health care through a screen, but a Meridian patient named Mariah said that telemedicine actually helps her be more honest with her providers.

“It’s easier because they’re not there, so I feel like I can tell more, and speak more and truly just be fully real. If they’re sitting right there, I might not want to say everything or say as much,” she said after finishing her first telemedicine appointment.

In Texas’s DeWitt County there are no practicing psychiatrists.

“We kept looking at what our needs were (in DeWitt County), and we did not have adequate access to mental health care,” Lynn Falcone, CEO of Cuero Health, told the Victoria Advocate.

Falcone knew that she was unlikely to be able to find a psychiatrist to come practice in the area, so she reached out to Access Physicians, a group that provides telemedicine services. Now, patients at Cuero Regional Hospital can have telemedicine appointments with psychiatrists.

Dr. Chris Gallagher, CEO of Access Physicians, said he is seeing more and more rural hospitals turning to telemedicine, especially for mental health services.

“Psychiatry is probably the most in-demand specialty,” he said. “There’s just not enough mental health coverage across the state, but the rural areas are particularly hit hard.”

Source: Telemedicine Closes Mental Health Treatment Gap For Rural Patients | The Fix

Frio Regional Hospital and Access Physicians are teaming up to keep cardiology patients closer to home in rural South Texas. The telemedicine group is providing specialty physicians to keep patients from traveling far to other facilities.

“There’s no reason that someone’s zip code should determine their access to the best clinical resources,” said Chris Gallagher, M.D., CEO, Access Physicians via release. “Pearsall residents rely on Frio Regional Hospital to be there for them, no matter their health care need or challenge. With our partnership, Frio Regional can keep that promise.”

On-site nurses and providers at Frio Regional will have consultation abilities with board-certified cardiologists via secure telemedicine technology throughout the day, providing more expertise than would regularly be available at the hospital, with the ability to treat arrhythmias, congestive heart failure, and more.

“Our mission is to improve the quality of life in our community by providing exceptional healthcare with compassion and respect,” said John Hughson, CEO, Frio Regional Hospital. “The telecardiology partnership with Access Physicians completely aligns with our mission … by bringing world-class cardiologists with compassionate bedside manner to our patients so they can stay close to home.”

Source: Access Physicians Bringing Telecardiology to South Texas – D Magazine

MEMPHIS, Tenn. (WMC) – Thirty-seven people in Shelby County have died from a suspected drug overdose-related death since the start of the year according to the Shelby County Health Department. Now Baptist MemorialHealth Care is using telemedicine to help tackle this growing epidemic.

The addiction specialists are brought in from the moment an addict asks a doctor for help. Telemedicine at Baptist Memorial Hospital now brings an addiction specialist that’s available 24/7 to meet with doctors and patients.

Focusing on Mid-South opioid crisis

“In addition to being able to save lives and stabilize we can also prevent further death and poor outcomes because we are able to treat these people acutely for their addiction and get the appropriate follow up medication and support,” said Dr. SDaniel Poor, ER Physician at Baptist Memorial Hospital.

The team effort to combat the growing opioid crisis started in September of 2019 when Integrated Addiction Care Associates partnered with the hospital to provide on-demand in-hospital consults, face to face with not only doctors but also the patient.

The overdose next door: How Shelby County is fighting the opioid crisis

The clinic’s approach is the first of its kind for West Tennessee. Bartlett based IAC tackles the road to sobriety for addicts through a three-step method caring for their patient’s physical, behavioral, and social needs.

The wrap-around care was the idea of Drs. Kathleen and David Stern after losing their son Alan in 2008 to an opioid overdose.

“It was very important to myself and my wife that we should really help other families so they wouldn’t have a lost similar to this,” said Dr. David Stern.

The Sterns opened the clinic last April and now see close to 400 patients.

Many of whom made the choice to change their life after a visit to the Baptist ER where the addiction specialists are called upon daily.

“I would like to think that it embraces them in kind of a way in a protective kind of cocoon so they can gain strength and then be able to renter which takes more skills to go back into the world where there are temptations and other things,” said Dr, Stern.

This program has since expanded from starting in Memphis. As of this month, it is now offered at Baptist’s Collierville and Tipton County locations with future plans to expand to Baptist Desoto.

 

Source: Memphis based hospital partners with addiction specialists to combat growing suspected drug overdose-related deaths

AMARILLO, Texas (KAMR/KCIT) — The entire nation is facing a physician shortage, according to projections from the American Association of Medical College. Dr. Brian Weis, the Chief Medical Officer at Northwest Texas Healthcare System, said the Texas Panhandle is no exception.

“If you look, a lot of the doctors coming out of training now, are heading to the major metroplexes. And so for a lot of these smaller regional facilities, they’re really struggling to recruit providers,” Dr. Weis said.

Data from the Texas Department of State Health Services shows nine out of the 26 counties in the panhandle have zero primary care doctors. When you increase that number to one primary care doctor or less, that expands to 12 counties.

Dr. Weis said telehealth is a growing solution to the problem.

“Some of our specialists, and subspecialists, provide services to those hospitals in a way that is accessible to patients in those communities, and they can stay in those communities,” Dr. Weis explained.

Dr. Shane Harper, Chief P.A. at the Texas Tech Department of Surgery said there are several ways to implement the technology into the medical field.

“Telecommunication can be something that’s over computer that’s at their desk or even now, even in their phones. For instance, telehealth could be where some insurance companies have it instead of going through your primary care physician, you can call a 1-800 number… and more or less have a facetime with someone to provide something simple, you know, cough and cold,” Dr. Harper explained.

From there, the technology has progressed to the point where specialists can see a patient for the first initial appointment, and then do all of the follow-ups via telehealth.

“If you live in Canadian, and you come and you see a specialist here, a cardiologist or whatnot…some type of follow up visits are just five-minute visits, ‘How are you doing, is your medication working?’ And really those are things that can be done as a face-to-face deal, over telehealth modality, versus coming all the way down to Amarillo, being here for five minutes, and then going all the way back to your home town,” Dr. Harper said.

The technology can also be used now for more serious injuries.

“We’ve brought it to the realm where we’ve done teletrauma, where someone is acutely injured in an outlying facility, if they’re set up with us, can go ahead and link up with us and we can see via very sophisticated FaceTime, that patient in real-time,” Dr. Harper explained.

Advancements in technology itself are not the only reason telehealth has progressed in recent years.

Dr. Weis explained, “There’s been some key changes in regulations at the federal level, that now allow for billing of these telehealth services.”

Rep. Four Price has been fighting for solutions to our rural healthcare problem for years. “I authored and passed some telemedicine legislation that broke down some significant barriers for providers to get paid by health insurance companies,” he said.

Rep. Price said the new technology brings hope to the panhandle. “Healthcare is an issue that’s always in the top two or three of what we deal with. It’s now one of the largest areas of our state’s expenditures and a very large $257 billion budget. So, I’m encouraged though, that we’ll find creative, efficient, and better ways to make healthcare more accessible.”

Looking forward, Dr. Harper said he hopes the technology can soon be implemented in ambulances, as they make a long trek with patients from surrounding communities and feed the data back to the E.R. in Amarillo before they even arrive.

Source: Telehealth offering a solution to primary care doctor shortage in Texas Panhandle | KAMR – MyHighPlains.com