Texas Medical Board restriction on telemedicine use

On April 10th 2015, the Texas Medical Board voted to restrict the use of telemedicine in the state of Texas by requiring physicians to conduct Face-To-Face visit with the patient before a diagnosis or prescription can be provided via telemedicine. The decision has garnered a lot of discussion because Texas is the only state implementing a more restrictive regulatory stance in the area of telemedicine while many other states are busily updating policies to allow for the increased usage of the technology.

Texas medical board

The ‘Face-To-Face” Requirement’

Details of the decision are as follows as reported by Hayes and Boone. Particularly contentious in this revised regulation is the requirement of completing an initial diagnosis through the use of “acceptable medical practices” which must include a face-to-face/in-person evaluation to establish a physician-patient relationship. Mental health services, as well as, scenarios where the patient is currently at a health facility, and attended by another healthcare professional, do not fall under the limitation.

The amendments also state “An online questionnaire or questions and answers exchanged through email, electronic text, or chat or telephonic evaluation of or consultation with a patient are inadequate to establish a defined physician-patient relationship.” (22 TAC 174.8(c))

Texas Retreating In The Face Of Growing Evidence

While the Texas Medical Board moves to restrict the use of telemedicine; Idaho, Utah, Montana and West Virginia joined the Federation of State Medical Boards’ interstate compact to remove barriers to telemedicine growth. According to Modern Healthcare, at least 11 other states have similar legislation pending. Thirty-seven percent of employers planned to offer their workers telemedicine consultations in 2015, and another 34% planned to do so by 2017.

To date, no research has been presented by the Texas Medical Board to legitimize the patient safety argument in the area of telemedicine misdiagnosis probabilities. And to the contrary, there are numerous studies identifying the cost effectiveness, time saving and patient care improvements.

  • According to Becker’s Hospital Review, Phoenix-based Banner Health’s tele-ICU system significantly improved patient outcomes where telemonitoring saved 34,000 ICU days and close to 2,000 lives in 2013.
  • A cardiac study at Partners Healthcare profiled 3000 congestive health failure patients who recevied in-home monitoring of weight, blood pressure, heart rate, and pulse oximetry where high-risk patients are identified with decision analysis support software.In 6 years readmissions dropped by 44%, saving the health plan $10 million.
  • A case report from the Department of Vetran Affairs detailed findings on a home telemedicine program that was also adopted by the VHA in which the more than 17,000 patient participants had a 25% reduction in the number of bed days of care and a 20% reduction in the number of hospital admissions compared with traditional care.
  • Another study from Health Affairs found that patients in telehealth programs had reduced spending of 7 to 13 percent or $312–$542 per person, per quarter compared to those that did not.

Texas: Most Vulnerable To Be Most Affected

This new restriction does not address the impact to rural patients, a large and growing problem in our nation, a challenge that is particularly acute here in America’s second largest state. With telemedicine access, rural hospitals in Texas have been gaining an affordable option to reach critical care specialists that are already scarce and often prove to be costly. It is sometimes impossible to recruit specialists to work in remote rural settings, where populations cannot support them and opportunities to interact with their specialist colleagues are limited.

Removing options for telemedicine simply reinforces the unfortunate situation that life altering specialists and subspecialist care will remain in the domain of densely populated urban areas. See the article by National Public Radio on how US Medical IT’s telemedicine solution has changed lives in rural Texas.

Evidence Based 21st Century Medicine

Telemedicine is offering new and innovative ways for business to extend affordable and convenient healthcare benefits to their employees. We believe that Texas, a state that prides itself on entrepreneurship, business development and employer enablement, has definitely taken a step backwards with these new regulations. We will monitor and post on new developments stemming from this decision. In addition, we hope there will be a return to evidence based regulatory practices so that Texas can return to the forefront of 21st century medical care.

Interested in learning more about telemedicine? Contact us at (877) 652-9367.
Our mission at US Medical IT is to thoughtfully integrate medicine and technology, creating the opportunity for broader knowledge distribution, better coordination of care, and ultimately the improved health and well-being of all. If you have questions about this topic, feel free to leave a comment or contact US Medical IT. Schedule an appointment with us to learn more about our high fidelity and cost effective telemedicine solution.


HIMSS Webinar: HIPAA Compliance and Health IT Immersion

We are excited to announce that our own CIO and President, Stephen Cracknell, will be the featured speaker at the upcoming webinar hosted on Healthcare Information and Management Systems Society (HIMSS). Titled “Technology Immersion: Compliance, Security and Privacy in Communication and Collaboration Scenarios”, the April 10th webinar will address HIPAA compliance, and how today’s technologies can help you ensure that the data that you work with is stored in a compliant and secure manner.



Friday, April 10, 2015
1:00PM CT/ 2:00 PM ET/11:00 AM PT


Learn how to tackle compliance, security, and privacy requirements, while using cloud services that enable your teams to share data, communicate with each other, and collaborate more effectively as a team.


If you work in the healthcare industry, this one-hour webinar is a valuable experience whether you’re in charge of IT, Compliance, Operations or Human Resources.

About US Medical IT

Our mission at US Medical IT is to thoughtfully integrate medicine and technology, creating the opportunity for broader knowledge distribution, better coordination of care, and ultimately the improved health and well-being of all. If you have questions about this topic, feel free to leave a comment or contact US Medical IT. Schedule an appointment with us to learn more about our secure cloud technolgy.


How easy it really is to trigger an audit

There is a common misconception that once an organization adopts sample Security Rule policies and procedures from the Office for Civil Rights (OCR), their IT security planning is done. Anchorage Community Mental Health Services (ACMHS) found out the hard way that a HIPAA compliance program is not that simple. 

ACMHS is a nonprofit organization providing behavioral health care services for the uninsured and underinsured with 5 facilities in Anchorage, Alaska. An investigation was opened when OCR received notification from ACMHS regarding a 2,743 records breach of unsecured electronic protected health information (ePHI). The breach was attributed to malware on ACMHS’ system. The investigation revealed that even though ACMHS had adopted sample Security Rule policies and procedures in 2005, there were no proactive execution of the policies. ACMHS’ failing to identify and address basic risks directly resulted in the breach. By not regularly updating available patches and running outdated, unsupported software, ACMHS leaves their IT resources vulnerable to attacks.

As a result, ACMHS agreed to pay a $150,000 fine besides commitment to a corrective action plan to improve its HIPAA compliance standing.

Healthcare providers have the burden to protect not only their confidential corporate and employees information but also patient health information. Security measurement needs to be of top priorities to the management team, yet cases like this keep surfacing more often than ever.

Many health care providers will need to overhaul their security efforts to ensure regular updates are in place. For instance, it’s common to see Windows XP (no longer supported) being used. See why this can potentially be a violation here.



Please refer to the Department of Health and Human Service website for more information about the breach and ACMHS agreement with the OCR.

Case Study: Care Options for Kids cut paperwork by 50%, giving them more time to help children

Our client Care Options for Kids, a pediatric home health therapy provider in Texas, adopted the cloud-based version of the popular Microsoft Office suite to sustain its rapid growth and avoid the cost and complexity of growing and maintaining a communications and collaboration infrastructure. Here’s the full story on Microsoft’s case study site

Care Options for Kids adopted Microsoft Office 365 to enable its therapists to use to collaborate from halfway across the state as though they were in the same room. The company wanted to save time and cost with the new software, and it’s done that. Therapists spend less time inputting data into patient charts, that data is more accurate, and therapists can view their patients’ files from wherever they are, rather than having to travel to a Care Options for Kids office. The size of patient charts has been reduced by 90 percent, not only saving the cost of paper files, but also the time to file and later find and retrieve those files. Processing teams save 30 to 60 minutes each day by working with data on screen rather than on paper.

In addition, there’s added value in the greater ability to capture, collect and report on operational and clinical outcome data. “This system allows us to be accountable on our operational and clinical outcomes, a key aspect of healthcare”, says Michael J. Reiswig, President and CEO.

Saving time, money and collecting meaningful data is great. But saving lives is even better. “With Office 365, we can provide better care, more proactive care than we could before,” says Kevin Worwood, Director of Clinical-Business Operations at Care Options for Kids. “That’s the best part.”

About US Medical IT

US Medical IT is a health technology service provider with primary office located in Dallas, Texas. At US Medical IT, our mission is to thoughtfully integrate medicine and technology, creating the opportunity for broader knowledge distribution, better coordination of care, and ultimately the improved health and well-being of the communities we serve. For more information, visit http://usmedicalit.com

Windows 10 preview and what it all means

By now, news about the Windows 10 preview has spread all over the Internet. Speculation and wonders aside, what do all of the new features mean for business users? Here’s a breakdown of the most prominent details that will be of interest to enterprises customers.


Windows 10 will be free for existing Windows users with current versions of the OS going back to Windows 7. The upgrade will be free for the first year after launch. Once a Windows device is upgraded to Windows 10, it will be supported for the lifetime of the device.


Enterprises customers will be able to opt-in to the normal consumer update pace or choose to receive only security and critical updates to their systems, or a mix of both. An example given by Microsoft is an investment bank “where mission critical systems on the trading floor receive only security updates, whereas mobile devices for financial advisors are kept up to date with the latest feature innovations – enabling the appropriate pace of updates for each device.” – See more on Windows blog.


Even as of right now, the Office experience already has already been worked into a multitude of devices and platforms (iPhone & iPad). Yet with Windows 10, the expectation is the new Office apps  will deliver a universal touch-first experience across devices from the get-go. Across phones, tablets and PC, new versions of Word, Excel, PowerPoint, OneNote and Outlook will be as smooth and consistent as one can expect from the “mobile first, cloud first” vision.

Personal Digital Assistant

Cortana, Microsoft’s personal digital assistant, will be available to PCs and tablets. Cortana used to be exclusive to Windows phones only, and has garnered rave reviews from fans over Siri, the Apple counterpart.


An new browser code named “Spartan” will be available with a new look and feel coupled with advanced feature enhanced by the touch experienced as well as Cortana’s presence.

Start Menu

Both the traditional Start menu and the Windows 8 start screen with their iconic tiles will be available to create the best experience for users.

Release Date

The consumer preview version will be available for PCs starting next week, and for Windows phones in February. The general release of Windows 10 hasn’t been announced, but it’s expected to launch in Fall 2015.

About US Medical IT

Our mission at US Medical IT is to thoughtfully integrate medicine and technology, creating the opportunity for broader knowledge distribution, better coordination of care, and ultimately the improved health and well-being of all. If you have questions about this topic, feel free to leave a comment or contact US Medical IT. Schedule an appointment with us to learn more about our secure cloud technolgy.



Case Study: Anesthesia Compliance Consultants Overcome Growth Hurdles with Office 365

Learn how our client Anesthesia Compliance Consultants handles the common hurdle to small businesses: growing too fast with too much paperwork for their small staff to handle. For more information, please click HERE to view the full story on Microsoft case study site.


As Anesthesia Compliance Consultants, LLC was blooming with success, it encountered a problem common to many small businesses. “We were good at what we did and the business grew,” says Dr. Lopez. “It got to the point where we weren’t eager to advertise our services because we couldn’t handle any more business without potentially affecting quality.”

What was holding ACC back was paper—lots of paper, up to 400 sheets per audit. Every business needs to handle client papers carefully, of course, but federal requirements such as HIPAA made the challenge particularly serious for ACC. Disaster recovery was a related concern; even computer files were at risk from a catastrophic disruption such as fire. And then there were more mundane obstacles. Finding a lost file could take half a day. Organizing and managing files was time-consuming and tedious. And it was tough to boost productivity when a single set of audit papers couldn’t easily be shared among staffers.

US Medical IT helped ACC to adopt the service and to find an increasing number of ways to make use of it. For example, they use Exchange Online to encrypt email and meet security and privacy requirements. They use Lync Online for video conferencing, which reduces the need for travel. And they use SharePoint Online to organize and collaborate on files, and as a disaster recovery solution.

“With SharePoint Online, I can organize my data so it’s easy to perform functions—such as removing personal identifiers—on large groups of files all at once,” says Dr. Lopez. “I can tag documents to find them quickly regardless of where they’re filed. It’s making an enormous difference in how much faster we can work while maintaining quality.”

Add it all up, and ACC is no longer hesitant about taking on new business. In fact, ACC is accepting 20-25 percent more business this year, an increase that Dr. Lopez attributes to the company’s use of Office 365.

Now the Lopezes are planning to add yet another dimension to their partnership—this time, courtesy of Office 365. They plan to expand their business by creating educational programs on compliance for the medical community, and SharePoint Online will play a key role in showcasing and hosting much of the content. With SharePoint, they will also be able to do audits without having to use real paper. All of the information can be uploaded to their secure site and the audit completed on SharePoint.

About US Medical IT

Our mission at US Medical IT is to thoughtfully integrate medicine and technology, creating the opportunity for broader knowledge distribution, better coordination of care, and ultimately the improved health and well-being of all. If you have questions about this topic, feel free to leave a comment or contact US Medical IT. Schedule an appointment with us to learn more about our Compliance Center.

Microsoft Enterprise Mobility Suite for Healthcare Overview

Bring Your Own Device (BYOD) is dominating the business world, but there’s still concern over how to best manage this new office norm in regards to security and collaboration. Therefore, it is no secret that mobile device management is an area where Microsoft is making some deep investments in to answer the need for security in the modern mobile office. What’s in it for healthcare providers to adopt Microsoft Enterprise Mobility Suite?

enterprise mobility suite

In the past, on-premises PC management solutions can cause a severe strain on businesses with limited resources. Often time, it is time consuming to switch between tools for PC management and security monitoring. Organizations need to effectively manage the rising number of workstations and employees’ devices (in the case of BYOD) without driving up operating expenses, reducing efficiency, or compromising data. At the same time, the workforce wants consistent access on the go across multiple devices.

To answer these needs, The Enterprise Mobility Suite comprise was created to answer business needs:

  • Simplified application deployment, software and hardware inventory, anti-malware, and policy control
  • Device management without any additional infrastructure, hardware, or software investments
  • Delivered through an easy-to-use web-based administration console

Above all, healthcare organizations want to achieve these objectives in a compliant manner.  From a compliance standpoint, it’s fundamental for healthcare IT teams to have the ability to encrypt and password protect devices that contain sensitive corporate data as well as the ability to wipe devices that are reported as lost or stolen. And Microsoft is the perfect provider to meet these expectations. More on Microsoft & HIPAA Compliance here.



Enterprise Mobility Suite for Healthcare

With real-time end point protection against malware threats, Intune keeps malware definitions up-to date, and automatically scans computers. Windows firewall settings and frequent software updates help secure your managed computers:

  • Inventory of hardware and software is required for healthcare providers’ annual Risk Analysis. InTune provides a ‘self-service portal’ where your IT staff can publish approved applications to employees. Your IT staff also has the ability to create and manage reports that provide information about software, hardware, and software licenses of connected workstations and devices in your organization.
  • Encryption is needed to avoid declaring a breach, antivirus, firewall settings and patch management which are crucial for your organization to abide by HIPAA regulations. InTune includes robust endpoint malware protection and the ability to control patching and service pack deployment. Your staff can also execute your organization’s security and patch management settings centrally through InTune’s policy settings and be notified of various device and workstation events through the alerts engine.
  • Finally, InTune can integrate with Azure active directory so you can take advantage of your existing user accounts and security groups to manage your security policies.

The new assistant to your IT team

Intune helps simplify IT administration by eliminating the need to plan, purchase, and maintain hardware for installing site system roles. The tool also reduces IT burden with a defined selection of applications for download from self-service portals. By monitoring devices through the cloud with integrated security and compliance management, Enterprise Mobility Suite is capable of management without infrastructure.


Access management and information protection

Microsoft Azure AD Premium and Azure Rights Management can help protect your corporate assets to deliver information protection in the cloud or in a hybrid model with your existing on-premises infrastructure and integrate information protection into your native applications.

Microsoft Azure AD Premium delivers robust identity and access management from the cloud, in sync with your existing on-premises deployments:

  • Cloud-based self-service password reset for your employees
  • Group Management, including user self-service management of groups
  • Group-based provisioning and access management for hundreds of Software as a Service (SaaS) applications
  • Machine learning-driven security reports to show log-in anomalies and other threats
  • Rich and robust synchronization of user identities from on-premises directories, including write back of changes
  • Reduce risk and support compliance requirements with comprehensive Multi-Factor Authentication (MFA) options


  • By reducing redundancy in device management and security control, Enterprise Mobility Suite will increase your team’s efficiency and allow more time for high-level tasks.
  • Downsizing physical requirements and eliminating wasted time equal reducing costs to your organization.
  • Protect your IT system and remain compliant with HIPAA requirements.


Businesses can purchase Azure AD Premium, Intune, and Azure Rights Management separately for $12 per user per month. The Enterprise Mobility Suite combines all three in a single suite for $7.50 per user per month. That is a savings of more than 30 percent.

Want to know more about how Enterprise Mobility Suite can compliment your practice? Get in touch with our IT experts at info@usmedicalit.com for more information.

About US Medical IT

Our mission at US Medical IT is to thoughtfully integrate medicine and technology, creating the opportunity for broader knowledge distribution, better coordination of care, and ultimately the improved health and well-being of all. If you have questions about this topic, feel free to leave a comment or contact US Medical IT. Schedule an appointment with us to learn more about our secure cloud technology.