Hosts Dr. Leo Damasco and Phoebe Gutierrez dive into July’s telemedicine updates, covering the CMS’s Wiser Act using AI for real-time billing audits, a legal clash over cross-state abortion pill prescriptions, new state privacy lawsuits, expanded interstate medical licensing, and a telehealth kiosk pilot in rural Texas improving access.
In this episode of Telemedicine Talks, hosts Leo and Phoebe unpack the latest developments in telemedicine and digital health for July. They explore the CMS’s Wiser Act, a 2026-2031 pilot using AI and machine learning to audit billing in real-time, flagging fraud and overpayments in select states. The discussion shifts to a legal battle where Texas targeted a New York doctor for prescribing abortion pills, highlighting the politicization of telemedicine across state lines. They also cover California’s $1.5 million lawsuit against Healthline for violating privacy laws by tracking user data, underscoring growing state-level scrutiny. The episode highlights the expansion of the Interstate Medical Licensure Compact, with North Carolina, Nevada, and Rhode Island joining to ease multi-state licensing. Finally, they celebrate a telehealth kiosk pilot in rural Texas, offering accessible care to underserved communities. Packed with insights, this episode is a must-listen for telemedicine enthusiasts.
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[00:00:00] Hey everybody, welcome back to telemedicine talks. , This is Leo and Phoebe. Hello again. And it's about that time, you know, it's at the end of the month and we are gonna talk about, kind of interesting things in the months and updates. all right, Phoebe, you're the best at this. So. I'm, I'm gonna go at it.
Let's kick it off. I mean, I think, yeah, you know, from my perspective, like July was kind of interesting. There's like a hodgepodge of different interesting kind of topics in the digital health space and compliance space and just like enforcement space. So, one of the things that I thought that was super relevant.
Um, and I know, you know, Leo, we've done a podcast about the one big beautiful bill already. Yeah, yeah. But, um, there's a lot of stuff that's kind of, , tied to government. Big, beautiful bill. And one thing that I thought was pretty interesting is, it is called the Wiser Act, wasteful and Inappropriate Services Reduction Model, [00:01:00] which is this new pilot that the Centers for Medicaid and Medicare are.
Launching in some select states basically to use AI and machine learning to ultimately like audit companies in real time. So it's going to basically are, you know, how is billing looking and then it's gonna like flag outliers or, that's kind of like my guess. They're obviously not saying exactly, what they're looking for, but.
From a regulatory standpoint, like as you know, an ex regulator like that is to me, what is probably gonna happen. So they're, they're basically using AI as instant regulators, right? yeah. In, in real time, basically. So they're looking for overpayments, they're looking for upcoding, they're looking for anything that kind of looks off.
I think they're also looking for over utilization. So one interesting thing as I was [00:02:00] scouring enforcement. This month, there was a case around genetic testing and this one company had claimed to do like, I don't know, 3 million genetic tests or, oh, sorry. It wasn't genetic testing. It was, catheters and, Basically when the regulators looked into it, they were like, the company couldn't even produce 3 million catheters. So like, how did we not catch this sooner? Huh? And so I think it's looking for things like that where if you have something running that's able to like flag some of those almost like obvious fraud cases or obvious, you know, kind of like overpayments.
I think that's what it's looking for. And so it's just looking for outliers, right? Just using AI to do so. Yeah, so there is still gonna be like a human element to it. So when I would do this work, you have a whole team that is kind of looking for these outliers. I would get my report of the outliers, and then from those I would decide what are the ones that we're gonna go investigate.[00:03:00]
And so this is just. Ridiculously speeding up that process and putting it on like a way, way, way larger scale to where instead of looking at a sample size, they're looking at everything. Yeah. And I think the biggest thing here is it doesn't matter if it's big, small, if there's any discrepancy, I think you're gonna be flagged for some sort of.
non-compliance or some sort of audit. Yeah. So that's, that's interesting. 'cause you're right, , we already know AI speeds everything up, right? Things that, especially, analysis, um, big, large amounts of data. It has cut our workload and, and the time and turnaround into frac.
Of what it is before. Right. And speeding everything up. And so I you, this is just a natural progression into that, but it's gonna be interesting to see how they use it and you know, how [00:04:00] they regulate the regulation too. 'cause, um, one, one of my big questions is, what kind of algorithms, what kind of data are they using to flag what is actually waste?
You know, there's, there's obvious ones, right? You know, like three 30 million catheters that they really can't make, you know, or, like billing discrepancies or these big patterns of billing where, maybe, , a practice is billing higher, you know, higher billing codes and just like, you know, that's just way out of the blue.
But, when you get to, are they gonna question is are they going to delve a little. deeper into kind of on the fence and how deep are they gonna do this? I think personally, I think it's a great idea. I think it protects our money and whatnot. But, yeah, that's my big questions is are they gonna be very transparent in what criteria they use or not?
You know, I hope they are Probably not right? Daydreaming. I mean, you have to also understand, right? Like all these rules and regulations are, they're there. So [00:05:00] anybody who's doing these services needs to understand what these rules are before they start, right? So the assumption is like, you're doing this today, you better be doing it correctly.
And if not, , we're gonna catch you and. I wouldn't give out my methodology behind the scenes of how I am, actively, you know, monitoring people because then you're gonna kind of know what you can potentially like get away with.
Yeah. Yeah. so I mean, in, in some realm they, they might, but like. Most of the time they're probably not going to. And kinda like what you said, I mean, I think it's gonna be something that's gonna be a work in progress because like, this is what you would call like a basic, like rules engine.
You're gonna need to build something super robust that ties all those rules, those complicated rules. Who, you know, how you interpret those rules, how the federal government interprets those rules versus like the lay person I mean, this is why companies hire me, is 'cause they can't understand that language.
that's gonna be the interesting discrepancy, right? Like, you're gonna be like, no, no, I'm [00:06:00] totally compliant and you're gonna, it's not. So, I mean, either way, I think, so the, the pilot is. starting in 2026 and it's going through the end of 2031 in some select states. and this kind of segues into like my next topic a little bit, but I think they're doing this now on everything.
Yeah. Because there has been such a huge uptick in enforcement. And overpayments that, in my opinion, don't warrant the normal thresholds for overpayments that like the federal government is watching already and already has some AI tools supporting monitoring now. Yeah. And do you think they use this tool during that big crackdown as well?
You know, recently, I don't think so. I mean, the crackdown all of that investigation I think was, that was all stemming from the [00:07:00] Biden administration. So that was all stuff that actually had been in the works for probably over a year or so. But I do think the idea is, is. Every year a crackdown like that is going to happen and it's just gonna get bigger and bigger.
Especially as this administration has said, fraud, wastes and abuse is like number one on their radar. And I met with a client this week who was talking about like overpayments. They had a question, they got an overpayment Notice from Medicare and they're like, well, we can't believe it, because it was such a small amount and.
That's kind of where, like in my head I'm like, normally overpayments are usually like in the 20 5K round. Yeah. You know, realm. Like you're looking at like a certain number and it's pretty apparent that they don't care if they've overpaid you by two pennies. Like you are going to get a notification that you've been overpaid and you are going to have to pay that back.
Yeah. Yeah. And this is gonna make it more efficient. Right. So you're right. You know, things that would've taken years to do now [00:08:00] will take. fractions , days, weeks, maybe even days. Right. So, yeah, no, that's totally interesting. And, and, , trying to relate it to the telemedicine space, right? we're gonna see probably a lot more scrutiny and a lot more, you know, , these high volume virtual services, , especially the niche services that prescribe over and over again.
, Especially if they deal with Medicare and Medicaid, uh, the federal programs. You know, they're, they're gonna be under the microscope, you know, why is this one service prescribing, you know, a proportionately increased number of, birth control versus not, you know, things like that.
Also, the coding practices as well, so yeah. These companies, , if you're starting to work for these companies, definitely understand how they code, and how the payer mix is. So, , yeah, if push comes to shove, , you could back yourself up, be like, Hey, , I think better understanding, personally, I think, , when I started I was kind of glib, , just like, Hey, okay, I trust the companies, which, you know, I, I think I'm, I've stuck with the companies [00:09:00] that I could trust in terms of compliance, right?
Because I, I've delve deeper, but, , this would've been way useful to know about when I was starting out. Better understanding versus just, almost kind of the wild, wild West before. yeah, a hundred percent. I mean, again, I think it's that you're thinking about the same services that I think are.
Kind of rif for fraud. So DME is of course gonna be like, I mean, yeah, if you're a DME provider and you're doing anything that is like slightly like questionable, like, oh my gosh, like please stop. oh yeah, look at the OI. It's all freaking DME, rrp M is CCC M. Genetics, genetics labs. Surprise.
Still COVID. Still COVID, believe it or not, right. so again, I mean, I think this is actually great. companies are gonna hate it because you're getting that real time oversight. But from, you know, my stance of having to do this stuff, I, I think it's gonna be great. It's gonna clean up a lot.
And I do think it's gonna reduce a ton of, I don't wanna say fraud, but I think it's gonna, potential fraud, but also [00:10:00] just like some initial mistakes that people are making. Honestly, you don't realize, 'cause you get audited three years in, you know, arrears and then you're like, oh crap, I've been overpaid all this money.
Right, right. So again, I think it's just gonna really help providers do things the right way too. but yeah, I thought that was a really cool update. No, that's, that's interesting to see and interesting to watch. And this, you said it's starting next year, right? With some pilot states and going further if it, if it works out.
Yep. That's. So we'll, we'll see how that goes and how that shapes really medicine in general. cool. let's see. , so one thing that I thought, , this is still going, I think we kind of heard about it late last year, which I thought was interesting, was.
this legal clash between this doctor in New York that prescribed abortion pills for a patient in Texas who, as you know, is one of the strictest anti-abortion laws. Right. And, you know, it doesn't allow [00:11:00] any, almost any type of abortion. I don't know the specifics. Don't quote me there, but, uh, I know that, yeah, they're one of the strictest, right.
And they have threatened legal action. Like severe legal action against doctors in their state, but also doctors from other states that are helping patients that live in Texas. So what happened was, this doctor in New York prescribed, , birth control medication, pharmacy pills to a patient in Texas, and now Texas is going after the doctor legally.
and Texas actually passed a judgment against this New York doctor. But New York is refusing to,cooperate with the, uh, Texas order. So, you know, you have the state to state fight. So it's interesting to see the back and forth between the states, you know, the different rules and how people are trying to push the literal borders of telemedicine where they practice.
And , [00:12:00] what's the argument there? What was the thought there? Because, well, you know, you are prescribing for a patient in Texas and you're, you're following these Texas laws, right? But, it's interesting that, okay, Texas can, you know, pass a judgment, but they can't really touch this person because they're in another state.
How, how far can they reach, if it's a state to state thing. 'cause this is not a federal thing, right? So what's your thoughts on that? Yeah, I mean, I think abortion access is just gonna be something that is going to be a very hot topic. I mean, there's a lot of states that have actually.
gone further than Texas and passed legislation around, criminalizing doctors who do provide any sort of service. I think it's the interesting thing is, yes, you're a, you're a provider in New York. Right. So you're doing everything that's okay, but you're treating somebody in Texas.
Yeah. Where these things aren't allowed. And so I think it kind of [00:13:00] begs the question of like, are, is that an illegal practice of medicine? Are you actually legally practicing medicine if we're not allowing that service? And so again, I think, you know, you can, not to take it away from abortion, but I mean it's the same thing of like marijuana, right?
Yeah. Like in California, like it's legal. In some states it's legal. If you prescribed it in a state like Alabama, like no. The doctor's gonna be kind of held liable for it. So I think that's the interesting case. And the unfortunate piece of it is, luckily for the doctor New York is, kind of like supporting, the physician and the physician's autonomy there. Um, it doesn't change the fact that like. Tech, this is going to significantly impact that physician. Yeah. And it's going to significantly, you know, take time and effort and money and part of your reputation to have to get back on, you know, track licenses too.
Right? Yeah. Licenses. Like I wouldn't be surprised if this provider, loses their Texas license probably. Oh, absolutely. It's probably gone now. [00:14:00] Yeah. And then , the unfortunate thing is once you lose one license, you actually have to notify all the other boards. Right. So then it's like, is Mississippi gonna take your license?
Is Alabama gonna take your license? Is South Carolina? all those other states that have similar,similar ideas around abortion access, I think, oh, hands down, they're gone. they're not gonna be able to practice in those states, for sure. Yeah. So it's gonna, again, it just, it, politicizes medicine, which I think is the, yeah.
The hard part of living in this world today as a non-physician. And that's one ofthe main kind of, arguments that this doctor was having, , why they did it and, just went forward with is just, , is just highlighting the politicalization, I can't say the word any who of medicine, which honestly, really shouldn't happen.
It should be, apolitical. It should be, , above that, but unfortunately as we see now already, right? there's definitely,large implications with that. so yeah, that's again, one of the big kind of major,arguments that this doctor's highlighting.
pretty ballsy. I think, [00:15:00] sacrificing a lot of your practice, for those primarily practicing telemedicine, that's huge risk, right? Because yeah. , Your licenses are gonna go down, yeah. and I think too, another thing to just think about, like when you come to, working as a physician in, telemedicine.
Let's say you're working for a company. was this, is this, was this person doing private practice or was she working for a large telemedicine company that offered these services? I think those things are gonna come into play, like I know, you're on some women's health platforms and or have in the past and do you know if certain services are allowed or not?
And I think that's another thing where it's like, gosh, like physicians really need to understand. , sure, okay. I've been doing birth control, or plan B, or some of the other things like, but are those things actually legal and are you gonna get in trouble?
And the question is does the company that you're working for understand those implications? Do you understand those implications? Yeah. Yeah. And could this potentially [00:16:00] happen to you? Yeah, no, absolutely. Definitely. it's a common theme there, Having an understanding of what you're signing on a line and what you're doing and what your company's doing on your behalf, is key.
because yeah, there's a lot of moving parts and especially crossing state lines, this is a good example of that, Yeah. So my next topic. was a little bit about just like some state privacy laws. And there's been some lawsuits. You guys know, I love talking about lawsuits, even though I hate lawsuits. But we're in America. That's what happens I guess, here. California sued a really massive company. I don't know if anybody knows of Healthline.
Healthline is like a blog company. so they share basic, just. Blogs and information about healthcare and different services. and basically what Healthline got sued for is they were tracking behind the scenes the people that were [00:17:00] accessing those specific articles. And the problem here, and this is why, like it's really against Basic like CCPA regulations and rules and a lot of marketing rules. And I think there's a lot of companies in digital health that,don't understand these rules and do them wrong. but if you are having people access your website and you are able to, let's say you have one person who's only reading HIV.
Articles, how to manage HIV, how to deal with HIV, best HIV medications, or, little things like that. It's easy to make the assumption that person potentially could have HIV, which is PPHI. And so,a lot of these. Telemedicine companies are tracking what people are reading and what people are looking.
And this actually passed earlier this year. I know we did a segment on this specifically, but I thought that this really summed it up. [00:18:00] Healthline had to pay $1.5 million for violating this in the state of California. And there's a lot of other states that are really, adding more and more rules around this Minnesota, Oregon, Connecticut, they're all following suit because we all know this is a data game and people are sharing data.
Yeah. And as these healthcare companies, like you actually can't be. You can't be tracking those things. So there's a lot of tools that you're actually supposed to like limit, and not use, but Interesting. Nobody listens. Yeah. Do they tag them on HIPAA laws or just. Just privacy laws, do you know?
It's just, it was just privacy laws. but again, these have some pretty significant penalties if you look into kind of like some of the rules. And the funny thing is like I actually have a tracker on my computer where I can go to any website and I can actually see if they have certain code installed on their website and if they are breaking these rules.
[00:19:00] And so . in my downtime, I would go to different companys websites and be like, they're violating this and they're violating this and they're violating this. and to me, I think it's interesting how many digital health companies have basically, for lack of better words,given the middle finger to these rules and said, screw it.
We are gonna just continue to do our pixel tracking regardless of what you know is required and allowed by law. and again, I think this is gonna be something that is going to be getting even further cracked down upon, especially as, these are companies that are actually providing care to people, whereas like Healthline is a straight up blog.
yeah. Straight up blog. So that's interesting. And then it goes to the whole like privacy kind of everything, right? that's a big theme right now too, not just health companies is just. What companies are tracking you. is there any way to, other than buying the software that you have, is there any way of turning this off or, getting better insight in it?
so the software's [00:20:00] free. You can actually get, it's, it is just a free software. It's just like a free, add-on. most marketing people have it, so it's not like a, it's not like a normal thing that like normal people would have. but part of it is as so many physicians. Or, operators are working with new telemedicine companies that are just launching, that are just getting in this game.
These are normal things that used to be allowed. These are things that were like in standard practice. So if you have one founder talking to another founder, they're like, oh, sharing their best tips and practices, not understanding the implications of some of these things.
And so I have just seen it in my experience. Over time, even post these rules. That, people are still violating it. Yeah. It's like a, something they install on their website and it's basically a way, like if anybody has ever visited a website that immediately got like an email or some sort of outreach that was very similar to that website,you're being tracked.
Oh yeah. No, I had to shut down a whole email address [00:21:00] because of it and I was like, oh, I'm done. Yeah. Yeah. 'cause it just mostly spam, Yeah. No, that's super interesting. It's horrible. I clicked on one, credentialing website and I have a hundred voicemails from credentialing companies thinking I'm a doctor, needing credentialing.
so yeah, that's again, I think that what's interesting is when people think of compliance more often than not, my question is my business set up correct? Yeah. Is my governance structure set up correct. How is, my privacy and security, do I need, additional, guardrails here, check my documentation.
And I'm always like, what are you doing on marketing? Like, how are you targeting people? Where is that information going? 'cause I think that's just something that people have just often forgot. and it just, it, it's one of those things, it's a slippery slope, like nobody wants to get caught.
Doing this. 'cause then again, then they're gonna dive in and, dig into everything else that you're potentially doing. yeah. And we've heard horror stories of doctors getting caught into that [00:22:00] too, and not knowing what they're getting into and just Hey, I, I didn't know it was wrong until, the med board came after me and was like, oh, I didn't know what I was talking about,
That's tough. all right. What next topic do you got Li? So talking about states,compact news, so the interstate medical licensure compact. if the IMLC or people that don't know what this is this compact or this agreement amongst different states that if you get licensed in one of the states involved in this compact.
You're allowed to get quickly, basically fast track license into the other states that are involved in this, compact. So this is a quick and easy way to get multi-state licensed. And the reasons why states wanna do this is well, hey, you know, everybody knows there's a shortage of doctors everywhere, right?
So this just allows doctors from different states to quickly get licensed up into the state [00:23:00] in a different state. See their patients. and yeah, since the beginning, more and more states are starting up now and over really it was just over the past month or so. Three more states jumped on board.
North Carolina, Nevada, Rhode Island, and California is not part of the compact, but they also introduced legislation which allows doctors from other states to treat Medi-Cal patients. So this is interesting. Right? So access, access, access, right. So interesting. I loved, yeah, I loved seeing that being, introduced because as somebody who's in California, , there's access issues everywhere. Yeah. But like California specifically. And so to me it's oh yes. More, more access, more specialists, more care, and now getting more universal, because now currently there are about what, 40 states in the, in the [00:24:00] compact, with. Three more states are, Arkansas, North Carolina, Rudd Island.
Legislation just passed. It's still pending. And states like Massachusetts, New Mexico, New York, even, and North Carolina, has, north Carolina's been listed twice, because it has dual status, but legislation's introduced in these states. it's just easier to comment on who's not part of the compact.
Arkansas, California, Oregon, South Carolina, Virginia. And Puerto Rico, US Virgin Islands as territories. so yeah, more and more. So this tells me a few things. One, telemedicine's not going anywhere. It's only growing, right? States are acknowledging that yes, there's this role, this, validates where we think telemedicine is growing and states are realizing this and are trying to utilize.
Utilize this access, right? they're acknowledging that, yes, there is a need and we need to do it. we need better access and this is really the only way to [00:25:00] go. , Good luck trying to convince people to move to that state, to improve access, you know, things like that. So they're realizing that yes, as a telemedicine doctor,, it's valuable to have other people.
See your patients if they live in different states. So that's awesome. yeah. Yeah. And I also think too,it's, I think it's global for providers,for nurse practitioners, they also have, I have no, I don't really track nurse practitioner stuff too close, but I know they have a number of states Yeah.
That they're able to do. IMLC. Yeah. Physician assistants are up to 19 now. and they're having again, like a slower role. Yeah. But it is pretty interesting. All of these states are really trying to make it as easy for physicians and providers to be able to, one, just be clinicians and not have to worry Too difficult about like the red tape and the barriers.
Yeah. But I also think they're removing as many potential barriers as possible. To [00:26:00] make it so that you can, work in other states, you can do virtual care, and you can actually like work at ease. Yeah. One interesting thing tied to this is a lot of these states are also issuing, bans on non-compete.
Which I think is really, that's interesting. Interesting. I have, I did a post about it, but there's a number of states and it's almost like growing by the day that are issuing these bans on non-competes California, of course, being the first. Yep. but ultimately,what are they saying there?
It's we don't have enough providers and you're not gonna sell your soul to one. You know, company, we are not gonna allow that anymore. and so it's just, kind of an interesting add-on to, the IMLC stuff. Yeah, no, definitely breaking down barriers. Um, so that's, that's very promising, , for this market.
yeah. The 50 state licensed doctors, there's gonna be more and more. It's just gonna be easier. and I think for the better. Just better access [00:27:00] and, Yeah, hopefully we see more doctors, more specialists too, needed to improve access.
Um, okay. So, , one other, like my last big topic, and this is actually like hot off the press, geez Louise, like this just happened yesterday or the day before. But again, one of the big things this administration is really pushing is how can we. how can we improve interoperability, data sharing, patient navigation.
Like how can we make this whole system like so much easier? And this week, the White House, it was interesting. They were doing,like techy stuff, right? Like the White House was releasing these like plugs and promo videos that they have, like this amazing update coming around,
potential innovation. and so this week they hosted, an event. That basically says that they are starting an initiative called the CMS Health Tech Ecosystem. And they've tapped the shoulder of about [00:28:00] 60 healthcare companies and different tech firms, to really. Start collaborating together to solve this problem.
And like when I say like they tapped tech firms like, I mean like Amazon, apple, Google, OpenAI, anthropic, like big fricking names, in this business. To where they can really focus on some like core pillars. mainly to just one, I think make healthcare a little bit more equitable, but also to just streamline stuff so it's not so clunky.
Yeah, no, this is,this is interesting ' cause further validates, health tech, telemedicine, so forth and so on. what I wonder what the 60 companies are. Trying to look it up right now, but No, that's interesting to see who they tap though. just quick look, ai, big ai, I think one of the AI gurus is one of the leads of this.
So it goes to show, one major focus. and, really it's gonna [00:29:00] be interesting to see what metrics they're tracking as well, access for sure. and how do they do that? And across the board. yeah. Yeah, there really it's there, there's a few key issues that they're focusing on.
So they're focusing on two main buckets here. Like one is like just basic interoperability, which I mean, I think. For people who don't know what that means, or basic, really it's like, how can we, how can you just continuously share data across systems, across teams and not have to provide the same information?
How can we share care plans? How can we share intake forms? How can we share, patient records and patient data versus, you having to provide all that information again? To providers, health plans, so on, so forth. and again, working across different networks and EHRs and tech platforms Yeah.
To do that, I think is the one big thing. California, again has been working on something, that they've called the data exchange framework. For the past few years. and I think California's [00:30:00] really hoping that they'll look at some of their learnings to be able to go this has worked and this hasn't, to try and like actually make it, come to life because it, it's a big thing.
It's a huge problem. Yeah. And that's why I think it's really cool that the federal government, because my, you know, my stance has always been if it's, if it's not done at the top down, like it's really not necessarily gonna work. And you're right, this is a big issue, working telemedicine companies, asking the patient what their history is and it only goes so far, right?
and trying to get the patient's data, trying to get, their records. a lot of times, sometimes, most of the times we're running blind on this and yeah, this is gonna be a good thing for patients and patient care and just universal. Yeah. Quality, universal quality care across,if we're able to see their chart across multiple systems, EHR, so forth and so on.
yeah, no, I'm looking forward to hopefully this succeeds and looking forward to, the operation of this. It's, yeah, it's gonna make the job a lot [00:31:00] easier just working throughout. Yeah. and I also think too, like they're also trying to streamline other types of things.
So like they're, leaning into kind of like apps and digital services Yeah. To like, you know, no more like paper forms. believe it, like people still use paper forms , like, you know, like, you know, building in more like conversational, like AI assistance for like, appointment scheduling and care navigation.
some of that stuff. And then of course, like really trying to get back onto like prevention and like, you know, quality and so focusing on like diabetes and o obesity management and some of those like key areas. so yeah, I'm again, like I'm all for it. Let's totally see, let's see how it goes with, All these big names in the same room. Let's see what people can agree on. A lot of cooks in the kitchen there though. We'll see. We'll see what happens. just a few big personalities, I assume. Oh, man. but no, hoping this one goes through actually. 'cause again, yeah, this would be great for patient [00:32:00] care.
Um, , so my next story is this telehealth kiosk pilot program in this small Texas county and Webb County.
And it involves this small area that has, what, 800 people in the population and really no full-time doctors in their community. So Access, I was reading up and Access the closest full-time doctor is about an hour away. And this is in what? Bruney, Texas. and what happened is this, company one med care station.
Basically create a kiosk, this virtual health kiosk with this big old touchscreen that's, very intuitive and interactive. And, patients go into this booth and are seen by medical providers in this kiosk. And it's, the initial response is very positive. people are going in and instead of traveling an hour away to [00:33:00] see somebody, they could pop in this little booth.
Get seen. and, I think this is a positive sign. one of my big positives in telemedicine is, hey, we could reach out into these communities that don't have access themselves. And right now I think it's just, this is primary care, acute care, the possibilities are endless.
You could reach out to specialty care. And this kiosk has like a full body screen, right? instead of this kind of face-to-face and things cut off, the patients are actually like standing full body and you could actually see, so a better virtual kind of, exam as much as you can, right?
But a better virtual exam. 'cause you could see the entire person. and this, the cost of this residence is act is actually free, right? subsidized by a big insurance company for better, for worse. So yeah, and they're trying to expand, they're trying to expand to more areas without [00:34:00] access and, yeah, it is, it'd be interesting to see how far this goes, it's looking like they're going to other parts of east and south Texas where again, access is limited.
You have to go, Texas is huge, right? And you have to go far out just to get somewhere. yeah, so check it out, check out the story, and check out the website. it's one med care station and it's cool, the technology's there and,yeah, you can almost, it's, it looks like one of those, like privacy booths in like the airports and whatnot and yeah, it's just, you just duck in and, you know, there's like an occupied sign.
it's almost like one big,mobile laboratory almost, Yeah. It turns red and whatnot,. Pretty interesting. I thought. Yeah. I am surprised that they haven't piloted more of these, given, I think, like you had said, like it is funded by, A large payer, but like it isn't every payer's best interest to have people go Absolutely.
To the doctor and get like preventative [00:35:00] care. Yeah. And so for me, I think one of the interesting things of like when I was working on some of the, my, my public health initiatives, how many people actually don't understand how to use any sort of technology mixed in with, With healthcare.
Yeah. And so part of it is I think it's just interesting that you're giving people the opportunity to like one, not just see a provider, but also if you don't have the right technology to be able to do it at home. Which I again, I mean I live in a populated area like Leo, like you live in paradise.
I think that piece of it is yeah, we just, we forget that these rural, like rural communities also don't quite understand how to effectively like, use telemedicine as it is. No, it's a, that's actually a great point and I'm glad you made it. 'cause one of the big speed bumps, one of the big inhibitors of expansion of telemedicine is this technology access, or not just access, but.
Technology knowledge. I was, I remember talking to [00:36:00] this one telemedicine company that was trying to expand into reservations and, native,native populations. And it wasn't the lack of need, but it was just the lack of one high speed internet access, And two, just knowledge of how to use the technology.
So. Yeah, I think this is great. It's bridging that gap so people don't have to figure out, how to get access. 'cause it's just given to them and they don't have to figure out how to set up their computer, their cameras. especially in the older population. You know, that's part of the problem is they just can't do the video consult 'cause they can't just figure it out.
and we get that story a lot from, current telemedicine providers. no, that's a good point. Is that. They basically spoonfeed the technology and the access make it more accessible too. So not just location, actually giving them the tools to do so. Yeah, I would be interested to see like the utilization data around it and has there [00:37:00] been uptick, Yeah, I have like forever wanted to use, like vending machines as a way to like.
Further increase, like I think like in my drink, if I was like a multimillionaire, like I would have like, you know, like I would have like vening machines on every single corner with like over the counter birth control and condoms and all the things that I think people, especially either like you're in a rural place or you're in a like lower income like that you struggle.
To me, I think this is the future of where we're going. And I think, I think it's really cool. Just imagine if pharmacies get into this too and like instill like a vending pharmacy in this,And Yeah. the doctor prescribes it and common drugs, their anti-hypertensive pills just get vented right there.
That would be interesting. Yeah, I would be surprised. Like I would be surprised, like it's almost like they would, they should tie these to a pharmacy or, something. I don't know if they're, how, [00:38:00] if there's local pharmacies there or not, how that works. again, like that's something I've seen in rural communities of like actually the pharmacy was more of the like care station than Yeah.
An actual hospital or office because. you have a pharmacy and a Rite Aid or something. Yeah. And so they would actually like really try to like closely tie, because I think there were more access to pharmacies. But yeah, again, there's so much you can do with this, especially like when it comes to the follow-up care that's needed.
it'll be interesting to see how successful it's, yeah. No, it'd be interesting to get a follow up on this,maybe what, like half a year down the line to see how this pans out. so no, that'd be fun to see. Yeah. Cool. that's all I got, in terms of this month's kind of wrap up.
anything else? No. yeah, like I said, you can, I did a post about it. Y'all can check out my, I Instagram if you are interested. But yeah, for the most part, still lots coming out on federal government stuff. I didn't wanna [00:39:00] bore everybody with another one about my, my, Medicare, Medicaid.
but there's a lot of implications, like in some of those things. one topic that I was gonna bring up, but I don't, it's really not relevant at all. but I thought it was really interesting and I don't know, maybe Leah, we can get your perspective. Is like how in the one big beautiful bill they did cap, student loans and how that could, or how that is gonna impact the future of medical students and who actually goes to medical school and who doesn't.
Yes. Yeah. Actually that was a big issue. I've seen articles on that saying that. Yeah. yeah, we should talk about that more. 'cause that's an interesting topic. Maybe we could talk about that next time. Yeah. But that was one thing that I was like, again, coming from somebody who is completely self-made, I, like I, I would not have been able to fund medical school myself.
And it'll be interesting to see like, is the doctor shortage going to get worse? And I think the answer is probably yes. Oh, absolutely. [00:40:00] Absolutely. I think it will, I think it will, especially. Especially also the view on medical school and being a doctor nowadays, right? And the challenges and the burnout and this and that.
So yeah, we're gonna see the shortage just get worse and, this access issue become more prevalent, Yep. Yeah. for those out there listening, if you have any. Great ideas or topics you want us to talk about or research or you thought, hey, this was cool. just drop us a line info@telemedicinetalk.com.
and our personal contacts are leo@telemedicinetalks.com and phoebe@telemedicinetax.com. Pretty simple. definitely subscribe and we will see you again next time. Chow. Aloha.