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Guide to Implementing Telemedicine in Your Practice

Posted by Michael Greiwe, MD on Apr 1, 2020 2:13:53 PM
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With the COVID-19 virus reaching crisis levels in the United States, healthcare providers must take steps to protect patients—and themselves.

Telemedicine, or the practice of providing care through video conferencing, is an important way to continue treating patients while enforcing social distancing. The Centers for Disease Control and Prevention (CDC) recommends practices leverage telemedicine for patient triage and treatment of non-urgent conditions. While these recommendations are important, many practice providers’ wonder about the steps necessary to add telemedicine to their practice. This article will help you understand telehealth tools and how to apply them.

Types of Telemedicine

There are four primary ways to implement telemedicine in your practice:

  • Real-time (synchronous) telemedicine, a service that offers live video conferencing with your patients.
  • Store-and-forward (asynchronous) telemedicine, which collects data and images, allowing you to review the information at a later time.
  • Remote patient monitoring, which can include transmission of biometric data from a patient’s wearable device to the provider.
  • Audio or texting via messaging technologies or a simple cellphone call.

No matter which telehealth technology you use in your practice, one primary consideration is the data security and HIPAA-compliance of the application. Commercial over-the-counter tools such as Skype has the potential to violate HIPAA rules, according to The HIPAA Guide. Healthcare providers should consider technologies that comply with all of the regulatory requirements for protected healthcare information.

How Can Telemedicine Benefit My Practice

Currently, social distancing is the primary preventative measure for the COVID-19 virus. That has elevated telemedicine into the spotlight as an effective means for providing quality care while keeping patients and healthcare providers safe.

Organizations as diverse as the World Health Organization, the CDC, and the American Hospital Association have suggested telemedicine as an effective way to lessen the spread of the coronavirus while still providing care to patients. Some of the current use cases for telemedicine include:

  • Providing supportive care to homebound, patients with chronic illnesses.
  • Care triage for patients with potentially mild presentations of the coronavirus.
  • Mental health support.
  • Routine post-surgical follow up care.
  • Patient education.
  • Provider-to-provider secondary consults.
  • Physical therapy.

COVID-19 symptoms present with a fever and dry cough. Unfortunately, these are also symptoms of seasonal flu or other illnesses. The influx of the “worried well” in addition to COVID-19 carriers has swarmed hospitals around the nation. Telemedicine is simply a better option.

Conducting the first visit by video would eliminate the spread of this highly contagious illness by completely avoiding the clinic waiting room. We now know that a hospital ERs were a primary vector for the spread of COVID-19 in Italy. Telemedicine can provide the necessary distance between the carrier and other at-risk patients and clinical teams.

Video visits are also highly efficient, allowing clinical teams stretched to the breaking point to work smarter.

In a recent article by The Economist, “Telemedicine is essential amid the covid-19 crisis and after it,” authors suggest that “remote healthcare is an important part of the response,” to the pandemic.

Guide to Implementing Telemedicine in Your Practice

Getting Started with Telemedicine

Once your practice determines that the use of a telemedicine application is the right approach, you must establish protocols for this new workflow. Here are several steps to consider:

  • Reach out to your private payers to understand coverage for these services.
  • Consider pre-screening protocols for your front desk team to determine which visits could be conducted via telehealth.
  • Determine when telehealth visits can occur, whether they are throughout the day or during specific time increments.
  • Set up a space to conduct the telemedicine visit.
  • Plan for adequately documenting and billing for these visits.
  • Talk with your telemedicine vendor about documenting patient consent.

Once your practice has decided to offer telemedicine, make certain you promote these visits as a way of supporting social distancing to protect your patients. Instructions should be listed on your practice website as well as conveyed by phone via scheduling or the front desk.

Getting Paid for Telemedicine

Historically, there were barriers to getting reimbursed for telemedicine. Private payers and CMS are rapidly eliminating these barriers and making it easier to adopt telehealth. As of April 1, 2020, CMS announced the addition of more than 80 new covered telehealth services, and they confirmed that all connected healthcare services would be reimbursed at the same rates as in-person visits.

While it’s clear that telehealth should not replace urgent or in-office visits, these reimbursement structures allow doctors to determine the best course of treatment that will also keep at-risk patients from unnecessary exposure to the COVID-19 virus.

While private payers have their own rules, of course, the CMS ruling is part of a national effort to promote telehealth as an effective model both for now, during the COVID-19 crisis, and for post-pandemic patient treatment. Some of the latest Medicare telehealth reimbursement changes include:

  • Patients can receive care from where they are; assisted living, hospice; at home, or in another facility.
  • Providers can now evaluate patients who only have audio phone access.
  • Home health agencies can use telehealth as long as it’s part of a patient’s care plan.
  • Doctors can provide a telemedicine visit even if they don’t have a pre-established patient relationship.
  • Clinicians can provide patient monitoring whether it’s for COVID-19 or a chronic condition.

Read the CMS Fact Sheet here.

Choosing the Right Telemedicine App

Telemedicine offers an opportunity for physicians to try the technology. Providing telemedicine to your patients isn’t a complicated process; with tools like SpringHealthLive, HIPAA-compliant telehealth technology is as close as your smartphone, tablet, laptop, or desktop.

The American Academy of Family Physicians (AAFP) recommends the use of telehealth tools to care for patients. Implementing telemedicine in your practice requires a few workflow changes, which we’ve outlined. However, with the influx of new applications like SpringHealthLive, adding telehealth to your practice takes just four key steps:

  • Download the SpringHealthLive app from the App Store onto your mobile device.
  • Enter your email and password.
  • Check the consent boxes.
  • Click “Enter Waiting Room” to join the videoconference.

SpringHealthLive was created by doctors for medical practice providers seeking to use the same technology in use at nearly 80% of U.S. hospitals today. SpringHealthLive is software-as-a-service (SaaS) that leverages the Internet to provide quality care to your patients.

For one low monthly fee, your practice can make use of telemedicine. Contact us and we can answer any questions you have about leveraging these critical tools to keep your patients and care teams safe.

Topics: About Telemedicine, "telehealth", "telemedicine", telehealth cost, CMS, telehealth parity, coronavirus, COVID-19