Crucial Considerations for Integrating Telemedicine and Telehealth in your Practice

Healthcare delivery through telehealth platforms has been around for several years now. However, the coronavirus crisis has resulted in an unusual surge in telehealth’s adoption- one happening at a rate never before observed.

According to a recent study published by Emarketer, 53% of the healthcare practitioners surveyed said they were using telemedicine because of the limitations imposed by COVID-19, but they had never used this technology before the onset of the pandemic. Another survey conducted by WayToGoal healthcare market research group showed that this widespread adoption is changing the way providers perceive telehealth and many expect to use telehealth in the long term, even without pandemic restrictions. 

Today, millions of Americans are getting care by connecting with a doctor electronically. It effectively mitigates the spread of the COVID-19 and other infections and increases protection for frontline health workers.

For healthcare providers delivering care during the pandemic and beyond, extending their practice virtually or even switching to a completely virtual practice just makes sense. Of course, adding or switching to telehealth practice is easier said than done. Here are some important considerations to take into account before integrating telemedicine into your practice.

1) Licensing and Other Regulatory Obligations

The first question of course is understanding the legal landscape for telemedicine. For example: 

  • If your patient is located in a different state than your practice, will you be considered eligible to practice telemedicine in the state where the patient resides? If yes, will you be required to gain licensure first?  
  • If you’re licensed and in compliance with regulatory constraints, would each physician who will be providing the tele-service appropriately credentialed by the facility in which the patient is receiving care, or otherwise following regulatory obligations and privilege? 

Apart from the points mentioned above, it is also important to remember that a telemedicine practice is required to comply with certain regulatory barriers, such as those from organizations such as the Food and Drug Administration (FDA), the Centers for Medicaid and Medicare Services (CMS), etc. 

Hence, it is crucial to ensure you are well-acquainted with all the telehealth regulations — not only from the state you practice from, but also for the state(s) where the majority of your patients are going to be located. You also want to make sure that you have all the necessary operational processes, staff, and skills to monitor the changing regulatory landscape in place. 

For a quick overview of common regulatory and reimbursement concerns, check out our on-demand Getting Started With Telemedicine webinar #3 – Getting Paid for Telemedicine  with healthcare attorney Anjali Dooley and healthcare compliance expert Mary Jean Sage.

2) Adhering to HIPAA Privacy and Security Rules

With the ever-increasing amount of healthcare data being stored and shared electronically, it has become imperative for providers to ensure that they are partnering with reputable companies. The Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) Act require providers to have a Business Associate Agreement (BAA) with any vendor that touches their patients’ Protected Health Information (PHI). The BAA simply makes the vendor legally responsible for any breaches of PHI that may occur. Thus providers should make sure that any service or technology they use that stores, exchanges, or maintains patient PHI are willing to sign a BAA and that they are adhering to these regulations and following data security best practices. This applies to a variety of services and technologies such as legal services provided by law offices, practice management systems, scheduling software, telehealth platforms, remote patient monitoring systems, and video chat apps. 

Doing this requires added measures for securing resource requirements, workflows, and technical architecture investments. Providers need to make sure that compliance is maintained at every single level of their data management model—right from the moment when it enters their system to when it leaves it.

You can try looking for a partner with demonstrated success in your particular industry when it comes to managing security in terms of how and where protected health information is stored, circulated, updated, and accessed, and how those handling this information are both monitored around the clock as well as trained to handle issues. 

3) Training your Staff well

In order for you to achieve the most favorable clinical and financial outcomes from your telemedicine program, you might be required to make a few alterations to your operational protocols. 

That’s because with a telemedicine platform, you’re bringing in way more than only a fresh piece of technology—you’re bringing in an entire opportunity to augment the way in which you deliver care. 

Your staff not only needs to learn how to use the new technology, but also when to use it (and when not to), and how to integrate it into their daily workflows. Nurse Practitioners, physician partners, and allied staff affected by the protocols will also be required to receive some form of preliminary training pertaining to their role in the process. 

Apart from this, your entire staff will also need training on integrating telehealth into their existing workflow—right from imaging, laboratory functions, registration and billing, to pharmacy, and follow-up—based on the requirements of your telemedicine program. 

4) Deciding on Technology Integration and Requirements

A number of new-age technologies are taking the world of telehealth by storm at present.  Not only do these include commonly employed video-conferencing solutions like telemedicine carts, but also the peripheral diagnostic devices used to monitor patients in remote settings.

1 out of every 4 deaths in the United States is a result of cardiovascular disease. That translates to a death every 37 seconds in the US alone. Remote patient monitoring can bring down the mortality rates and improve the patient outcomes by helping with early detection of underlying issues and ensuring rapid medical response to cardiac conditions. 

What often goes unnoticed is both the potential of this technology to integrate into existing processes, workflows, and infrastructure; and for it to be able to scale for broader use. 

The technologies chosen to be integrated should hold the potential to be put to use easily by all providers across the organization’s departments. The same goes for whether or not it can be integrated with the institution’s imaging infrastructure, EMR or EHR, and lab systems running atop the enterprise-wide security infrastructure with single sign-on. 

Simply put, whatever partner you choose should be capable of validating and demonstrating how the technology can integrate with the workflows, protocols, and equipment you already possess, or how things need to change to be clinically safe, and operationally and fiscally efficient. 

You need to constantly think of ways to adapt and innovate in order to achieve telemedicine success.

5) Streamlining Billing-related Procedures

Billing is a feature providers often completely fail to pay heed to when telemedicine programs are piloted. You’ll first need to figure out the procedure for ensuring precise billing for both professional fees and facility fees of your staff as well as partners, so you don’t find yourself on the wrong side of a call from the concerned authorities. 

You will also need to figure out what codes should be used for telemedicine billing, and whether your site will be able to benefit from facility fees. Another usual challenge is understanding how to equitably compensate a team of physicians supporting a service when they themselves have to pay disparity. 

Consider how you’ll address disparate pay scales for providers participating in your telemedicine solution. If your specialists live and typically practice in a large metropolitan area, they will invariably be paid a higher rate than where a patient in a remote, rural area resides. However, reimbursement will likely be linked to the patient’s location, not the provider’s. 

6) Furnishing an Exceptional Patient Onboarding Experience

Lastly, it is extremely crucial to remember that while telemedicine makes accessing care convenient for patients, they can often also be hesitant when it comes to embracing it in their daily lives. A few of your patients might not historically be technologically savvy and might end up feeling that they can’t use something like telemedicine because they won’t always have the backup or help that they need.

Getting your patients onboard with telemedicine more often than not demands that you show them the benefits that come alongside its adoption, and not simply tell them that. By telling them it is going to be easy, they may still hesitate. By walking them through the experience to show that the actual connection takes far less time and effort, they will be confident to attempt doing it by themselves without supervision. 

The effort on the part of the organization can be as little as 5-10 minutes, but the outcomes can significantly create opportunities for transportation-less care for those who struggle to get to sessions, increase telemedicine utilization, and provide additional opportunities for follow up once other obstacles are removed.

Integrating telemedicine with your healthcare practice is really more about the effort you put in than the time or money you invest. This is one of those technologies that can get you instant results and contribute toward ameliorating your practice’s bottomline when done right. 

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