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Telehealth today and tomorrow Part One

Telehealth is the key to surviving our current crisis. Later, it will be essential to practice success. Here’s what to consider when offering telehealth services, along with a look at the future of telehealth for practice success.

Part one of a two-part series that covers the steps to take now and in the near future to secure a thriving practice.

With the arrival of the novel coronavirus, telehealth technology has become a necessity. But this necessity has kickstarted a massive trend to come: Long after the national health emergency ends, virtual care will become a preferred mode of care to patients and their doctors.

Before deciding on the right telehealth technology, private practices have many considerations to take into account — to survive as a business in the near term, and thrive in the future.

The in-office, personal relationship between healthcare providers and patients has always been at the center of care. That human interaction will never go away, nor should it. The COVID-19 pandemic, however, has forced practices to adjust that connection, using telehealth to maintain both the continuity of care and the trusted doctor-patient relationship. Telehealth is a rapid response to this modern crisis, but it will have lasting impact, with a variety of healthcare benefits.

The rise of telehealth

Telehealth has gained popularity in a few different ways. In the first scenario, it has been used increasingly within forward-thinking health systems that are looking to improve follow-up care, bring convenience to patients, and cut costs.

In the second scenario, large telehealth networks cater to patients with hundreds of on-call doctors. In most cases, a patient logs in to an online network and sees an available physician. This serves a valuable need for immediate care, but the patient doesn’t get to see their local, trusted doctor.

Before the need to expand care during the crisis, private practices had limited opportunities to use telehealth for care and receive reimbursement for their services. For instance, telehealth for typical E/M visits had been generally restricted to patients in rural areas, who lack easy access to care, or in healthcare facilities.

Now adopting telehealth has become an immediate, pressing need for nearly all healthcare providers. In a PatientPop March 2020 survey of private practices, nine out of ten expressed interest in a telehealth solution, reflecting the technology’s new status as a care necessity.

Changing telehealth regulations and requirements

Government and insurance telehealth requirements have been recently relaxed, or removed altogether, in response to COVID-19. These changes, enacted with remarkable speed, are expected to set the stage for the widespread adoption of telehealth in the near future. It’s unlikely that all loosened requirements will remain after the pandemic, but some may not revert back. The reality is probably somewhere in the middle.

There are a number of factors that indicate the healthcare industry is likely to hold onto expanded telehealth use.

  • A high volume of patients will have experienced the convenience of virtual care and, similar to the change in consumer habits after first trying Uber or Amazon, will want that option all the time.
  • Practices will see the savings in time, the opportunity to see more patients, and the potential of better outcomes.
  • With hospitals and large healthcare systems expending major efforts to integrate more telehealth into their operations, it will be difficult to revert back to the traditional restrictions that may nullify some of that work.

Summary of regulatory updates for Medicare during the COVID-19 pandemic:

Here are some of the changes CMS has enacted for Medicare patients to help them access care:

  • Patient location expansion. A patient no longer needs to reside in a rural area or be in a healthcare setting to receive virtual care from a doctor or other healthcare professional. Being at home is acceptable.
  • Technology expansion. Private practices can now use a wider array of communication tools for virtual care, as well as the defined “telehealth” use of synchronous audio and video. Doctors can even use non-HIPAA-compliant video conferencing tools, allowing for increased access to care during the pandemic (more about this usage after a pandemic discussed below).
  • Provider expansion. There are now more specialists and types of providers who can use telehealth with their patients. Federal rules have also been relaxed to allow some doctors to work across state lines. AMA guidance for treating Medicare patients allows for the temporary waiver of regulations that require a provider to be licensed in the state where they deliver care services.
  • Patient cost-sharing rule removal. For many types of visits, doctors can waive patient obligations (including copays) at their discretion. In some instances, waiving patient cost-sharing is mandated. This varies by state and insurance provider.

Telehealth payments are also moving toward parity with reimbursements for care delivered in person. Before the national health emergency, 10 states had payment parity between in-person and virtual care. Now, CMS is reimbursing telehealth visits at the same rate as in-person visits. Commercial payers, which often follow the lead of CMS, are also expanding opportunities for network providers to utilize telehealth.

Procedure codes for usual office visits have also been modified so all providers can conduct those visits virtually, and properly bill for them.

Telehealth solutions: What to do now

In the current crisis, you may have quickly selected a video platform to help bring you through the current crisis. Or, you may have referred your patients to telehealth networks.

You may want to also think ahead to a more comprehensive telehealth approach. There are several considerations to review.

The most important is that medicine will no longer be practiced the way it was before the global pandemic, and you can take advantage of the many benefits to your business and patients.


Benefits for the patient

  • Today. With stay-at-home orders in place across the nation, virtual care visits are safe and convenient as the first consultation or ‘port of care’ for quick check-ins and follow-ups after an initial visit, or for ongoing or chronic care management.
  • Tomorrow. If your practice continues to offer telehealth after COVID-19, your patients gain from this convenience, as well as the continuity of care you can deliver by supplementing an in-person visit with virtual care visits. As their usual practitioner, you’re uniquely positioned to meet this need: you know them best and have the ‘whole picture’ for treatment. This includes their medical history, personal history, lifestyle, recent health, and treatment preferences. Patients feel most comfortable when their usual doctor can conduct follow-up appointments and ongoing care management.


Benefits for your practice

  • Today. Virtual visits can help your practice bring in new patients and keep seeing current patients who might otherwise have turned to a telehealth network for care.
  • Tomorrow. Telehealth visits can reduce no-show appointments, and keep appointments streamlined and efficient, with measurable time savings for both you and your patients. This affords your practice the ability to see more patients when desired or needed, along with in-office appointments.

You can also use telehealth as a patient acquisition tool when you continue to market your telehealth services in online search, across your web profiles, and on your practice website. (See more below).

Caution: There are ‘hidden’ drawbacks to certain telehealth solutions

Along with the benefits of telehealth come specific pitfalls of some solutions.


Drawbacks of ‘quick-fix’ video-app-only solutions

For the duration of the COVID-19 crisis, regulators have relaxed telehealth requirements to increase patient access to care. That means private practices can use non-HIPAA-compliant two-way video technologies such as FaceTime, Zoom, or Skype as a temporary option. However, these don’t meet HIPAA compliance requirements. After the national emergency lifts, providers should be prepared to shift to a compliant solution to continue with telehealth appointments.

Video apps that lack HIPAA compliance aren’t designed for healthcare and, therefore, can’t be integrated into your practice management system. This makes it difficult to manage patient volume for an extended period of time, and forces your staff to move back and forth between the stand-alone video app and your pre-existing practice management system.

These apps also lack the tools to really help your practice work efficiently. They don’t have features that allow your staff to manage virtual visit schedules, send appointment confirmations and reminders, process patient intake forms, and take secure patient payments.


Drawbacks to ‘referring’ your patients to telehealth networks

If your patients have health concerns during the COVID-19 crisis, and you don’t offer virtual visits as an option, patients may ask you to recommend a telehealth network. They will almost always prefer to see you, but will seek another way to meet their needs if necessary.

Large telehealth-only networks can be useful but, by their own admission, they’re intended to fill gaps in between visits with a patient’s usual providers.

Now is the time for your practice to begin offering an alternative to these networks, or risk losing opportunities to see your own patients.


The best telehealth scenario for practices going forward 

You are best positioned for future business success and improved patient satisfaction if you adopt an end-to-end telehealth solution that works with your business, and  regulatory, compliance, security, and workflow requirements.


Part Two of the series will be published on Thursday, April 23, and focuses on what practices should look for in a telehealth platform, and how telehealth could work with other smart devices and technologies in the future.

Learn more about PatientPop Telehealth by visiting patientpop.com/telehealth.

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