Over the past several months, providers and their patients have had to ramp up telehealth in a hurry. Although reviews are early, usage is on the rise and both clearly acknowledge the potential for telehealth in everyday practice. But providers also say they struggle to “see” as many patients a day through telehealth as they do in-person. And patients, well…they’re still not clear on how the whole thing works. Do they download an app somewhere? Is the tele-visit covered by insurance? (And here’s something both doctors and patients should be asking: What if the Internet connection drops during the visit?)
Rather than leave these questions unaddressed as we usher more patients back to traditional in-person appointments, let’s continue moving forward on integrating telehealth effectively into healthcare organizations of all types and sizes. Doing so will give providers a tested, proven means for delivering a variety of appointments that make sense for the patients’ individual needs—and for staying in contact with our most vulnerable patients.
With that, here are some suggestions to make telehealth work better for doctors and their patients.
Behavioral Health, Interoperability and eConsent: Meeting the Demands of CMS Final Rule Compliance
In a webinar on April 16 at 1pm ET, Aneesh Chopra will moderate a discussion with executives from DocuSign, Velatura, and behavioral health providers on eConsent, health information exchange and compliance with the CMS Final Rule on interoperability.
Tip #1: Show the value of telehealth right away
This is hard to do if you try to transition all your patients to telehealth at once, so start with patients who need it the most. Right now, that definitely includes any patient who has or thinks they have contracted Covid-19. Even if their condition doesn’t currently require hospitalization, they are still frightened and isolated in their home. Often in their own room to reduce exposure to other family members.
These patients need to know someone—their doctor—cares. They also need to know how to treat their symptoms. (At this point, providers have more insights here than we all did earlier in the year. Give your patient up-to-date, evidence-based guidance beyond “if you feel short of breath, go to the ED.”) Telehealth is an ideal means for connecting with and supporting these patients during a difficult time. Documenting their symptoms is also an important contribution to public health.
Other patients who need additional support as we find our collective footing during the pandemic: new moms, many of whom may be experiencing post-partum issues; patients with chronic diseases that put them at higher risk if they contract COVID-19; and people trying to adhere to a substance abuse program.
Tip #2: Prep your patient ahead of the telehealth appointment Ahead of tele-visits, reach out to patients to make sure they know how to connect to the provider; that they have a working Internet connection; and importantly, understand they can fall back to just a telephonic call if the Internet connection is troublesome. That way, the tele-visit can proceed to the end.
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A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Pre-visit communication also allows the patient to ask questions about payment and what to expect.
On that note, it’s also a time to set patient expectations—on everything from the length of call to reminding the patient to find a quiet, private space during the tele-visit. Providers shouldn’t assume patients will always be at home. Many may need to conduct the tele-visit elsewhere for different reasons.
Sending patients a questionnaire ahead of time is one way to queue the conversation up, and many providers can do this through their patient portal.
Tip #3: “Room” patients. Just like you do for in-person appointments, have a nurse or MA begin the call, then queue the provider to enter. This improves efficiency, which can increase volume of tele-visits per day.
Tip #4: Put a clock in a visible spot over the provider’s head This helps the patient track the appointment length and reinforce originally set expectations about how long the appointment will last.
Tip #5: Control as many variables as you can
The most uncontrolled scenario for a telehealth visit is when both the provider and the patient are remote. Ideally, you want your physicians and staff to conduct the visit from a controlled office environment. This addresses certain HIPAA issues, limits potential IT issues and eases the rooming process. This scenario of having your provider in the clinic generally increases efficiency, reduces compliance concerns, and improves patient satisfaction with the visit.
Tip #6: At the beginning of the visit, confirm the patient’s location
This could be needed for emergency services, and again, we can’t assume the patient is conducting the tele-visit from home. They could be at a relative’s, or a parking lot with a stronger wi-fi signal.
Tip #7: Have a help desk for both patients and providers
This isn’t just for any technical issues that arise, although that is a primary reason to have a help desk. Depending on the platform used for telehealth visits, tech issues could range from the simple, such as a password request, to the more complex, like how to upload documentation from the visit into the EHR.
Many EHRs offer telehealth capabilities but come with an implementation and learning curve to optimize them for efficient use. A strong support system in place heads off potentially frustrating situations that lead to foregoing of telehealth. Moreover, a help desk can do much of the pre-communication ahead of the visit.
Tip #8: Measure patient and provider satisfaction. This is an emerging model of care. Check in with patients after their tele-visit to find out what they liked and what needs work. Ask the same of the providers and staff on the other side of the tele-visit.
Act on the findings as rapidly as you can. It will make telehealth work better and faster for your organization. In turn, patients will come to expect the quality care that telehealth with your organization consistently delivers.
Photo: nicescene, Getty Images
Jeanette Ball, RN, PCMH CCE, is a Client Solution Executive at IT consultancy CTG (NASDAQ: CTG).
