Telehealth best practices: Building a long-term workflow

In the wake of the COVID-19 outbreak many health care practices were forced to implement telehealth as quickly as possible, and often didn’t have enough runway to deeply consider an ideal long-term workflow. If your practices’ initial reaction was to put something in place that was good enough for now but could be phased out in a few months when everything went back to “normal,” you are certainly not alone.

The writing is on the wall; the use of telemedicine will not only be critical for managing this pandemic but will fundamentally change how care is delivered moving forward. In fact, some experts predict 20-30 percent of routine visits will continue to be virtual ones moving forward.

After quickly implementing a short term solution, practices now find themselves evaluating their long term telehealth future at a time where driving efficiency and value is absolutely critical. As groups start to look ahead, it’s important to remember that telehealth is not a one-size-fits-all approach. After working closely with hundreds of practices across a wide variety of specialties, here’s what we’ve learned about telehealth best practices from those that have been the most successful at incorporating telemedicine.

TAKE AN INTEGRATED APPROACH

You’ve already invested time, effort, and money into your current systems and clinical workflows. Your telehealth solution should plug right in and work directly with those systems already in place, not outside of them. A virtual visit should be just as efficient, if not more than an in-person office visit. The more systems that integrate together, the less effort required of the practice and/or providers to onboard and manage. For example, why not interface your practice management system with your telehealth solution? Send automated appointment reminders based on the clinic schedule, conduct the virtual visit, and bill for the encounter, all from one place.

HAVE A PLAN FOR PRE- AND POST-VISIT COMMUNICATION

Just like a face-to-face visit, virtual encounters start well before the patient connects with their doctor and extends past when they hang up. Build a workflow that utilizes the office staff to frontload the onboarding of your patients to make sure they are ready to go when it comes time for their visit, and reduces the administrative burden on the providers. Reducing the burden on office staff is also a key consideration. For example, staff can enroll patients at the time an appointment is scheduled and set an automated appointment reminder to send 48 hours prior to cut down on manual follow-up. On the day of the appointment, a medical assistant (M.A.) can handle the check-in process and record any self-taken vitals, queuing up the patient for the provider. Once the visit is complete, staff can schedule a follow-up appointment or touch base regarding any outstanding items like labs or prescriptions via secure text messaging. Integrating key team members and all of the pre- and post-visit communication into your overall telehealth workflow will ensure virtual visits run as smoothly as your office visits.

DON’T BECOME CUSTOMER SUPPORT

You are not technical support, nor should you have to be. You have enough going on in your practice without having to troubleshoot technical issues with a telehealth platform for your patients. To reduce the risk of no-shows and rescheduled visits due to technical difficulties, it's important for patients to have easy access to fast, reliable customer service.

STANDARDIZE YOUR TELEHEALTH WORKFLOW

There are numerous telehealth solutions available ranging in quality, security, functionality, and price, but when you find a solution that fits your needs, it is important for everyone to use the same system. Complexity and room for error increase when each provider is using a different platform, forcing the office staff to search within multiple systems for needed information. Not to mention managing multiple workflows and fielding questions for each disparate system - what a headache! When telehealth visits are all done on the same platform and tied to a patient record, you can ensure providers and staff are on the same page.

DON’T BOTHER WITH SINGLE-USE SOLUTIONS

There is more to telehealth than just video communication. Why have multiple communication systems when you can use one that allows you to communicate internally, with referring physicians and colleagues, and also with patients? Care gaps happen when health care teams are forced to manage a complicated web of disparate solutions. You should be able to manage every step of the virtual visit process, from sending appointment reminders to patients, documenting and billing for encounters, and conducting post-visit follow-up, all from the same place.

Budgets are tight right now. During the height of the COVID-19 pandemic, virtual visits may have represented the vast majority, if not all office visits, justifying the investment in telehealth as a standalone solution. As offices begin to re-open, telehealth will undoubtedly continue to play a vital role in care moving forward, but the percentage of virtual visits is expected to decrease. If virtual visits only represent a quarter of your total visit volume, it will become essential for telehealth solutions to drive value and revenue in other areas of your practice as well, such as secure communication, charge capture, or care coordination.

ENABLE TRANSPARENT REPORTING & DOCUMENTATION OF TELEHEALTH VISITS

The last thing you want to worry about is being able to provide adequate proof of your telehealth encounters, especially when payors start to implement restrictions. Accurate, detailed reporting and documentation features will be key to ensure you receive the maximum reimbursements. All calls should be time-stamped and associated with a specific patient profile, making it easy to provide proof of all encounters.

MAINTAIN HIGH LEVELS OF SECURITY WHEN USING TELEHEALTH

Yes, it’s true, enforcement of HIPAA compliance has been temporarily relaxed under these extraordinary circumstances. But experts don’t expect that to last. Plus, why gamble with the security of your patient’s personal health information (PHI) information when there are other options? As the health care industry works to establish a new normal, practices know that any long-term solution needs to be secure in order to reduce the potential disruption and financial risk as policies continue to evolve.

Ted Ranney is vice president of business development at pMD. A 25+ year veteran of the health care industry, Ted is the former CEO of Pima Heart, a predominant cardiovascular group in Tucson, AZ, and currently heads business development for pMD.

pMD was founded over 20 years ago with the mission to reduce medical errors and save patient lives, and have developed a set of products and services to support this mission. The HIPAA-compliant software arms health care professionals with powerful, intuitive mobile tools that improve patient care. With pMD's secure communication, telehealth, and data capture platforms, health care teams finally have an elegant and simple technology to maximize efficiency and collaboration, capturing everything right at the point of care, and driving value across the workflow.