Telehealth Platform Requirements for Small Practices

Smaller practices do not have money to burn on failed technology implementations, so finding the right application is crucial to the overall experience. These practices should carefully consider how telehealth could set them apart from their competitors by solving a specific problem. Typically the problem solved is one of convenience; telehealth improves access to care by allowing the doctor or midlevel to travel virtually to the patient. This convenience is a key benefit of these services for patients, along with the reduction in overhead costs for providers.

But a telehealth service line isn’t appropriate for every type of care, so understanding the target audience and the health needs you will solve with the service is important. Discussing how the service will roll out is also important if you want patients to actually leverage telehealth.

Generally speaking, the telemedicine platform should solve a problem in your practice and provide a value-add to both patients and providers. Understanding upfront your goals and the benefits you’re seeking will help you create a more positive experience for everyone involved.

You have options for how to deliver the service. Telemedicine can be offered via secure video conferencing or you can use it to send large files for consultative purposes in an asynchronous or store-and-forward model. Or, store-and-forward can be used to create a patient portal where patients can “chat” with a doctor or other provider. The patient can answer prepared questions and the clinician can respond, or upload images. The asynchronous application of telemedicine works well for patients with chronic conditions that require frequent monitoring, or even for post-surgical patients.

Most states allow the video visit and most payers reimburse for these tools. It makes for a more flexible option for patients and providers. Both telehealth options meet the quadruple aim of enhancing access; lowering costs; improving care quality; and reducing physician burnout.

The process of introducing a telemedicine option to patients in a small clinical setting requires practice staff to look at workflows to consider how the technology will lend itself to your already-established processes – and what will need to change. Good questions to ask your telehealth vendor at this point include:

• What steps have been taken to make the platform HIPAA-compliant?
• Do all devices support the software?
• Can the software be branded to fit your practice?
• How user-friendly is the software?
• Can it integrate with an EMR?
• How secure are these tools?

The goal is to not create additional workflows that create more headaches but to look for software and create a process that is simple but effective. One issue to consider is that in many cases the telemedicine software was created post-EMR, so integrating these tools takes a bit of work by the vendor to make things seamless. Also ask your vendor if they can help your providers with “webside manner,” so that they will feel comfortable before going live with the service.

Reimbursement models have widely improved for telemedicine visits, with CMS broadening what’s covered in their 2019 Physician Fee Schedule. They added additional originating sites and geographic exemptions, as well as adding new codes for remote physiologic monitoring and chronic care management.

Click here to read the Center for Connected Health Policy’s Fact Sheet on the Finalized CY 2019 Physician Fee Schedule.

On the private payer side, 37 states and the District of Columbia have parity laws that require payers to reimburse the same whether the visit is virtual or on-site. In most states, the laws prohibit insurers from withholding telehealth reimbursement based on the location of the patient. This means the patient can have a visit from their home or office, which is a unique benefit of the service. But it should be noted the benefit cuts both ways; clinicians do not have to travel to a clinical setting to make use of these tools.

One reimbursement tip for the small practice: Some states define telehealth or telemedicine as services offered in real-time, which means store-and-forward technologies are excluded. Your telehealth vendor should know what service would work best in your area.

Too, billing for telehealth with private payers is certainly different from Medicare or Medicaid. Some payers require modifier codes, some do not, and this includes CMS. As for any reimbursable service, check with your payer for more details.

One thing to note: The cost savings is clear for small practices due to the reduction in overhead that comes from a virtual visit. These visits are also typically shorter, which will stretch reimbursement further. The impact on a small practice could be considerable.

One of the biggest mistakes we see in small practices rolling out telehealth is the assumption that they can launch and patients will just instinctively want to use the service. After picking a telehealth service, practices must then promote the tools so patients will make the transition. Any new service line must be supported with education and promotion, whether it’s virtual care or some other clinical offering.

Creating patient materials that show the benefit of the service for busy or sick patients is important. Practice staff must be coached on how to promote these tools to patients. Just like doctors and clinical staff, your patients must understand how to use these tools and why they’re changing healthcare in new ways to improve patient engagement, access, and satisfaction.

OrthoLive offers a HIPAA-compliant, secure, and low-cost telehealth tool for orthopedic practices. It’s a viable option particularly for the small clinical provider, although the application easily scales to larger practices.

Talk to our team about using telemedicine to improve the lives of your patients and your practice providers.