Finding the telehealth-life balance

The effect of telehealth on schedules

For providers offering telehealth, this means more virtual visits on the books — a link to follow, or a phone number to call, rather than an exam room to visit for a face-to-face interaction.

Prior to the pandemic, Medical Colleagues of Texas, a 12-provider multispecialty practice, did not offer telehealth appointments. As of mid-May, the practice conducted roughly 75% of its visits via telehealth, and the rest in person.

“We see approximately one face-to-face appointment per physician per hour and the rest via telemedicine,” said Practice Administrator Ethan Bing. “That way we remain productive while limiting patient exposure.”

Ethan said he expects these ratios to remain in place until stay-at-home orders are lifted, at which time the practice will begin to transition back to in-person appointments. However, he expects the practice to continue to offer telehealth appointments.

“I doubt we will stop them fully,” Ethan said. “Patients will demand them and that can’t be ignored.”

Whether telehealth is a fit depends on the specialty

Telehealth is a more likely fit for certain specialties than others.

Before the COVID-19 outbreak, radiology, psychiatry, internal medicine, neurology, and family medicine were the top specialties engaged with telemedicine, a 2019 study by Doximity found. Anesthesiology, general surgery, orthopedic surgery, OB-GYN, and oncology were the specialties least engaged.

The viability of telehealth may also depend on a practice’s location and patient population.

Hugh Chatham Memorial Hospital serves a largely rural population in North Carolina and Virginia through its network of 23 locations that offer specialty primary care, urgent care, and express care.

“Telemedicine has been a challenge,” said LeAnn Hooker, Clinical Coordinator Administrator. “It’s definitely been a challenge in a rural area, where patients struggle with technology and having access.”

The organization has focused on educating patients on how to use the technology, LeAnn said. The practices use Zoom to facilitate virtual visits.

If your practice is considering telehealth, here are a few questions to keep in mind:

• What are your reasons for implementing telehealth? What problems are you looking to resolve, and what goals do you want to achieve?
• Who needs to be involved? What kinds of workflows will telehealth introduce?
• How will you educate the care team?
• How will you make the case to your practice?
• How will you seek out and evaluate potential vendors?

For a detailed timeline with these and other steps, check out the Telehealth Implementation Playbook from the American Medical Association (AMA).

“We see approximately one face-to-face appointment per physician per hour and the rest via telemedicine. That way we remain productive while limiting patient exposure.”

Ethan Bing, practice administrator at Medical Colleagues of Texas

Opportunities telehealth brings to the table

There are many advantages of telehealth, as practices have found, most notably the reduction of exposure to COVID-19. In the weeks following the outbreak, it was one of the only ways to help patients outside of emergency care.

Still, implementing telehealth can be a struggle for practices unused to providing care this way. Traditionally, many held off due to questions about reimbursement, the 2019 MGMA study found.

On a recent webinar, we offered practical tips for billing telehealth services based on new regulations from the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS), and other agencies.

While these changes may be temporary, telehealth has lasting financial advantages. Providers can see greater numbers of patients via telehealth and see patients at any time. It’s more time efficient — provided there’s a good internet connection. Plus, no-shows create less of a financial burden.

In addition to financial benefits, telehealth cuts out the extra time spent moving patients around a facility. Patients are spared the need to travel to the facility, take time off from work, or arrange childcare.

For patients with chronic conditions, telehealth can expand access to care and provide a new way to stay in touch with providers about chronic conditions. Telehealth, coupled with patient engagement solutions, can provide education and counseling to encourage patients to make healthy decisions between visits. Click here to learn more about Greenway Care Coordination Services.

Tips for getting started

What if your practice is new to telehealth? You’re not alone. Given the rapid adoption of telehealth, many are struggling to understand the new technology.

Here are a few tips for a successful launch:

• Read up on state guidelines for the services being offered. Each U.S. state has different regulations and Medicaid guidelines concerning telehealth. Read up on payer guidelines as well, as these also will differ.
• Adhere to a prioritization plan based on local, regional, and national COVID-19 statistics and guidelines.
• Consider the needs of patients as they relate to available resources and prioritize the highest-risk patients. You can also rebalance the schedule by applying an objective priority scoring system such as the Medically Necessary Time-Sensitive (MeNTS) Scoring System. MeNTS is easy to share and communicate and can be used in a variety of medical settings.
• Have a contingency plan in place. For example, make sure staff is available to support all aspects of the care cycle and have a backup plan if staff members become unavailable. 
• Review cancelled and delayed appointments and look for opportunities to reschedule in-person appointments as telehealth appointments.

Your prioritization process and criteria may vary in real time. Communicating expectations of staff and patients will be key. If your practice wants to stay competitive and continue to provide quality care, telehealth provides an opportunity to do both.

Looking to get started with telehealth? Greenway® Telehealth™ — coming in fall 2020 — is our new virtual care solution, designed with the provider and patient in mind. With this secure, HIPAA-compliant telehealth solution, you can provide care remotely, increase engagement, and improve workflow efficiency with an easy-to-use interface. Find out more here.