By Jessica McBurney, RN
As COVID-19 continues to change how clinicians practice medicine technology has become the shining beacon of hope that many practices are turning to in order to serve their patient population, while adhering to social distancing recommendations. Though tech has been all the rage in recent years, rapidly changing industries as we know them, one might say that healthcare has been lagging in its adaptation of automation and tech savvy solutions. Let’s face it, healthcare is a beast and implementing new technology can be a heavy burden on resources; both time and money.
However, once COVID-19 burst onto the scene, many medical and dental practices were left with no choice; they either had to close their doors or quickly adapt a virtual platform to avoid screeching to a halt. So, if it wasn’t on the forefront of their minds before COVID-19 it’s likely they are seeking resources and trying to find a plug and play solution to provide patient access and keep the lights on after COVID-19.
In the state of Oregon and much of the United States, authorities have ordered both medical and dental offices to restrict all non-emergent treatments in the hopes of diverting thousands of life-saving supplies and personal protective equipment to healthcare workers on the front lines. But this doesn’t have to mean the end of patient visits and revenue all together. For many practices, deploying a technology solution like telehealth can help them maintain some form of productivity and reimbursement through this social distancing period related to our national health crisis.
Many practices are turning to DataDx and IT consulting groups, like Centerlogic, for solutions as they continue to find themselves with rapidly shifting priorities as the healthcare crisis evolves. Our healthcare community is in dire need of quickly ramping up their technology suite and DataDx and its partners are here to provide guidance, resources, and access to best in class technology and services to meet the needs of our community.
While it’s not a solution to every ailment, telehealth is an excellent option to help patients and providers overcome barriers to access and care delivery. Among other benefits, telehealth can overcome geographic barriers to healthcare, especially for specialized providers, and provide access to patients in underserved areas where clinician shortage exists. Telehealth can be used across most specialties for medication checks, behavioral/mental health visits, chronic care management, and follow-up visits.
In our current situation, it allows healthcare workers to triage and assess possible COVID-19 cases from a safe distance and make testing and treatment recommendations without the risk of exposure to the system. This will have a profound impact on our ability to dramatically reduce community and healthcare worker exposure to the virus.
Before you begin the journey to find the perfect telehealth solution, there are a few things you will want to consider. For instance, do you have proper IT support, either in-house or through an IT consultant who can guide you through the implementation and ensure you’re set up for success. To answer some of these basic questions, we asked our friends at Centerlogic how they have been handling these requests. Here is some of the wisdom they shared with us.
Q: What are the technology needs of the practice to get telehealth going?
A: Traditionally, these services work on most devices, but there are a few important things to consider before making the leap. The practice typically needs to setup workflows for scheduling and organizing the appointments. Next, they need to address their billing and payment collection process. (Co-Pays, etc.) (more on this later). Finally, we have noticed the providers usually prefer one device to chart on while they use a laptop or other device to do the conference call, but when devices are limited, some use only a Laptop and switch back and forth. This is somewhat of a personal preference, although we have seen greater efficiency when using dual devices as it reduces having to toggle back and forth between applications.
Q: How are you assisting in their vetting of different platforms and what works best for them?
A: Right now we are sticking with what we have seen work best. There are quite a few telehealth platforms out there so I know it can be challenging when making a selection. However, the most important piece to consider is ease of use for the patient and physician. They will want a platform with proven success and the most seamless user interface. We want to avoid providers having to waste time fiddling with the conference or the patient having issues installing or using the software on their side.
Additionally, although the HIPAA requirements have been relaxed during this time, allowing you to use services like Skype or FaceTime, we still recommend the platform be HIPAA compliant if at all possible. Depending on the solution you choose, some may be a longer-term commitment and you don’t want to get caught in the HIPAA crosshairs down the road when regulations return to normal.
If you do choose to use a non-HIPAA compliant application, according to the Department of Health and Human Services, “Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications.” You can find more information on this topic from HHS by clicking here
Furthermore, make sure the platform is compatible with mobile, preferably for both iOS AND Android. They will have patients that are only able to access this type of technology from a mobile device and they don’t want to limit their access.
Regarding the cost of these platforms, most are fairly reasonable and there are even a couple of free versions out there that meet the above requirements. Here are a couple we have used and recommend:
Doxy – https://doxy.me
Zoom for Healthcare – https://www.zoom.us/healthcare
Q: How do you implement effectively, develop workflow and train both staff and patients to use the new system?
A: We usually start with workflows that we have seen work well at other clinics. To start, identify visit reasons acceptable for telehealth. Discuss with clinical staff if appointment duration modifications need to be made to their standard scheduling. Allowing for additional visit time in the beginning may make sense as your providers acclimate to this type of practice. Once your staff settles in, this can be adjusted to maximize production.
It’s also important to create training documentation for your internal staff as you’re working through the process. They may also want to consider creating a simple FAQ for patients to help them navigate the tool. That way, internal staff can ensure they do not run into technical issues at time of appointment; though the reality is, this may happen a few times.
Also consider an email message to patients in your system to introduce them to the new tool. If they have a website, have their marketing team display the new system and messaging on their homepage to create even more awareness around access to this new feature. They might also want to include this information in their welcome message when patients call in, if applicable.
*If your practice does not have a marketing resource, we highly recommend NumanaSEO
OTHER THINGS TO CONSIDER
Navigating telehealth billing requirements has traditionally been complex, however given the most recent evolution of COVID-19, CMS has relaxed restrictions to make it easier to access telehealth at this time. Per the Centers for Medicare and Medicaid Services
“Medicare has temporarily expanded its coverage of telehealth services to respond to the current Public Health Emergency. These services expand the current telehealth covered services, to help you have access from more places (including your home), with a wider range of communication tools (including smartphones), to interact with a range of providers (such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social worker). During this time, you will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling and preventive health screenings. This will help ensure you are able to visit with your doctor from your home, without having to go to a doctor’s office or hospital, which puts you and others at risk of exposure to COVID-19.”(2) CMS is also working to “Establish new codes to allow providers to correctly bill for services related to diagnosis and treatment of the illness.”(2)
Understanding the terms of the individual contracts are critical for success and proper reimbursement. What is happening in the private health insurance sector remains unclear and may vary from payor to payor. Our team is staying on top of the latest changes and working to provide resources and tools to help navigate telehealth along the way. Our Payor Contracting Specialist, Courtney Stevenson has partnered with Chris Grinstead of Santiam Hospital to build a quick lookup tool for telehealth codes to help providers accurately code visits and have a better understanding of which CPT codes, place of service, and modifiers are required per payor (More on this to come).
Furthermore, many of our clients often encounter challenges with their billing and collections vendors, and the most recent CMS changes have only made this more obvious. If this sounds familiar, we have found an excellent resource in Enter Health
Enter is a fully automated, AI enabled, billing solution that works around the clock to get you paid. While it might not seem like the right time to reevaluate your billing practices, it will be crucial to have well established practices in place once we’re back to business as usual.
Healthcare is experiencing unprecedented times and being presented with seemingly insurmountable challenges. Managing a practice during this time can be intimidating and stressful, but it doesn’t mean having to close your doors. We encourage you to have conversations with other practices and consultants in the area to get a better idea of strategies you may not have considered. It may seem like the recommendations for the COVID-19 response is one size fits all, but there are a variety of solutions that can be tailored to fit your practice’s needs.
To explore Telehealth as an option for your practice, email us at info@datadx.com for a free consultation We look forward to getting you plugged in to the right resources to get you through this challenging time.
https://www.aafp.org/journals/fpm/blogs/gettingpaid/entry/coronavirus_testing_telehealth.html
https://www.medicare.gov/medicare-coronavirus#500
https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html