Telemedicine (also referred to as “telehealth” or “e-health”), according to the AMA, spans a continuum of technologies that offer to deliver healthcare including:
- Real-time, audio-video communication that connect healthcare workers with patients in different locations.
- Store and forward technologies that collect images and data to be transmitted and interpreted later.
- Remote patient-monitoring tools such as blood pressure monitors, Bluetooth enabled digital scales and other wearable devices that can communicate biometric data for review (which may involve the use of mHealth apps).
- Verbal/audio-only and virtual check-ins via patient portals, messaging technologies, etc.
We want to focus on what healthcare practices should consider before offering telemedicine, as well as some other common questions. We asked Dr. Amar Shah, MD, family practitioner, of VitalCare Family Practice in Chesterfield, VA, to paint us a clearer picture of what all of this means specifically. He offered a lot of answers to common questions, as well as a “Top Five Things to Consider Before Offering Telemedicine”.
A: “Top 5 things:
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- Provider/Staff buy-in
- Have an EMP platform that seamlessly integrates telemedicine into your workflow
- HIPAA compliance
- Offer telemedicine visits as part of the script when scheduling appointments.
- Be prepared for an influx of patients and appointments when you start offering the service.”
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Q: As a physician, why and when did you decide to offer telemedicine?
A: “Telemedicine helps break down barriers to care. Many patients have problems with transportation, conflicting work hours, and childcare duties. Telemedicine offers patients a platform to engage us through the convenience of their own home or car. The COVID 19 pandemic was the impetus for us to offer this service to all our patients, so that they may continue to quarantine and isolate themselves in a safe environment.”
Q: From your perspective, what are the pros and cons of telemedicine?
A: “Our telemedicine platform is seamless with our Electronic Medical Records (EMR), so it is HIPPA compliant. There is little staff training and patient education is done with an easy two clicks of a button. The cost of the service is nominal: $2/visit. The only con is that the patient must have access to internet/Wi-Fi.”
Q: What did you have to have in place in order to provide telemedicine for your patients?
A: “Our patient engagement strategy was strong from the beginning. We posted signs, had staff wear pins, and provider buy-in was key. We encourage and help patients sign up for our free portal and HEALOW app while in the office. From there it’s only a click of a button to start a Telemedicine visit.”
Q: What feedback have you received from your patients about telemedicine?
A: “Our patients love it. We had a patient last week who needed to be seen urgently. We scheduled him for a telemedicine visit. We immediately recognized he was bleeding internally and directed him to the ER. He was admitted for 4 days, internal bleeding was controlled, and was given 4 bags of blood. We did another telemedicine appointment just after his discharge and he thanked us for saving his life.”
Q: Operationally, what should a doctor consider before offering telemedicine?
A: “You need a strong patient engagement strategy. Have buy-in from staff and providers to encourage patients to sign up.”
Q: What is it like working with health insurance for this service?
A: “The billing for telemedicine is the same as regular in-office visits except for an extra modifier GT code. All payors are reimbursing appropriately.”
Q: How has offering telemedicine during the Covid-19 global pandemic impacted your practice?
A: Having telemedicine has “been the difference between bankruptcy and abandoning our patients to continuing to engage and provide high quality care.”
This post was written in conjunction with Healthcare superhero, Dr. Amah Shah of VitalCare Family Practice. He is committed to delivering high quality care by using technology to break barriers to care. Some examples are increasing patient engagement by providing everyone with a free Eclinicalworks HEALOW app, Open-Access scheduling so patients are seen the same day and providing Tele-Visits for working families. VitalCare can be considered a true medical home for patients and their families. Dr. Amar Shah is the medical director for Virginia Care Partners providing medical oversight to over 800 physicians in the Richmond metro area. He is leading a movement to elevate healthcare in Richmond by transforming practices to focus on high quality and lower cost for patients.