Hartman Executive Advisors provides telehealth consulting services to help organizations evaluate, select and implement the right telehealth technology for your organization.
Businesses across the nation have been affected by the impact of COVID-19, including healthcare providers. Non-urgent patient visits have declined over the past few months, causing a significant decrease in revenue for some healthcare facilities. Telehealth services provide patients a safe alternative for on-site visits, allowing them to continue with routine visits, remotely.
Healthcare providers who offer telehealth services have not only retained their current patient base, but also noticed an increase in new patients. The use of telehealth services allows healthcare providers to provide up to twice as many services to patients than they were able to before.
Why Telehealth?
In addition to the obvious need for continuing to provide care amid the COVID-19 pandemic, there are longer-term strategic advantages to incorporating remote services into your business model.
Expand Access To Care
- As patient expectations change for how and when they receive medical services, healthcare organizations must adapt to meet the need
- Telehealth removes barriers of geography and transportation that could otherwise prevent patients from receiving treatment
- Healthcare providers can see patients from anywhere, be it a brick and mortar facility or in their home offices
Increase Patient Engagement
- By choosing continuous monitoring, patients take a more active and accountable role in their healthcare
- A positive experience will increase the likelihood that patients will continue to seek care on an ongoing basis
- Families can more actively participate in the care of a loved one
- Parents don’t need to bring their children with them to appointments
Increase Revenue And Lower Operating Expenses
- Maintain or reduce physical facilities
- Attract more patients
- Self-scheduling and other administrative functions can allow for growth without adding staff
Reduce Unnecessary Hospital ED Visits And Readmissions
- Determine if a patient needs to go to the emergency department before they make the trip
- Keep readmission rates low and minimize revenue impacts by seeing patients before they head back to the hospital
The Telehealth Ecosystem
Key Considerations In Choosing A Telehealth Platform
- Integration with your billing system to capture services and revenue
- State and Federal regulatory compliance of the platform and how you use it
- Current state use cases, and also future use cases
- If you require EHR integration, what level of integration do you need? Not all platforms will integrate with your EHR
- How quickly do you need to be up and running and seeing patients remotely?
- Budget and revenue opportunity — what is the ROI for implementing telehealth in your organization?
- Patient and provider population — how likely will they be to adopt new technology? How easy will this be for them to use?
- Patient experience, training, and access to the platform you select from the devices they use
- Professionalism and presentation of the provider and the provider setting
- How to provide quick support when things go wrong (and they will!)
- Will you need to integrate medical devices? Not all systems support this
Common Pitfalls (And How To Avoid Them!)
- Making a purchase based on the best sales presentation
- Have clear and documented evaluation criteria in mind before you start to shop around. Rate and rank products based on these criteria.
- Choosing software based on features vs. function
- Evaluate software based on how well it fits your future workflow
- Buying too little or too much
- Purchase software that has features you need and can implement. Avoid solutions that have
more functionality than you will realistically use.
- Purchase software that has features you need and can implement. Avoid solutions that have
- Poor implementation planning
- Choose an executive sponsor early on and build a capable team to manage all aspects of
selection and implementation
- Choose an executive sponsor early on and build a capable team to manage all aspects of
- Not considering user experience
- Understand impacts to patients and providers……and be prepared to address them
- Ignoring the cultural impact to your patients and your practice
The Benefits of Telehealth for Healthcare Service Providers
One of the greatest benefits telehealth provides healthcare service providers is the ability to continue treating and diagnosing patients remotely. Telehealth services have been shown to improve the way providers are able to treat and perform follow ups with patients. For example, doctors and surgeons are now able to schedule post-operation follow ups via telehealth, removing the need for in-office visits for post-op patients. Notable top benefits of telehealth services for healthcare providers include:
- Reducing patient no-shows
- Improving internal workflow and efficiency
- Retaining current patients and acquisition of new patients
- Avoiding patient to patient and patient to provider cross-infections
- Improving engagement with patients via remote monitoring
Opportunity for Growth
Healthcare providers who offer telehealth services have experienced growth since implementing these services. In fact, those who do not offer telehealth services have experienced a decrease in their patient base, as many of those patients have moved to competing healthcare providers who offer telehealth services.
Software And Platform Integration
Another significant benefit of telehealth services is the streamlined integration into existing platforms and internal processes. A streamlined integration can provide numerous benefits for both patients and healthcare providers. Some of the most important benefits include:
Streamlined Billing and Invoicing
- Ease of access to patient documentation and medical history
- Minimize manual processes, duplicate data entry, and transcription errors
- Save time and cost, while increasing accuracy
- Practice management and reporting that includes all care types
- Patients accessibility to remotely acquire medical advice and consultation
Accurate Visit Documentation
Healthcare providers who utilize telehealth video functionality benefit from the ability to record and store the video call. This allows healthcare providers to reference prior visits and ensure documentation accuracy. Continuous access to these records also improves care coordination and patient diagnosis and treatment.
Streamlined Workflow
Working remotely often limits access to resources and communication among team members, increasing the difficulty of a streamlined workflow. With limited face to face interaction, processes such as billing, prescribing and documenting, services can suffer, potentially causing confusion and costly mistakes.
Telehealth services enable healthcare providers to execute their normal workflow through patient portals and virtual meetings with both patients and team members.
Telehealth Requirements
As healthcare providers consider acquiring technology to offer telehealth services, it is important to determine if both their IT infrastructure and internal operations meet the requirements necessary. The basic requirements for telehealth services are outlined below.
Bandwidth
When implementing telehealth services, it is important to understand what the minimum bandwidth requirements are for running telehealth software successfully. Both parties must have a strong internet connection for quality video streaming and voice connection. At a minimum, both the patient and healthcare provider should have internet speeds of 15Mbps download and 5Mbps upload.
HealthIT.gov recommends the following minimum bandwidth speeds, which vary based on the type of healthcare provider.
- Single Physicians: 4 Mbps
- Small Practices (2-4 Physicians): 10 Mbps
- Nursing Homes: 10 Mbps
- Health Clinics (5 Physicians): 10 Mbps
- Large Practices (5-25 Physicians): 25 Mbps
- Hospitals: 100 Mbps
- Large Practices: 1,000 Mbps
Bandwidth Speed Capabilities
In order to better understand bandwidth requirements, the sections below outline bandwidth speed ranges as they relate to operational needs.
- Practice management functions, email and web browsing
- Simultaneous use of EHR and high quality video consultations
- Non real time image downloads
- Remote monitoring
- Facility management functions, email and web browsing
- Simultaneous use of EHR and high quality video consultations
- HD video consultations
- Non real time image downloads
- Remote monitoring
- Clinic management functions, email and web browsing
- Simultaneous use of EHR and high quality video consultations
- HD video consultations
- Real time image transfer
- Remote monitoring
- Hospital management functions, email and web browsing
- Simultaneous use of EHR and high quality video consultations
- HD video consultations
- Real time image transfer
- Continuous remote monitoring
- Hospital management functions, email and web browsing
- Simultaneous use of EHR and high quality video consultations
- HD video consultations
- Real time image transfer
- Continuous remote monitoring
Billing
When deciding to offer telehealth services, it is important to make sure that the telehealth system chosen is able to integrate with EHR and billing systems. Without proper integration, notes and documentation from telehealth appointments can be lost and billing departments may have a difficult time sending accurate invoices.
Billing Codes
Physicians and healthcare providers can find up-to-the-minute billing codes, processes, documentation requirements, and more for Medicare and Medicaid in The Centers For Medicare & Medicaid Telehealth Services Booklet.
Cybersecurity
As the use of telehealth services increases, so does the volume of IT vulnerabilities and risks. By conducting patient visits and hosting confidential medical records online for telehealth, cybersecurity threats carry significantly more risks. Healthcare providers who are considering implementing telehealth services should ensure their IT infrastructure security is up to date and safe from the latest threats. Below are security recommendations healthcare providers should consider implementing prior to engaging in telehealth services.
Continuous Identity Authentication
In addition to requiring strong login credentials, healthcare providers should implement the use of multi-factor authentication, commonly referred to as MFA.
Multi-factor authentication requires users to not only login via their username and password, but also requires the user to confirm or “authenticate” their access through a second mechanism like a smartphone or key fob. The use of multi-factor authentication significantly reduces unauthorized users’ ability to access sensitive and confidential information or data.
Performing Regular Cyber Risk Assessments
Cybersecurity risks and threats are continuously evolving, which means healthcare providers need to be able to identify weaknesses and vulnerabilities in their IT infrastructure on a consistent basis. In relation to telehealth services, cyber risk assessments are beneficial to healthcare providers who seek to:
- Implement new telehealth software into their existing infrastructure
- Secure sensitive data (i.e. patient portals)
- Remain compliant with Federal and State regulations
Documentation
In order to offer telehealth services, the Center For Medicare/Medicaid Services requires providers gather a list of documentation. These documentation requirements include:
- Licensure
- Malpractice
- Prescribing
- HIPAA security
Licensure Documentation
Licensure documentation requires telehealth service providers to comply with laws and regulations set forth by the state’s professional licensing board. In some states, obtaining a telehealth license is a requirement prior to offering telehealth services.
Malpractice Documentation
Currently, malpractice documentation requirements have not been established, as most insurance carriers cover telehealth under standard malpractice insurance policies. Purchasing additional malpractice coverage may be required for those wishing to offer telehealth services.
Prescribing Documentation
Telehealth service providers who intend to fully treat their patients must have the ability to prescribe. In order to prescribe to patients, prescribers must be able to prove the validity of the patient-prescriber relationship. For new patients, establishing a relationship with prescribers via telehealth may not be considered valid.
HIPAA Security Documentation
Although most reputable telehealth software providers claim to be HIPAA compliant, the software alone does not mean the telehealth provider is completely HIPAA compliant. In order to remain compliant, telehealth providers must adhere to the same regulations and requirements of HIPAA under normal circumstances.
HIPAA Requirements
Although cybersecurity and HIPAA requirements for telehealth share similar characteristics, it is important to note the different requirements set forth through HIPAA. Due to the nature of the information hosted and transferred via telehealth, HIPAA encompasses a particular set of compliance standards and guidelines. In order for healthcare providers to remain HIPAA compliant when administering telehealth services, specific guidelines must be adhered, to including the following:
- Authorized users can only have access to ePHI (electronic Protected Health Information)
- Secure communication systems should be implemented for ePHI protection
- Implementation of ePHI monitoring systems in order to prevent data breaches
Storage Of Third Party Data
For healthcare providers who decide to store patient data through a third party technology provider, a Business Associate Agreement (BAA) with the third party technology provider is required. A BAA requires third parties to state their methods used to ensure protection of data and regulatory audits of the data’s security.
When creating a Business Associate Agreement, telehealth service providers needs to include the following information.
- Description of the permitted and required uses of protected health information by the business associate
- Guarantee that the business associate shall not use or disclose confidential health information, unless permitted or required by the contract and or law
- Required use of safeguards to prevent use or disclosure of confidential health information, unless provided for by the contract
- Requirement of reasonable steps taken when a data breach or violation is identified
- Business associate is required to report problems to the Department Of Health and Human Services if termination of contract or agreement is not feasible
Telehealth Technologies In 2020
The benefits of implementing telehealth services is apparent, but the vehicle or vehicles in which healthcare providers choose to offer telehealth can make a difference. Before healthcare providers begin implementing telehealth services, they should consider which technologies to use based on their location, infrastructure and current patient base. Below are some of the top telehealth technologies in 2020.
Kiosks
Telehealth kiosks provide patients the ability to virtually connect with their healthcare provider, without having to acquire the hardware/software necessary for at home telehealth care. These kiosks are commonly placed in community centers or retail clinics, where patients are able to easily access them.
An additional benefit includes the convenience of having a central location where all patient information can be stored and accessed.
Mobile App
Among the variety of telehealth technologies available, telehealth services via mobile apps are the most versatile. Patients who own a smartphone or tablet can easily download a telehealth mobile app to visit their doctor remotely. These mobile apps provide patients the convenience of accessing documents and records virtually anywhere. Additionally, healthcare providers who use telehealth mobile apps are able to send users daily reminders or health tips straight to their device.
Telephone
Offering telehealth services by phone grants healthcare providers the ability to consult with other providers or specialists during a patient visit. Providers can also use this functionality to send prescriptions to pharmacies in real time.
Remote Patient Monitoring Tools
Commonly referred to as “self-monitoring” or “self-testing”, remote patient monitoring tools assist healthcare providers by remotely monitoring the health of their patients. In addition to lowering the costs associated with frequent patient monitoring, it also remains in compliance with HIPAA guidelines and standards.
Features And Functionality
- Consider the pros and cons of basic solutions to more sophisticated solutions
- Typically, the more feature functionality you buy, the more expensive, complex, and time-consuming the solution is to implement
- When it comes to patient experience, simplest is best
- Providers are looking for systems that are also easy to use and virtually match their existing workflows
Who Is Using Telehealth?
Community Health Centers
Before COVID-19, community health centers were beginning to offer telehealth services to their patients in order to improve overall satisfaction and increase their profit margins. During the COVID-19 pandemic, community health centers who already had established telehealth services were able to minimize virus transmission by reducing the number of patients coming into their practice for appointments.
Community health centers are able to increase their visit counts and revenue through telehealth services by extending office hours, reducing patient no-shows, retaining current patients and acquiring new patients from competitors who do not offer telehealth services. Patient satisfaction also improves, as telehealth allows providers the ability to offer on-demand care anytime, anywhere.
Senior Living/Care Providers
Through the use of telehealth services, senior care providers are able to safely care for their residents, thus decreasing the possibility of spreading viruses and diseases to staff and other residents. By utilizing remote patient monitoring tools with telehealth, providers are able to remotely monitor their patients’ vital signs, glucose levels and more.
Telehealth services provide an additional convenience for elderly patients by removing the need for long waits or traveling long distances for office visits. It also enables family members who may be unable to attend in-office visits to participate in virtual appointments.
Skilled Nursing Facilities
Skilled nursing facilities (SNFs) that have started offering telehealth services to their patients have seen a reduction in rehospitalization and virus transmission, and improvements in patients’ health. With the assistance of telehealth technologies such as remote patient monitoring tools, skilled nursing facilities are able to provide treatment to patients by continuously checking vital signs and overall well-being remotely.
Ambulatory Care Providers
Among ambulatory care providers who have adopted the use of telehealth services, the number of in-person visits decreased by nearly 60 percent. In addition to reducing in office visits, telehealth services have also improved internal workflows and processes for ambulatory care providers. Telehealth and patient portals have made it easier for patients and providers by streamlining processes such as registration, insurance, copays and document gathering.
Through telehealth mobile apps, providers are able to easily access patient documents, communicate with pharmacies, collaborate with specialists and remain HIPAA compliant. These apps also provide benefits to patients such as remote video chats, provider-patient texting options and an easy to use and navigate patient portal.
Physician Practices
Physician offices are able to control the volume of patients coming in for appointments by treating many patients through telehealth services. By reducing the number of patients coming in, physicians can focus on patients with more serious issues requiring hands-on care and reduce the risk of transmitting diseases or viruses.
Telehealth services also play a large role in profit margins, as those physician offices who do offer these services are able to retain their current patient base and also acquire new patients moving from competitors who do not offer telehealth services.
Community Service Providers
Community service providers work for their respective communities by offering their time and services to those in need. Amidst the hardships brought about by COVID-19, individuals and families who routinely take advantage of the services offered by community service providers have been affected by their inability to access these services. Telehealth, or remote care, services provide community service providers the ability to continue engaging and serving their clients remotely.
Urgent Care Centers
Telehealth services reduce in-office visits by providing patients the ability to visit with a healthcare provider over a video call or online chat. Patients often find greater satisfaction with urgent care centers that offer telehealth services as they no longer have to spend time in waiting rooms or driving long distances to consult with a healthcare provider.
Family Care Providers
With telehealth services, families who are unable to travel to doctors appointments or are unable to leave their homes are able to visit with healthcare providers more frequently. Families with members who have recently been released from the hospital or have newborns benefit the most from being able to remotely access their healthcare provider. Patient portals also provide additional benefits to families, as they are able to access important medical documents and records almost instantaneously.
Schedule Telehealth Consultation
The demand for telehealth services continues to grow every day, and organizations who wait to offer telehealth services may quickly face a significant decrease in their patient base. Reach out to Hartman Executive Advisors for unbiased guidance to help you evaluate telehealth options and determine which technology is best suited to meet your needs by calling 410.587.0064 or by requesting a consultation online.
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