Culturally, Americans may be at the point where activities that may have seemed unusual a few months ago have evolved to social normalcy. Everything from masking in public to seeing a doctor virtually has become a part of the fiber of our country in the same way social distancing has become a part of the standard language.
CNBC says that telemedicine visits will top one billion this year. That is a far cry from the slow adoption we’ve seen in prior years, fueled in part by doctor reluctance to adopt telehealth technology and major barriers to telemedicine in the form of reimbursement and other regulatory restrictions.
With the CDC endorsing telehealth as a tool for social distancing, and CMS broadening reimbursement and easing restrictions on telemedicine, the stage has been set for every practice to use. But adding telehealth to your practice creates new technology adoption challenges as well as potential customer-facing service line issues. We’ve compiled a few tips to help you avoid any beginner mistakes and lessen the risks as you seek to implement telehealth during COVID-19 and beyond.
Tip #1 Maintain Privacy
It’s almost ironic, after years of HIPAA-compliance rules, that CMS has waived privacy requirements for telemedicine. We wrote about this startling change in our sister company’s blog, SpringHealthLive. Despite the waiver that allows healthcare providers to leverage any commercial telehealth app, we strongly advise selecting technology vendors who are HIPAA-compliant for your telemedicine visits. The risks today of security breaches that would expose patient healthcare data remain high. Should this occur, the damage to your patients and your practice reputation could also be high. That’s why commercial vendors such as Skype or Facetime are risky to use for a healthcare application. Look for a telehealth app that establishes informed consent with the patient as part of their standard log-in.
When you invite a third-party vendor to provide your team with a telemedicine demo, we recommend that one of your top three questions to ask include privacy considerations to protect your patient and practice.
Tip #2 Understand the Best Application for Your Telemedicine Service Line
We understand that telemedicine does not work well for every type of visit. While CMS no longer requires that you offer telehealth to only established patients, recognize that how you provide care will affect the experience of your customers. Telehealth today is perfect for maintaining social distancing. It allows your team the space to provide a triage service for patient symptoms without requiring a face-to-face visit. Telemedicine can help keep your patients and providers safe from the potential exposure to the virus, which is likely why you have adopted or are considering these tools. Practices should recognize that newer patients may be more difficult to assess over established patients with a clinical and human connection to your practice.
Tip #3 Trust in the Doctor-Patient Relationship
The doctor-patient relationship is sacrosanct; which is exactly why some doctors still believe putting a video screen between them and the patient is somehow wrong. The truth that we’ve seen firsthand is that a virtual house call, when handled properly, in no way sullies the relationship that you have with your customers.
The clinical definition of the doctor-patient relationship requires an exam, advice, and diagnosis; but that is just one layer. There is also trust that exists between the caregiver and patient, which is some ways is almost more important to establishing the doctor-patient relationship than the actual diagnosis. Can a video conference or phone call continue this precious link? How should doctors change their bedside manner to adapt to the video screen? The answer is that telehealth is a tool that allows doctors to provide the same level of care as a face-to-face visit. The basic elements of trust, caring, and clinical knowledge all come into play during a telehealth visit. You may need to call upon some creativity to see an injury by looking through the lens of a cell phone. The patient may need to jump up and down to witness peritonitis or they may need to take their own temperature under your instruction. But the basic levels of preliminary assessment and diagnosis are the same.
Tip #4 Work on Your Web Side Manner
The way you build a bond with a remote patient may be different, but its importance is just as high or higher than the in-office experience. We’ve found that focusing on the environment and the interaction are the two best ways to build a strong “web side manner” into the patient experience. For example:
- Build a strong rapport with your online patients by providing them with customer support so they feel comfortable with your new telehealth app and service. Your telemedicine vendor should have very strong customer support that helps patients feel comfortable with this new way of receiving care. Make sure your doctors and midlevels are equally comfortable with the service. There should be a seamless transition between the appointment to the clinical visit to e-prescriptions or follow up visits. Clinicians should have established protocols for looking into the camera lens, the distance of their body from the camera, what they wear, and how they act. If the doctor feels uncomfortable with the technology tool, this will not play well to the patient on the other end of the call.
- Create a professional yet warm exam environment with a tele-friendly exam room. A well-lighted, quiet, clean space with no distractions or background noise is a minimum requirement. Room backgrounds are crucial. Pay attention to what the patient will see behind the doctor. Provider clothing should be solid colors with the standard white coat, and the camera should frame the clinician’s face. Practice reflective listening during these visits, just like any visit and look the patient in the eyes—which in this case means the doctor will look into the camera lens.
One benefit of the telemedicine visit is that the doctor’s full face will be on display, instead of just his or her eyes showing over the top of the mask. This will help install a warmer environment where the doctor’s smiles are clearly seen.
For orthopedic providers seeking a telemedicine option, OrthoLive offers a telehealth app that can help you keep social distancing in place while providing routine or follow-up care to your patients. Talk with our team today about how telemedicine can help your practice.