Telemedicine Best Practices: The Steps to Success

Why Introduce Telemedicine into Your Practice?

By now, you have likely heard of telemedicine but may be unsure how to best implement it into your practice. Employers are increasingly offering telemedicine as a lower cost option for employees1 and at least 29 states now require health insurers to pay for telemedicine services.2 With the telemedicine technology market expected to grow at a compound annual growth rate at more than 18 percent by 2020. It only makes sense to jump on board or be left behind in a competitive industry. Telemedicine reduces in-office overhead and improves the provider’s efficiency. This makes it possible for the practitioner spend more time on each visit or to see more patients. The ease-of-access for patients reduces no-show, improve compliance with the provider care plan. It also allows practitioners to work from home, choose their own hours and reduce the amount of time it takes to see patients. 

Telemedicine is a prescription for any practice wanting to improve: 

• Revenue - Implementation of a telemedicine program generated 11% in cost savings, leading to an estimated ROI of $3.30 in cost savings for every $1 spent 
• Patient accessibility - 76% of patients care more about access to healthcare than need for human interactions with their provider
• Patient care - No patient outcome difference was found between telemedicine appointments and in-person office visits 
• Competitiveness - about 90% of healthcare execs report their organizations have already begun developing or implementing a telemedicine program
• Physician work/life balance - 79% of physicians consider video visits to promote a more flexible work-life schedule

4 Steps to Get Started 

One of the most common concerns of practitioners is that implementing telemedicine will be expensive, complicated and time consuming. Fortunately, because of cloud technology, in four steps, you can implement telemedicine affordably, easily and quickly. 

Step 1: Define goals, strategy & timeline 

Clearly articulate the goals of implementing telemedicine, how and when you will measure progress, and exactly how and when you plan to reach those goals. 

Step 2: Coordinate cross-functional team

Get input and buy-in from providers, staff and other business services, like marketing before creating a small implementation team. Designate one project leader who will serve as the main point of contact and provide progress updates. 

Step 3: Consider rules, regulations and reimbursement

Laws, regulations and coverage vary by state so do your homework or rely on telemedicine technology provider to know the facts before you begin offering the service to patients 

Step 4: Select a technology partner

Evaluate the provider and the technology for ease of use, security, ease of integration, security, branding, and reimbursement & regulations verification. Keep in mind your provider should partner with you and be available to help your patients and your team with any questions that may come up. 

How to Build Telemedicine into Practice Workflow 

If your practice has been doing things the same way for many years, implementing telemedicine may at first seem to be a big change. There is almost always pushback whenever new technology is brought in and additional training is needed. Telemedicine should not be considered an added burden to manage, but an exciting enhancement to your practice that will likely result in significant ROI, patient satisfaction and better work-life balance. 

Things to Consider when building telemedicine into your workflow: 

Technology 

Choose a cloud-based solution for the easiest, fastest implementation and integration with your EHR, secure encryption, and built-in features to help you navigate through regulations and reimbursements. While new technology can be daunting, telemedicine uses high speed internet connections and high-definition cameras on devices most everyone in the U.S. already uses. Neither you nor your patients will need to buy special equipment or require training to use the service. 

Training 

While no one will need training on how to use the technology, you will need to educate staff and patients about the value of telemedicine, when and how it will be used. Schedule a short training session for staff so they are comfortable marketing it to and answering questions from patients. Offer to download the application on patients’ devices for them if they have it with them at the time of an in-office appointment, then walk them through how to open the application and log in. 

Timing

Determine when telemedicine visits will take place during the day and how they will be scheduled. You may want to block off certain hours of the day to conduct video visits, particularly if your practice has a high volume of in-office appointments. Because video visits need to start and end precisely at the scheduled time, it may be more challenging to have them interspersed throughout the day. 

Staffing - Video visits do not necessarily have to be conducted by the primary physician. Just as with on-call rotations, consider alternating days with fellow practitioners in your practice. You can also enlist nurses and physicians assistants to conduct the calls when appropriate. 

Fees

Work with technology provider to understand which services are covered by insurance and how much video visits will cost patients. Not every call will need the same amount of time so price sessions in time increments. Alternatively, inform your patients the call will last X minutes and if you need additional time, a follow-up appointment can be scheduled. 

Reimbursement - Reimbursements may vary by state and care given. Make it easy and choose a telemedicine solution with reimbursement expertise and eligibility verification built in so you can save time and get reimbursed faster. 

Compliance

Choose a video conferencing solution that is HIPAA compliant, is encrypted, leverages peer-to-peer networking, and does not store video transmissions. The provider should also be willing to sign a Business Associate Agreement binding them to HIPAA rules.Your patients may want to better understand their privacy with video visits so consider adding a paragraph to your HIPAA forms explaining how video visits are equally compliant. 

How to Market Telemedicine to Patients 

Now that you have the technology and process in place, it’s time to let your patients know about your new service offering. You do not have to spend much money marketing telemedicine and many solution providers will equip you with plenty of materials to promote video visits. The most valuable marketing will come from your staff who interact with patients. Ensure front desk staff, nurses, schedulers and billing understand how and when to talk about telemedicine to patients. 

• With incoming patient calls, offer telemedicine as an option, when appropriate 
• Inform in-office patients of the option for their next appointment 
• Keep brochures and signs suggesting patients inquire about video visits in waiting room and exam rooms 
• Inform all patients of the option and “how to” in newsletters, social media, medical bills, etc. 

4 Steps to Educate Patients about Telemedicine 

Most patients will be receptive to telemedicine for its convenience but may need to have a conversation with you or someone on your staff. Don’t assume they understand what telemedicine is or how it works. Instead, take the time to explain it and answer their questions. Keep in mind, many patients will need to be assured the care will be the same and their privacy will be respected. 

Step 1: Define it 

“Telemedicine allows us to conduct visits using audio and video over the internet, rather than meeting in person.” 

Step 2: Explain it

 “We schedule a video visit like an in-office appointment. You will open a free application designed specifically for this purpose on your smartphone, tablet or computer with internet access and a camera. I will open the application on my end and we will talk to and see each other just as we would in the office. We can discuss symptoms, lab work, prescriptions, follow-up care, treatments and any questions you or I have.” 

Step 3: Sell it

“Our patients love this new option because there is no travel or wait times, no need to leave work or schedule childcare, no exposure to sick patients, and it can be done from the privacy and comfort of your home or office. We make sure your insurance company will cover this type of visit before we schedule it.” 

Step 4: Defend it - “If we believe you will be better served at an in-office appointment, we will not suggest a video visit. If we are on a video visit and believe there needs to be an in-office follow up, we will ensure that happens. Studies show most healthcare visits are just as effectively treated using video visits as in-office appointments. Our telemedicine solution is 100% HIPAA compliant so confidentiality is assured, particularly when you use basic online prudence, such as using strong passwords and joining the call in a private area.” 

How to Ensure A Positive Telemedicine Experience 

At the heart of telemedicine is the fact that it does not replace face-to-face doctor-patient interactions, but makes them more accessible. Patients will be able to see practitioners from their computers or devices so it’s important to present a professional, secure environment. Here are a few best practices to ensure your patients feel they are receiving top quality care, even without being in your office. 

• Make eye contact with the camera so the patient feels you are looking at them 
• Discourage interruptions by suggesting children, pets, televisions or other 
• distractions are removed during the call 
•  Control your background so the patient sees you in a professional environment 
• Have the right technical infrastructure to enable you to have access to their charts, lab work or imaging while you are on the call 
•  Eliminate distractions on your end by placing a sign on your door that you cannot be disturbed during your calls 
•  Keep hand motions to a minimum as they can be distracting on a video visit 
•  Dress appropriately, even if you are working outside of your office or after/before clinic hours 
•  Minimize natural light by ensuring you are not sitting in front of a bright window so your patients can easily see you 
•  Speak in a normal voice without shouting or talking too quietly, asking patient if they can hear you well before proceeding with the appointment 
•  Share tips with patients about how they can follow many of these same steps for the best possible telemedicine experience