Telehealth— the practice of providing a range of healthcare services remotely, as opposed to face-to-face— is revolutionizing the practice of medicine.
Adopting it can help you substantially grow your medical practice, according to Nick Hernandez, founder and CEO of ABISA, a consultancy specializing in strategic healthcare initiatives.
“I have been helping practices implement telehealth for nearly 5 years,” says Hernandez, “and one question I am often asked is ‘what are the CPT codes available for reimbursement?’ Here’s a current (2019) sheet I’ve put together.”
Among other things, telehealth enables medical practices to increase access to care, reduce costs, improve outcomes, overcome geographical barriers and reduce hospital admissions and readmissions.
The concept isn’t anything new, having first been envisioned back in 1924. However, it has become exponentially more popular in the past few years, according to Hernandez.
“When you think about telemedicine, you are actually thinking about video interaction between a patient and a doctor, about whatever clinically is going on with the patient. Telehealth is actually a broader term that’s more encompassing. It covers telemedicine as well as other things like training, administrative meetings, and continuing medical education, in addition to clinical services,” he says.
There are two components to telehealth. The first is a video component, where a doctor is talking to a patient in real time, or electronically sharing information. An example might be a picture of a patient’s skin lesion that is forwarded to a dermatologist to gain his or her opinion.
The second component of telehealth allows remote monitoring of patients, such as heart monitoring or tracking of blood glucose levels.
Hernandez says telehealth can eliminate the need for expensive or time-consuming travel to medical appointments.
“We reduce the need to move the patient or take potential time off from work or school (for a face-to-face medical appointment),” he says, adding that it can also bring specialized medical services to rural areas that lack them.
Correctly utilized, telehealth can make your medical practice run more efficiently.
“Lastly and perhaps more importantly, from a business aspect it’s a differentiator and a growth mechanism. It’s a differentiator because right now not everyone is doing telehealth.”
If you use telehealth, you can set your practice aside from others who are not taking advantage of it.
Hernandez says telehealth is a growth mechanism because it can expand your patient volume, increase your catchment area and increase certain lines of service that you provide.
Settings that use telehealth and telemedicine include rural medical practices, clinics, hospitals, schools, prisons, skilled nursing facilities (SNFs) and assisted living facilities (ASFs).
In addition to facilitating video conferences between patients and doctors or other medical staff, telehealth can be used for consultations between medical providers, consultations between rural health clinics and specialists or hospitals, and training of medical staff in different locations.
Like anything else, if not handled properly, telemedicine can negatively impact your medical practice and create some disgruntled patients, according to Hernandez.
“At the end of the day you still have to preserve that patient-provider relationship.”
Telehealth is not without its challenges, one of which is licensing. Hernandez says if a doctor in Florida treats a snowbird from New York State, he cannot use telehealth to continue to do so once the patient returns home, because the Florida doctor is not licensed to practice medicine in New York.
Clinics that are located on borders between two or more states may also run into licensing issues if they use telehealth services.
Other potential challenges include liability, privacy, equipment costs, connectivity costs, and reimbursement challenges. On the latter point, Hernandez notes that patients are often willing to pay cash for a second medical opinion that could cost them much more had they needed to travel a long distance for a face-to-face medical appointment.
Another challenge of not being face-to-face with the patient is that the doctor cannot touch the person as part of the diagnosis. He or she will likely have to ask the patient several additional questions to determine what is causing symptoms, or tell the patient that he or she needs to examine them in person.
The rewards for embracing telehealth can be well worth any challenges you may encounter. Hernandez cites a Veterans Affairs study of 17,025 adults using telehealth services.
The study found that telehealth resulted in a 25 percent reduction in patient lengths of stays in hospital and a 19 percent reduction in hospital admissions. Patients using telehealth reported a mean satisfaction rate of 86 percent, all at a cost of $1,600 per patient per annum.
If you are interested in moving into telehealth, Hernandez suggests starting off with a feasibility study to lay out why you want to do it and develop a short-term, medium-term and long-term plan for moving forward.
There is no one-size-fits-all template for telehealth. You need to develop a system that works for your practice.
“Overall, telehealth has similar costs to that of traditionally delivered care, but the improvements in quality and service are major,” he says.
