Annual telehealth visits have risen from 350,000 in 2013 to 7 million in 2018, and they’re expected to become 15 percent of all clinical visits by 2024. But there’s still much confusion about what exactly telehealth is and its overall purpose.
Primarily, telehealth is a way for providers to both expand their patient network and for underserved populations to gain access to high quality care they otherwise wouldn’t have. But implementing a telehealth system doesn’t make sense for every healthcare facility or clinician.
At the American Association of Nurse Practitioners’ annual conference, Kelli Garber, MSN, APRN, PPCPN-BC, and lead advanced practice provider and clinical integration specialist at the Medical University of South Carolina’s Center for Telehealth, broke down the primary considerations if you’re interested in dabbling in telehealth.
1. Why do you want to use telehealth?
Garber stresses that leading with the “why” is crucial because telehealth can waste resources. She adds the goal should never be to replace in-person interactions — telehealth exists to supplement and increase healthcare access to those who might not otherwise have it.
If your patients are largely millennials and gen-Xers, telehealth may make a lot of sense for your practice. Some 40 percent of millennials and 27 percent of gen-Xers report that a having telemedicine option is “extremely or very important” to them compared to 19 percent of baby boomers.
To answer the “why” question, you also need to understand the different applications for telehealth, Garber says. Some common uses of telehealth are education, research, practice and consultation. Many providers also combine more than one, especially education and research.
Follow-up questions: What’s the goal of using telehealth? What problem are you trying to solve? How would telehealth change the current state of your practice?
2. Why type of telehealth would be the most effective for your situation?
Telehealth is a more general term for remote healthcare that does not always involve clinical services. Telehealth includes telemedicine, which is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.
Under the umbrella of telemedicine, there’s also synchronous interactions, which involve real-time audio and video with or without the use of peripheral devices, and asynchronous, which includes recording, stored images and messaging, such as e-visits and e-consults, online interviews and recorded video visits. Some providers also use mHealth, which includes home monitoring, wearable devices and health apps.
3. Where will the patients and provider be located?
Knowing this ahead of time is important because practitioners need to follow the laws of the state of the spoke/originating site (where the patient is located) and the hub/distant site (where the provider is located).
Follow up question: How many distant and originating sites will there be?
4. Will it be cost-effective?
You may’ve heard that telehealth saves practices money because telehealth companies insist that digital visits cost less than in-person ones. But a 2017 report from Kaiser Health News found that’s not always the case.
Why? To start, you might need to pay extra for faster internet service. Also know that you could end up spending more time dealing with insurance companies. Some insurers don’t cover telemedicine, some only cover it in pricier plans, some only cover it for certain codes, and some only cover it for certain providers. That said, current regulations require all 50 states and Washington, D.C., to reimburse for some type of live video.
Follow-up questions: How will telehealth affect RVUs? Is the service billable? Does the EMR require updating to process telehealth billing correctly? Do you have existing telehealth equipment? Can you and your patients afford internet that will support the connection necessary for telehealth visits?
5. Will you maintain your quality of care? If you can’t, will you go the extra mile to make sure your patients find someone who will?
Above all else, Garber says providers using telehealth must understand that digital services don’t absolve you from meeting evidence-based practice requirements. Garber recommends looking into telehealth guidelines for your specialty, as well, adding that most professional organizations for specialties have telehealth guides. The American Telemedicine Association is also an excellent resource.