Telehealth continues to rapidly expand, due in large part to the COVID-19 pandemic, and is viewed as an effective method of healthcare delivery. It may reduce costs, increase access, decrease wait times, enhance patient compliance, and increase patient and family engagement. Conversely, with the use of telehealth comes considerable costs associated with obtaining the necessary equipment, unclear or evolving reimbursement issues, and an increased risk for privacy breaches. Patients and providers alike must also be motivated to “buy-in” to the process. Additionally, many providers have concerns that significant clinical signs and symptoms may be missed by distanced examinations.
A properly selected telehealth system can provide an effective format for healthcare delivery absent an in-person visit. Many factors must be considered when implementing telehealth technology in your practice. The following recommendations will help you determine if the use of telehealth technology will benefit you and your patients:
1. Assess the need of your providers and patients to determine which telehealth platform is best suited to your practice. This may include one or more platforms. The four main categories are:
- Live Video-Conferencing
- Asynchronous Video (Store-and-Forward)
- Remote Patient Monitoring (RPM)
- Mobile Health (mHealth)
2. Waivers have been put in place during the COVID-19 pandemic that allow for the use of Facetime and other non-HIPAA complaint platforms. This will require diligent monitoring by the practice regarding the potential removal of such waivers in the future.
3. As part of the vendor selection process, ensure that they offer a secure, HIPAA compliant platform that also provides data encryption and allows you to protect patient data and comply with privacy regulations and disclosure protocols in case of privacy breaches. Vendors must provide a Business Associate Agreement.
4. Include key staff and providers in the selection process to determine the best system for your practice and patient population. Explore the ability of the vendor(s) to customize options that fit your needs.
5. Create an informed consent process and a document for the use of telehealth services as recommended by the American Telehealth Association.1 Contact the law firm of Fager Amsler Keller & Schoppmann, LLP at (877) 426-9555 to obtain their sample consent form.
6. Generate and retain formal documentation of all telehealth patient care visits. This documentation should be part of the patient’s record, and all aspects of the encounter should be thoroughly documented.
7. Establish a monitoring program/quality improvement process to evaluate patient care outcomes and technical performance issues. Include questions regarding the telehealth experience in patient satisfaction surveys.
8. Prepare a contingency plan for use in case of a technology failure. Communicate any disruption in service to the patient as soon as possible in advance of a scheduled telehealth encounter.
9. Engage in continuing education to ensure key competencies. Both providers and staff should receive ongoing education regarding updates to the practice’s telehealth system, along with refreshers on patient privacy and engaging patients via telehealth.
MLMIC advises our insureds to continuously monitor the effectiveness of their telehealth visits and address any identified areas for improvement as part of their overall program. Additionally, we offer a number of resources to support telemedicine use among policyholders:
- Effective Telehealth Patient Engagement, a risk management tip determining whether a telehealth encounter is the right choice for an individual patient;
- Telehealth & Cybersecurity Considerations, a blog post with practices to help reduce the risk of privacy breaches or cyberattacks related to the use of telemedicine;
- Liability Considerations Related to Use of Telehealth, a blog post with risk mitigation strategies related to use of telehealth; and
- Key Considerations to Help Healthcare Organizations Optimize Telehealth Use, a blog post with key themes related to telehealth that have emerged from the pandemic.