As adjusting to life in the midst of a pandemic has become the new normal, so too has our adaptation of technologies that help keep us connected to friends and family while “social distancing”. In lieu of meeting face-to-face, alternative means of connecting, such as through Skype, Zoom and Facetime, are now being used more than ever for personal use. While some areas of the world are beginning to see what may be the light at the end of the tunnel in terms of lifting stay-at-home orders and slowly reopening businesses, it’s still unclear what the future may hold in terms of returning to the old normal.
We’re fortunate to be in a position where much of the infrastructure to support such a shift was largely in place already – technology that enables highly personal communication while remaining physically distant has become increasingly ubiquitous and accessible in the last decade especially. With CMS expanding coverage for telehealth, and commercial insurers following closely behind, offering telehealth services to your patients may be a wise and viable option.
Telehealth and telemedicine – what’s the difference? Telehealth refers broadly to all clinical, educational and administrative services delivered remotely, while the term telemedicine applies specifically to remote clinical care provided by a licensed professional.
In the midst of great uncertainty and fear, it’s undoubtedly daunting to introduce a new method of providing care to your patients. Let’s explore some ways you can leverage existing systems to support the introduction of telehealth in your practice:
1. Take small steps and appoint a champion.
Rather than rolling out telehealth to your entire patient population from day one, consider narrowing down your population (see population stratification suggestions below). Working with a smaller group of patients will be less overwhelming to your staff as you introduce new methods of delivering services. Appoint a champion in your practice to coordinate and promote your telehealth implementation. A champion can support fellow staff members and patients alike in adopting telehealth.
2. Identify and stratify your population.
Determine who among your patients is at greatest risk and should wait to physically return to the office until the worst of the COVID-19 impact has passed. Communicate your telehealth services to this subset of your patient population. According to the Centers for Disease Control and Prevention (CDC), those at greatest risk for severe illness include:
- Patients aged 65 years and older, particularly if chronic conditions are present.
- Patients with moderate-to-severe asthma.
- Patients with chronic lung diseases, such as chronic obstructive pulmonary syndrome (COPD), cystic fibrosis and idiopathic pulmonary fibrosis.
- Patients with type 1, type 2 or gestational diabetes.
- Patients with serious heart conditions, including coronary artery disease, heart failure and pulmonary hypertension.
- Patients who are severely obese (body mass index of 40 or above).
- Patients who are immunocompromised due to cancer treatment, immune deficiencies, HIV, prolonged use of corticosteroids and/or other immune-weakening medications.
- Patients with chronic liver disease, such as cirrhosis.
3. Consider introducing a remote monitoring program.
Use of remote monitoring programs in conjunction with telehealth enable healthcare providers to support and manage patients at the greatest risk as safely as possible. While remote patient monitoring may not be a viable option to introduce early on in your telehealth journey, the benefits are worth exploring.
4. Offer telephonic case management.
Telephonic case management delivers quality care through interventions and collaboration with a focus on promoting health by actively coordinating care and preventing readmissions.
While not all care can be delivered remotely, many routine services and chronic conditions that were once provided through in-person office visits can easily be handled via telephonic outreach. Some routine care services that can be delivered remotely include:
- Wellness exams
- Follow up visits
- Seasonal allergies
- Basic health and lifestyle education
- Medication adjustments and managing side effects
- Reviewing lab results
Examples of chronic conditions that can be managed remotely include:
- Coronary artery disease (CAD)
Introducing telehealth in your practice doesn’t have to be overwhelming. Take small steps and communicate with your staff and patients along the way. And don’t forget to look for bright spots.