The Age of Telehealth is Upon Us
June 2, 2020
We’ve been through the dark ages of scribbling notes and keying into computers hoping to avoid lawsuits while trying to maintain our incomes. For years, we looked at telehealth platforms cautiously. We worried about reimbursement. Today, most of the states have adopted parity laws. These laws allow doctors to be reimbursed the same amount of money for telehealth visits as for office visits. We worried about maintaining quality of care. Now, smartphones allow us to gather important biometric vitals such as blood pressure, pulse, weight, temperature, blood sugar, even heart and lung sounds. We worried about brief but accurate documentation. With advances in voice recognition technology, your entire conversation with the patient can now be automatically transcribed into a PDF. We worried about continuity of care. There are a plethora of apps in telehealth which allow us to choose the mode of care we wish to participate in. Some doctors may choose the urgent care environment where they see patients they’ve never seen before and will possibly never see again. While other doctors may choose to see only patients with whom they have an established rapport. Other options allow you to pick shift care, nursing home care, gig care (flexible hours), direct pay care, and even managed care. So there are a multitude of options for all physicians on the table now.
Even if you choose not to do televisits, there are bold new developments in telemedicine that will make you reconsider. Medicare is now trying to promote telehealth by paying for non-face to face clinical care (the work your staff does for free now). Medicare has two new programs: remote patient monitoring (RPM) with codes 99453 (initiation of RPM one time payment of $21), 99454 (initiation of device monthly payment of $69), and 99457 (20 minutes of non face to face clinical care payment of $53 monthly) and behavioral health integration (BHI) with code 99484 (20 minutes of non face to face clinical work). Adopting these programs into your practice for just one hundred Medicare patients a month would result in over $150,000 of new revenue annually. More importantly, this will improve clinical care, patient experience, lower total healthcare costs, and even improve our work lives. Thus addressing the quadruple aim of improving our overall health system performance. I have instituted these programs in my practice with great acceptance. My patients have responded very favorably to these new services because they are more invested in their care when they do things actively and are routinely communicating with my staff. The programs have resulted in less ER visits and hospitalizations as well as better blood pressure and blood sugar management as we can respond more quickly to abnormal results. The RPM and BHI programs are much simpler to institute and perform than the chronic care management (CCM) program and the compensation is much greater. If you are interested in starting telehealth, contact me and I will give you step by step instructions to take to integrate telehealth into your practice.
Imagine having the ability to practice medicine confidently without having to vex over writing or typing. Imagine having time to be able to truly engage with your patients. Imagine the health system evolving to have professional coders reviewing videos of your care for reimbursement purposes. Imagine when no one can question the care that was delivered. Imagine parity of primary care with specialists. Imagine a time when you can see everyone that needs to be seen and have more time with your family. I hope, as John Lennon says, “I’m not the only one.”
Important points to understand about Telehealer/telehealth/RPM.
May 14, 2020
In the days of Coronavirus physicians and patients have adopted technology out of necessity. It is easy to choose options in the marketplace that are low cost and simple to use during the emergency. With a little extra effort and expense, patients and physicians will experience the benefits and convenience that more robust platforms provide. Doctors have decreased documentation time and increased revenue from offering remote patient monitoring. Telehealer provides continuity of care and less burnout because it is intuitive and convenient. The best in class platform provides confidence in the care provided to patients by giving physicians access to patients' vitals measurements while making it easier to meet MIPS requirements.
Medical care for the long haul requires continuity of care. In telehealth just a simple registration by the patient helps keep things in order. Options like Telehealer record the interaction so you can better document the encounter. If a picture is worth a thousand words, then a video should be worth a million. The video recording allows the patient to review their providers recommendations later and follow them better. A video recording can also show a consultant the reason why a patient is being referred to them.
Recorded encounters also save you a ton of time; as your EMR data entry is much simpler-just refer to the video and place your diagnosis codes and CPT codes and you’re done! You can see more patients and have more personal time to enjoy life. We also realize the need for flexibility as not all doctors or patients want the recordings. Telehealer offers the option to see the patient without recordings or transcriptions - this actually decreases the cost involved tremendously but still avails physicians the ability to use the app for remote patient monitoring. If physicians choose to commit to a year-long subscription they save 20%. When remote patient monitoring is used, telehealer telehealth visit costs can become free.
Most telehealth platforms don’t allow transmission of a patient’s current vitals. With Telehealer's ability to convey current vitals, providers can give better plans of care knowing the actual status of many chronic diseases. Patients can be more connected to the practice by transmitting vital measurements on a routine basis. The physicians and staff can incorporate vitals monitoring into their workflow easily as most of the process is automated and patient-driven. Physicians can set parameters for abnormal measurements and the automated response the patient receives. The devices patients need to measure their vitals are reasonably priced and simple to use.
Telehealer allows for customized patient education videos to be created or selected by physicians. The educational videos may be accessed at any time by the patient and should lead to better compliance with treatment plans and hopefully better outcomes. Patients and physicians can also access telehealer basic functionality on the web at their desktops, laptops, and tablets. The low priced other programs do not afford the practice to order prescriptions, labs, or radiology studies. They can’t even allow the physician to give the patient an excuse note or return to work correspondence.
The future is upon us as Medicare and many commercial insurances now cover remote patient monitoring. Patients, as well as insurances, see the value of monitoring. There are studies that show better outcomes and compliance with remote patient monitoring. With Telehealer, regular low tech devices that are FDA approved are compatible. Having more time, while improving the practice revenues and improving physician MIPS scores results in a trifecta. We will return to our routine practices soon enough with the grey cloud of coronavirus in our rearview mirrors but hopefully, we will have improved our practices with a silver lining of incorporating both telehealth and remote patient monitoring.