Several doctors have created a guide to quickly implement an outpatient telemedicine program during the COVID-19 pandemic.
The toolkit, published in the Journal of the American College of Surgeons, discusses the importance of physician and staff training, patient education, an electronic medical system, hardware, billing and coding, and technology support.
“The dramatic impact of COVID was obviously a big surprise: Within five days, we went from vague concerns about an infectious disease to immediate orders to stay home,” said lead author Dr. Catherine Matthews of Wake Forest Baptist. Health in Winston-Salem, North Carolina.
“We did not have much time to prepare our great academic medical practice for the immediate conversion of in-person visits to an alternative solution,” he told Reuters Health by email. “Our two primary concerns were the continued well-being of our patients, with the provision of good access to care and employment for our office staff.”
The team decided that telemedicine was an obvious solution, but in trying to figure out how to use their platform, they were unable to find specific resources to help. Through a trial and error process, they developed a plan to implement telemedicine at their location and decided to create a guide for other providers to overcome some of the barriers.
“We were so amazed by the efficiency of our system and the high patient satisfaction that we wanted to share our toolkit with others,” said Dr. Matthews.
The authors describe eight elements necessary to integrate telemedicine: an existing electronic medical record system, audiovisual platforms, institutional IT support, use of hardware by doctors and patients, provider and staff training, patient education, patient participation and caregivers, and integration of coding and billing.
For example, the group used the Epic electronic medical record system, the MyChart application, and video services such as FaceTime, Google Duo, and Skype. Since sanctions for HIPAA violation have been temporarily suspended, other video calling services are also available, they write, though doctors must exercise caution.
“If MyChart video viewing capabilities are built into your Epic EMR system, commercially available video conferencing software should be used as a last resort,” the authors write.
A provider and staff training session can last about an hour, which could include brochures and a simulated telemedicine visit, which provides time to explain obstacles and solutions to video visits. Fortunately, the authors add, patients tend to have the necessary devices to access the portal or video calls.
“Patients are also informed about the potential benefits of a telemedicine visit, such as not postponing their health care needs while staying safe at home, having the ability to save travel and waiting time, and avoid the costs associated with transportation and parking, “the authors noted. Note.
With billing and coding, telehealth requires an understanding of eligibility and terminology, as it differs from typical office visits. The guide provides a list that describes the type of visit, the eligibility requirements, and the billing codes that can be used.
In one month, the group completed 638 telemedicine visits, allowing them to continue outpatient services and cancel some appointments. They were also able to keep about 75% of their hours of employment for their staff, they write.
“The vast majority of patient disability, death, and discomfort are not yet related to the coronavirus, so it is critical that we provide comfort, relief, and cancer treatments, even in the midst of the pandemic,” said Dr Benjamin Kaffenberger of Ohio Wexner Medical Center State University in Columbus, Ohio. Kaffenberger, who was not involved in the article or guide, has investigated telemedicine and dermatology consultations during the COVID-19 pandemic.
“Everyone is doing things differently. There have been some practices that have been doing this for several years, and there are some practices that have never attempted something like this,” he told Reuters Health by email. “The groups that have more experience helping to support and influence hospitals and practices that are inexperienced is a great example of cooperation during this difficult time.”
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Originally Published On: Newsdio
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