How to use Telehealth in Clinical Practice (Telemedicine)

Telehealth in Clinical Practice physician on phone

The Coronavirus outbreak has brought to the forefront an increased need to implement and utilize Telehealth in Clinical Practice. The $2 trillion stimulus package includes $185M for Telehealth (Telemedicine), at critical access hospitals. Many practices are scrambling to either purchase this software or implement a portion of their EHR that they have never used before.


Telehealth in Clinical Practice

Implementation of a Telehealth or Telemedicine program becomes an enormous task, given all of the challenges that are being brought to medical practices in treating patients under the new paradigm.

At this point in time, many software vendors are being taxed to the limit in being able to help practices with this issue. Based on the fact that there are over 100 Telemedicine software packages on the market, we acknowledge that no one can know all of the Telehealth applications being used. 

A consulting firm, which also has expertise with a variety of EHR software applications, should be able to help. Qualified and experienced staff is essential and they can quickly work with you and your vendor to get you up and running.  Consequently, this will let you take full advantage of the use of your particular software package. The consulting support should be able to work with you in a safe and remote environment.


CMS broadened access to Medicare Telehealth services

On March 17, 2020, CMS announced the expansion of benefits to Medicare beneficiaries during the COVID-19 outbreak. Under the Coronavirus Preparedness and Response Supplemental Appropriations Act and Section 1135 waiver authority, the Centers for Medicare & Medicaid Services (CMS) broadened access to Medicare Telehealth services, so beneficiaries can get a wider range of services from their doctors and other clinicians without traveling to a health care facility.

On March 6, 2020, Medicare began temporarily paying clinicians to furnish beneficiary Telehealth services residing across the entire country.

Before this announcement, Medicare could only pay clinicians for Telehealth services, such as routine visits in certain circumstances. For example, the beneficiary getting the services must live in a rural area and travel to a local medical facility to get Telehealth services from a doctor in a remote location. In addition, the beneficiary generally could not get Telehealth services in their home.

Under this Section 1135 waiver expansion, a range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, can offer a specific set of Telehealth services.

The specific set of services beneficiaries can get include evaluation and management visits (common office visits), mental health counseling, and preventive health screenings.

Beneficiaries can get Telehealth services in any health care facility, including a physician’s office, hospital, nursing home, or rural health clinic, as well as in their homes.

This change broadens Telehealth flexibility without regard to the beneficiary’s diagnosis. At this critical point, it is important to ensure beneficiaries follow CDC guidance to reduce the risk of COVID-19 transmission, including the practice of social distancing. This change will help prevent vulnerable beneficiaries from unnecessarily entering a health care facility when clinicians can meet their needs remotely.


A successful Telehealth clinical practice visit

Just talking with a patient over the Internet via Zoom, GoToMeeting, or other conference call-in on-line meeting platform is NOT Telehealth.

  • Documentation requirements for a Telehealth service are the same as for a face-to-face encounter.
  • The information of the visit, the history, review of systems, consultative notes, or any information used to make a medical decision about the patient should be documented.
  • Best practice suggests that documentation should also include a statement that the service was provided through Telehealth, both the location of the patient and the provider and the names and roles of any other persons participating in the Telehealth service.


What to do next

Before starting to schedule Telehealth visits, physicians should screen their schedules to identify patients who can be seen using the capabilities of their Telemedicine software application.

Patients should be contacted and offered the chance to have the visit via the Telemedicine application and offered information on the limitations of visits via Telehealth.

  • Scheduling the visit;
  • Gather information from the patient prior to the visit such as chief complaint, allergies, previous related conditions and capturing of vital signs (if possible);
  • Consult with the patient via the Telehealth video conference application;
  • Record findings and suggested treatment plan; and
  • Communicate with the patient about the treatment plan, including any prescriptions that are necessary.

Many of the steps, as outlined above, can be performed by an assistant, thus reducing the provider’s time and thus making the Telehealth visit safer and effective for the patient but also more efficient for the practice.


Need help in how to use Telehealth in Clinical Practice?

The Fox Group’s consultants not only have the technical expertise to help you with the implementation of Telehealth software, but also have deep knowledge of the workflow of clinics to help you set up to provide the Telehealth service for your patients.

Our billing experts can assist you in making sure that you are billing for the correct codes under the guidelines for Telehealth. The Fox Group can guide you as to the most efficient use of your Telehealth software as well as advise you as to how to make the Telehealth visit as efficient as possible.

When you need proven expertise and performance

David Pack, MS, Senior Consultant

Mr. David B. Pack has over 30 years’ experience in the Healthcare Software industry as a Manager and Software Technologist. Achievements include founding, building and growing an EHR Software Company.