Many physicians have increased their use of telehealth during the COVID-19 crisis. Clinic visits dropped almost 60% in March and stayed there. In April, the Commonwealth Fund cited that about 30% of outpatient visits occurred remotely. The pandemic has accelerated the use of telehealth, and many physicians are finding it convenient, efficient and liked by patients.
Lay the groundwork
Of course, not all specialties, or even conditions, are well suited for telehealth. While psychology and psychiatry appear to be readily adaptable, areas such as orthopedic surgery and podiatry, as well as any medical condition that requires a hands-on approach, are clearly much less so.
Established patients are more likely than new patients to adapt well to telehealth, though much depends on the specific person. In addition, many states and insurance carriers require that the first visit with a patient be in person (unless circumstances make this impossible). It’s wise to be cautious in using telehealth with new patients.
Privacy is another issue. Your telehealth platform should have strong built-in security features, but consider your physical location when conducting telehealth visits as well. Check whether anyone is within listening distance of conversations between you and patients, and be aware of other people who may be present near the patient’s site. Those conversations are confidential, but the patient has discretion to determine who’s in their home during the discussion. Also, it’s important to tell the patient who on your staff is participating.
Have staff discuss technology requirements with the patient and get an informed consent form signed before the telehealth visit begins. It’s wise to clarify what you will do if there’s a technology problem — try again or require an in-office visit? Make sure all parties understand insurers’ current billing policies for telehealth visits, and inform patients they can stop or refuse treatment.
Assess and improve
Conducting telehealth visits is different from in-person interactions. Have you ever watched yourself do a consult on video? Consider background, lighting and what you’re wearing. Determine whether you have any distracting quirks when on video that you didn’t know about. Make sure you’re looking at the camera and not the view screen when speaking to the patient.
There may be other ways to assess a patient’s health remotely. Family members, if willing and able, might be able to assist in things such as taking pulse readings or temperatures. Certain types of musculoskeletal injuries can be evaluated using the Ottawa ankle and foot rules.
It’s important to be willing to tell a patient that an issue is too difficult to fully evaluate remotely, and that it will be necessary for him or her to come into the office. If you have a sense that you’re missing something by conducting a telehealth visit, act appropriately and in the patient’s best interest.
Prepare for the new normal
It’s possible that, when things go back to whatever the “new normal” is going to be, telehealth will go back to being an “extra service offering” rather than a core component of your medical practice. But it’s also likely that if patients — and you, yourself — try it and like it, telehealth will become a significant part of your practice permanently.