Telemedicine Is Here to Stay. What Can Your Practice Expect?
Although many physicians do not think of themselves as business owners, their practices are businesses that are as vulnerable to disruption as other areas of the economy. The pandemic and its affects on medical practices made this apparent to everyone in the healthcare field.
As practices dealt with restrictions imposed during the worst of the pandemic, offices closed and staff was laid off or furloughed. In additional to the difficulty of treating urgent patients, there were economic losses. The AMA reported that the average number of in-person visits to physician offices fell from 97 per week to 57, according to a survey of 3,500 physicians who provided at least 20 hours of patient care a week prior to the pandemic.
Fairly quickly, physicians turned to telemedicine to treat patients remotely. Many found this an effective and efficient way to treat patients. Paycheck Protection Program (PPP) loans, EIDL grants and the Medicare Accelerated and Advanced Payment Program helped with costs of the transition as well as other qualified pandemic related costs, but other issues began to surface. Many of these problems were related to the speed with which physicians adopted telemedicine. In the immediacy of responding to the pandemic, providers did not stop to think about how systems would work together. The result was that they and their patients sometimes needed to sign onto more than one portal to get a complete picture of the patient’s care.
Now that things are settling into the beginning stages of a new normal, hospitals, facilities, and physician practices must take a closer look at the costs associated with adopting a permanent telemedicine component of their practice.
At a minimum, a practice offering telemedicine as an alternative service delivery method needs computers, video equipment, a power supply to allow for mobility and peripherals (e.g., an examination camera) with storage.
A sizeable investment is needed for a robust and scalable system. Some software and hardware providers charge based on the number of users or number of units while others charge a fixed fee. Many provide cloud-based solutions that is HIPAA and PIPEDA compliant. Costs vary widely based on equipment and capacity.
The major components of an inclusive telemedicine system include:
- Web-based encounter management portals. These portals are needed to communicate between each pillar of the encounter—patient, medical device data and the physician. It may be possible to integrate this technology with the practice’s existing video-conferencing capabilities. The costs vary between $1,500 and $10,000 per patient site.
- Specialty-related medical devices. As the technology grow, more and different types of equipment become available. As an example, the initial investment for a primary care practices should range between $5,000 and $15,000. As a start, the practice would need an examination camera, ENT scope and digital stethoscope. More equipment can be added as the practice grows. Different specialty practices would need to add more/different technology, raising the cost.
- Providing staff with the skills and knowledge they need to use the software and hardware in the practice’s telemedicine systems. This training should be on both the physician side and the patient side, the latter so they can provide assistance as needed. In addition, they should be trained in how to foster personal relationships during remote interactions.
- Whatever systems, hardware and software you use has to be backed up with the support the practice needs to keep them working seamlessly.
Telemedicine will continue to play an increasingly important role in delivering care. Like other societal changes caused by the pandemic, it is the wave of the future.
Medical Economics even referred to it as the Uberization of medicine. It is difficult to equate medicine with Uber, but it is all about ease of use. The pandemic caused everyone to move online faster than ever before. When patients were asked why they would book a telemedicine appointment rather than an in-person visit, the answer was convenience. They specifically pointed to easy-to-use technology (69%), communication (57%), online scheduling capabilities (47%), and immediate appointment availability (47%).
Eighty-one percent of practices surveyed by the AMA in July-August 2020 reported an average 32% drop in revenue. To be sustainable, healthcare practices should take the time now, while the new normal still is forming, to evaluate how they can make their practices more profitable.