Pandemic Opportunity - Starting Telehealth

Parang Mehta, MD.

The Covid-19 pandemic has been a major setback for the healthcare sector. Footfalls have fallen in clinics all over the country as patients try to avoid infection by staying home. Many practices are struggling to meet expenses and stay open.

This is an advantageous time to add telehealth to the services provided by a clinic. The regulators are encouraging it, and patients want it

Telemedicine is an established mode of providing care to patients, and it has been a boon for many patients as well as physicians. Patients are getting the care they need on an ongoing basis, from the safety of their homes. Practices can optimize capacity utilization by providing remote consultations. Research estimates that there will be a billion teleconsultations by the end of 2020. The changes in regulations because of the pandemic have greatly favored telehealth providers.

Advantages of Telehealth

Telehealth is the provision of healthcare services by the use of telecommunication technology. It makes it possible for patients living in rural and remote regions to consult specialist doctors. Seniors who find it difficult to travel can also consult their regular care providers using telehealth. Patients are spared the trouble and expense of traveling and parking for a medical consultation.

Existing staff can be easily trained to support telehealth. Equipment required need not be very expensive

For doctors, especially specialists, it opens the possibility of providing services to patients in different places without having to commute. Patients find telehealth services convenient, allowing practices to compete with emergency rooms and walk-in clinics. Unused physician time can be used for telehealth, increasing practice revenue. Telehealth reduces no-shows and increases repeat consultations, improving practice revenue. Physicians providing telehealth are not restricted to their office; they can work from home, and even while traveling.

Telehealth provides safety. Patients can avoid leaving their homes, and physicians can reduce their exposure to patients. This is valuable in this pandemic.

Telehealth Before the Pandemic

Telehealth is tightly controlled in normal times. Only patients residing in a federally designated rural area can utilize these services. Physicians must be registered in the state where the patient lives. Only existing patients can be consulted virtually; new patients cannot avail of telehealth consultations. Patients have to go to a designated health facility to have a remote consultation.

Telehealth entails the sharing of a lot of data. The patient shares his data, including name, address, email ID, telephone number, and credit card information. During the consultation, the patient's history, prescription, diagnosis, and prescription are discussed, which are considered protected health information (PHI). It is the responsibility of the provider to keep this data secure. The software used must have robust encryption and security features. Two laws, HITECH (Health Information Technology for Economic and Clinical Health Act) and HIPAA (Health Insurance Portability and Accountability Act of 1996) apply to the provision of telehealth services. They prescribe the security measures and describe penalties in case of non-compliance.

Reimbursements have also been an issue. Doctors have been advising patients on the phone for years, without any way to monetize the consultation. Many payers would not pay even for a formal teleconsultation, or pay at reduced rates compared to in-person consultations.

Changes in Telehealth During the Pandemic

Covid-19 has taken a huge toll on human life, and people are rightly scared to leave their homes. Telehealth has been a valuable service for patients to consult their doctors.

Many relaxations in the regulations have been announced for the duration of the health emergency declared by the department of health and human services (HHS). Currently, physicians may provide remote consultations to new patients, to patients residing in urban as well as rural areas, and to patients residing in other states also. Patients are now allowed to avail of remote consultation from their own homes. This has opened up a vast pool of new patients (and increased revenue) for physicians who opt to provide telehealth services.

There are also waivers in place for some provisions of HIPAA. At this time, patients and physicians can communicate over regular meeting platforms like Skype and Facebook. This is significant, as many patients find it difficult to navigate the telehealth apps. Many physicians reported that they were spending significant time instructing their patients in the use of their telehealth platform. The use of meeting software that patients are already used to will make the process easier and encourage them to use it for consulting their doctors.

Most payers are now paying for telemedicine consultations, though not all are paying at par with in-person consultations.

The Future for Telehealth

Most patients who try telehealth like it. Telehealth is here to stay.

The worry is that all the relaxations will end with the health emergency. However, a bipartisan bill (the Protecting Access to Post-COVID-19 Telehealth Act) has been introduced in the House. This bill seeks to continue some of the provisions related to telehealth even after the emergency. Though the security requirements will be restored, the geographical requirements would be removed. Patients could continue getting consultations from their homes; doctors could continue providing services to patients in other states, rural and urban.

Only about a quarter of physicians provided telehealth services at the beginning of 2020. It was seen as an optional service, and not very remunerative. The Covid-19 pandemic has changed all that. Patients are avoiding physical attendance at clinics and hospitals. Doctors need an alternate revenue stream, and patients need a way to continue getting care. Telehealth is going to be a major part of healthcare now, and early adaptors will benefit substantially.

 

Last Revision: Sep 21, 2020