3. Focus on Quality
Given the ad-hoc nature of most remote care service launched in response to the healthcare crisis, you cannot allow yourself to “fly blind”, even for a single day. In addition to volume stats, you need to collect and act on data on clinical quality, patient & clinician acceptance, technical performance and financial performance.
Next, you need to designate an individual to monitor and analyze the data on a daily basis. Associated with the agreed-on metrics to collect, the executive decision team must then continuously define the key actions to take once a metric goes above or below the desired threshold – and put those actions in place when needed.
4. Consistent Internal Pre-Authorization
The rules and regulations around telehealth reimbursement have and will continue to change frequently. In order to prevent the delivery of care that is either unknowingly non- reimbursable or even illegal, you need to establish a process by which every scheduled telehealth appointment will be reviewed before the visit by a central decision authority.
While initially each and every visit may get the “go ahead”, there will quickly come a time when lifted regulations are rolled back. It is thus important that everyone at least notify the central pre-authorization team to make sure that the telehealth visit should proceed.
5. Pre-Visit Patient TechCheck
One of our key desired hallmarks for telehealth is to enable physicians to “practice on top of their license”, enabling them to “only do what only they can do”. For the workflow design this includes removing any administrative, legal, or operational tasks on the physicians’ workflow.
Especially when a provider has to troubleshoot the patient’s audio, video, or connection options, their productivity sinks enormously, and with it their tolerance for making telemedicine work for them.
The best practice is to truly dedicate the time to ensure that each patient, at the time when the appointment is scheduled, can conduct a quick TechCheck: Does the patient have the adequate technology (smartphone, tablet, PC) and adequate, reliable connectivity, and the ability to operate the technology well?
6. User Training
For the final of the six hallmarks, we are focusing on two separate audiences: training for the providers and training for the supporting staff.
Provider Training: All providers offering telemedicine need to be trained on a variety of aspects of telemedicine. This training should be delivered just-in-time on an as-needed basis. It can be conducted in person or remotely or via a pre-recorded video/ presentation. This training should cover clinical guidelines (inclusion and exclusion criteria), policies (licensure, consent, emergency contact, privacy, etc.), billing rules, webiquette/webside manners, use of the telemedicine technology, the process for e-prescribing, post-visit documentation and follow-up visit scheduling as well as access to support.
Staff Training: Similarly, training materials (documents, presentations, etc.) should be developed for the various audiences affected by telemedicine, including, but not limited to schedulers, patient service representatives, medical billing staff/coders, MAs & RNs, providers and leadership.
Resources: In addition to live, interpersonal training, the creation of short explainer videos and single-page cheat-sheets will go a long way to reminding people of the key basics.
Launching telehealth rapidly and quickly was exactly what was needed in the early weeks of the Covid-19 health crisis. But before things get too much out of control, it is important to retroactively reapply the key hallmarks of telehealth success as laid out above.