For organizations around the nation that are shifting to a remote care model by connecting with patients at a distance, here is a helpful checklist (in no particular order) of the various aspects of this new clinical service to keep in mind.
1. Clinical Guidelines: Clearly define clinical criteria to decide which patients and which chief complaints are suitable for remote care and which ones are not.
2. Medical licensure: While reimbursement regulations have been relaxed, medical licensure requirements still may apply at the state level.
3. Emergency Procedures: Ensure that in the case of an emergency on the patient end (harm to themselves, to others, by others, etc.) you can alert the appropriate authorities.
4. Privacy: Ensure that the patient’s privacy is protected during the consults.
5. Billing: The rules and regulations around telehealth reimbursement have and will continue to change frequently. You need to establish a central authority that internally pre-authorizes any telehealth visit.
6. Scheduling: Telehealth appointments should be scheduled as designated telehealth visits with their own appointment type to allow for appropriately billing and tracking of telehealth visits.
7. Telemedicine Consent: Depending on your state’s statutes or the requirements of the payors, patients may need to consent to this form of care orally or in writing and processes need to be in place capturing that consent was obtained.
8. Technology Testing (Patient): Confirm and test beforehand that the patient has adequate technology (smartphone, tablet, PC),
adequate, reliable connectivity, and the ability to operate the technology.
9. Telehealth Technology: Consider using different technical solutions for delivering remote care, based on the clinical specialty and the patient population.
10. Support Processes: With an increasing number of telehealth users comes the need for having a first line of contact to address telehealth-related questions. You need to establish both, operational and technical support.
11. 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 asneeded 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 prescriptions, post-visit documentation and follow-up visit scheduling as well as access to support.
12. Allied Health 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.
13. Communication/Publicity: Lastly, and very importantly, you need to clearly communicate your vision, your objectives, your directives and processes regarding the use of telehealth to all staff members as well as to your patients and the public at large.
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