5 Critical Steps to Take Before Incorporating Telemedicine into Your Urgent Care

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5 Critical Steps to Take Before Incorporating Telemedicine into Your Urgent Care

In the 21st century, seeing a doctor is as easy as logging into a website at a predetermined time and communicating one-on-one with a medical practitioner trained in telemedicine. Once the domain of astronauts and patients with extraordinary needs, telemedicine is becoming a more common—and convenient—way for patients to visit with their doctor.

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What's Included

Introduction

A woman walks into a doctor’s office—or maybe she doesn’t. In the 21st century, seeing a doctor is as easy as logging into a website at a predetermined time and communicating one-on-one with a medical practitioner trained in telemedicine.

For many urgent cares, finding new ways to meet patients’ needs keeps them relevant and successful in a very dynamic industry. This entrepreneurial attitude is one of the hallmarks of the urgent care industry. With constant movement towards new ways of delivering care, many clinics are now considering incorporating telemedicine into their business.

Telemedicine isn’t really new, but it is more readily available to the general public than ever before. Once the domain of astronauts and patients with extraordinary needs, it’s becoming a more common—and convenient—way for patients to visit with their doctor.

Chapter 1

So What is Telemedicine?

At its core, telemedicine allows doctors and other medical practitioners to see, diagnose, and treat patients from a distance using telecommunications technology—generally a computer, tablet, or other mobile device—in a secure online environment.

Smart devices, hi-definition video, wearable monitoring devices, high-speed internet and wireless connections, and device accessibility provide an unprecedented opportunity for patients to connect with healthcare providers from their homes, offices, cars, and even in assisted living facilities.

Patients increasingly driven by convenience are warming up to the idea of seeing their doctor on a screen versus in person. Telemedicine may not be the best approach for any condition, but as with more experienced telemedicine practitioners and constantly improving technology, it’s becoming a viable and smart choice for patients and providers all over the world—and changing medicine in big ways.

It’s no surprise that many urgent cares are considering adopting telemedicine into their practice. It offers a larger pool of patients, time and cost savings, and solutions for crowded clinics. Given the right equipment, training, and personnel, the main ingredient necessary for a successful telemedicine practice is secure video transmission.

Yet, it may not be the right move for every urgent care. There’s a lot to consider before moving forward with telemedicine as your newest service line.

Why Telemedicine?

Urgent care and telemedicine can in most cases peacefully walk hand in hand because they share many of the same goals—saving patients’ time, increasing efficiency, increasing overall savings to the healthcare system, and most importantly, providing high quality medical care to patients on demand.

Telemedicine offers:

  • Increased access to care
  • Improved patient outcomes
  • Increased cost savings
  • Increased patient convenience
  • Improved efficiency

Telemedicine can be used for a wide variety of health services. Here’s a short list of common conditions an urgent care provider may treat via telemedicine:

  • Allergies
  • Arthritic pain
  • Asthma
  • Bronchitis
  • Colds and flu
  • Diarrhea
  • Infections
  • Insect bites
  • Pharyngitis
  • Conjunctivitis
  • Rashes
  • Respiratory infections
  • Sinusitis
  • Skin inflammations
  • Cellulitis
  • Sore throats
  • Sprains and strains
  • Bladder infections
  • UTIs
  • Sports injuries
  • Vomiting

But this list is far from complete. Great breakthroughs have been made using telemedicine in the areas of:

  • Radiology
  • Psychiatry
  • Dermatology
  • Ophthalmology
  • Phrenology
  • Obstetrics
  • Oncology
  • Pathology
  • Rehabilitation

At its most basic, telemedicine requires the addition of secure video to your clinic, enabling private interaction between patients and care providers. Telemedicine-specific training focused on best practices in this unique healthcare space will also help to ensure the success of your telemedicine practice and the satisfaction of your patients.

Chapter 2

Who Benefits from Telemedicine?

Patients

By far, the biggest benefits of telemedicine go to patients who (more than ever before) want the convenience of healthcare on demand. Telemedicine provides this care without the aggravation of traveling to the clinic, taking time away from work and family, and exposure to other sick people, which is especially appealing when a person is not feeling well in the first place.

Telemedicine also offers big benefits among specific populations and market segments in rural parts of the world and small towns where there is limited access to healthcare. This technology not only allows patients to see a trusted physician, but also to expand their care team to include specialists when needed. School nurses, visiting nurses, and patients in nursing homes can all benefit from medical advice and care offered through telemedicine.

Early research also suggests that the addition of telemedicine services for increased access to care, follow-up appointments, reviewing test results, and management of chronic conditions can improve patient outcomes and stimulate patient engagement.

Many people have expressed doubts about the ability of doctors to diagnose and treat a patient without actually seeing them face-to-face, but the right training and highly sensitive equipment allow doctors to thoroughly examine patients. And when they are unable to make a confident diagnosis, they are free to schedule time in the clinic.

Accurate wearable monitoring equipment also helps doctors make good decisions with essential and relevant data for patients with more chronic conditions.

The beauty of telemedicine is that it is available to all, but not required, leaving room in the system for those who prefer to take a more traditional healthcare route.

Providers

Healthcare providers can also benefit from providing telehealth services with increased operational efficiencies. In fact, many are already enjoying the convenience of telemedicine with store-and-forward solutions such as teleradiology services; remote-patient monitoring to collect health data like blood sugar, blood oxygen levels, and heart rate; and the quick sharing of lab results.

The next step for many providers is real-time telemedicine, aka the video visit. Video appointments can reduce the length of patient encounters—which means doctors can see more patients, more efficiently boosting revenue. Other benefits include reducing no shows and cancellations, engaging patients in their own healthcare, and building loyalty.

The Healthcare System

Technology’s impact can be seen and felt in every segment of our lives. With most every consumer good and service available on demand, it’s not surprising that healthcare is also responding with technology.

Telemedicine is the next step in providing healthcare when it’s needed where it’s most convenient. With this new technology, wait-time can be reduced for in-person visits, people with non-urgent conditions will be less likely to seek care in emergency rooms, and patients can manage chronic conditions and post-treatment care in ways that better fit into their everyday lives. All of this makes the delivery of healthcare more efficient and contributes to the overall good health of the general population.

Even those who prefer in-person visits with their primary care physician will reap the benefits of a healthcare system that’s more efficient and responsive to the specific needs of each patient.

Keeping healthcare affordable and accessible for every individual in the nation is one of the great challenges of our time. Evolving technologies like those that power telemedicine go a long way to helping solve this challenge.

Chapter 3

5 Critical Steps to Take Before Incorporating Telemedicine into Your Urgent Care

If you’ve decided to take the leap into telemedicine, follow these five critical steps to ensure your success.

Step 1 – What is your motivation for doing telemedicine?

The telemedicine services you provide to your patients (and/or your market) should be tied to the reason you’re offering telemedicine in the first place.

  • Do you want to make visits more convenient for existing patients?
  • Do you want to offer additional services to existing patients?
  • Do you want to enter new markets and find new patients?
  • Are you choosing telemedicine to retain current patients who want virtual office visits?
  • Are you trying to balance the load throughout the day/week in a single clinic or across a number of clinics?

The term telemedicine includes a very broad range of services, but there are generally three types of telemedicine strategies: Store and forward; remote monitoring; and real-time clinical telemedicine. For urgent care clinics, real-time telemedicine is by far the most commonly practiced services. Once you get clear on your motivation, it’s easier to choose the telemedicine services that make the most sense for your business.

Real-time telehealth

Often called synchronous telehealth, real-time telehealth involves two-way live interaction between a patient and provider usually via secure video. It’s a virtual alternative to an in-person visit. This is primarily what people envision when they think of telemedicine.

Real-time telemedicine is an opportunity for urgent cares to expand their services in a variety of situations.

  • Load balancing

One of the most common, and possibly most practical, uses for telemedicine is load balancing. For clinics with multiple locations, it’s not unusual for one or two clinics to have a substantially higher patient volume. To stabilize volume between clinics, patients can be given an option to visit a practitioner at a different physical location via telemedicine.

Telemedicine allows urgent care providers to give patients a choice to see an offsite provider when a convenient face-to-face appointment is not available. This makes for happier patients, who are able to get on-demand care—and for clinics and providers who can work at a pace that makes sense.

  • Virtual visits for patients in rural areas

Getting medical care in rural areas is increasingly difficult as small clinics may struggle to stay solvent and patients have fewer options. Telemedicine helps connect patients with qualified providers. For clinics already offering clinic-to-clinic telemedicine, it can be smart to open a clinic in a smaller town or lower traffic area without a full clinic staff, but instead, offering telemedicine visits, even when a patient is physically present.

  • As a part of an occupational medicine program

Telemedicine can be a great addition for OccMed providers and the businesses they serve by eliminating non-essential trips to an emergency room or clinic, and as a safe alternative for patients who can’t drive or who live in rural areas.

A telemed visit can include more than one provider, the patient, and other participants when needed. It’s a good way to conduct scheduled follow-up visits without major disruptions in a patient’s work day. By offering service outside traditional work hours, on weekends, and on holidays, telemedicine can improve employee presenteeism and productivity and is easy to implement at a low cost.

  • To support nurses in schools or group residential facilities

When staff medical practitioners in group homes and schools are confronted with non-emergent conditions, support is just a telemedicine visit away. This can be especially helpful when transportation is not readily available, or in the case of geriatric patients, is not prudent. Under the advice of a telemed doctor, the decision about next steps can be made after the condition is evaluated by a telemedicine doctor.

  • Alternative to traditional face-to-face healthcare

In today’s on-demand healthcare landscape, some patients simply prefer the convenience, and sometimes lower costs, available through telemedicine. For conditions such as cold, flu, and other common illnesses, telemedicine can be a first line of care.

Once patients try real-time telehealth visits, they may decide to make it their first choice when it makes sense for their medical care.

Store and Forward

Store and forward telemedicine is all about data and sharing information. Not often regarded as “telemedicine,” these solutions have become integrated into the current healthcare landscape allowing various providers to work together to come up with the best care plan for patients.

When used in the context of a telemed visit, these solutions allow various healthcare service providers to share medical data like lab results, images, and records with other providers at different locations through the use of secure platforms—all in real time.

One of the biggest benefits of store and forward telemedicine is efficiency. Since providers can access information at different times from different places and still work together, the time from the initial visit through diagnosis and treatment is quicker and patients have access to a whole team of doctors working together to get the best possible outcome.

Remote Patient Monitoring (RPM)

Although not particularly relevant to urgent care providers except in special cases such as occupational medicine, remote patient monitoring is a telemed service worth mentioning.

In the past, monitoring patients meant a stay in the hospital or frequent visits to a clinic to check on vital signs or progress. With remote patient monitoring, and the participation of the patient, providers can now track important data like blood glucose levels, blood pressure, and heart rate.

Many remote patient monitoring solutions automatically update patient data and send it to primary care providers and specialists, giving doctors the ability to see warning signs and intervene if they see inconsistencies or potential medical problems.

Step 2 – Review your state laws for practicing telemedicine.

Not all states are created equal, at least where telemedicine is concerned. To make a good choice, learn more about the laws for practicing telemedicine in your state. The following questions are a good place to start.

  • Does your state have parity laws?

Parity laws require insurance companies to reimburse telehealth services at the same or equivalent rates as in-person visits. Many experts agree that for the United States to move away from volume-based healthcare toward care based on value, providers must be able to achieve good outcomes while providing improved access to high quality care anytime, anywhere.

The priority of any medical practice is the needs of the patient. Unfortunately, in states where parity laws are not in place, it’s not always prudent for an urgent care to offer telemed services—even when it may be the best answer for the patient. If a provider cannot get paid equally for services rendered online, offering telemedicine is not likely a good business decision.

Clinics must also see a return on investment. Since a telemed visit often costs the patient less, clinics must be sure they’re not decreasing their own revenue with lower-cost services. At the same time, telemedicine services may draw new patients from farther away to balance any decreases and in return, generating new revenue.

  • What does your state say about scope of practice?

Telemedicine has a limited scope—and in the U.S. this scope of practice is determined by the state. In some cases, choosing which patients should be seen and what conditions can be treated through telemedicine is clear. Providing care for a patient with a broken bone will require an in-person visit. But in other cases, the line is not as well defined.

It’s not surprising that some practitioners are reluctant to diagnose symptoms without actually seeing a patient. Before diving in to telemedicine, it’s important to consider the legal restrictions and the malpractice ramifications that could affect your clinic.

  • What does your state say about the location of the patient?

When accepting new telemedicine patients, their location should be a key factor. State laws sometimes restrict practitioners from accepting new out-of-state patients, but allow out-of-state telemed follow-up care. Some states restrict the use of telemedicine to patients in rural areas. As the practice of telemedicine becomes more common, state laws are being rewritten to ensure that patients get the best care possible while opening up new avenues of care for doctors.

Step 3 – Review your payer contracts.

As you consider a new telemedicine service, it’s essential that you take a good look at current payer contracts to be sure it’s a good financial choice for your business. Some contracts that have been in place may need to be renegotiated to include telemedicine.

Begin with finding the answers to the following questions:

  • What does your contract say about reimbursing for telemed?
  • What does your contract say about the scope of practice?
  • What does your state say about location of patient?
  • Do you even plan to submit claims to insurance?

The answers you find will help you make good choices—not only about whether or not to launch a telemedicine practice, but also about how you will incorporate it into your current urgent care practice.

Step 4 – Choose a financial model.

With your current goals in mind, determine what financial model will best help you meet these goals. You may choose a combination of direct revenue from traditional payers if the legal restrictions in your state are friendly to telemedicine providers. This model will require a thorough review and possible revision of your claims processes. Check specific state guidelines and train staff to be certain you can meet all the requirements to ensure reimbursement.

Another option is to collect cash up front from telemed patients. This choice requires a thorough evaluation of the market and your competition. Research what other successful practices have done to make it work. Determine what your patients pay for this service and what you need to charge to make it worthwhile financially.

Step 5 – Choose a clinical champion (or two).

Once all the plans are in place, choose a champion to help get your telemedicine practice off the ground. Look for a respected, enthusiastic clinician with influence who can not only be the role model for other staff, but who can actively help you build your telemedicine practice.

Get some additional support from an MA, nurse, technician, or other staff for the triage process. Your clinical champions will be your on-site experts on not just the technology you use, but how to address patients electronically and how to approach the scope of the practice.

Based on the type of services you provide and the vendor you choose, your clinical champions will help establish your workflow and train your personnel.

Chapter 4

The Future of Telemedicine

With the industry shift to delivering value-based healthcare in which the quality of outcomes means more to reimbursement than the quantity of encounters, telemedicine solutions will be one of the most effective routes to improving care in a few important ways.

Increasing access

Telemedicine makes time, space, and distance irrelevant for many patients in rural communities, patients without access to reliable transportation, or people confined to their homes. By allowing providers to see patients where they are, patients have convenient access to doctors and other healthcare professionals removing barriers to care.

Increasing effectiveness

Bridging gaps in care with virtual consults and follow-up care via telemedicine supports the continuum of care and improved outcomes.

Increasing engagement

Perhaps one of the biggest benefits of telemedicine is engagement. With doctors and other providers available online, patients accustomed to on-demand services are more likely to connect with the healthcare community and stay in longer-term relationships with their doctors.

Much of today’s medical care is not delivered within a value-based framework, and telemedicine remains a relatively small, but growing, healthcare option. In an increasingly value-driven world, it will be vitally important that providers—and not just urgent care providers—to be really efficient and cost-conscious with their services delivery. Telemedicine will be vitally important to these efficiencies.

Looking to add additional revenue streams to your urgent care?

The experts at Experity Consulting can help uncover your center’s untapped potential.

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