Physicians nationwide scrambled to set up telehealth, a critical tool that allowed them to see patients at the height of the pandemic. There wasn’t necessarily the time then to thoroughly vet telehealth platform vendors or perfectly refine workflows in the office.
Now as a bit of normalcy has returned to the routine—and with 70% of physicians saying their organization is likely to continue using telehealth—it is a good time to take a step back and reevaluate the way telehealth is working for patients, physicians and other professionals in the clinic and how it could work better.
The AMA has updated a toolkit to help practices identify different types of telehealth services, employ efficient telehealth workflows and understand how key regulations affect telehealth.
“It’s highly variable based on the individual physician preferences, as well as the patient population and the resources the practice has, but everyone has a better sense of what they are comfortable with and what their needs are. It’s a good time to go back to the start line and reevaluate,” said toolkit co-author Jill O. Jin, MD, MPH. She is an internist, clinical assistant professor of medicine at Northwestern University Feinberg School of Medicine, and a physician adviser at the AMA.
Her practice reevaluated its telehealth platform and workflows recently, ultimately choosing a new platform. Dr. Jin said the checklists and other steps in the AMA STEPS Forward® toolkit “Telehealth Integration and Optimization” (PDF) are helpful for this process.
Supporting telehealth is an essential component of the AMA Recovery Plan for America’s Physicians.
Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.
Following the creation of a strategic plan, the AMA toolkit outlines these five steps to help practices improve patient access, satisfaction and continuity of care, while enhancing care team well-being and increasing revenue.
Decide which services to offer
Telehealth isn’t limited to COVID 19-related circumstances and physicians continue to gain a sense for which visits work well virtually and which are best done in person. Among telehealth services payable under the Medicare physician payment schedule are emergency department visits, advance care planning, diabetes management visits and the Medicare annual wellness visit.
Pick the right platform
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Choosing or switching to a platform that matches the physician practice’s needs is essential. Many practices have provided audio-only visits, while others have used Doximity Video or Doxy.me, two platforms designed with medical settings in mind. Other practices have relied on more all-purpose videoconferencing platforms such as Zoom, FaceTime or Microsoft Teams.
The toolkit provides more than a dozen questions to ask about privacy, security, logistics and patient support and usability as your practice considers the best telehealth platform to meet its needs.
Understand relevant laws and policies
No matter which delivery model a practice chooses, it must meet all federal and state laws and standards related to:
- Billing privacy and security.
- Informed consent.
- Medical licensure.
- Credentialing and privileging.
- Prescribing.
- Quality reporting.
- Liability.
The toolkit answers some common questions and provides links to resources to find out more about these areas.
Develop team-based workflows
Telehealth workflows should parallel in-person workflows as much as possible and should incorporate team-based care principles. During the pandemic, telehealth workflows often reverted back to the “doctor does it all” model, which is not a sustainable solution.
Learn more with a related AMA STEPS Forward toolkit, “Telemedicine and Team-Based Care: Improve Patient Care and Team Engagement by Using Team-Based Care in Telemedicine.”
Assess and optimize
Similar to when changes are made with other processes, it’s important to engage champions and early adopters, capitalize on and communicate successes internally and get frequent feedback on inefficiencies and opportunities for improvement.
Another valuable resource is the “AMA Telehealth Implementation Playbook” (PDF), which provides further guidance on how to implement, evaluate and scale successes for telehealth integration.
