If you’re wondering whether your practice should start offering telemedicine services, this prediction is sure to get you off the fence:
By 2018, 40 percent of primary care encounters in the U.S. will be delivered virtually.
That’s according to Dr. Thomas J. Handler’s research (which is available to Gartner clients). He predicts virtual care delivery models, also known as telemedicine, will continue to grow quickly thanks to improving technologies, health care policy changes and patient demand.
This guide explains how you can capitalize on telemedicine’s many benefits. We’ll tell you what it is, show you how to pick a platform and give you insights about the potential return on investment (ROI).
(Click on a link below to jump to that section.)
Telemedicine Definition and Examples
The American Telemedicine Association defines telemedicine as “the remote delivery of health care services and clinical information using telecommunications technology.”
That description may sound pretty broad, but that’s because many different kinds of services and scenarios are considered telemedicine. Here are some examples to help you visualize the possibilities:
- Video consultations: A bedridden surgery patient uses a secure, video chat-enabled platform to show the physician how their wounds are healing after an operation.
- Virtual monitoring: An internet-enabled medical device placed in a patient’s home monitors vital signs daily. The data is automatically sent to the patient’s health care provider, so they can take swift action on any abnormal findings.
- Remote evaluations (aka “store-and-forward”): A mobile dental hygienist takes X-rays and intraoral camera images of patients’ teeth and later sends the records to a dentist (whose practice is in a different location) for evaluation. The dentist can then diagnose oral health issues and recommend treatment.
For the purposes of this article, we’ll cover the kind of telemedicine that occurs between physicians and patients. Keep reading to find out how to add virtual care services to your practice’s offerings in a cost-conscious and effective way.
The Top Telemedicine Benefits
As Handler suggests, telemedicine may actually be preferable to in-person encounters for some types of patient care. Patients think so, too. A Software Advice survey of 381 patients found 75 percent are at least “moderately interested” in using videoconferencing software for a virtual visit in lieu of an in-person office visit for a minor ailment (e.g., cold symptoms).
We compiled this list of telemedicine benefits to explain why this might be the case:
Top Telemedicine Benefits
Small medical practices in particular have a great deal to gain from these benefits. Since they must constantly see enough patients to pay practice costs, it is important for them to explore effective ways to grow and keep their patient base.
Potential ROI for Virtual Consultations
Telemedicine’s return on investment (ROI) comes from two sources: money saved and money earned.
Providers are able to extend office hours and offer more appointments since they can work from home without worrying about overhead costs (e.g., staffing and utilities). That leads to more appointments, patients and income.
Consider the following use cases showing telemedicine is a wise investment for some private practices:
— Physician’s Practice
“The ROI has been great. If one translates my billable time as my investment, then my ROI has been 80 percent or higher.”
— Dr. John Mayer, Doctor-on-Demand user interviewed for this article
One CloudVisit client recently reported a practice revenue increase of more than $20,000 over a 12-month period through video consultations alone.”
That said, it’s important to point out some factors that could impact telemedicine profitability for your practice.
For example, it’s possible you won’t be able to get reimbursed for certain kinds of telemedicine services, depending on your state laws and whether you’re billing through a private insurance plan or Medicare/Medicaid. (Read a recent state-by-state analysis of reimbursement limitations and opportunities here.)
Even so, some patients may be willing to pay a reduced, out-of-pocket fee for telemedicine consultations. Consider this pricing option if your likelihood of being reimbursed for certain services is lower than you’d like.
5 Steps to Start Offering Telemedicine Services
There are five main steps to efficiently introduce telemedicine at your practice. We’ve listed them below, along with details on how to achieve each goal:
1. Assess your resources.
A thorough evaluation of the practice’s workflow, available technology and patient needs will help you make important decisions down the line. Ask yourself the following questions:
|When it comes to workflow||How many more patients per day am I capable of seeing? Am I willing to extend my hours? Does my staff have time to handle extra training, a larger volume of calls and more scheduling tasks?|
|When it comes to technology||How good is my internet speed and connectivity? Do I already own web cams or other video-enabled mobile devices I can use for telemedicine?|
|When it comes to your patients||How many of my patients would be interested in telemedicine? (Consider asking patients directly or examining your claims history to see how many of their issues could have been resolved virtually.)|
2. Determine your compensation options.
As we pointed out in the previous section, insurance may not reimburse some telemedicine services. Reach out to all your payors to learn:
- What kind of compensation you’re eligible to receive
- Whether your clinical documentation needs to be adjusted
- Which services get the highest reimbursement rates
3. Choose a platform and include it in your risk assessment.
We’ll give you a rundown of platform types, their advantages and how to pick one below. Regardless of which vendor you select, though, you need to keep your practice’s security risk assessment front of mind to safeguard patient privacy and security.
The law mandates risk assessments. Adding a new telecommunications application will inevitably increase your patient data exposure risk. Find out how to create or amend your practice’s risk assessment here.
4. Discuss roles, responsibilities and challenges with staff.
Make sure roles and responsibilities for handling telemedicine patients are clear among staff. These may include help with documentation, scheduling and/or billing. Even after training is complete, set periodic staff meetings to address the practice’s new software and services so everyone can ask questions and share concerns.
5. Get the word out.
Patients won’t request services they don’t know about. Publicize your new telemedicine offerings by posting about them on your social media channels, asking colleagues to send you referrals and posting notices in your waiting room.
How to Pick a Platform
There are two main types of platforms you can use for live video consultations: an electronic health records (EHR) system with integrated telemedicine capabilities or a stand-alone telemedicine solution. We’ll break down the pros and cons to help you pick the best one for your organization.
The lowdown: EHR systems automate clinical operations for health care providers by enabling the digital creation and storage of patient records.
Within the last few years, many vendors have acquired or partnered with companies that have telemedicine functionalities by integrating those functions into their EHRs. Clinicians with this type of platform usually have to seek out telemedicine patients themselves.
The business model: EHR pricing varies widely depending on your practice size and preferred deployment model. Providers may have to pay a fee for access to video chat functionalities in addition to the vendor’s standard license or subscription fees.
Major pros: It’s ideal to use the same platform for all your clinical care to avoid duplicate data entry.
Major cons: Depending on the system, telemedicine functionalities may be underdeveloped compared to stand-alone systems.
Well suited for: Practices who’d like to keep all their clinical documentation in one place, particularly if most of their telemedicine visits will involve existing patients.
The lowdown: Stand-alone telemedicine platforms are not meant to manage the health records of all your patients, though many require patients to enter their medical history before the video consultation begins.
Some platforms include billing and scheduling applications. Appointment requests usually come in for providers through the platform: Patients sign up, state their reason for requesting a consultation and are assigned a clinician.
The business model: These vary by vendor. Some vendors charge doctors a monthly subscription fee, while others treat practitioners as independent contractors who get a percentage of whatever the patient pays per visit.
Sample vendors: Teladoc, eVisit, American Well
Major pros: These systems are mostly ready to go “out of the box.” Their functionalities are typically more robust. For example, they may offer virtual waiting rooms and clinical decision support tools to direct patients to the correct provider.
Major cons: You get limited access to a patient’s medical records and some platforms won’t easily interface with EHR systems.
Well suited for: Providers hoping to expand their patient base (rather than primarily using telemedicine for existing patients) and/or practices that don’t want to invest in a new or replacement EHR system.
Telemedicine can be lucrative for small practices. It shouldn’t replace in-person encounters with patients, but it can provide a low-overhead source of additional income while making you more marketable and accessible to patients.
Some key factors to keep in mind as you consider implementing this technology are licensing and liability insurance. Not all state licensing boards allow clinicians from different states to deliver care or write prescriptions.
Unless you’re licensed by multiple state boards, your potential new patient pool may be smaller than expected.
Regarding liability insurance, we should note malpractice lawsuits stemming from telemedicine consultations are rare but concerning. You may be required to pay an extra premium depending on your liability insurance plan.
If you’re motivated to begin offering telemedicine services after this article, download and print the checklist below. It will help you keep track of the tasks you should accomplish: