How to Start a Telemedicine Practice

Many doctors are asking themselves - should I start practicing telemedicine?

Telemedicine consumer adoption reached an all-time high in 2017. And the estimated adoption for 2018 may double 2017, as usage projections are off to a fast start from the epic flu season this winter.

Many medical professionals - doctors, nurse practitioners, physician assistants, & psychologists to name a few, are wondering if they should start practicing telemedicine in 2018. Then asking, "how do I get started?"

Providers should consider a variety of critical questions and weigh the pros and cons of various choices before diving-in head first.

Do I want to use telemedicine as an expansion of my current practice?

This is the hardest and first threshold question before getting started. Do you envision telemedicine as an add-on for use with your current patients? If that is your plan then you have several business decisions to ask yourself. If employed, does my current employer allow me to adopt any telemedicine practice? How will I encourage adoption by my patients? Will I make telemedicine available to all patients or only certain types of patients? How will I bill for my telemedicine services? Will I try for insurance reimbursement, or allow after hours telemedicine on a cash pay convenience payment system? How do I protect the privacy and security of my patient information? Will I only do video calls or allow for secured asynchronous communication, ie, text messaging? Does my current malpractice coverage include Telehealth treatment and cyber liability?

The list of uncertainty can grow, fast. In a rapidly developing industry, it's important to stay current on new developments. Here's a list of telemedicine newsletters you should be reading. But first, let's break down some of the larger fundamental questions.

What are the advantages of starting a telemedicine practice?

Starting a telemedicine practice can come with numerous benefits. These include increased convenience for patients, more repeat business, improved patient outcomes, a wider geographical net to draw patients from, higher patient engagement, lower practice costs, and a better work-life balance.

Patient convenience

Telemedicine offers a convenient way for patients to access care. Not having to drive to a facility, park, and sit in a waiting room, (not to mention taking time off work and arranging childcare) can make fitting doctor visits into a hectic schedule much easier and more appealing for the patient.

This added convenience also means fewer no-shows and last-minute cancellations, because the patient can conduct telemedicine visits from anywhere. In some cases, when work or child care responsibilities arise at the last minute, patients can switch some in-person visits to virtual appointments to accommodate their schedule.

Improved patient outcomes

Telemedicine can also improve patient outcomes, particularly for those with chronic conditions who need regular assessments. Monitoring these patients can be challenging in a traditional office setting because of the time it takes to set up appointments and for patients to travel to the facility.

Travel time can be particularly difficult for patients who live in rural areas. Telehealth removes these barriers, allowing for easier access to health services that they can receive virtually.

More engaged patients

Remote care can help patients become more engaged with their health care. The ease of making and keeping appointments means their care is less likely to be disrupted. Easy text-message and email options offered by telehealth platforms increase patient and physician communication.

This convenient communication channel allows the patient to ask questions, report early warning-signs, and easily make follow-up appointments when necessary.

Lower costs, higher revenue

A telehealth practice can also save you money by cutting down on healthcare service costs, such as front-desk help and office supplies. Additionally, it may increase revenue, as virtual visits are more time efficient than in-person appointments. This means providers can see more patients in the same amount of time.

Extended hours

With telemedicine, practices can offer extended hours in the mornings, evenings, and on weekends, all without the requirement of staffing a brick-and-mortar office. Just note that while major advancements have been made to improve reimbursement for telehealth in recent years, state telemedicine laws and health insurance plans vary, so it’s best to research reimbursement policies specific to your state before getting started.

Better work-life balance

A telemedicine practice can lead to a better work-life balance. Many providers may be hesitant to travel for business or vacation because they are worried about disrupting their patients’ care. Telemedicine offers an additional peace of mind, because providers know they can connect with their patients in case of a health emergency.

What technology should I use that is safe, secure and user friendly for my patients?

If you are going solo, picking the right technology partner can check off several of the boxes reducing your uncertainty. Most virtual care products can work for an individual or across an entire practice. The frequent setup is a monthly fee which can range from $70-$500 for unlimited use of the technology platform for you and your colleagues.

And the technology partners can help make your virtual care as successful as possible. For example, Spruce Health is a virtual care platform that facilitates collaboration among your care team and allows for virtual care visits with your patients.

Spruce can help you onboard your patient population by sending secure email and text messages to your existing patients following all applicable HIPAA regulations. Spruce and other communication platforms like Medici that allow you to set your own price for consultations with patients, which can be asynchronous text or live video. You can treat your patients after hours, refill prescriptions, refer patients to colleagues, and reduce needless emergency visits by making yourself available via a smartphone app.

Does my current employer or EHR already have a virtual care tool?

Check your current options, as your EHR may already come with a virtual care tool built in. Using an existing EHR can make the process of patient communication and billing much, much easier with all of your patient profiles and contact information already built in.

Chiron Health is a telemedicine tool users of Athena Health's EMR can adopt to synchronize with other services in the practice such as scheduling and insurance reimbursement.

If your EHR or employer has a tool available, use it! In addition to the monthly fees, it saves your the headaches of integrating a new product to your workflow and can be especially advantageous for insurance billing for follow up care or monitoring chronic conditions.

How do I plan on getting reimbursed for my telehealth visits?

Your time is valuable. You need to get paid for it. If you are considering insurance reimbursement picking the right telemedicine platform can help immensely. Companies like Mend or Zipnosis work with you and your existing patient demographics to maximize your insurance reimbursement.

Many providers also elect to treat virtual care as a cash pay service. This makes sense to both sides as the provider is often allowing for night and weekend availability, and consumers are willing to pay out-of-pocket for that convenience.

Most of the platforms mentioned above facilitate per visit cash fees for virtual care visits via text or video. Another option growing in popularity by group practices, charging a flat monthly subscription which allows individuals or families to pay a monthly fee for unlimited night and weekend access to telemedicine care.

Practices that use this model rotate the provider that covers the evening shifts for any patient to access. This may be an attractive option if you work in a group setting that serves primarily a young family demographic.

Am I better off going to work part-time or full-time for a telemedicine focused company?

Tired of answering all these questions… simpler options do exist. Many telemedicine technology companies directly employ their own "virtual clinic" network of medical professionals. Doctors can work part-time or full-time seeing patients virtually from their home or from the employers corporate offices.

The pros of this approach - the telemedicine company figures out the software tools, scheduling and reimbursement model for you. This route is a good fit for doctors looking for a regularly set supplement to their existing schedule, say 20 hours a week, or looking to work from home for a few years to start a family and still want to practice medicine.

What are the benefits of telemedicine during COVID-19?

During COVID-19, telemedicine allowed providers to triage patients, improve the safety of providers, staff, and patients, avoid travel, cut down massively on time in waiting rooms, lower exposure risk, and keep practitioners on the job and providing care. It also lowered costs and increased revenue.

Here’s a rundown of the key benefits of telemedicine during COVID-19:

Telemedicine slowed the spread

At the start of the pandemic, telemedicine became a vital way of managing the spread of COVID-19. Medicare and many private insurance companies encouraged telehealth visits and allowed doctors and therapists to bill for virtual services.

Easier triage

Virtual visits became a form of tele-triage to help determine how sick a person was and if they needed to come in to be seen or could manage their own care at home.

Improved safety

Using video conferencing for visits meant patients could be seen safely from their home, avoiding travel on public transportation and sitting for hours in the waiting rooms around others, potentially exposing themselves to the deadly virus. Despite these conveniences, patients still received appropriate care. Remote healthcare visits also helped keep practitioners safe, healthy, and able to continue their work.

Telemedicine benefits in the post-pandemic world

While much has changed since the early days of the pandemic, COVID-19 remains a threat. However, providers and patients can still leverage telemedicine to help prevent the spread of COVID and other harmful pathogens like the cold and flu viruses. This is especially important for patients with chronic conditions and a weakened immune system who are at a greater risk if they become infected.

The pandemic became a huge source of anxiety for these patients, so knowing they can still see their doctor virtually without putting themselves at risk can help put them at ease, thereby improving their stress levels and overall health.

Healthcare providers can continue to use telemedicine to triage patients and prevent them from unnecessarily coming into the office when their care can be managed virtually. It can also help cut down on unnecessary and costly visits to the emergency room and urgent care centers by offering another option for care outside of normal business hours.

Summary

Providers need to weigh a number of variables before deciding on a telemedicine practice. As a provider, you’ll find plenty of benefits, including convenience of care, improved patient engagement, lower overhead costs, increased revenue, and prevention of spread of infectious illnesses, such as COVID-19 and the flu.

However, you’ll need to find a telemedicine software partner that suits your needs, and consider how you’ll get reimbursed for telehealth visits. You’ll also need to take into account whether offering telemedicine part-time or full-time is right for you.

Once you’ve thought through these factors and you’re ready to take the plunge, check out this guide to learn more about how Wheel can help you set up your own telehealth practice.