12 Guidelines for Launching a Telehealth Company

Get your telehealth company to market—rapidly and compliantly—by carefully planning for these twelve workstreams.

If you’re thinking about launching a virtual care service nationwide, we’ve outlined the twelve critical workstreams you’ll need to plan for to ensure you’re delivering safe, compliant, and clinically sound care to your customers and patients.

1. State coverage
2. Asynchronous vs. synchronous modalities
3. Consult platform & EHR
4. Treatment areas
5. Clinical protocols
6. ePrescribing
7. Pharmacy fulfillment
8. The Friendly PC
9. Cyber liability coverage
10. Patient journey
11. Virtual care clinicians
12. Workforce management

1. State Coverage

Where will you deploy your telehealth service?

Many companies are taking advantage of the opportunity to extend nationwide telehealth to support an entire customer base—whether or not that’s a core healthcare service.

To get moving, it can be advantageous to initiate a pilot in 3-5 high population states to ensure that operations and logistics are finely tuned, with a planned national rollout soon after.

When deciding where to launch, consider how many clinicians with various state licenses you’ll need, as well as each state’s telehealth regulations. While some states have recently changed telemedicine policies, there are still legal modalities to keep in mind.

Leverage our up-to-date database of statewide telehealth policies to help guide your launch geographies.

2. Asynchronous vs. Synchronous Modalities

What telehealth modality best serves your patients?

Once you determine which states to provide service in, you’ll need to establish the best modality mix for your business and review the corresponding state regulations.

Some states, like Texas or Florida, support asynchronous telehealth visits, historically known as “store and forward.” The adaptability of asynchronous telehealth makes it ideal for a wide variety of direct-to-consumer care offerings. This enables both patient and clinician to interact on their own timeline through the use of a dynamic patient intake form—streamlining the consultation process in a safe, compliant manner.

While a majority of states now allow for asynchronous virtual care for many treatment areas, the remaining require either live synchronous visits via video or phone or a combination of the two modalities. At this stage in planning, it’s important to speak to a lawyer or firm specializing in telehealth, like Foley & Lardner or McDermott, Will & Emery to ensure you’re abreast of the latest state regulations and requirements.

3. Consult Platform

Which telehealth technology solutions will you need?

After mapping out your modality mix, the next step is to determine the telehealth technology solutions platform you’ll adopt.

If you’re planning a national rollout, your platform should include a combination of both synchronous and asynchronous telemedicine service functionality.

Should you buy or build a telehealth platform?

For many companies, it starts as a “buy or build” question, as there are copious configurations and features critical to evaluate based on the treatment areas, modalities, and service you're offering to patients. Some platforms are better suited to synchronous visits, while others—or even combination configurations—can serve async and sync needs well.

Wheel can support your needs with a consult platform designed to work seamlessly within your patient workflow. We collaborate to identify the features and functionality necessary for your brand and clinical experience, then launch the optimal platform for a scalable service.

4. Treatment Areas

What specific telemedicine services will you offer?

It’s important to explicitly map out the discreet treatment areas you want to focus on as patients engage telemedicine services for a wide variety of healthcare needs.

The advantage of today’s virtual care brands is that they don’t have to be all things to all people.

Conduct an audit to evaluate the telehealth whitespace and determine your treatment niche.

• How will your brand elevate or expand the status-quo in care?
• Who are your primary competitors and how can you augment or revolutionize that service?
• What common presentations are patients like these more likely to experience?

Every telehealth provider should be upfront on its website about what treatment areas are served. Telemedicine companies can tailor the offering to just dermatology, diabetes management, primary care, or lifestyle needs like erectile dysfunction or women’s sexual health, for example. The key is planning those services in advance and with great detail.

"A patient can walk into a private practice clinic and the team can handle almost anything they present with. But when a patient shows up online to a virtual care visit, a company must be prepared clinically with the right protocols for the right treatment areas.”
- Dr. Rafid Fadul, Executive Medical Director at Wheel

5. Clinical Protocols

What are the clinical protocols for each telehealth treatment area?

Once you determine the treatment areas your telehealth company is interested in serving, then it’s time to design the protocols.

Clinical protocols frame the initial patient intake that historically would have taken place in a face-to-face medical interview between the physician and the patient.

At a minimum, clinical protocols must define:

• Patient history and physical (H&P)
• Patient symptoms
• Comorbidities
• Current medications
• Appropriate and approved medications for each treatment area
• Drug-drug interactions to avoid
• Potential drug side effects
• Contraindications
• Refill guidelines

Clinical protocols guide the design of the patient intake algorithms, which systematically informs the professional medical decision by the telehealth clinician.

Clinical protocols ultimately protect the patient, the clinician, and the care-providing company—ensuring safe, clinically-sound care delivery for each visit.

“It’s imperative that telehealth companies map out every appropriate question. This is where the art of medicine becomes translated into a very clear process for digital delivery.”
- Dr. Andrew Zimmerman, Medical Director at Wheel

6. ePrescribing

How will you manage telemedicine prescriptions?

It's important to remember that in telemedicine, a good outcome isn't always a prescription. Sometimes when it comes to urgent care telehealth services, the best outcome is care navigation, directing a patient to an in-person primary care clinician in a clinic.

That said, it’s critical to build the capability to prescribe medication into your platform.

To provide a full-service telehealth offering, you’ll need technical integration with an ePrescribing service like DoseSpot.

Be sure to clearly outline all of the prescriptions your clinicians can administer within your clinical protocols and cross-reference this list with clinician practice guidelines. For example, in some states, nurse practitioners have differing prescribing privileges than physicians. You should also consider highlighting on your website the common medications your prescribe and classifications of prescriptions your service will not provide, such as Schedule III or IV controlled substances.

7. Pharmacy fulfillment

How will you fulfill telemedicine prescriptions?

A patient has received a prescription through your telemedicine service. Now what?

Options for fulfillment are wide-ranging, including sending that prescription to the patient’s preferred pharmacy, like CVS or Walmart, or providing a mail-order prescription service.

To streamline this process, many companies are finding it advantageous to partner with white-labeled pharmacy fulfillment companies, such as GoGoMeds or Capsule—delivering a seamless brand experience to patients.

8. The Friendly PC

Is your telehealth company in compliance with Corporate Practice of Medicine laws?

In order to deliver telehealth services in compliance with many state laws prohibiting the Corporate Practice of Medicine, you’ll need to establish a “Friendly” PC, also known as a physician-owned Professional Corporation.

These laws were designed to prevent general for-profit businesses from profiting from the care delivered by a physician.

“While the Corporate Practice of Medicine laws generally seem antiquated, inconsistently interpreted, and misaligned with our modern healthcare system, the industry must be mindful of them and operate in the most legally compliant way.” - Griffin Mulcahey, Chief Strategy & Legal Officer and Co-Founder of Wheel

What is a Friendly PC?

Friendly PCs offer the construct required today to deliver care in a compliant, legal way. The PCs, or Professional Corporations, are exclusively owned by licensed physicians. They are considered “friendly” because they work closely with the telehealth company operating as the Management Services Organization (MSO). The MSO provides administrative services to the PC, and usually employs the physician owner of the PC, but does not directly influence clinical decision-making.

Since Corporate Practice of Medicine laws vary from state to state, with differing degrees of stringency and interpretation, it's advisable to engage the services of legal professionals well-versed in telemedicine to navigate the optimal PC structure. This also applies to nurse practitioner utilization, as there are also Corporate Practice of Nursing laws in many states.

Companies like Wheel are well-equipped to navigate this legal complexity, and are additionally able to provide access to physician executives who can serve as PC owners—a functionally different role than a chief medical officer.

9. Cyber Liability & Medical Malpractice

Do you have legal protections in place?

In this day and age of technology-administered healthcare, HIPAA violations can occur due to tech platform glitches and hacking. And while uncommon, medical malpractice suits in telemedicine are still possible. The best way to protect your company from either a tech-related breach of protected health information (PHI) or a malpractice claim is to ensure you have an appropriate cyber liability policy and malpractice insurance for your providers.

Cyber liability for telehealth

Cyber liability insurance covers the business cost of a data breach due to a virus or malicious cyberattack where sensitive information is exposed or stolen.

Covered expenses can include:

• Patient notification costs
• Credit monitoring
• Cost of defending claims by state regulators
• Fines
• Penalties
• Loss from identity theft
• Asynchronous failures

Insurance companies can offer competitive rates for these policies, tailored specifically to telemedicine delivery.

Medical malpractice for telehealth

It’s good practice for telemedicine companies to provide medical malpractice insurance for their healthcare providers. As virtual consults are typically for routine visits and lower in complexity, virtual care is relatively low liability. But you should still evaluate the scope of medical malpractice insurance offered and ensure your policy includes telemedicine, as not all policies do.

At Wheel, we offer medical malpractice coverage for our entire network of virtual care clinicians to give clients greater peace of mind.

10. Patient Journey

Have you considered all your patient touchpoints?

Every great patient experience starts when the provider puts themselves in the patient’s shoes. This is key to designing an impeccable virtual care visit.

Successful telehealth brands do a thorough job of mapping every customer touchpoint to ensure there are no gaps or oversights in the patient experience and clinical care delivery.

The process of journey mapping forces decision-making that will align your organization around workstreams to be addressed. Designing a clear picture of every patient touchpoint can result in higher patient satisfaction, as well as better management of the operational lift required to support your virtual care offering.

Patient journey evaluation questions:

• How are patient leads generated?
• Where do patients enter the “front door” of your telehealth experience?
• What messaging do they see to frame their expectations?
• When and how do patients enter personal information?
• Do patients schedule a call or wait in a queue?
• How long do visits take on average?
• Are patients able to send chat messages before or after the visit?
• What questions are answered by a non-clinical support admin?
• What questions are answered by a clinician?
• What is the process for referring out, if necessary?
• How are medication refills supported?
• What does follow up look like?

11. Virtual Care Clinicians

How will you find and train healthcare providers?

Finding high-quality clinicians is just the first step in building your telehealth workforce. The greater challenge companies face when scaling a telehealth offering is training care providers and utilizing them in the most efficient way possible.

“At Wheel, virtual care clinicians aren’t found, they’re made.”
- Wheel CEO & Co-founder, Michelle Davey

Webside Manner best practices

It takes deep training in Webside Manner to fully optimize a workforce of clinicians that can provide great care and outcomes—while simultaneously delivering a stellar brand experience with high patient satisfaction.

• Employ a neutral background devoid of pictures or personal items
• Provide ample lighting while avoiding backlights or shadows from windows
• Ensure the environment is relatively sound-proof and private (no kids or pets)
• Dress professionally in scrubs, a white coat, or other appropriate attire

It’s advantageous to identify a partner, like Wheel, that can source, credential, and train a large number of high-quality healthcare professionals to support your patient needs.

12. Workforce Management

How will you deploy the right number of telehealth clinicians effectively and efficiently?

Even if a company does initially find and train high-quality healthcare professionals, the more complex puzzle to solve is how to deploy the right number of those clinicians effectively and efficiently.

The U.S. healthcare system was designed to support geographically centralized clinicians that manage patients locally. As a result, clinician state licensing requirements don’t scale nationally. This makes planning a nationwide telehealth service incredibly challenging.

Effectively managing a clinical workforce requires a near-perfect demand forecast, which as any finance or operations executive can tell you is nearly impossible to predict. Thus, it’s challenging—and expensive—to staff clinicians based on peak or low patient volume expectations.

To properly scale, you’ll almost certainly need to outsource and automate your clinical workforce management.

Wheel’s unique, white-labeled tech platform solves this exact problem for many companies.

How Wheel’s modern workforce management solution works

1. Our curated marketplace sources the optimal mix of multi-state licensed physicians and advanced practitioners to support your needs.
2. We deploy proprietary technology that matches the right clinician to the right patient for on-demand care—all within your own branded platform.
3. The result is compliant care delivery that doesn’t break the law—or the bank.

Wheel costs clients far less than traditional locums tenens staffing options, and flexes up or down based on your variable patient demand, saving precious resources.

Entering the exciting telehealth market with Wheel

Are you ready to get your telemedicine company moving?

Organizations looking to add a virtual care offering can expect success by planning ahead with an understanding of the critical fundamentals for an effective go-to-market strategy.

Wheel provides the turn-key services and trusted consultation you need to get the competitive edge in virtual care delivery--launching you within days, not months.

If you’re looking to rapidly accelerate your telemedicine launch, Wheel’s white-labeled, tech-enabled solution can support your launch in as little as two weeks.

Contact us and let Wheel be your best-kept secret in telemedicine.

For more information or guidance, schedule a meeting with our sales team to get answers to your questions on go-to-market strategies and virtual care best practices.