“The tools and guidelines being created now are already helping many to use telemedicine and will continue to help define its role at this moment, and shape the future of physician practice.”
~ Dr. Russell Libby, Pediatrician & Board Member, Physicians Foundation
Nobody likes change. It is difficult, challenges us to think in new ways, and requires the formation of new habits. Sometimes we welcome change, and sometimes it is forced upon us with a heavy hand. Such is the case with adopting the benefits of telehealth and remote care for independent medical practices. Prior to the COVID-19 pandemic, these health care initiatives were eyed with caution and often implemented in a haphazard way, if at all.
Then the pandemic hit, and patients abruptly stopped coming to medical offices for care. Serious concerns arose about maintaining patient health, but also about the very survival of the independent practice itself. In response, many medical providers swiftly decided that telemedicine was just the cure needed to heal these wounds. With this motivation as their guiding force, they quickly began making the changes necessary to integrate telehealth as part of their patient care system.
Where does this upheaval leave the patient in the process? While telehealth may function smoothly on the provider’s part, it does no good if the patient does not understand how to use it properly. Initial early adapters were able to adjust to the new way of communicating with their medical care team, and results have been good.
But how can those benefits be expanded to a patient population that is desperately in need of monitoring and remote care? Now more than ever, the responsibility is even greater for independent practices to help these patients overcome their concerns about remote care.
Education and Communication are Key to Effective Remote Care Implementation
The emerging field of telehealth includes practices that provide health care services to patients who are not physically present in the office. Under this broad umbrella, telemedicine refers more to providing clinical services through videoconferencing and electronic health communications with other providers.
Remote care is also part of the telehealth continuum. This allows a practice to monitor a patient’s condition and oversee preventive care measures. New technology, such as blood pressure monitors, glucose meters, oximeters, and pacemakers, can measure vital signs and transmit key data to the medical practice for analysis. Results may require a change in prescription, further testing, or additional patient motivation to comply with positive health care measures. Other examples of remote care include behavioral health services and chronic case management.
Telehealth can reduce any barriers regarding time, cost, and convenience. The practice, however, needs to get patients comfortable with remote care services, so it can thrive and remain independent. Here are the top ways your practice can overcome patient concerns in order to increase the use of remote care:
Common Telehealth Scenarios
Some care requires in-person observation or discussion, and patients still need to be seen in the office on an annual basis, but there are certain health scenarios which lend themselves easily to telehealth visitations:
- Prenatal visits, lactation visits, childhood mental health issues.
- Asthma and allergy management.
- Minor health issues such as pink eye, or minor lacerations and abrasions.
- Weight management motivation.
- Review of results from lab tests, X-rays, or specialist consultations.
- Surgery follow-up care.
Remote Care Benefits to Clearly Communicate to Patients
Patients will not commit fully to the remote care process unless they believe there is value in it for them. Fill your introductory communications with benefit statements that highlight:
- How difficult it can be for patient and caregiver to schedule and attend an in-person visit, especially for those with mobility issues.
- The time and money that can be saved by not making regular commutes to a doctor’s office for routine care.
- Patients can wait for the appointment in the comfort of their home.
- The importance of remote monitoring and care for at-risk and chronic care patient populations, and the increased ease of doing this from home.
- Ability for the provider to have regular access to current critical data, so adjustments can quickly be implemented.
- Patients need assurance they will still receive a high level of medical care.
- Increased access to the medical care team.
- Continued ability to adhere to social distancing guidelines, especially for susceptible or immunocompromised patients.
Patient Education System for Remote Care
Although some patients do adapt quickly, most will need to be educated as to their options and shown how to use telehealth. Steps your practice can take to introduce patients to the new world of telehealth include:
Announcement
After you are sure your telehealth program runs smoothly internally, set a date to go wide with an introduction to a broad patient spectrum. Messaging at this point should include a focus on the increased convenience of the process, and the ease of receiving care without an office visit. Have plenty of information available in-office, and provide details through your patient portal, website, e-newsletter, and social media channels. Patients to target initially include:
- Remote care patients who need constant monitoring for their condition
- Those you have seen in-person and informed of the telehealth option for follow-up purposes.
- New patients who can quickly be brought into the new system after their first in-person evaluation.
Setting Initial Appointments
Setting the first telehealth appointments for your independent practice may require an in-person telephone conversation, or explanatory email. Points to cover to motivate patients to set their first remote care appointment include:
- Overview of what telehealth appointments can do.
- Reminder of telehealth benefits.
- Explanation of opt-out process.
- Check for technology access.
- Confirmation of secure communication environment.
- Is there a need for a pre-appointment walkthrough?
- Discuss billing procedures.
- Confirm HIPAA compliance.
- Secure patient consent.
- Geographic location requirements to meet state licensing limitations.
- How to reschedule if needed.
- Confirm details and thank patient for participation.
Introduction
Once patients are aware of the move to remote care and telehealth, you need to provide more in-depth information about the process itself. When a telehealth visit is scheduled, send an email or set up a telephone run-through to explain how to access the app or platform. Cover what the patient should expect during the visit, including:
- Technology requirements, including Wi-Fi, camera and audio
- Paperwork to be completed prior to the appointment including history, consent, privacy, and HIPAA forms
- Logistical needs, such as a private environment
- How to facilitate the conversation with the provider
- Payment and billing practices.
Reminders
Patients who are comfortable making an in-person visit could forget a digital interaction. Provide email or text reminders one week prior and on the day of the visit. About 15 minutes before, send a reminder regarding how to access the platform and any check-in procedures.
Patient Chart Integration
Integrate all results into the electronic health record (EHR) to carefully document the session.
Follow Up
After the conclusion of a telehealth or remote care session, send an email or text summary of the visit, and remind the patient of any agreed-upon action steps.
Emergency Care Protocols
Patients should be aware that they do not have to wait for a telehealth appointment in case of emergency. Instructions should be easily accessible on what steps to take in these critical situations.
As the initial patient cohorts become comfortable with the process, you can expand your telehealth capabilities to the entire patient base. Use your website, social media and email channels to communicate the benefits patients have received so far and explain how you will introduce it to everyone.
Barriers to Remote Care
As part of your implementation plan, include solutions to help patients overcome any barriers that could prevent them from receiving remote care:
Access to Technology
Some patients, especially those in urban and rural areas, may not have home access to the higher levels of technology needed for telehealth care. Identify community-based resources, such as libraries and senior centers, which might be able to facilitate the process within privacy guidelines.
Language Differences
It may be necessary to have a translator present for certain visits, but this must also conform to privacy requirements.
Lack of Technology Capabilities
These patients might be the hardest to bring into the telehealth fold. Consider assigning a team member to host a seminar or practice session with these patients to take them through the process step-by-step
Patient-Centered Telehealth
The best way to make patients comfortable is to demonstrate that high levels of care can still be provided through the remote care process. It may be your tenth televisit of the day, but it is your patient’s only interaction with you. Make each patient feel that a video conference appointment with you is as good as, or even better than, an in-person visit. Ways the independent practice can increase this level of comfort include:
- Make sure your practice has access to the most powerful tools for remotely communicating with your patients.
- Set up a secure and private communication environment dedicated to telehealth appointments. There should be no distracting noises in the background.
- Ensure that all information obtained during the communication is quickly and accurately entered into the EHR.
- Review the patient chart prior to the interaction, to familiarize yourself with the last visit and highlight primary medical issues.
- Put thought into how you look and act during the appointment. Understand that patients might feel awkward with a video conversation. Take steps to smile, engage in quick banter, and put them at ease before launching into the clinical part of the visit.
- Ask questions, allow time for the patient to respond, and show that you are actively listening.
- Demonstrate attentive behavior. Let the patient know if you have to look away for a minute, or input details into the chart.
- Agree on next steps in the treatment plan during the interaction. Ask if there are any questions or concerns.
- Confirm action items in writing after the visit.
Best Practices for Helping Patients Overcome Remote Care Concerns
Best practices to successfully help patients overcome remote care concerns at your independent practice include:
Communicate Frequently and in Varied Ways
Your practice cannot introduce such a drastic change to the way care has been provided without having a strong communication program in place. Remote care is not something that can just be implemented, with the expectation that patients will simply have to adjust. Explain the upcoming change during in-person visits, distribute print information at the office, have video demonstrations on your website or in-office TV screens, offer in-person or online seminars, and provide regular email and social media updates as program implementation proceeds.
Educate
It might take some time to thoroughly educate staff and patients on remote care implementation. Take it slowly and allow plenty of opportunity for input. Look at suggestions received and evaluate their merits. If you regularly receive a specific criticism, discuss how that issue can best be resolved.
Motivate
Patients must be reminded of the benefits of participating in remote care on a regular basis. Without compromising patient privacy, promote results of positive interactions and share suggestions as to what made a particular patient feel more comfortable with the process.
Vendor Support
Work with a technology partner who is heavily experienced in implementing telehealth and remote care processes at a variety of independent medical practices. Your vendor can be a valuable source of information on overcoming barriers or concerns, and successfully rolling out a program that leads to rapid acceptance and integration.
Healthcare Technology Solutions Designed By and For Independent Practices
Amazing Charts was founded in 2001 by a practicing family physician to help medical practices thrive. We have grown consistently since then by creating easy-to-use solutions for delivering patient care. Today, we offer a variety of additional capabilities designed to help independent practices succeed, including Electronic Health Records, Practice Management, Billing Services, Population Health and Remote Care. Call 866-382-5932 to learn about our products, schedule a practice consultation, and learn more about telehealth pandemic lessons that can help your independent practice grow.
