The healthcare industry is one of the most rapidly changing spaces in the American economy, and nowhere is that more evident than healthcare organizations' widespread shift toward digital technologies. The mass movement toward electronic medical records (EMR) software is often the most prominent element of the ongoing digital revolution in healthcare, but telemedicine is quickly taking the entire field by storm as well.
What is telemedicine, and how does it work? Most importantly, is it right for your healthcare organization? Read on to find out.
What is telemedicine?
Telemedicine, also known as telehealth, is a technology solution designed to virtually connect patients with their healthcare providers for consultations, diagnoses and treatment plans. While telemedicine and virtual healthcare is still relatively new in the healthcare industry, it is quickly becoming a preferred tool for practitioners and patients alike.
The difference between telemedicine and telehealth
While the two terms are related, they are not interchangeable. Telemedicine is the specific practice of providing physician care to a patient from a distance. Telehealth is the general term for using information technology to provide care at a distance. The primary difference is that telemedicine involves direct communication between a patient and their physician. Telehealth can include many different kinds of information and services, such as medical education, record transfers, administrative work and many other health services that are not part of direct patient care.
It is important to distinguish between these terms, because they can bear large impact on many aspects of healthcare. Telemedicine is often billable by government payers. Non-care telehealth will not even enter into a reimbursement conversation.
On a different note, telemedicine and telehealth fall under different provisions within HIPAA. Other regulations will regard the two concepts as distinct. Rules for direct care will always be different for the rules for supplemental healthcare activities, and healthcare providers need to consistently make this distinction in order to remain compliant.
The growth of telemedicine in the healthcare industry
Just how quickly is the use of virtual healthcare growing? More than 7 million people relied on telemedicine tools to connect with their healthcare providers in 2018, up from just 350,000 in 2013. Today, more than half of all hospitals in the U.S. currently have some type of telemedicine service.
The spread of COVID-19 increased the reimbursement for telehealth visits as well, potentially signaling a new breakthrough for the technology. In light of the novel coronavirus pandemic, the Centers for Medicare & Medicaid Studies (CMS) announced on April 30 several directives to improve access to healthcare via telemedicine. These include expanded reimbursements through Medicare and Medicaid for the delivery of telehealth services to federally qualified health clinics and rural clinics, as well as reimbursements for the use of audio-only telemedicine solutions.
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How does telemedicine work?
The term "telemedicine" can refer to a wide range of solutions, from simple video conference tools to complex diagnostic systems. At its most basic, a telemedicine solution offers two features:
- Video conferencing: Virtual consultations generally take place through some form of video conferencing software. In some cases, this is a broad platform like Zoom. In others, it is a proprietary platform developed specifically for telehealth purposes.
- Patient portal: Telemedicine solutions also feature a patient portal, either as part of the telehealth platform itself or as an integration with a healthcare organization's practice management software. The portal enables patients to set appointments and communicate directly with their provider over a secure channel.
"To deliver the most impact, telehealth should operate in concert with other patient engagement tools, like messaging applications or online portals, and work from a shared platform that integrates with other practice technologies, such as provider communications or document management," said Mike Morgan, CEO of Updox.
To this end, it is important for telemedicine solutions to easily integrate with a healthcare organization's existing IT systems, including EMR software and practice management tools. This makes it easy for providers to document virtual encounters alongside other clinical notes, and to support the billing department in securing reimbursement from insurers for telemedicine visits.
These are some other features telemedicine solutions might offer:
- Diagnostic hardware: Diagnostic hardware can expand the effectiveness of a telemedicine solution. For example, a traveling nurse could use camera attachments to deliver a full examination of a patient's ears, nose and throat, transmitting images back to a doctor at a remote location.
- Annotation tools: Some telemedicine software allows providers to take notes directly on images, highlighting areas of concern or abnormalities. For example, a doctor examining a rash on a patient could make notes or draw diagrams directly on the image and save it for later.
- Software integrations: Telemedicine solutions could offer direct integrations with other healthcare IT products, like EMR software and practice management systems. These integrations are useful for streamlining a healthcare organization's overall workflow and integrating telemedicine into the wider process of care delivery.
Depending on the complexity of your healthcare organization's needs, some or all of these features might be desirable in a telemedicine solution.
How does a telemedicine appointment work?
It starts with the patient enlisting a service. The patient can talk to their physician and see what service they recommend, or they can look at popular services to find a physician through an app or another technological resource.
Once a patient and physician are paired, a session can start. Ideally, the contact will be a video chat so the physician can see issues as well as communicate with the patient. In limiting circumstances, voice and text communications are also used.
Through whichever medium, the physician will provide direct medical consultation to the patient, and then the session will conclude. Obviously, some services cannot be provided remotely, in which case the physician will make a recommendation and referral to a practice that can provide the necessary care.
Telemedicine appointments are protected under HIPAA and all other relevant healthcare regulations. Physicians are still liable for the care they render through telemedicine appointments. In every way possible, remote doctor visits are regarded the same as in-person appointments.
What are the benefits of telemedicine?
Telemedicine offers various benefits to both healthcare providers and patients:
- Improved access to healthcare: Patients who have limited mobility or live in underserved areas, such as rural communities, can use telemedicine solutions for easy access to healthcare providers.
- Streamlined workflow: Telemedicine solutions reduce no-shows and last-minute cancellations for appointments, as well as the front-office burden of managing a waiting room. They also cut down on unnecessary urgent care or hospital visits, keeping overall healthcare costs down.
- Improved patient experience: Telemedicine provides a more convenient experience for patients, increasing overall patient satisfaction and retention. The ability to set their own telemedicine appointment also gives patients more influence over their healthcare.
- Better tracking of chronic conditions: For patients with chronic conditions, telemedicine solutions make regular tracking and treatment planning easier. For example, a patient with diabetes could use a wearable device to check their blood pressure and upload their results to the patient portal daily, helping providers recognize when an in-person visit might be needed.
"Forward-looking practices are using telehealth in lieu of in-person consults, cutting down on needless office visits, saving practices time and money and adding a customer convenience feature for patients," Morgan said.
What are the challenges associated with telemedicine?
Telemedicine software is relatively new to the healthcare industry, so it has some natural limitations and drawbacks. For example, the lack of clear regulatory guidance has often led to confusion as to how insurers should reimburse telemedicine visits. Additionally, the way healthcare organizations document and archive telehealth visits varies, leading to challenges in sharing information across multiple providers.
"Some practitioners report broken continuity when a patient bounces from one healthcare provider to another, and their medical records are lost or incomplete," said Inga Shugalo, healthcare IT analyst at Itransition. "There are no specific regulations on telemedicine reimbursements either, so providers have to balance between patients' expectations and their own price policies."
In addition to these concerns, it is important for healthcare organizations to ensure that their telemedicine solution truly offers HIPAA-compliant security measures before, during and after a telemedicine visit, said Abby Lev, a psychotherapist and founder of CBT Online.
HIPAA requires that sensitive electronic personal healthcare information (ePHI) be protected by end-to-end encryption. Moreover, only authorized users should have access to any ePHI either stored or transmitted by a telemedicine solution. Healthcare professionals must monitor ePHI communications to prevent or identify any data breaches.
Reimbursement for telehealth
The HHS now recommends telehealth resources to take as much burden as possible during events like the COVID-19 pandemic. With that recommendation has come exceptions and leniency for health regulations. This has opened many doors for telehealth reimbursement.
Ultimately, reimbursement depends on a number of factors. In many states, telehealth services can be covered by Medicare and Medicaid. With a private payer, the individual policy will have a lot to say about how reimbursement works. In general, the major factors in reimbursement will be the type of telehealth, who is paying and what state is involved.
What can be treated with telemedicine?
Precisely what types of conditions can be diagnosed or treated with a telehealth solution depends on the capabilities of the solution itself and the hardware available to the healthcare provider. A simple video conferencing solution that integrates with EMR or practice management software, for example, might only be suitable for a brief consultation.
"Telemedicine is used by providers to triage patients without office visits, monitor patients with chronic symptoms and see patients remotely, broadening the spectrum of care," Morgan said. "By adding telehealth applications to their workflow, practices can meet consumer preferences and add flexibility to care coordination."
More expansive telemedicine platforms include diagnostic tools that can be used to closely examine ear canals, throats, skin abrasions and more. Of course, systems with these advanced capabilities tend to cost significantly more.
How your healthcare organization implements a telemedicine solution will depend on various factors, including your specialty, your patients' needs and your goals. To help you learn more about telemedicine and how it might improve your healthcare organization, business.com reviewed some of the best telemedicine solutions on the market and created a guide to help you choose the right one for you.
Related healthcare IT solutions and medical practice services
Many medical practice software solutions and third-party services go hand in hand. For example, an electronic medical records (EMR) system and practice management software are closely related. A medical billing service might work within your practice management software, while a medical transcription service can help you create notes in your patients' charts, which are stored in your EMR system.
If you are looking for a full suite of healthcare IT solutions or additional medical practice services that could help you improve the way your practice runs, take a look at our other medical practice review categories.
Electronic medical records systems
An EMR system contains all the necessary clinical tools for a provider's encounter with their patients. In an EMR system, providers can review their schedules, access patient charts, e-prescribe medication, and order lab tests and access results. Some EMR systems also include tools to easily review patient histories and map trends in their health over time.
An EMR system's ability to integrate seamlessly with practice management software determines how well the administrative and clinical departments work together. It can be an indispensable tool to healthcare providers, but choosing the right one is key.
Medical practice management software
Practice management software helps your front and back offices carry out their daily tasks. It generally includes appointment-setting, insurance eligibility verification and medical billing tools. One of its most important features is reporting tools for viewing financial information about your medical practice and charting performance over time. Integrations with EMR systems are essential for medical practice management software, as the two contain relevant information for both the clinical and administrative departments of any medical practice.
Medical billing services
Medical billing services, also known as revenue cycle management (RCM) services, offer a way to outsource your billing department. Medical billing and coding can be complex and time-consuming processes, and maintaining an internal staff for it can be quite costly. Medical billing services generally work directly within your practice management software to perform coding and billing services, including follow-ups on outstanding claims and denial management.
Many medical billing companies also work to get providers at a new practice credentialed with the appropriate payers and provide additional reporting tools to contextualize a medical practice's cash flow. To learn more, see business.com's best picks page and reviews of the top medical billing services.
Medical transcription services
Medical transcription services create internal documentation, patient charts and communications by way of audio dictation. These services generally give you multiple ways to securely upload audio dictation, and then they return a transcript within 24 hours. Some medical transcription services also offer direct EMR entry, plugging in transcribed notes to the appropriate place in an EMR system, saving providers and their staff time and effort. To learn more, see business.com's best picks page and reviews of the top medical transcription services.
Telemedicine changing the healthcare industry
Telemedicine solutions are becoming common in modern healthcare. While telehealth is now widely known and increasingly trusted by patients and providers alike, there remain some significant challenges to realizing the promises of virtual care. As the COVID-19 pandemic has demonstrated, there is a need for greater regulatory clarity on how insurance companies should reimburse telemedicine visits.
However, the strides telemedicine has made in the past five years show that it is here to stay and likely to remake the way healthcare is delivered. When implemented correctly, telehealth offers convenience to patients and efficiency to healthcare organizations. Those benefits will continue driving innovation in the space and adoption among healthcare organizations.