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Thursday, 19 March 2020

Telehealth Systems: Standalone or Integrated?

Frustrated Computer Business Owner Professional

Agencies are scrambling to figure out how to deliver services via the web during the pandemic. Telehealth represents an option that has clear benefits for keeping providers and clients safe. The government, by issuing waivers and reducing restrictions, is very much on board with us managing our cases through teleconferencing.

One of the questions confronting managers is whether to use a stand-alone service (like Zoom) or one that is integrated into their EHR/practice management system. While the stand-alone services may be simpler or cheaper to implement, integrated systems have some clear advantages worth considering:

  • One system for everything
  • According to one study, the number of physicians who self-reported telemedicine as a skill doubled from 2015 to 2018, and it continues to increase by about 20% per year. Telemedicine patient visits also increased annually by 261% between 2015 and 2017. One of the reasons for this growing trend is the fact that telemedicine offers several advantages over in-person care, including:

  • Limiting community exposure
  • The surest way to introduce inefficiency and error into a clinic’s operations is to have separate systems for scheduling, documentation, billing, appointments reminders, and the like. The same goes for telehealth. The last thing you want is for data from those appointments getting lost in the shuffle because they reside in separate programs that all require their logins and routines. Your staff will certainly feel more comfortable if all their workflows reside in one system they know and trust.

  • Scheduling a telehealth session should be just like scheduling any other session
  • The most sophisticated systems essentially treat video appointments the way they do any other type of patient contact. It’s just another option on the scheduler – which means that you should be able to send reminders, initiates the appointment, and enter notes right through the calendar system. Your staff will appreciate that they don’t have to learn another method or do anything different from normal.

  • Record and store sessions automatically
  • A significant benefit to telehealth is that it makes it simple to record sessions -- if you have the right technology. You should be able to configure your sessions such that the system will start recording from the first “hello” or let you begin it manually. More importantly, that recording should attach to the patient’s file like all other patient data. No one wants those files anywhere other than with all the other files associated with a particular client.

  • Teleconferencing via the Patient Portal makes it easy for clients
  • The best systems use the patient portal as the entry point for consumers to connect with providers over the web. After all, most of them already use this site to communicate with the agency and check appointments, billing, and prescriptions. Logging into the portal for video sessions is just another way to use a known connection point, thereby making it easier and more convenient to use.

  • Stand-alone systems are platform-independent
  • Some clients have iPhones, while others have Androids. Some have Windows laptops while others are iOS users. You don’t want to worry that everyone has to use a different videoconferencing system depending on the operating system. One tele-psych system should fit all.

  • Group therapy via the web should be an option
  • Here’s where integrated systems have a clear advantage. The best of them make it simple to schedule, conduct, and chart therapy groups for up to at least ten clients at a time. That’s a tall order for systems that aren’t specifically designed for behavioral health services. But you’ll need that facility if you’re intending to maintain as many of you regular groups as possible.

  • Keep teleconferencing secure
  • The media are already carrying reports of security breaches (now called “Zoombombings”) that have disrupted teleconferences nationwide. It’s chilling to think that someone’s video therapy could be breached and broadcast. Integrated telehealth systems are likely to have a higher level of security.

  • Maintain compliance with HIPAA and other regulatory requirements
  • While some of these regulations may be temporarily suspended, they won’t be over time. And you might just find that you have good reason to offer telehealth services even after the COVID-19 virus has finally faded away. So it makes sense to adopt strategies that continue to protect patient information and allow for auditing/data tracking.

  • Benefit from automated billing rules for telehealth services
  • If your EHR knows immediately when and how to bill for a telepsychiatry, you’ll have a much better chance of getting reimbursed. That’s because these types of visits often require a special modifier that the EHR should be able to apply. Also, because new waivers and rules are evolving daily, you’ll need your practice management system to work seamlessly with the telehealth module. Splintering those two systems would certainly increase the likelihood of claim rejections.

Decision making during a crisis is fraught with risk. Fortunately, telehealth as a treatment modality has been available for years, both in this country and abroad. It’s also become easier to evaluate separate modules for EHR/practice management systems because most of us have already considered new functionality for our operations. And the principles underlying those decisions are straightforward. We all want solutions that make our work lives easier, reduce our risks, and keep us compliant at all times.


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