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Best Practices when Choosing a Telehealth Platform

 

“Simplicity is the ultimate sophistication.” Leonardo da Vinci

 

Written by: Scott Allen – President, 2MI Software Solutions, Inc.

 

 

Over the past year and a half, I’ve been asked the same question at least once a day, “what is the most important thing I need to look for in a telehealth platform?”

 

My answer has evolved to simply this “you need a platform that delivers the highest quality video in a secure, compliant application that is easy to use for both clinicians and clients with reporting and workflows that play well with your EHR system.”

 

The demand and consumer adoption for Telehealth services in both medical and mental health care is rapidly increasing. In addition to Medicaid coverage, there are now 35 states with laws stating that private payers must reimburse telehealth services.  Maximizing your clinical resources has become more challenging as practices add multiple locations nearer clients in need.

 

Choosing a Telehealth platform for your practice can:

  • Expand your Geographical Reach
  • Improve your Clinical Efficiency
  • Increase your Revenue

 

So, what to look for?  Having talked with hundreds of healthcare executives and clinicians, we’ve compiled a Best Practices guideline with must haves and nice to haves.  Let me also preface that nearly all providers we have spoken with are entrenched in their EHR systems and are looking to add Telehealth without disruption of their current workflow and with as little redundancy as possible for their clinical and administrative staffs.

 

Must Haves

High Quality, Reliable Audio and Video:

Making virtual sessions as close to face-to-face sessions is critical to providing quality care.  The ability to listen and read your clients verbal and non-verbal cues without interruption is a must. Your platform must also be reliable.  Video quality should not vary from day to day and be influenced by outside environmental influences. Without quality and reliability, your telehealth services will be short-lived.

 

Security and Compliance:

HIPAA = Confidentiality.  Protecting your clients PHI is an absolute priority regardless of the treatment modality.  There are requirements under the HIPAA and HITECH guidelines that must be met when choosing and implementing a telehealth platform.  Make sure your telehealth platform provider is willing to sign a Business Associates Agreement.  You should look for a cloud based web application vs. a native application or client based software.  With a cloud-based web-application, no PHI of any type is stored locally on any device.  However, platforms requiring downloading software or applications to devices (PC, Mac, & Mobile) bring in the HIPAA rules surrounding physical security of those devices and breach notification if those devices are lost or stolen.  Note: Online meeting apps with Video, while encrypted are NOT typically HIPAA compliant platforms.   Additionally, as these applications were optimized for screen and document sharing and NOT video, bandwidth usage is typically high and video quality is typically low.

 

Administration and Ease of Use:

Your clinicians already spend too much time writing notes and doing clerical work which takes away from what they are trained for and what they are paid to do.  Having a platform that can be centrally administered by non-clinical staff further increasing the value of providing Telehealth services.  Ease of use for both the provider and the client is essential.  Requiring a client to download an application on their phone or device is a lot to ask.  Minimizing “Clicks” to enter a video session is paramount for both Clinicians and C and will ensure faster use and adoption of your telehealth platform.

 

 

Proof of Services:

Having a paper trail for any type of health care service is a must as we know billing issues and audits are part of every practice’s operations.  Your platform should be robust enough to provide easy reporting with metadata that includes at a minimum:

  • Provider Name
  • Client Name or MRN# (associated with EHR system)
  • Date of Session
  • Time of date
  • Duration of the session.
  • NPI# of originating and distant sites

 

 

Low Upfront and Operational Costs that can Scale:

One of the biggest issues our clients talk about is how they can get started using telehealth affordably.  Unless you are ready to start serving walk-ins via Site-to-Site Tele-psych services, it takes time to build your clients who want or need to utilize video sessions as part of their care plan.  Many SaaS platforms will charge by the number of staff users in your practice which can lead to large upfront and on-going operation costs.  Choose a platform that allows you to have as many staff users on it and as usage increases, your platform can scale by increasing the number of video sessions needed. The other major issue is hardware and connectivity.  Your platform shouldn’t require high-end expensive hardware nor should you need a T-1 line or Google Fiber internet speeds.   Off the shelf PC, Mac and mobile devices working on standard WIFI and even 4G broadband should be enough to power your video sessions.  Bottom line is that your Telehealth platform should be a Profit center, not a Cost center.

 

Forms Exchange:

As our clients roll out Telehealth services, one of the challenges is making sure informed consent and client/counseling agreements include language for privacy surrounding the use video services. Being able to share documents with your clients on the platform and even have clients e-sign agreements is a great feature and simplifies operational workflows.  It is also important to track, prove & report on the forms that Clients have signed.  Other forms can include treatment plans, “about me” forms and study/reference material for your clients.

 

Nice to haves

Customization and Branding:

Having a dedicated “server” is one way to ensure you can customize your platform with your logo or brand.  The ability to have all session notifications sent from your email domain coupled with the customization provides a great deal of peace of mind for your clients.  Knowing that they are communicating on your practice’s platform and not some random open platform provides them with a level of comfort.  Having a static URL for Provider and Client login pages is also helpful as you can place these “Provider and Client Login Portal” links on your website.  This way, you never need to worry about forgetting the login or have trouble finding it from any internet enabled device.

 

Site to Site Connections and Walk-in Services:

Having a simple way connect your “sites” to each other and provide services via an “open pipe” is a useful feature for any practice wanting to load-balance clinical resources.  In a medical setting such as urgent care centers, this feature makes it easy for doctors to treat clients in other locations which reduces wait times increasing the number of patients that can be seen.

 

Calendaring and Session notifications:

While much of the calendaring is done via the EHR system, your Telehealth platform should provide standalone capabilities including session creation, automated notifications via text and email, calendar blocking showing available and non-available times.   Clients should be able to request sessions.  These features should be easy to view with accepted sessions, declined sessions, and tentative sessions color coded.  You should also have the ability to resend session invite and information easily.  Lastly, make it as easy as opening an email to join a session for your clients.  The easier it is for them, the more willing they will be to utilize virtual services.

 

In summary, adding a telehealth platform should be easier than selecting and implementing an EHR system and should include simple on-boarding allowing your clinicians simple instructions on how they can get started using video sessions.   It should be scalable allowing you time to roll out your telehealth services and maintain low operating costs as your use ramps up.  Lastly, your telehealth vendor should be willing to offer consultative services on distance counseling training, certifications, level 1 IT support, and aide in billing codes and legislative rules as they apply in your practice location.  I hope this information proves helpful and welcome you to contact me should you have any questions regarding your telehealth needs.

 

About the Author:

Scott Allen is the President and Co-Founder of 2MI Software Solutions, Inc.  A Raleigh, NC based software company that offers VPCare360, a HIPAA compliant cloud based Telehealth platform.  For more information on 2MI Software or VPCare360, please visit www.VPCare360.com or email sallen@2mi-software.com