During the pandemic and beyond.
While some practitioners have used telemedicine for quite some time now, this technology represents a paradigm shift for many in long-term care, requiring them to adjust to the nuances of both conducting and documenting virtual visits.
The transition to telemedicine use can go much more smoothly if you’re equipped with a few expert tricks of the trade. GEHRIMED user Kenneth Kubitschek, MD, FACP, CMD, and CEO of Carolina Internal Medicine Associates, shared his six top tips with us, plus a helpful note on how your EHR technology comes into play.
- Gather quick patient statistics first. Dr. Kubitschek encourages nursing staff to take vital signs and collect other relevant patient information prior to the start of a telemedicine visit so you can save time and focus clearly on the patient during the call.
- Prepare the patient. “It helps to have a nurse call on the patient prior to your ‘visit’ to make sure that they can adapt to technology, they know what will happen, and they have the ability to participate,” said Dr. Kubitschek. This step ensures a much more comfortable visit on both sides of the call.
- Get verbal consent. Kubitschek explained, “On every telemedicine visit, I use the same phrase to get the patient’s verbal consent. I want them to be aware of the limitations of this technology. This is important.” Clear communication can save you a lot of headaches down the road.
- Check your connection. Ensure that the facility knows what bandwidth and other telecommunication capabilities are necessary for an effective, uninterrupted visit, and double-check your own connectivity before appointments. Dr. Kubitschek observed, “You can’t control what’s happening on the other end, but you can and should make sure that everything is ready to go and reliable on your side.”
- Understand which billing codes to use. Under a new emergency waiver from the Centers for Medicare & Medicaid Services (CMS) published on March 6, 2020, Medicare can pay for office, hospital, nursing home, and other visits furnished via telehealth. CPT codes 99201-05 and 99211-15 along with a GT or a 95 modifier are the most commonly used billing codes. The waiver also relaxes HIPAA requirements to allow the use of more common communication technologies, such as Skype.
- Realize the limitations and maximize the capabilities. “Of course, there are limitations to this technology,” said Dr. Kubitschek. “If a patient is having abdominal pain, I can look at his or her abdomen, but I can’t touch it. I can only address issues that I can assess without an in-person physical exam.” With that said, expect to see new technology in the near future that will further enable virtual care. For instance, Dr. Kubitschek noted that he had a patient with atrial fibrillation send him an EKG from his Apple watch. “He wasn’t sure if he was in regular rhythm, and I was able to see that he was,” adding that there are currently devices that enable practitioners to look into patients’ ears, eyes, and throats remotely.
Telemedicine & Your EHR
Telemedicine allows practitioners to capture the data they need remotely, which they then document, organize, and share in their EHR platform. According to Dr. Kubitschek, telemedicine can make using an EHR even better because you can collect and record patient information during virtual appointments without being intrusive to the patient. And if your EHR is “intuitive and user-friendly” like GEHRIMED, it allows you to share information easily during telemedicine visits.
“For instance, GEHRIMED lets you send questions or information to facility nurses when you’re entering data,” he said. “You can say that a patient has a problem, such as difficulty swallowing, that should be followed up on.” It’s important to be able to do this in real time so that that nothing gets lost or delayed.
Finally, before jumping on the telemedicine bandwagon, consider how to implement virtual visits with the least amount of workflow interruption possible. (It helps to have an easily integrated EHR). Ensure that all practitioners and team members involved with the telemedicine services receive the training necessary to be both comfortable and competent before rolling out the technology to patients.
Regardless of your previous use of telemedicine, it’s clear that this technology is a powerful tool for long-term and post-acute care practices right now, and it shows real promise for the future.
Curious to learn how GEHRIMED and telemedicine could empower your practice to succeed during these unprecedented and uncertain times? Contact us today.