If you’re overwhelmed at the thought of adding telemedicine to your practice, realize that in some ways, you’re probably already practicing telemedicine, says Michael R. Brown, DO, the assistant chief medical informatics officer at Mosaic Life Care in St. Joseph, Missouri.
“Every doctor can remember the last Friday night phone call they got from a patient with a urinary tract infection who just needed prompt treatment,” says Dr. Brown, a family medicine physician. “We’ve been practicing telemedicine since the phone was invented, but now we’re getting paid for it and doing it in a systematic way.”
More than half of the nation’s hospitals are now using telemedicine, according to the American Telemedicine Association (ATA), and more than 15 million Americans received some sort of telemed care last year. Considering adding telemedicine to your practice? Here’s how to get started.
1. Learn how telemed works in your state. States vary as far as which telemedicine services private insurers, Medicare and Medicaid will pay for. The American Telemedicine Association offers state-by-state details and clinical practice guidelines for telemedicine to its members.
2. Communicate with your insurer. Physicians who plan to enter the telemed arena should let their insurers know because they might need to pay extra or obtain a policy rider, according to Jonathan Linkous, the ATA’s CEO, who shared this advice in Medical Economics.
3. Design your approach. Telemed can encompass a wide range of services, including video consults, online appointment scheduling and 24/7 phone access to physicians. “For physicians who are reluctant to add telemed to their practice, I recommend starting with letting patients look at their medical records, ask questions and schedule physician visits online,” Dr. Brown says. “Patients love it and really appreciate it.”
Physicians who want to offer patients 24/7 phone access without providing it themselves can work with national telemedicine chains such as Teladoc and American Well. “The difference in that model is that when your patients call, they’re connected with whatever provider is there—it’s not you or someone from your practice,” Dr. Brown notes.
4. Anticipate the demand. “Health care professionals worry they’ll turn telemedicine on and be overwhelmed, but none of my colleagues have had that experience,” says Dr. Brown, noting that many telemed patients are relatively young and healthy.
5. Scope out tech options. If you want to allow patients to view medical records, email physicians and schedule appointments online, you’ll need an electronic medical record system with a secure patient portal.
For videoconferencing, setup may be easier than physicians imagine. “We started out using computers and webcams a lot, but then realized it’s easier to use smartphones,” Dr. Brown says. Mosaic now uses a proprietary IT system for telemedicine, but initially the practice used a HIPAA-compliant app from VSee that provides secure video conferencing. Physicians and patients can access the app through a smartphone, tablet or a computer with a webcam.
6. Considering treating patients in other states? Find out whether your state permits it and check to see if your state is part of the Interstate Medical Licensure Compact, which will soon streamline the process of obtaining licenses in multiple states.
Along with sorting out your licenses, you’ll have to stay abreast of continuing medical education requirements in various states, notes critical care medicine physician David Edward Tannehill, DO. Dr. Tannehill, who practices at the Mercy Clinic in St. Louis, holds licenses in six states through Mercy’s intensive care unit telemedicine program. “Different states have different CME requirements, and some states have mandatory CME that my home state doesn’t require,” he says. “Because of that, I obtain more CME than is required for my home state.”
Editor’s note: This article was updated Oct. 11, 2016, to reflect changes to the American Telemedicine Association website.