Consulting Services • Published 7/21/2020 Telehealth: How to Assess Your Readiness

Last updated on 7/21/2020

Prior to COVID-19, telehealth usage had seen consistent growth year over year among healthcare providers. Although the telehealth market was fast-growing, regulatory restrictions and limited opportunities for reimbursement tempered adoption. In the months of March and April 2020, as providers began to experience disruptions related to COVID-19, there was a significant expansion of telehealth. For example, the NYU Langone Medical Center saw virtual urgent care visits grow by 683% and video doctor visits grow by 4,345% between March 2 and April 14!

Today, we are seeing strategic efforts by providers across the United States to implement telehealth services for their patients. As the impacts of COVID-19 continue to be dynamic, there is an increased need for those strategic efforts to be proactive in order to maximize the benefits of telehealth.

With patient and healthcare consumer expectations quickly shifting, it’s imperative that providers develop thoughtful strategies for delivering telehealth services.

Telehealth trends

Telehealth communications have evolved to support many different aspects of a patient’s experience with their provider. Telehealth can be tailored to fit the patient or the services that are being provided. Some examples of the flexibility of telehealth services include:

• Virtual Check-Ins: short, patient-initiated communications with a healthcare practitioner.
• E-Visits: Patient-initiated communications through an online patient portal instead of face-to-face.
• Remote Patient Monitoring (RPM): monitoring services spanning different specialties such as cardiovascular and internal medicine, as well as primary care visits.

States are also passing legislation to provide guidance on the role of telehealth services within healthcare organizations. For example, the Louisiana Medicaid program covers telehealth services that substitute for an in-person encounter in the case of consultations, office visits, and pharmacologic management. Louisiana also requires private payers to cover telehealth services uniformly, as they would normally cover in-person medical services. The lifting of regulatory barriers has helped facilitate rapid adoption of telehealth:

• CMS expanding telehealth benefits for Medicare beneficiaries;
• HHS allowing the use of traditionally non-HIPAA friendly communication tools; and
• Fewer rules on who can provide services and what services can be provided.

A growing segment of all Medicare, Medicaid, and commercial outpatient, office, and home health could be delivered virtually. With patient and healthcare consumer expectations quickly shifting, it’s imperative that providers determine which services can be delivered through telehealth and develop thoughtful strategies for delivering these services.

Assessing your telehealth opportunity

Many healthcare organizations have begun implementing these services within their operations. Detailed knowledge about a practice’s capabilities is necessary in order to implement the resources required to use telehealth services efficiently.

A thorough assessment of the viability of different specialties within an organization can help you understand where telehealth services can be beneficial. However, this assessment requires a fundamental understanding of criteria unique to each healthcare practice, including:

• Market potential;
• The internal demand to supply telehealth services; and
• What percent of visits will utilize telehealth within a given period of time.

Providers will need to gather information to support reimbursement possibilities for those who use telehealth. Evaluating current processes for billing telehealth services would also provide detailed insight into potential improvements, especially related to how telehealth is coded for billing.

Once the assessment has been completed, the next step is to outline a plan supporting cash-flow opportunities, as well as the long-term success of telehealth services. A telehealth plan should include focus in the following main criteria: Strategic, Operational, Financial Modeling, and Coding/Documentation.

• Strategic planning involves attention to the geographic considerations for the organization, as well as marketing opportunities within the space.
• Operational planning provides support for the implementation of telehealth services. This plan provides information on a hybrid model for visits, combining in-person and telecommunications. The plan lays out the importance of appropriately scheduling trained management to provide these services. It will detail the costs of technology needed to implement the telehealth services, how to charge telehealth services, and how to process them internally with necessary documentation.
• Financial Modeling planning supplies insight to the volume of services available to the organization, and would also be used to project revenue possibilities.
• Coding/Documentation planning supports the organization by training staff and providers with capturing, coding, and documenting telehealth services. This helps organizations prepare for future audits, as well.

Security & privacy considerations

The importance of providing security and privacy measures for healthcare organizations looking to implement telehealth services is pivotal. The Department of Health and Human Services is using enforcement discretion and, in some instances, waiving HIPAA violations during the COVID-19 crisis, in an effort to address the nationwide public health emergency. However, this still places a significant burden on providers to ensure reasonable security and privacy practices, while providing minimum guidance. There are many facets of security and privacy protocols to consider. The following list details some important concerns, and controls that could be implemented to mitigate breaches of protected health information or systems.

Data security

• Managing the assets and permissions for telehealth services and the personnel that use them can limit the chance of compromised data.
• Providing sufficient cybersecurity training to users and implementing password controls are important ways to prevent breaches with sensitive medical information.
• Encrypting data while in transit helps protect the confidentiality of the information.
• Limiting the access to data within the system allows for better control over the systems in place, which maintain and store the data.

Monitoring & response

• Continuous security monitoring should be required to identify any potential cybersecurity attacks.
• Maintaining security settings that are appropriate to the type of sensitive data that is being protected.

Data storage

• Appropriately secured data back-up that can be recovered if a security event occurs.
• Maintaining routine and scheduled updates to storage, to ensure the availability of back-up information, if needed.
• Limited user access to back-up storage, to control who has the ability to manage the data.

This brief survey will help gauge your practice’s readiness for the future in telehealth by ranking each question via a 1 – 5 rating (1 = not ready, 5 = optimally positioned). If you would like to discuss your telehealth readiness in detail, please contact our team. 

Survey Question	Rating (1 – 5)
Have you analyzed how telehealth may allow you to expand markets and referral relationships?
How effectively is your current telehealth platform or application integrated into your EMR and Practice Management System (scheduling and billing)? Is it HIPAA compliant for the long term?
Are you planning for how you will monitoring insurance-specific changes (e.g., services covered, pre-authorizations required, etc.)?
Is there a well-thought-out strategy for collecting co-pays and co-insurance, as well as copies of insurance cards?
Is the billing team reviewing payments to confirm appropriate payments and mitigate common tactics used to impede full payment?
How rigorously have you conducted a Coding/Documentation review to optimize revenue and protect against future audits?
Does the scheduling process for patient appointments and available providers work effectively?
Are you providing a maximally-beneficial array of clinical services via telehealth?
Is there a proactive plan in place for marketing and communication?
How strong is the plan to balance telehealth with on-site to sustain strong patient relationships?