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PRACTICE MANAGEMENT
Top Seven Tips for Telehealth
By David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group
Though telehealth was an established method of delivering care before the COVID-19 pandemic, it exploded during much of 2020 as healthcare practitioners faced an immediate need to reduce exposure by providing care—or at least triage—remotely when appropriate. Now that practitioners and patients are more comfortable with and able to have in-person visits, the need and desire for vir- tual visits has declined, although not to the same level as prior to the pandemic. Many believe there will continue to be a desire on the part of both patients and practitioners to use telemedicine for healthcare delivery going forward.
Under usual circumstances, telemedicine is compar- atively low risk. That said, telemedicine brings certain specific risks to both patient safety and practice liability. Minimizing those risks calls for adapting daily practice
routines around informed consent, documentation, and other standard components of a patient encounter, as well as adjusting the practice’s insurance coverage.
The following are seven recommendations for any med- ical or dental practice providing care via telemedicine:
1. Distinguishbetweennewand established patients.
The foundation of care remains the practitioner-pa- tient relationship. If someone you have been seeing calls with a problem, it is appropriate to either speak with the patient on the phone or have some form of video chat, regardless of their location, so you can establish the level of care needed.
With new patients, however, proceed with caution. During the pandemic, some restrictions on virtual first visits were relaxed—but just because you can treat a new patient by telehealth does not mean you should. A new patient may be more difficult to assess by remote means, and new patients are also more likely to be experiencing an acute situation that is not appropriate to treat by tele- health. As a rule, see a patient in person for the
first visit.
Both first visits and ongoing care will need to comply with state licensing regulations. Check the webpage
for your state’s health authority for updates regarding state-to-state licensing issues. (For more information, see our article, “Interstate Licensure for Telehealth Can Fuel Medical Practice Growth.”)
2. Maintainprivacy.
Consider who is in the physical space or within listening distance of the conversation when treating patients by phone or video chat. This includes other people in the patient’s space—and in yours.
Practitioner-patient conversations are confidential.
It is up to patients to determine who can be with them
in their home environment during the visit, but it is the practitioner’s responsibility to discuss the question of confidentiality. Also, you want the patient to know who from your staff is participating—unlike with an office visit, the patient may not know who is in
the room.
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