As the global COVID-19 Pandemic rages on, confusion continues about such terms as Remote Patient Care, Telemedicine, and Remote Patient Monitoring
Remote Patient Care
The goal of Remote Care is to provide as much health care service as possible without the patient visiting the office. For some, they think of this as nothing more than a traditional video chat session between the provider and the patient, conducted over an existing video chat service. Even just a few years ago Health Affairs made little distinction between Remote Care Management and telehealth. However, Remote Care has grown well beyond the simple video chat. It now encompasses Remote Patient Monitoring as well as automated surveys, interactive messaging and custom care plans to help providers spot trends that, if left un-noticed, could result in hospitalization or death.
Advances in Telehealth
Telehealth has moved well beyond the simple video chat session conducted over a commercially available service. Dr. John Waits of Cahaba Medical Care in Bibb County, Alabama states, ““The easiest thing to do would be to FaceTime everybody, but it’s not as secure.” There is also an issue with exposing a doctor’s cell number to patients. “If I’m off call for a week, I don’t want them leaving voicemails on my cell phone if they have chest pain.”
Comprehensive services address the complex system of workflows, privacy regulations and billing processes that need to be effectively managed to make telehealth work. Clinicians must have a way to properly track and notify patients of telehealth visits, whether they are “instant” or “on-demand” appointments, or if they are scheduled in the future. Mechanisms need to be developed to track patients as they arrive at their telehealth appointments and that allow them to see multiple clinicians at one time or move between clinicians for various consultations. They also need the familiar “post-exam” consultation where they receive follow-up instructions and book their next appointment.
All this activity must be properly recorded and coded so that the provider can submit to CMS or the private insurer for proper reimbursement.
This is one of the newer applications of technology that helps patients manage their health between visits to their provider. Pre-scheduled surveys (either by voice or by text) ask questions of the patient to monitor their condition. During the recent COVID-19 pandemic, systems would call patients every day and ask them questions such as, “Are you coughing more than usual today?” or “Do you feel out of breath, even when sitting still?” Monitoring the answers and alerting clinicians when answers fall outside of the expected range is key to enabling providers to be pro-active in their treatment.
Remote Patient Monitoring
As networking technology has improved, it is now possible to place devices in a patient’s home that report measurements directly back to a cloud-based system. This can be done even if the patient has no in-home network or any technical knowledge. With multiple, machine-reported readings per day, providers can even manage medication and other complex issues without the patient having to come to the office.
Billing and Reimbursement
The recent economic downturn has hit businesses in every sector. Healthcare providers have not been immune to this. They face both the problem of reduced office visits and the complexity of getting reimbursed for out-of-office services.
Dr. Christopher Adams, a rheumatologist at East Alabama Medical Center put it rather succinctly, “The telehealth reimbursement is tragic.” Rural areas in Alabama are particularly hard hit, since prior to the Coronavirus pandemic, there was no system in place in Alabama to pay for telemedicine visits for primary care.
As Remote Care reimbursement is rolled out, many primary care physicians didn’t get much time to roll out a telemedicine service. “Our whole healthcare system for 70, 80 years is designed around coming into the doctor’s office, and now in a weekend we were trying to implement this thing we’d normally spend 18 months rolling out,” said Waits.
While many practices have recently attempted to roll-out Remote Care programs on their own, the reality is that it is just not that simple.
The infrastructure needed for a workable, widely adopted telemedicine system “simply did not exist” in Alabama prior to coronavirus, said Dr. Adams.
“From my personal experience, we tried two different ways of doing it before our medical center IT department said to heck with it, we’re going to contract this out to a third party.”
Remote Care Partners
Remote Care Partners has a comprehensive set of services that answer the needs of providers who are still struggling with the complexity of rolling out Remote Care. Visit www.remotecarepartners.com to get more information or request a demonstration.