How to Start Your Own Telemedicine Practice
In 2018, 18 percent of physicians in the U.S. offered telemedicine services. Two years later, that number has jumped to 48 percent, according to medical research firm Merritt Hawkins. Granted, the pandemic has played a role, prompting many providers in private practice to deliver “touch-free” care in the spirit of social distancing. But will they cut the connection and return to in-person visits only once the public health emergency subsides? Probably not.
The wave of the future is a hybrid practice, with both in-office appointments and virtual visits. If you’re interested in getting on board, here’s a telemedicine implementation plan to help you become an online provider.
Starting your own telemedicine practice
In many ways, starting a telemedicine practice is like starting a new business. There are rules and regulations, a learning curve, and a financial commitment. A good place to start is with the laws governing telemedicine programs.
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1) Telemedicine and the law
Telemedicine is a service that allows practitioners to connect with patients using an app, video, smartphone, or other digital forms of communication. During virtual visits, practitioners can diagnose and treat illnesses and injuries. For doctors in private practice, telemedicine serves a wide range of patients from the homebound to the busy corporate executive.
Learn the telemedicine laws in your state. Your state medical board and the American Telemedicine Association’s website are great resources for this. Discover what is and isn’t allowed in your state. For instance, some states will allow you to engage in a virtual visit while a patient sits at home. Others require the patient to visit their doctor online from a medical facility.
Understand what Medicare will and won’t pay for. Before the pandemic, the Centers for Medicare & Medicaid Services (CMS) had strict reimbursement policies in place for telemedicine services. The CMS broadened its reimbursement parameters in March. Medicare will now pay for telemedicine visits between patients and providers such as doctors, nurse practitioners, psychologists, and licensed clinical social workers. The new guidelines will be in effect for as long as COVID-19 remains a public health emergency.
Know your state’s laws around e-prescribing. Again, laws vary from state to state. Ask your state medical board for guidance. As for controlled substances, the Drug Enforcement Administration (DEA) recently eased its restrictions in light of the pandemic.
2) Telemedicine and technology
To set up a telemedicine practice, you’ll also need to look at technology partners. Many existing video communication companies have created platforms specifically for the telehealth industry such as Zoom for Healthcare. Telehealth is a broader term used to describe digital technologies that promote health and patient education. Telemedicine sits under the telehealth umbrella and is specific to provider/patient care.
Here is a guide to choosing a telemedicine platform that’s right for your practice.
As you explore telehealth vendors, look for a platform that:
Integrates with your electronic health records (EHR)
Complies with HIPAA rules as well as state medical board regulations
Offers tech support for you and for your patients
Includes a high-level of security features for your patients’ data
Provides customization features so you can get exactly what you want
Requires minimal changes to your existing software and hardware programs (unless you’re due for a serious update)
Does not impact your internet speed or your network’s performance
Telemedicine startup costs
As with any new venture, calculating startup costs and return on investment is part of the process. Much of the cost in telemedicine depends on the platform you choose and whether or not you will need additional staff and equipment like tablets, microphones, headphones, etc. Providers and technology vendors say the cost typically ranges from free to $500 a month, though there are free platforms available.
The Telehealth Implementation Playbook published by the American Medical Association (AMA) suggests you “determine if your organization or practice is financially ready for telehealth by starting to understand the cost of implementation and how telehealth could have a positive impact, whether that would be through reimbursement, improved patient experience, increased access for patients, or reduced no show rates.”
The AMA handbook goes on to say that telemedicine implementation may reduce costs by improving health outcomes, patient experience, and provider satisfaction. In other words, you may benefit from positive ROI while delivering value to your patients, your organization, and your community.
Two more helpful publications include the ATA’s Quick-Start Guide to Telehealth During a Health Crisis and the Medicare Telemedicine Health Care Provider Fact Sheet.
Advantages and challenges of implementing telemedicine
Weighing the pros and cons of a telemedicine service includes looking at barriers and exploring how to overcome them. Some barriers include:
Lack of consistent reimbursement models
Licensing challenges
Regulatory issues
Security and privacy concerns
Not enough evidence to support a positive impact on costs and outcomes
Safety considerations around e-prescribing
Challenges regarding physical workspace
Workflow disruptions
Patient resistance
To address challenges, the AMA formed The Digital Medicine Payment Advisory Group (DMPAG). This team of experts identifies barriers to telemedicine and makes recommendations such as coding and coverage solutions.
On the other hand, there are plenty of advantages to providing telemedicine services, including:
Follow-up care to help your patients with compliance and medication management
Symptom triage
Visits to discuss lab results
Group education for patients with chronic diseases such as diabetes or asthma
Easy access to mental health services in communities with gaps
Easy access for patients with mobility issues
Easy access for established patients who travel often or must relocate temporarily
Next steps
As you get ready to dive into the world of telemedicine, here’s a 10-step guide courtesy of the AMA:
Identify the need
Form the team
Define success
Evaluate the vendor
Make the case
Contract
Design the workflow
Prepare the care team
Evaluate success
Scale
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