Why telehealth should be your top EHR requirement

Telehealth refers to a means of remote healthcare service delivery. From a conceptual perspective, telehealth involves both delivering service remotely and the technologies that allow for healthcare services to be delivered remotely. The Health Resources Services Administration in its formal definition of telehealth identifies the following technologies used to deliver remote healthcare services which include: “videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.”

Telehealth technology has been available to medical practices for years, however, its most common deployment has centered on using telehealth as a tool to provide remote healthcare services in areas with a shortage of care providers. Over the last decade, telehealth adoption has grown gradually, with significant gains in usage occurring over the past few years. Evidence of this growth in demand is seen in a recent report published by Frost and Sullivan.  Frost and Sullivan report that the demand for telehealth is anticipated to rise 64.3 percent in 2020, with an anticipated five-year compound annual growth rate of 38.2 percent.

With efforts to mitigate the spread of the virus in healthcare settings, the COVID-19 pandemic has forced healthcare providers to either deploy telehealth services for the first time or for those practices already offering telehealth services an opportunity to further expand its use moving forward healthcare practices may want to explore the reasons why telehealth features should be their top EHR requirement.

Changes in telehealth policy in response to the COVID-19 pandemic

With limitations on in-person medical visits during the COVID-19 pandemic delivering care via telehealth became a consideration for practices searching for ways to provide non-emergency routine care to patients while still complying with mitigation measures.  For those considering improving or initially implementing telehealth features, the current regulatory environment offers an excellent opportunity for healthcare practices to rely more heavily on telehealth services and also put in place an infrastructure for greater implementation of these services beyond the pandemic. 

In response to the pandemic, government regulations sought to provide incentives for providers to offer routine care to their patients remotely. For example, in February 2020, the CDC issued guidance advising health care providers to offer clinical services through virtual means such as telehealth. The underlying motivation for this move was based both on the need to eliminate opportunities for the spread of the virus in healthcare practices but also sought to avoid disruption of preventive care for patients, particularly those individuals with preexisting conditions that put them at risk of severe complications or death if they contracted the virus. 

Subsequent to the CDC’s recommendation, the government instituted policy changes that facilitated the use of telehealth CMS expanded reimbursement for telehealth services to include an additional 80 telehealth services that will be reimbursed on par with in-person services. Many commercial insurers also followed CMS’ lead by agreeing to pay for telehealth services on par with in-person services, as well. 

In addition to moves to establish parity in reimbursement between telehealth and in person services, Congress also included provisions in legislation to facilitate telehealth adoption.  As part of the Appropriations Act passed by Congress, CMS was authorized to relax Medicare reimbursement requirements for telehealth services. The Appropriations Act specifically addressed restrictions on the patient’s location when receiving telehealth services. Providers were, however, required to have seen the patient within the past 3 years to be reimbursed for these services. The subsequent CARES Act passed by Congress goes further in relaxing reimbursement rules for telehealth services by permitting CMS to waive any further Medicare reimbursement requirements and removes the 3-year requirement.

Telehealth beyond the COVID-19 pandemic

The benefits offered by telehealth extend beyond the need to mitigate the spread of the COVID-19 virus. In fact, integrating telehealth capabilities into a practice’s existing clinical and technology infrastructure can offer several potential benefits. Some of these benefits have been outlined in an article published in BMC Public Health. The authors conducted a systematic literature review of studies examining the benefits practices that adopted telehealth realized. The authors identified a number of benefits which include more efficient use of resources, health care acquired infection reduction, improving access to care, and the better coordination of care across care settings. 

The BMC article referenced above provides a general outline of the benefits offered by telehealth services. Moving forward it’s important to look at two of the more important benefits that practices can realize. 

Engaging and serving hard to reach patients

Telemedicine technology provides an opportunity to deliver health care services remotely and in real-time to patients who do not have immediate access to a doctor. In addition to providing access to care for patients who may not be able to easily access their provider, it can also ease the ability for patients who, due to time constraints or medical vulnerability, may not be able to easily access routine care.  When thinking beyond the pandemic the expansion of telehealth services and the continuation of can serve as a valuable tool in addressing underserved populations. 

Making your practice more efficient 

As health care costs continue to rise, and as shortages of medical providers are a reality in many areas, telehealth technology serves as a method of delivering care, which controls costs while maintaining the quality of health care services. A 2015 peer-reviewed article published in the Journal of Medical Internet Research on the benefits of telemedicine makes the case that telemedicine can facilitate care over a distance, reduce the time needed for diagnosis, improve access to hard to reach patients, improve quality of life, and improve patient satisfaction. Further, the article noted that telemedicine can potentially make health care workers more efficient, by reducing reduce non-urgent office visits and health care encounters. 

A study conducted of the Hospital at Home program a telemedicine program focusing on elderly patients with compromised immune systems, initiated by Johns Hopkins Medicine in Baltimore affirms telehealth’s cost savings potential. Data collected on the program, showed a total savings of 32 percent on cost care when comparing telehealth patients with their peers not using the program.   

Before the pandemic, providers using or even considering using telehealth services encountered barriers to offering telehealth services primarily in the form of limitations on the reimbursement for telehealth services. However, policy changes made in Spring 2020 expanded the scope of telehealth reimbursement. At this time, it’s not certain if these changes will remain, however, the benefits offered by telehealth may provide the necessary evidence for policymakers to remove these barriers on a permanent basis.