The Telehealth Ten
Whatever the future may hold, one thing is certain: Telehealth is here to stay.
Posted in Risk Management on Monday, December 7, 2020
Many clinicians who hadn’t even considered telehealth pre-COVID have started utilizing this service as a way to maintain their practice and relationship with their patients when office visits are limited. Although telehealth visits have decreased since states have loosened some COVID restrictions; providing this option for patients can be important to your practice. Should you opt to offer telehealth, you'll have to find a balance that works for you and your specialty.
Laws and Regulations Address Telehealth
Since the onset of the pandemic, the Center for Medicaid/Medicare improved their reimbursement model to encourage use. And, many private insurers addressed the need to provide coverage for telehealth. A number of states enacted laws requiring private insurers to reimburse for telehealth visits.
To further the use of telemedicine permanently, on August 3, 2020, an executive order was signed to improve telehealth access to and quality of rural healthcare.
Standard of Care
An issue which comes up frequently — and may soon be at the heart of claim allegations — is whether the provider met the standard of care when it comes to assessing, diagnosing and prescribing. While telehealth can be an excellent vehicle, there are certain times when a telehealth visit just can’t meet that need. Using telehealth does not change the standard of care. Most states dictate that when using telehealth the standard of care is the same as if the patient was being seen in person.
The Telehealth Ten
To make your job a little easier, the American Journal of Medicine published “The Telehealth Ten,” a guide for patient-assisted virtual assessments. The steps include how to address the assessment areas you would normally address in a live visit, performing them virtually with the patient assisting. So, for an easy example, have the patient weigh themselves the morning of the visit!
The ten steps in the article address each area:
- Vital signs
- Skin assessment
- Neck
- Lungs
- Heart
- Abdominal
- Extremities
- Neurological
- Social determinants
When engaging in telehealth, it's important to consider an informed consent specifically for telehealth so expectations can be addressed early on. It is too soon to tell whether there will be an increase of claims arising from telehealth during the pandemic. However, anticipated allegations will arise from misdiagnosis, assessment failure, and inappropriate prescribing/medication management as these are the leading allegations even for in-person visits.
Remember Three Things
Set expectations, use informed consent, and document, document, document!
Reference: Four New Statistics That Prove Telemedicine Isn’t Just a Pandemic Fad