BUILDING YOUR 2021 PLAN

Telemedicine Considerations for Podiatry Practices

Are you using this medium to its potential? 37

BY KARNA W. MORROW, CPC, RCC, CCS-P

his past year has motivat- vironment. The patient’s understand- Scores are Changing Medicine.” It re- ed many practices to ‘test’ ing of factors that contribute to their minded readers that the majority of the option of telemedicine well-being could benefit from your patient complaints (96%) are related to address the needs of pa- literal viewpoint. A virtual visit will to bad customer service, offering long tients when the “office” is never completely replace the face-to- wait times and poor communication Tunavailable, but a disruption in your face encounter in any specialty. But as examples. Is that a perception or a workflow isn’t new or limited to the with the upcoming patient base more reality? The patient may be experienc- coronavirus (COVID-19). Telemedi- comfortable with technology and the ing pain or discomfort when schedul- cine is a patient-focused service line that may be the one constant to your practice in any circumstance. Telemedicine is a patient-focused service line There are considerations—treat- ment and care options, patient ac- that may be the one constant ceptance, delivery platform, and re- imbursement. There are benefits—re- to your practice in any circumstance. duced exposure between patients and staff, increased patient compliance and satisfaction, and expanded ac- unpredictable access to the brick and ing an appointment to see a podiatrist. cess to remote patients. mortar, the practice will benefit from That pain may continue for a peri- The obvious limits to telehealth having a complementary delivery od of time until they can be seen and visits in a more hands-on specialty method in place. then they must drive a variable dis- like podiatry should not discourage a Back in the 1970s, Life cereal had tance to the office. They may also de- provider from reviewing the way care a commercial with the catch-phrase, cide they just don’t feel well enough has always been delivered. Practicing “Mikey likes it!” The characters were to come in and either cancel or not in an area where winter poses a real skeptical about something new and show. Following the patient who does or perceived travel risk to the patient, waited until the younger sibling tested arrive at the practice, that patient is extending access to their provider the product. A well-thought-out im- already uncomfortable and possiibly from the comfort of their home may plementation plan for tele-visits may annoyed at something that happened encourage patients to reach out soon- strike the same surprising result with enroute. Even a short wait in an un- er and feel more commitment to their your patients. The October 2019 issue comfortable waiting room (sorry, treatment plan. There can be value of Medical Economics featured an ar- nothing will match their overstuffed in observing the patient’s living en- ticle titled, “How Patient Satisfaction Continued on page 38 www.podiatrym.com JANUARY 2021 | PODIATRY MANAGEMENT BUILDING YOUR 2021 PLAN

Telemedicine (from page 37) tient virtually when responding to of the respondents noted they would more in-depth phone calls or ques- consider switching providers for recliner at home) will seem like an tions. When appointments are sched- the offering. Public demand drives eternity and add to their annoyance. uled for non-treatment visits (consul- healthcare policy which includes re- The person next to them may cough tations, re-evaluations, etc.), the front imbursement policy. or sneeze or have a painful-looking desk can offer the tele visit to save the The Centers for Medicare and brace and your patient’s anxiety just patient time. The automatic response Medicaid (CMS) Outpatient Prospec- increases. A poor patient evaluation “you’ll need to schedule an appoint- tive Payment System (OPPS) 2020 isn’t about their individual experience ment” can be updated to “would you Proposed Rules contain key infor- with the practice but rather the collec- like to discuss that with the provider mation on the future reimbursement tive experience of the entire event. in a tele-visit?” Improved communi- for telehealth services—at least for Replay that same patient’s expe- cations between the practice and the Medicare patients. The upside is that rience when scheduled for a televisit. patient will naturally increase the rela- as many know ‘so goes Medicare, so The patient remains in a comfortable tionship to and loyalty of your patients. goes the world of reimbursement.’ overstuffed recliner until the provid- er is ready to start the visit. Within their own environment, the patient It is worth the investment of time is relaxed and can focus on describ- ing their condition or their progress to determine the best way telemedicine can augment instead of being focused on the office environment. When the initial assess- the quality of care you provide. ment is a virtual meeting, the patient also has the chance to become com- 38 fortable with the provider on their The cheapest marketing is a positive The formal comments and responses terms. The first face-to-face when referral from an existing patient. from practicing providers are vital to they start treatment isn’t a hesitant It can be tempting to implement a the policy process. and new experience. A recent survey telemedicine workflow that uses the The practice and delivery of noted that 72% of the 1,000 respon- video features of Skype, Facetime, or healthcare continues to respond to dents had their first virtual care visit other social media. This is convenient, the needs of the community. Do the ever during the pandemic, with over but not compliant. Zoom recent- homework. Check the state regula- 75% saying they were very satisfied ly drew the attention of the Federal tions especially if the practice and with their experience.1 Government with multiple reports of patient cross state lines. Ensure your Will Brady, senior advisor to HHS video sessions being “zoom bombed.” risk management policy covers the Secretary Alex Azar has been quoted Select a vendor that is able to inte- additional services. It is worth the as saying “Telehealth is now the pre- grate telemedicine, including the investment of time to determine the ferred method. People want this as video aspect, within the EHR mod- best way telemedicine can augment the first site of care. We are seeing a ule. ONC certification will ensure that the quality of care you provide. PM demand from consumers.”2 all aspects of the tele-visit are secure If there is hesitancy within the from data encryption, user authenti- References: team about telemedicine for your cation, and patient verification. There 1 https://www.kyruus.com/pa- practice or your current patient mix, is efficiency in being able to document tient-perspectives-on-virtual-care) 2 ease into this service by creating a the patient care during the encounter. https://www.fiercehealthcare.com/ positive experience with the patient There is the saying in academ- practices/cms-upcoming-medicare-pay- ment-rule-to-include-proposals-to-expand- portal experience. An integrated pa- ic medicine—leading edge/bleeding telehealth`0 tient portal is an essential component edge. Not every new technology, of a successful tele-visit. When the pa- procedure, or process is embraced tient is making payments and request- by the insurance payors as rapidly Karna Morrow, CPC, ing appointments from the comfort of as the medical community. Howev- RCC, CCS-P, is an im- their home, it will be second nature to er, COVID-19 has definitely had an plementation manager participate in a visit from home. Each impact on payor policy. Many pay- for Practice EHR. She staff member will play a significant ors quickly relaxed copayment rules has spent nearly three role in helping the patient adapt to a and/or expanded coverage for tele- decades in the industry virtual office. Clinical staff can remind health services “temporarily” during leading electronic health the patient about requesting medica- the pandemic. Now they are seeing record (EHR) implemen- tations and providing tion refills online or accessing educa- it may be very difficult to put the consulting and training tional materials through the portal. genie back in the bottle. The same for a variety of healthcare organizations. Morrow When the patient is reaching out via survey referenced above noted that is a frequent contributor to highly regarded the messaging system, it will be easier almost 75% of the respondents want- industry publications and national conferences, for them to reach out via tele-visit. ed virtual care to be a standard part providing insights on practice management, cod- Consider reaching out to the pa- of their care moving forward. Half ing, billing, and other industry-related topics.

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