A Leader’s Guide to Telehealth Expansion

Last week, the Centers for Medicare and Medicaid Services expanded telemedicine access to Medicare beneficiaries in an effort to keep at-risk populations safe during the COVID-19 pandemic.

Under this new 1135 waiver, Medicare will now pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020. A range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, are now able to offer telehealth to their patients. Medicare beneficiaries will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling and preventive health screenings. Read this CMS fact sheet for comprehensive information about the expansion.

Prior to this change Medicare would only pay for telehealth on a limited basis—when the person receiving the service was in a designated rural area and if they left their home to go to a clinic, hospital or certain other types of medical facilities for the service. But in light of the concerns over community spread of the COVID-19 coronavirus, beneficiaries are now allowed to stay in their homes and still receive these services via telehealth.

In light of this policy change, many providers are no doubt scrambling to get their telehealth capabilities up to speed. But it’s not just the technology that needs to work in order to provide patients a seamless care experience via telemedicine, says John Coldsmith, DNP, MSN, RN, NEA-BC.

A seasoned executive whose experience spans nursing leadership and hospital operations, Coldsmith has seen his fair share of telehealth programs get launched—with varying degrees of success. Here are his tips for leaders as they expand telemedicine programs at their facilities—whether that expansion is being done in response to a public health emergency or not. 

Telemedicine is about technology and people

While the runway to implementing a telemedicine program in the wake of a Public Health Emergency is undeniably short, spend what time you do have to make sure you choose the right technology and people for the greatest chance of success.

“It’s easy to see telemedicine as either a technology solution or a remote provider solution,” he says. “It’s harder to see that both of those have to work well for your program to be successful.”

Many rural providers are finding HIPAA-compliant video conferencing solutions are viable substitutes for a more formal telehealth-specific technology platform. But don’t stop at technology. Find the team members in your facilities and practices that already are super-users of this kind of technology or are eager to become ones. They will serve as champions as you test and roll out these services.

Assemble the right team of stakeholders

Regulatory issues, provider credentialing, HIPAA compliance, IT considerations, billing—standing up a telemedicine program takes so much more than the right technology and clinicians delivering the care. But for rural hospitals and physician practices, Coldsmith admits that assembling the right team of stakeholders can be a challenge. Take IT, for example. Do you have an existing IT department or designated individual? In the absence of those, how can you prepare front-line clinical staff to troubleshoot telemedicine technology issues?

Practice makes perfect

It’s a cliché because it’s true, Coldsmith says. If you’re quickly adding telemedicine capabilities now, Coldsmith recommends carving out time to practice, even if it’s just most-hands-on-deck for an afternoon of training.

“In all of this, we also have the patient to consider,” he says. “Technology is wonderful, but the more you practice the better the outcomes. You want to minimize their frustrations with this transition as much as possible.”

Stay engaged

“The most successful programs are ones where leadership is engaged throughout the process,” he says. But in his experience, some leaders check out once the decisions are made and implementation begins.

“It’s not enough to just help make the decisions on the front end,” he says. “For a telemedicine program to actually be used and have longevity, there needs to be consistent engagement from leadership. Stay engaged throughout the implementation and execution and be the link between all the various stakeholders.”

Decide who will own telemedicine—that person’s department may be different from one organization to the next—and charge that leader with ensuring new users are onboarded appropriately, that the platform is utilized consistently across all users and that it’s being subject to ongoing evaluation, such as Ongoing Practice Performance Evaluation.

“Too often where telemedicine fails to deliver is when you allow inconsistencies to creep in,” Coldsmith says. “That’s why it’s so important for oversight and leadership to stay the course even after the so-called implementation phase. Implementation is never over, as long as there are new users on both the provider and patient side.”

HealthTechS3 and a well-vetted team of executive and interim leaders are ready to help you get telemedicine-ready. Whether you need to quickly implement a program in response to the COVID-19 Public Health Emergency or you have a longer runway, our experts can share best practices and assist with implementation. Contact us today at John Coldsmith, Clinical Consultant at john.coldsmith@healthtechs3.com.