Telemedicine Software

How to Implement Telemedicine

Telemedicine can be implemented in many ways, and, depending on the size or specialty of your practice, there is a variety of services for you to consider.

Telemedicine is an emerging field, but it is already saving practices and hospitals money. A general care visit through telemedicine is, on average, $100 cheaper than an in-person appointment. By quickly seeing patients remotely, it can prevent unnecessary hospital readmissions and reduce your overhead.

It will be up to you to decide how much time and money you want to invest in telemedicine, as it will require a change in your office dynamic and finding a balance between your in-house patients and remote patients. However, there is an estimated return of investment of $3.30 for every $1 spent on a telemedicine program. There are already practitioners who are full-time virtual doctors.

Cost

Pricing for telemedicine varies depending on the company, the size of your practice and to what scale you want to implement it. You'll likely receive a quote from the company for the custom system you'll design with the service. Be aware that most software solutions will charge a monthly or annual fee.

Connection

Since telemedicine lives online, you will need to have a strong internet connection. Most telemedicine services recommend that you and your patients use broadband-level speeds for consistent connection for live chat. This can be a barrier if you're trying to reach rural areas that are without updated internet speeds.

Equipment

The best equipment requires little setup and should be easy for both you and your patient or their caregiver to use. Basic setups will require you both to have a computer with a microphone and web camera for video chatting with patients. Some services can provide you with these.

For remote biometric devices, either the company can lease them or you can purchase them from third-party vendors if they're compatible with the service. Some equipment is proprietary to the service, however. These devices can include stethoscopes, blood pressure monitors and scales. These devices work digitally and will remotely upload results to the system for you to view.

Some platforms just require a simple application that allows you to converse with patients over mobile phones or tablets.

Training

Working with patients remotely is a different experience from working with them in person, so a telemedicine platform that provides training on how to interact with them is a great service if you've never done it before. Complicated equipment like ambulance kits require training, so it's essential that you find a service willing to provide such training. If you plan on working with caregivers or remote staff members, they will require training as well.

Laws Concerning Telemedicine

Telemedicine is still a new tool for doctors, so when it comes to applying medical law and insurance statutes, states are still grappling with how to deal with them. As a result, laws regarding telemedicine vary from state to state, which can restrict how much you can do with it and how you can get paid. Depending on where your practice is located, it may be impractical for you to implement telemedicine.

Medical licenses

While telemedicine allows you to communicate with patients over long distances, in most cases, it still needs to be within state borders. You must have a valid license to practice medicine in the state your patient is in. You may be restricted to using telemedicine in the state your practice is located, unless your state's license is accepted by select other states. You can check with your state medical board to find out where your license is accepted.

HIPAA and FDA

The Health Insurance Portability and Accountability Act (HIPAA) is the main reason that you can't simply perform telemedicine over Skype or another public chat program. An acceptable telemedicine program must be secured and adhere to the strict privacy standards set by HIPAA. Communications through these programs are heavily encrypted, and patients' health data is secured in approved databases. Likewise, any medical devices that you use in conjunction with the telemedicine platform must be FDA approved.

Reputable telemedicine companies publicly state that they follow these standards, but it is ultimately your responsibility to ensure you are following the law by using legally certified technology.

How insurance works with telemedicine

State laws differ on how practices can be reimbursed for telemedicine.

• Private insurers, for the most part, have embraced telemedicine as a way for clients to spend less on health care, as it leads to less expensive trips to the doctor's office or emergency room. Although only 18 states have laws that require private insurers to provide coverage for telemedicine in some form, most major insurance providers already include telemedicine in their plans nationwide.
• Medicaid covers telemedicine in 16 states, and most of those states only allow live video chat. There are exceptions depending on the state, so check with your state medical board.
• Medicare is even stricter in that it can only cover telemedicine when it is implemented for patients at an approved medical facility in a designated rural area.
• Direct payment is an option for certain telemedicine platforms, but it is likely to be costly for patients.

These services can accept major credit cards and sometimes FSA or HSA cards.

ePrescriptions

Many platforms allow you to prescribe medication to a patient virtually, but the laws regarding this also depend on the state. A few states allow you to prescribe medication freely, but most states set the restriction that you can prescribe non-narcotic medication only. A handful of states does not permit ePrescriptions at all.