Utilize Telemedicine: How do I get started?
How do I start setting up telemedicine?
As long as you have a reliable internet connection, you can get started conducting patient visits via telemedicine. Your first step should be to check with your state medical society to see if there are any special requirements for you to practice telemedicine. You should also check with your malpractice carrier to ensure you are covered for telemedicine visits. In light of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has relaxed many requirements for Medicare patients, and states are following suit for Medicaid patients. For example:
- Restrictions on the originating site and geographic locations for the provision of telehealth services have been temporarily waived (including the ability to provide care across state lines).
- The requirement that a physician must have seen the patient within the last three years prior to the telehealth visit has been temporarily waived.
- Certain provisions of HIPAA will not be enforced for covered healthcare providers utilizing telehealth services.
Check with your state medical society for the most recent telemedicine updates in your area. The Center for Connected Health Policy is maintaining an updated list of state level telehealth waiver information. The AAAAI’s advocacy firm, Hart Health Strategies, is also providing regular updates.
What platform do I use?
There are many telemedicine platforms available, and features and pricing vary. Some EMR systems have telemedicine capabilities embedded, so you may want to check with your vendor. Colleagues or your state medical society can be good sources for recommendations (the AAAAI cannot make platform recommendations).
Do I need to have the patient sign a telemedicine consent form?
It depends. There is wide variability in state and payer requirements for consent ranging from no requirements to verbal consent only to obtaining written consent that must be stored in the patient's health record.
- The Center for Connected Health Policy’s state map lets you check requirements for your state.
- The American Telemedicine Association has sample telemedicine consent forms.
What do I do if the patient is not able to connect? Can I still have an encounter?
If the patient cannot connect via video, you can hold the visit via telephone using the telephone encounter codes as long as it is an established patient. Due to the temporary relaxation of parts of the HIPAA rule, you can also connect with new or established patients via popular applications that allow video chats such as FaceTime, Skype, Facebook Messenger and Google Hangouts. You should notify patients that these third-party applications potentially introduce privacy risks, and enable all available encryption and privacy modes when using such applications.