Healthcare providers have been using telehealth to provide treatments to patients due to the coronavirus pandemic. Many providers use zoom or telephone to diagnose and give treatment to clients or patients, but that doesn’t mean they’ll be able to do the same thing once the public health emergency (PHE) ends. The relaxation in federal and state regulations regarding telehealth access and coverage was to help providers adopt telehealth during COVID-19, and some current freedoms will end with the end of the country’s declared PHE.
At this point, many professionals enjoy the benefits of telehealth and currently consulting with TBHI to think through their permanent transition and future marketing of telehealth after the pandemic, either for hybrid telehealth or exclusive telehealth practice. They need to adjust their workflows for a post-pandemic time and approach for a mix of virtual visits with in-person visits to provide effective healthcare services. In addition to the previously published Hybrid Counseling article posted by TBHI, several other groups are publishing succinct and useful articles to help such clinicians fully consider their options.
Below are suggestions first offered by Relatient, a Tennessee-based developer of patient engagement services. We describe their five steps and further refine their ideas to offer you what both medical and non-medical providers may want to consider take to establish an effective post-pandemic, hybrid healthcare system.
Notify Clients or Patients
Now that many consumers have experienced the benefits of telehealth, they will be looking for professionals who offer them the same convenience long-term. Estimates of people preferring telehealth are expected to rise as telehealth becomes more embedded into the standard care management process. A fully hybrid healthcare system is possible now, including a preference for the virtual waiting room; appointments with assessments and treatments that can be performed remotely; all the while in combination with in-person appointments, and for people who prefer to see their doctor in person. Many times, these digital networks also allow remote care where accessible and convenient. Hospitals, groups, and even independent practitioners can deliver push notifications, known as demand or broadcast messaging, through their websites to patients, informing them about how and where they can access care. (See Vagaro or Clevertap for a company that claims to be HIPAA-compliant in offering email, push and text messaging services for both mobile and desktop.) Providers in a wide variety of settings can also use social media (Facebook, Linked In, Instagram, and even YouTube) to spread the message and educate all current and future patients. Caution is needed to remain HIPAA-compliant in social media. However. See HIPAA and Social Media: The HIPAA-Compliant Social Media Guide and/or Social Media Guidelines Adopted by ASPPB for light reading about a variety of considerations. For a 1 Hour CME or CE program that covers many of the to-dos, this TBHI webinar may be more appropriate: Social Media.
However, a hybrid healthcare system will only work if patients understand what they can and cannot access through it. If they haven’t done so yet, it is wise for organizations and independent clinicians to maximize their use of websites to give clients and patients a place to see their options and consider their needs.
Secure Communication Channel
The first step is to help clients and patients understand what they can and cannot do with more sophisticated technological channels. A simple website is the best place for professionals to start, even if it is a 1-page website. Its goal may need to be to provide a place for clients and patients to see their options and consider their needs. This doesn’t need to involve many words, but clear and engaging pictures are important.
The second step is to choose the communication channel(s) of most relevance for the population being served. Whatever the clinician’s choice, HIPAA (or PIPEDA if in Canada) mandates require consideration. While enforcement of national or federal laws has been relaxed (see 5 Key Tips for HIPAA Compliant Telemedicine), laws have not gone away.
A telephone is a tested tool for gathering more information, getting quick questions answered, and even assessing and treating. See these additional TBHI articles to learn about telephone telehealth, otherwise known as telephone teletherapy:
- Telephone Telehealth Safety Procedures for Professionals
- COVID-19 Telephone Telehealth Reimbursement
- Controversy about Eliminating Telephone Telehealth Coverage
In addition to the telephone, there are more convenient channels for communication, such as text messaging platforms. A secure chat platform allows patients and consumers to connect on their own time while allowing office workers to find the best solutions and add to the conversation without tying up phone lines. These messages can also link to other resources, giving the patient/consumer information on whether to select in-person or virtual care, what services meet the patient’s needs, and how to schedule an appointment. The important thing for providers is to choose safe and secure channels and let patients know exactly what they can and can’t do and what information can and can’t be shared online. Read more about secure text therapy:
- Texting in Mental Health Treatment: Regulatory & Ethical Considerations in Text Therapy
- Text Therapy: 12 Risk Management Considerations
- Text Therapy & App Security in Telehealth
Scheduling Appointments Online
The most common way to book an appointment with a healthcare professional before COVID-19 was to contact the office or clinic over the phone. The hybrid healthcare system has changed that trend, and medical practices can now create an online platform that can remove phone calls and waiting rooms altogether. And as the nation shifts to hybrid healthcare, practices must integrate these tools with the back end, so office staff and providers can benefit as much as the patients.
An online scheduling tool should be simple to use, even for patients who are not fluent in English or familiar with digital health. Visitors should choose not only between virtual and in-person appointments but also the provider and care they need. A clear set of instructions should be given on what to expect, bring, and when to arrive for virtual or in-person appointments. A simple and easy appointment form increases the possibility of a patient/consumer being on schedule for their appointment and selects that practice for future care needs.
The online scheduling platform should connect with the electronic health record to ensure that the physician has all of the patient’s records accessible before the appointment; this also means that all notes and related details from the session, whether in person or virtual, are entered into the medical record for future care opportunities. Practices should also send out appointment reminders and links to the online platform if the session is virtual.
Client or patient registration allows the providers to collect a wide range of relevant information quickly and easily. With online care, professionals can collect this information online even before the telehealth appointment. Billing, insurance, health and wellness tips, client or patient education about telehealth, and information on other services can be organized in advance of the care visit, freeing the provider and patient to focus solely on the reason for the visit.
Online registration reduces the wait time of filling forms and updating records upon arriving at the office or logging on to the portal while containing all the information a provider needs before the patient’s appointment. The registration process should be easy to use, with clear instructions. A comprehensive but concise form will improve patient engagement and ensure that the practice is getting all the information it needs and not missing out on any important health data or opportunities to improve patient care.
Accept Hybrid Healthcare System
The medical professionals need to take the hybrid healthcare system as a regular part of the procedure, rather than thinking of it as anything added to or different than the usual protocol. Many surveys have indicated that both patients and providers easily adapted to telehealth during the pandemic. All the signs indicate that the hybrid healthcare system that combines in-person and virtual care will be the norm once the public health emergency ends. As federal and state lawmakers are still discussing how telehealth will be regulated and reimbursed, the providers need to lay the groundwork for hybrid care rather than waiting.
Hybrid Telehealth: Blending of Telehealth and in-Person Treatment
Want to practice telehealth across state lines or international borders? Interstate as well as international practice is certainly legal, but you must know what you are doing. There are a number of rules to follow and hoops to jump through. Whether you want to practice telehealth, teletherapy, telepsychology, telepsychiatry, telebehavioral health, or telemental health, this course will show you how!
PLEASE NOTE: the Telebehavioral Health Institute (TBHI) has recently been rebranded and is now known as Telehealth.org
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