Telehealth Best Practices: Enhancing “Webside” Manner

Tag Archives: Public Health EHR

Telehealth Best Practices: Enhancing “Webside” Manner

Best Practices for Telehealth Webside Manner

Staying safe during the COVID-19 pandemic continues to increase the use of telehealth among healthcare professionals. 75% of individuals in the U.S. who have behavioral health conditions are continuing therapy services during COVID-19. Additionally, virtual care has increased 1.6x since the summer of 2019.  And telehealth is here to stay. Convenience, access beyond clinical hours, and increased continuity of care are just a few of the key benefits in providing telehealth. With such an increase, we pulled together a list of best practices when conducting a telehealth appointment. Just as physicians focus on bedside manner during an in-person interaction, telehealth encounters have a proper “webside” manner.

Why is “Webside” Manner Important?

“Webside” manner is just as important as a regular bedside manner during client appointments. Webside manner is similar to bedside manner. It’s the way clinicians interact with patients during an appointment.

Studies show positive provider-patient relationships matter. When providers receive training in empathy, eye-contact, and other relationship-building strategies, health outcomes often improve. In other words, there are no negative side effects when you focus on maintaining a positive relationship with clients. Building a good rapport is crucial to providing meaningful care. So, how can you enhance your telehealth experience?

Best Practices for a Telehealth Encounter

Before the Appointment

If you are new to telehealth, we recommend practicing before your first client encounter. Even if you are experienced in telehealth, best practices are important reminders before each appointment. Here are a few items to consider:

  • Have the correct equipment – Having a reliable computer or laptop with video functionality will be best for telehealth. Devices often perform best when plugged into a power source. Consider investing in a headset and a USB camera if your current technology isn’t up to par.
  • Test your internet connection – Nothing can interfere with a patient encounter more than having poor communication. During a virtual appointment, internet connection can interfere with communication. Continually test your connectivity to ensure you provide the highest quality care. Placing the router close to your office helps improve wireless connections. If you can’t do that, consider getting a wireless range enhancer to boost your wifi signal. 
  • Physical space – When using video for telehealth, physical space determines whether a client can see you clearly. Proper lighting, for example, affects how well a client can see you. You may also consider a physical space that isn’t prone to unexpected sounds (from kids, pets, etc.). Additionally, make sure you are comfortable in the space before the appointment begins. Being intentional about your physical space decreases possible distractions.
  • Practice – Grab a colleague to practice with. Set the stage just as you will during your appointments. Ask for feedback on how your space looks, whether the connection seems to be working properly, etc. For instance, a colleague may be able to comment on what the patient experience is like when logging into the telehealth appointment. Practice provides further confidence in using telehealth, which may be a new concept to you or your client.  
  • Have a back-up plan – It is no secret that technology can provide unexpected roadblocks. Whether it be a client’s internet giving out or a device losing power, know your backup plan. A backup plan may look like calling your patient instead of using video. Luckily telehealth compliance and reimbursement are flexible when issues do occur (some rules have become more relaxed during COVID-19). Your agency may provide you with a specific backup plan when things do not go as expected. Know the recommended procedure so you are prepared when challenges arise. 

During the Appointment

It’s time for a telehealth appointment! After proper preparation, remember virtual communication best practices. Consider these tips:

  • Focus on the camera to mimic eye contact.
  • Be aware of body language.
  • Stay seated when possible.
  • Avoid distractions. This tip may seem obvious, but taping or fidgeting is often more distracting on video than in person.
  • Be clear. Clarity on a virtual platform is critically important. For instance, ask clients if they can hear you okay. Ask clients if they need any clarification or have questions during each encounter. Being clear may seem like a simple communication practice, but double-checking your clients’ understanding is better than assuming they heard everything.

Your Reliable Solution

With telehealth on the rise, you need a reliable solution to continue providing meaningful care to your clients. That’s why Patagonia Health has developed an integrated telehealth solution. Our telehealth app allows users to easily integrate video appointments into their workflow. The solution is both secure and very easy to use. Interested in learning more? Contact us today. 

Resources:

https://telemedicine.arizona.edu/blog/bedside-manners-telehealth-understanding-how-your-screenside-manners-matter
https://blog.pcc.com/virtual-bedside-manner-connecting-with-telemedicine
https://healthpayerintelligence.com/features/beyond-covid-19-telehealth-partnerships-member-engagement?eid=CXTEL000000530175&elqCampaignId=14727&utm_source=nl&utm_medium=email&utm_campaign=newsletter&elqTrackId=2c159cc5ff9b41378a689e2ef8be71d4&elq=6c4fc3af848642a99574d8eafa593fbd&elqaid=15411&elqat=1&elqCampaignId=14727
https://www.wheel.com/blog/ways-to-improve-your-telehealth-webside-manner/

Contact Tracing and Next Steps

Contact Tracing During COVID-19

States move toward reopening, public health decisions continue to be in the spotlight.

As curves plateau and state economies continue to struggle, people around the country are asking: when will we get back to normal? Public health and government officials, however, focus on how we return to normal. As of May 1, more than half of US states began reopening businesses and easing previously strict orders and mandates. Although, what we remember as normal before this pandemic will not be how states reopen right away. 

In order to contain this public health crisis, experts consider how to safely move toward reopening. Testing, tracing, and self-isolating will be key in taking the next steps. Communities will rely on four building blocks to combat COVID-19: contact tracing, testing, and eventual COVID-19 treatments and vaccines. These building blocks work together for an effective plan to return to society. Public health professionals will focus on where the virus is in communities and how to continue to reduce the spread. 

What is Contact Tracing?

Contact tracing is a public health strategy designed to contain the spread of an infectious disease. The idea works by tracing and contacting each person who may have been in contact with an individual who tests positive for an infectious disease. By informing individuals when they may have been in contact with a positive case, we can monitor and advise others appropriately (e.g self isolate if they also show symptoms). The concept is fundamental to public health and even more important during the current pandemic. In the U.S., we are fortunate to have strong local health departments. The staff at health departments work as quiet soldiers day in and day out to keep our communities safe. When our everyday lives aren’t at risk of infectious disease, we don’t even realize the work being done by local health departments.

The Importance of Tracing Positive COVID-19 Cases 

Johns Hopkins School of Public Health recently released a report on COVID-19 contact tracing in the United States. The report estimated each positive COVID-19 person can infect 2 to 3 other people, on average. This leads to an alarming statistic: if one person spreads the virus to three others, the first positive case can turn into more than 59,000 cases in 10 rounds of infections.

How Does Contact Tracing Work?

In addition to providing immunizations to the public, county health departments ensure communicable diseases such as STD, HIV, and tuberculosis (TB) do not spread in communities. They do this by helping infected individuals and tracing all contacts. For example, when someone tests positive for TB, health department staff are responsible for tracking and contacting all people who that person has been in contact with. The staff’s focus is to make sure each individual is safe and not positive for TB. If connected people show symptoms of the disease, appropriate actions will be advised, such as self-isolation. Electronic Health Records designed specifically for public health have contact tracing functionality for TB built into their software. During the normal course of life, an individual can come in contact with hundreds of people. The EHR software enables staff to efficiently contact and track positive cases, decreasing the chance of widespread infection. 

Contact tracing can quickly isolate people who are or may be infected to stop the spread while allowing healthy people to engage in society. COVID-19 tracing efforts by public health departments will be critical as we reintegrate back into society. Additionally, if there is a second wave of COVID-19, preparing contact tracing measures now enables more effective action in the future.

How States are Already Working Towards Reopening

States, such as Maryland, have released extensive reopening plans to the public. Governor Larry Hogan recently stated that when moving toward reopening, his administration is working to “move rapidly, but not recklessly.” Maryland’s building blocks include testing and having a plan for enough personal protective equipment. They have additionally worked hard to prioritize their contact tracing workforce. COVID-19 Link, a new platform to be used for robust contact tracing operations, will help collect information about people who test positive for COVID-19 and anyone they have come in contact with. Maryland has expanded their workforces to 1,000 contact tracers who will be trained on this platform using data from the region’s health information exchange (CRISP). Public Health EHRs connect to Health Information Exchanges, including CRISP, to provide real-time data, which is crucial during an epidemic. 

Public Health Workers, We’re Here for You.

We know county local health department staff are on the frontlines of finding answers about COVID-19 and doing hard work of contact tracing. As an Electronic Health Record provider focused on public health, we understand the importance of your work. Thank you, healthcare heroes! If there is any way that we can be a resource to you during this time, please reach out to us today

Telehealth Part 2: New Rules and Regulations from CMS

Telehealth: New Rules from CMS and Resources

During these unprecedented times, many adjustments are put into action to accommodate the new normal of social distancing. As previously discussed in our New Rules for Telehealth Technology blog post, the COVID-19 pandemic is causing a large spike in virtual healthcare visits. In these times of rapid change, normal rules and regulations are relaxed to increase accessible care. The Centers for Medicare & Medicaid Services (CMS) recently adjusted its policies so more practitioners can use telehealth during the COVID-19 outbreak. 

How CMS is Responding to COVID-19

Public health emergencies, such as the COVID-19 pandemic, require the U.S. healthcare system work quickly to make sure people are receiving necessary care. As the largest health insurer in the nation, CMS plays a critical role in enforcing new safety and billing guidance during these uncertain times. CMS has implemented temporary changes during our country’s state of emergency. Here is a quick summary of the timeline so far:

Timeline: 

March 13 – The United States declares COVID-19 as a national emergency. CMS publishes an initial emergency declaration fact sheet for healthcare providers.

March 17 – CMS announces an expansion of telehealth services covered for Medicare beneficiaries. CMS also approves the first state request for 1135 Medicaid waiver in Florida.

March 27 – 34 states officially approved for a Medicaid waiver under Section 1135 (see the CMS Newsroom for updated numbers).

March 30 – 80 additional telehealth services added under Medicare coverage.1  

These dates are only a few noteworthy occasions of the many changes made in the past month by our country. CMS reports that Medicaid waiver requests are being approved in historic turnaround times. Fulfilling waiver requests quickly grants states ample flexibility to serve individuals on Medicaid, who are often underserved in communities. CMS reports, “Other types of Medicaid waivers can require months of negotiation, but in light of the urgent and evolving needs of states during COVID-19 CMS developed a streamlined template for facilitate expedited application and approval of Medicaid 1135 waivers.”2  

What does a Section 1135 waiver mean?

The Medicaid-specific waivers approved to many states are under Section 1135 of the Social Security Act. These waivers specifically provide the healthcare system greater flexibility for providing care to individuals. Some of the temporary flexibilities include:

  • Waiving requirements in the authorization for fee-for-service program
  • Out-of-state providers can provide care to another state’s Medicaid population if they have been impacted by the national emergency
  • Waiving requirements that providers be licensed in the specific state they are providing care in (as long as they have equivalent licensure in another state)
  • Suspending requirements relating to pre-admission or annual screenings (specific to nursing homes)

CMS changes are evolving each day. It is important now more than ever to stay up to date with the facts. Regulations differ on a state and local level. As always, follow the guidance of your local health authorities. For further details on the Section 1135 waivers (specific to state Medicaid), please visit Medicaid.gov or trust reliable news sources, such as the CMS Newsroom. Furthermore, CMS is regularly updating this webpage to keep beneficiaries and healthcare professionals up to date.

Further Expansion for Telehealth

Telehealth is continually seeing an expansion during the COVID-19 pandemic. CMS is now allowing 80 additional services to be provided through telehealth, specifically for Medicare patients. Covered healthcare professionals may use any non-public facing product, such as FaceTime, Skype and Facebook Messenger to provide telehealth during this public health emergency. Penalties won’t be imposed on covered providers who have not entered into a HIPAA BAA with these vendors.

Billing has also been adjusted, allowing healthcare professionals to bill telehealth visits at the same rate as in-person visits. New and existing patients can now be at home while receiving various forms of healthcare.

As always, see CMS.gov for more information on the temporary regulatory changes and other changes that might be implemented. 

Patagonia Health is Here for You

There is so much information out there about COVID-19. Patagonia Health is here for you as a resource. We are regularly updating resource pages to specifically help you sift through the noise. 

State-Specific Telehealth Coding and Billing Cheat Sheets and other Educational Resources

COVID-19 Resources for Public & Behavioral Health

As a trusted Public and Behavioral Health EHR, practice management, and billing solution, we understand the importance of combating the ongoing pandemic of COVID-19. Our team is currently collaborating with customers to develop a fully integrated telehealth solution. If we can be a service or resource for you, please contact us today. 

References:

1 https://www.beckershospitalreview.com/telehealth/cms-adds-85-more-medicare-services-covered-under-telehealth.html

2 https://www.cms.gov/newsroom/press-releases/trump-administration-approves-34th-state-request-medicaid-emergency-waivers

Additional Resources:

The National Council’s COVID-19 Resources

CMS Emergency Information on COVID-19

Medicare Telemedicine Health Care Fact Sheet

Historic Expansion of Telehealth Announcement from HHS

Patagonia Health Releases COVID-19 Risk Assessment and Public Health Management Decision Making Tool

COVID-19 Risk Assessment Tool will become available to all Patagonia Health EHR Users

Patagonia Health, an Electronic Health Record (EHR) focused in Public and Behavioral Health, is in the final stages of developing a COVID-19 Risk Assessment and Public Health Management Decision Making Tool. Public Health professionals are on the front lines of combating the growing COVID-19 pandemic. Local Public Health agencies are tasked with identifying cases of COVID-19 and working with government officials on how to advise the community on precautionary measures. 

The risk assessment and decision-making tool in Patagonia Health works to automatically categorize an individual’s risk of infection. Similar to screening tools developed during previous public health emergencies, such as the Ebola outbreak, the COVID-19 Risk Assessment tool follows CDC guidelines exactly. The assessment will automatically open during the patient check-in process. The software will automatically categorize the patient’s risk level and save the results directly to the patient record. 

Additionally, Patagonia Health is working with LabCorp to facilitate the distribution of COVID-19 test kits. Users who have the LabCorp bi-directional lab interface can order COVID-19 test kits directly through Patagonia Health EHR. COVID-19 ICD10 diagnostic and CPT codes are updated and available to users in the interface. The assessment tool will become available to all Patagonia Health EHR users, free of charge, by March 23, 2020. 

About Patagonia Health, Inc.

Patagonia Health, Inc. is a healthcare software supplier with a cloud and apps-based software solution that is designed specifically for Public and Behavioral Health agencies. The solution includes an integrated, federally-certified, Electronic Health Record (EHR), Practice Management (PM) and Billing software. The company’s mission is to solve two major barriers to EHR adoption − usability and cost − and address customers’ number one problem: billing. Patagonia Health’s highly-intelligent solution is extremely easy to use and provides timely data for organizations to improve workflow, streamline operations and take their organizations to the next level. For more information, visit https://patagoniahealth.com.

Patagonia Health Expands EHR for Home Visit Intervention Tracking

Home Intervention Tracking in EHR System

Patagonia Health enhances its electronic health record (EHR) software by improving functionality for Home Visit intervention tracking and documentation. Home Visits, used by both public health and behavioral health agencies, create specialized needs for the providing agency.

Intervention Tracking with Enhanced Usability

According to Patagonia Health Chief Enterprise Architect, John Ramsey, the software improvements enhance usability for both on-site documentation and after-visit reporting. “A home visit is very unlike a clinic environment,” Ramsey notes. “Additionally, the necessary documentation varies greatly from state to state and agency to agency.”

Patient Interventions and the information gathered during home visits can now be managed and modified within Progress Notes. The enhancement makes the user experience more streamlined, eliminating double data entry. According to Ramsey, “Users make the modifications to the interventions, and the information gets stored in both places:  Patient Interventions and Progress Notes.”

Custom Reports for Home Visits

Further, Patagonia Health continues to develop customized forms to assist public health and behavioral health agencies. These reports allow staff to pull data from patient records easily. The ability to demonstrate procedures and care administered during a Home Visit is critical for agencies to provide supporting documentation for both grant and insurance funding.

Electronic health record software, which enhances the home visit, says Ramsey, “is good for the patient and good for reporting.”  

Expanding its public health and behavioral health EHR with Home Visit intervention tracking and documentation is evidence of Patagonia Health’s continued commitment to both its customers – and the clients they serve.

For more information, visit https://patagoniahealth.com, or email info@patagoniahealth.com.