Telehealth Best Practices: Enhancing “Webside” Manner

Tag Archives: Telehealth

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/

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

New Rules for Telehealth Technology

It’s no question that COVID-19 is rapidly changing the way we live and work. New social distancing restrictions and shelter-in-place orders cause businesses to become creative in how to stream services online or operate from a distance. Since the beginning of this pandemic, healthcare providers have been on the front lines. As social distancing becomes increasingly important, even healthcare workers must implement measures to serve clients from afar. Telehealth is an even hotter topic right now for just this reason. 

We’ve seen a spike in organizations using technology to continue providing care. Offering telehealth keeps both patients and healthcare professionals safe during the COVID-19 outbreak. For that reason, the government recently lifted restrictions on telehealth. Telehealth is expanding to every type of healthcare provider, not just those working to treat COVID-19. The expansion of telehealth helps slow the spread of COVID-19 and provides more healthcare access to individuals during this unique time. 

So, what are these lifted restrictions and how can you get started with telehealth?

What is Telehealth?

Flow chart describing the differences between telehealth and telemedicine

Before we can understand new rules and regulations for telehealth, it’s important to define what telehealth is. Telehealth is the distribution of health-related services electronically or through telecommunications. It allows for individuals to receive health education, clinical visits, health administration from a distance by utilizing technology.1 Telemedicine is a category of telehealth. Telemedicine refers directly to clinical services being offered electronically. Telehealth covers a large umbrella of health services, as shown on the flow chart.

Relaxed HIPAA Regulations for Telehealth

The Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) released last week that normal penalties on HIPAA noncompliance will not be imposed on organizations providing telehealth. This means that normal HIPAA requirements are now being relaxed to allow more healthcare workers to use telehealth. These rules may vary across states, so it is important to check local health authority updates. However, relaxed HIPAA regulations do not mean relaxed privacy standards. Security of a patient’s private health information is always held at first priority. These relaxed penalties allow professionals to begin offering care electronically as soon as possible. Here’s what you need to know about the new HIPAA guidance from OCR:

Healthcare Workers Can Now Use “Non-Public” Products to Offer Telehealth

Non-public products include technologies such as:

  • Apple FaceTime
  • Skype
  • Google Video Hangouts

Non-public applications still allow for the privacy of a patient’s information; whereas, public applications may not provide the same security. Public-facing applications are prohibited in electronic healthcare visits, even with the relaxed HIPAA regulations.  OCR specifically prohibits such “public-facing” solutions, which include apps like Facebook Live or Tik Tok.

Safety Not Automatically Ensured

While the commitment to privacy and security remains the same, it’s important to note safety is not automatically ensured in these non-public solutions. OCR recognizes the use of these applications will present potential risks in privacy. 

Clients and healthcare professionals should work diligently to confirm encryption and privacy modes are enabled in non-public applications. It is always better to double-check privacy settings rather than assume everything is in place. 

Roger Severino, the director at OCR, recently stated, “We are empowering medical providers to serve patients wherever they are during this national public health emergency.”2 Telehealth will allow more people to access the care they need during this trying time in public health history.

Getting Started with Telehealth

With telehealth quickly expanding, it’s important to know how to get started. The American Medical Association recently released a helpful quick guide to facilitate using implementation for providers. When getting started, it’s recommended organizations think through these 3 steps:

  1. Designate team members to make decisions quickly about solution options for a facilitated implementation
  2. Make sure your malpractice insurance carrier policy covers telehealth options
  3. Develop a base knowledge of the payment and policies that come with telehealth services

HHS additionally provides a list of technology vendors claiming to be HIPAA compliant.3 While this is not an exhaustive list, it includes vendors that would qualify as HIPAA-compliant products under the normal HIPAA circumstances. These vendors additionally claim to be willing to enter into a HIPAA Business Associate Agreement (BAA) with healthcare providers. In short, BAAs are legal documents that ensure video service products protect patient privacy. Products on the HHS list include:

  • Skype for Business / Microsoft Teams
  • Updox
  • VSee
  • Zoom for Healthcare
  • Doxy.me
  • Google G Suite Hangouts Meet
  • Cisco Webex Meetings / Webex Teams
  • Amazon Chime
  • GoToMeeting

Again, these products are not an exhaustive list. Although, they may be important to consider as a longer-term telehealth solution. These products have more established privacy policies as they are commonly used under normal HIPAA circumstances.

Stay Up To Date on Telehealth News

It is likely that we will continue to see an increase in electronic care options and policies as the COVID-19 pandemic continues. To stay up to date with the growing expansion and changes in telehealth, be sure to check trusted sources. The following links are resources to trust during the ongoing pandemic:

Patagonia Health is Here to Help

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. As always, if there’s anything we can do to support you, please reach out to us. 

Blog Resources

1 https://www.healthit.gov/topic/health-it-initiatives/telemedicine-and-telehealth

2 https://www.hhs.gov/about/news/2020/03/20/ocr-issues-guidance-on-telehealth-remote-communications-following-its-notification-of-enforcement-discretion.html

https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html

https://blog.sigmundsoftware.com/hipaa-telehealth-coronavirus-provision?utm_campaign=Sigmund%20Blog&utm_source=hs_email&utm_medium=email&utm_content=85054459&_hsenc=p2ANqtz-8whNmUMZQfoIIp6zYVPoTQsnUVjhzK1ueThi9-6oo_XmdcqLlTmQaK2Z8exzrEIi6qGHnLyuM-1vIzI9icv1dz1UhT8A&_hsmi=85086582

https://www.ama-assn.org/practice-management/digital/ama-quick-guide-telemedicine-practice?utm_source=twitter&utm_medium=social_ama&utm_term=3207044834&utm_campaign=Public+Health