PracticalDermatology

Although telemedicine capabilities have existed for years, many dermatology practices have not regularly incorporated this type of visit into their care delivery options. Until now.

As COVID-19 ushered in social distancing measures and state-mandated lockdowns, health care providers scrambled to implement telemedicine so they could continue to deliver care while minimizing viral exposure. However, in the haste to get things up and running, providers often turned to solutions that were not ideal for long-term success. As dermatology practices consider next steps regarding virtual care visits, it’s important to look beyond the basic platforms and establish a safer, more user-friendly telemedicine strategy that supports patient needs while preserving privacy, security, and care continuity.

Role of the Federal Government In Spurring Telehealth Adoption

In March 2020, the Centers for Medicare & Medicaid Services (CMS) relaxed HIPAA obligations for the duration of the COVID-19 public health emergency. The agency also expanded coverage for telehealth and increased reimbursements for virtual care visits. These actions made it possible for all health care providers to offer virtual care options without worrying about searching for HIPAA-compliant solutions (temporarily, of course). Health care organizations could rapidly spin up services, paving the way for a precipitous rise in the number of telehealth claims, which have more than tripled since the start of the pandemic.

While initially convenient, many of the virtual communication platforms providers used were not HIPAA compliant and were riddled with security flaws. They introduced the potential for hackers to enter the telemedicine appointment and created situations where patient’s private and secure information could be compromised. In response, many of the platforms put in additional protections, but they often didn’t go far enough and, in some cases, made the technology more difficult to use, especially for older patients who are not as tech-savvy. Patients and providers have become increasingly frustrated, and the mounting challenges around privacy and security have introduced the potential for lawsuits.

Going forward, dermatology practices will need to consider different options for telemedicine. If for no other reason, consider that eventually the government’s exceptions will expire, and providers will be required to once again adhere to HIPAA telemedicine regulations. Since many of the currently used platforms do not meet these stringent requirements, they will no longer be an option for practices to use.

We’ve Come Too Far to Turn Back

Even after the pandemic recedes, the consensus is that telemedicine visits will remain popular with patients and providers alike. According to CMS Administrator Seema Verma, “I think it’s fair to say that the advent of telehealth has just been completely accelerated, that it’s taken this crisis to push us to a new frontier, but there’s absolutely no going back.”

The industry will mostly likely see a further jump in adoption in the coming months and years. By the end of 2020, the US telehealth market is predicted to reach roughly $10 billion, with a year-over-year growth of 80 percent. It is expected to continue expanding over the next five years, with a Compound Annual Growth Rate (CAGR) of approximately 30 percent from 2019 to 2025. Patients in particular are eager to see telehealth offerings continue. A recent Sykes survey of 2,000 US adults found that 60 percent of those surveyed say the COVID-19 pandemic has increased their willingness to try telehealth.

The increased acceptance of virtual care presents opportunities for practices to expand their businesses and grow revenue. For example, by getting onboard with a comprehensive strategy, practices can remain competitive in the marketplace. Now that patients have had a glimpse of how convenient telemedicine can be, they will soon be demanding this option from their providers. Instead of spending an entire morning waiting to be seen for a quick follow-up appointment, patients will want to connect online and see the doctor from the privacy of their homes. Those organizations that establish safe, secure, and easily accessible virtual health options will not only meet current patient demand but also attract new customers because of it.

A solid telemedicine program can also ensure an organization is ready to navigate future crises that require remote medicine. One thing we’ve learned from COVID-19 is that large-scale outbreaks of contagious diseases can occur anywhere at any time, and this current crisis will not be the last of its kind. Plus, the pandemic is far from over, especially in the US. As of this writing, more than half of states are seeing a rise in new cases, and America leads the world in infections.

Looking ahead, a viable and safe vaccine is still 12 to 18 months away, which means there will not be one in time for the second wave of COVID-19 that is predicted to hit the US sometime in the fall or winter of 2020/21. When the next influx of sick patients occurs, lockdowns and social distancing measures will most likely be reinstated, and practices will again find themselves relying on telemedicine solutions. Those dermatology organizations that have already implemented a virtual care program will be less affected by the second wave, allowing them to maintain financial viability and more successfully weather the crisis.

Creating a telemedicine program for the future

With a proposed $200 million in new telehealth expansion funding from the Federal Communications Commission (FCC), providers have the opportunity to establish a more comprehensive telehealth offering than has existed to date. To that end, dermatology practices should be looking past “band-aid” options and instead create more robust programs that enable safe, secure, and convenient care while supporting dermatologists, nurses, and operations staff.

What does such a telemedicine strategy entail?

Overall, it should provide a safe and pleasant virtual care experience while ensuring clinical efficiency and maintaining the ability to properly document, code and charge for the visit. More specifically, it should encompass the following characteristics:

Prioritizes system security and privacy. As previously mentioned, a critical flaw of many of the solutions used during the pandemic is that they did not adequately protect patient privacy or secure a patient’s protected health information. Going forward, dermatology practices need to seek out solutions that are HIPAA-compliant and use the latest security features, such as encryption and other tools, to protect patients and staff. Without robust security, a telemedicine tool may cause more problems than it solves and limit the benefits of virtual care going forward.

Offers convenience for the patient. Since patients have become accustomed to communicating with people remotely, they have come to expect telemedicine appointments to be equally as user-friendly. An America Well survey found that convenience was a primary factor in how receptive patients were to telehealth adoption. Therefore, even a secure and HIPAA-compliant solution will not provide the anticipated benefits if patients find it difficult to use. Some features that could make a solution more intuitive include easy sign-in, clear navigation, and the ability to access key functionalities on mobile devices and tablets.

Integrates with existing technology. One of the challenges of the communication platforms used during the pandemic is dermatologists struggled to efficiently and effectively chart during the patient visit. With multiple tabs and windows open it can be hard to manage documentation and remain focused on the patient. Over the course of an appointment, a provider may appear distracted as they toggle between systems. This can be frustrating to the patient and the provider. The physician may also miss key details, which could present a patient safety issue and negatively impact care quality.

When a telemedicine solution integrates with an electronic medical record (EMR), a dermatologist can chart, take notes and engage patients during virtual visits, all from a single platform. Providers experience zero productivity loss and patient satisfaction improves because a provider is completely focused on the individual in front of them. Smooth alignment can also enable higher care quality because there is less chance the provider will miss important information during the exchange.

An integrated solution can also be more convenient. For instance, when a telemedicine application fits seamlessly with a practice management system’s scheduling functionality, providers can send appointment links to patients so they can join with just one click. The system can also deliver automatic notifications that will inform office staff as well as patients of updates or changes to their appointments.

Meets the unique need of dermatology practices. Generic virtual meeting solutions were never meant to support the intricacies of a medical appointment. And even those solutions targeted to health care may not fully meet the unique needs of dermatologists. However, when a solution is designed with the specialty in mind, it can enable richer experiences that preserve care quality, improve efficiency and foster satisfaction. For example, a key aspect of dermatology practice is closely examining the skin for abnormalities, such as melanoma, eczema, or dermatitis. When practices use a telemedicine solution that is designed especially for the field, they are able to use a camera to conduct a virtual evaluation ahead of a potential in-person visit. Not only does this ensure well-documented care, it can help prioritize which patients should be seen in the office and which can continue to be treated remotely. As conditions with COVID-19 evolve, and physicians may be asked to limit the number of in-patient visits they accommodate, having the ability to prioritize patient encounters will be critical, ensuring those individuals who need in-person care the most are able to receive it.

The Paradigm Has Shifted

By all accounts, telemedicine is here to stay. Developing a robust strategy for virtual care visits that prioritizes security, privacy, and convenience can make telehealth appointments ideal for patients and providers. By embracing this medium and implementing technology that enables it, a dermatology practice can better respond to patient needs and weather any future unexpected situations that require virtual visits.