Telehealth has been on the horizon for all healthcare workers for the past several years. The need for social distancing amid the Covid-19 pandemic has caused many regulatory bodies to relax regulations and encourage healthcare providers to offer telehealth visits in place of physically being in the patient’s home.

For hospice providers, who often see patients in person, conducting telehealth visits involves adapting new technology and procedures and adapting their bedside manner to translate on the screen.

Below we’ve outline 3 keys to conducting successful telehealth visits:

Step 1: Setting Expectations

A successful telehealth visit starts with preparation. For many, virtual meetings are a new experience. These visits require new technology and new compliance procedures to be run effectively. The first step is choosing a software provider for hosting your meetings. Before you commit to a program, be sure to verify the security, call quality, and usability of the system. These factors may seem obvious, but when any of them are missing, virtual visits become significantly harder. Healthcare IT reviewed several telehealth integrations here.

Another key to a successful telehealth visit is preparing your clinicians and patients for how a virtual visit will be held. Clinicians should become familiar with how to initiate a virtual visit and do a test run of the software. Clinicians should also think about the implications of where they will be conducting visits. If they are at home, they will want to be in a room that has good light. If they are in an office or medical facility, they want to find a spot where the background won’t be distracting.

Patients should also be sent materials outlining the logistics and possibilities that exist with virtual visits. Some benefits to highlight include:

1. Decreased travel time means the patient has more time to ask questions and spend with the clinician
2. There is no wait time to see a clinician
3. Family and caregivers can easily join the conversation

Step 2: Connecting with Patients

Especially for patients who are unfamiliar with technology, providing comfort over a screen may be difficult. Patients may feel anxious about using technology, communicating through video, or being off of their normal routine. To make the patient more comfortable, the clinician should set a confident and positive tone for the meeting.

Despite the physical distance inherent in a virtual visit, telehealth visits also have a humanizing effect. Video screens allow the patient to see the clinician in their natural environment. Clinicians may also look be more relaxed in how they are dress or how they conduct themselves.

Clinicians can take advantage of this more casual setting. Below are a couple of strategies to put patients at ease. 

1. Be aware of behavior: Many video visits allow clinicians to see themselves as they chat. Clinicians should be aware of how they are coming off to patients. It is more important than ever to not look disinterested or distracted.
2. Speak slowly and emphasize verbal cues: There may be lag time or difficulty with audio during a telehealth visit. Speaking slowly lets the patient catch up if they miss a word. Putting a little more emphasis on verbal ques can also make up for a patient not being able to see the clinician’s full body language.
3. Leave extra time: A little extra time may be needed to check in on how patients and family are doing, especially amid the Covid-19 crisis. Clinicians should take advantage of the platform to explain patients’ conditions and answer any questions that the patient may have.
4. Find a personal touch: Look for something personal about the patient such as a new sweater or a cheerful voice and use it as a way to build connections. 

Step 3: Charting and Billing

Charting correctly when doing a telehealth visit is important. NHPCO is updating their Covid 19 resource site, including telehealth documentation and billing requirements, daily. The most recent guidance on telehealth documentation can be found here. We encourage hospices to continue to check with regulatory bodies as the requirements around telehealth evolve.  

As a general rule, hospices should complete their normal documentation procedures as well as record when they conduct a telehealth visit. The reason for conducting the telehealth visit should also be present in the patient’s chart and plan of care. 

Summary

Telehealth has been on the horizon for some time, and it does not appear to be going away any time soon.

Hummingbird’s EMR makes it easy for hospices to bill for telehealth visits. mumms works with hospices to conduct compliance reviews and put guardrails in place to ensure that all requirements are being met.