The COVID-19 pandemic is changing the way healthcare professionals are interacting with their patients. At the height of the pandemic, healthcare practices of all types have turned to telehealth/telemedicine to interact with patients remotely. Telehealth software use is being driven by necessity since patients are advised not to physically go to a medical clinic or any other healthcare facility due to the risk of COVID-19 exposure. But not every healthcare specialty lends itself well to telehealth. In certain scenarios, patients need to see their providers in person.
As government and healthcare officials are slowly relaxing the restrictions regarding visiting healthcare offices, the risk of COVID-19 exposure is still present. Patients are now more aware of how the virus spreads and the risk of being infected by contact with people, places, and objects (including pens, clipboards, and shared devices like tablets and kiosks). It’s preferable that patients use their own devices with the aid of a mobile app patient portal to complete the patient intake process.
The Virtual Waiting Room
Some officials want to prevent the use of the traditional waiting room as much as possible since forcing patients to sit in a room in close proximity to others is a breeding ground for viruses. For instance, in New York City, patients are advised to remain in their car until it’s time for their appointment as contact with potentially contaminated objects should be limited at all costs. Because of new protocols enacted across cities, for how patients receive in-person care and limit exposure to contamination, a patient intake option that can be completed on one’s own devices via a mobile app patient portal would be beneficial.
Patient Portal For Medical Clinics
Healthcare providers are seeking a solution to complete intake forms, gather patient clinical histories, and other documentation virtually. A patient portal for medical clinics can provide patients with a means to complete necessary forms online before a consultation, (leading to a better in-person experience) and deliver more efficiency to doctors and medical staff by cutting down wait times. Patient portal solutions are also valuable because healthcare practices can utilize them to inform patients of new policies before a visit to the office and disseminate educational materials. Some examples include the requirement for patients to wear masks during visits, instructions for virtual check-in, the protocol for reporting COVID-19 symptoms prior to arrival, where patients should wait before an appointment, precautions to prevent the spread of COVID-19, etc. HIPAA compliant appointment reminders, broadcast messaging, and bidirectional patient messaging are pivotal in communicating new protocols for visiting a provider.
The healthcare landscape has drastically changed since the onslaught of COVID-19, which has forced medical practices and healthcare organizations to change how they operate to meet the evolving needs of patients and prioritize public health. Consider the importance of integrating a patient portal for your medical organization. Contact us to learn more.
Within the healthcare industry, medical jargon can be thrown around with little rhyme or reason. This may not be a problem for professionals within the field but may prove difficult for the general public, especially for patients trying to figure out what their medical payer may or may not cover. Terminology such as telehealth and telemedicine are often used interchangeably. The truth is that these terms refer to a different way of administering health care via existing technologies or a different area of medical technology.
Telemedicine is the clinical application of technology of a physician delivering medical care to patients remotely using technology including telecommunications infrastructure. Telemedicine refers specifically to remote clinical services.
Telehealth is more of a consumer-facing approach that refers to the technology and services used to provide medical care and medical services remotely. Telehealth can refer to remote non-clinical services.
Is Telemedicine or Telehealth more predominantly used?
As a result of our Google traffic research, we discovered that on average telehealth was searched 23,987 over the past 12 months, while telemedicine was searched 32,044 times.
Through our analysis of the major healthcare payers and IT vendors, the majority of organizations (57%) use the term telehealth. These organizations include Medicare, Amwell, Teladoc, MDlive, Epic, Eclinicalworks, United Health Group, and Aetna. 21% of our subjects including Snap.md, Cerner, and Humana use the terms telemedicine or telehealth interchangeably. Medicaid, Doctor On Demand and Doxy.me comprise the final 22% that make use of the term telemedicine.
WhatsApp provides end-to-end encryption, but that does not mean that it is HIPAA compliant. There are other facets of HIPAA that must be satisfied before the software can be deemed compliant.
Since WhatsApp does not require users to enter a password for every session, it does not provide the required access controls.
Because messages and attachments are easily deleted from Whatsapp, audits cannot be conducted, which is necessary for HIPAA compliance.
WhatsApp lacks the controls to make sure all communications that contain ePHI (electronic personal health information) are completely deleted remotely once an employee leaves the employment of a Covered Entity.
WhatsApp has not agreed to sign a BAA with a covered entity.
Whatsapp is NOT a HIPAA compliant telemedicine software and should not be used to share ePHI or deliver online healthcare since doing so would violate HIPAA regulations. Healthcare professionals may use WhatsApp for general communication or for providing de-identified PHI.
If healthcare professionals would like to leverage a HIPAA compliant video communication tool, some companies have already stated that they will enter into a HIPAA business associate agreement and follow HIPAA compliance regulations. The Office for Civil Rights (OCR) has provided a list of HIPAA compliant telemedicine software:
The Federal Communications Commission (FCC) COVID-19 Telehealth Program authorized by the CARES Act will provide $200 million in funding to support healthcare providers in offering telehealth services to patients during the coronavirus pandemic. The COVID-19 Telehealth Program aims to fully fund telecommunications services for eligible healthcare providers. Funds can be used to purchase devices and software needed to provide vital telehealth services in response to the COVID-19 pandemic. This support will continue until the program’s funds have been depleted or the COVID-19 pandemic has ended.
Who qualifies for the FCC Telehealth Fund?
The COVID-19 Telehealth Program is open to healthcare providers/organizations that treat patients within the USA. The FCC Telehealth Program is limited to nonprofit and public healthcare providers, including:
Post-secondary educational institutions offering healthcare instruction, teaching hospitals, and medical schools
Community healthcare centers or healthcare centers providing healthcare to migrants
Local health departments or agencies
Community mental health centers
Rural health clinics
Skilled nursing facilities
Associations of healthcare providers consisting of one or more entities falling into the first seven categories
The goal is to allocate funding to providers that serve areas which have been the most affected by COVID-19, and where support will be the most impactful on addressing the current healthcare challenge.
Participants are chosen based on responses to the following criteria:
Conditions to be treated
Goals and objectives to be achieved with the funding
Timeline for the deployment of the proposed service(s) or devices
Metrics that the applicant will use to help measure the impact of the funded services and devices
Geographic area and population served by the applicant
Whether funding will help high-risk and vulnerable patients
What products qualify for the FCC Telehealth Program?
The FCC Telehealth Program will support eligible healthcare providers to purchase telecommunications, information services, and connected devices required to provide telehealth services at this time.
Eligible services and connected devices for funding include:
Telecommunications and broadband connectivity services for healthcare providers or their patients.
Information services and online connected platforms for remote patient monitoring, patient-reported outcomes, the transfer of patient images and data, and video consultation.
Connected devices/equipment such as tablets, smartphones, or other devices to receive care at home (e.g., broadband-enabled blood pressure monitors, pulse monitors, oxygen monitors), or telemedicine kiosks/carts for healthcare providers.
Vendors of eligible services and devices are not eligible to apply for funding. The program is also not intended to fund the development of new websites, systems, or platforms.
How to acquire funding?
Obtain an FCC Registration Number (FRN) from the Commission Registration System (CORES), as well as a CORES username and password.
Obtain an eligibility determination from the Universal Service Administrative Company (USAC) by filing FCC Form 460 through My Portal on USAC’s webpage.
According to the Families First Coronavirus Response Actpassed on March 18th, 2020, congress requires payers to cover telehealth visits (with health care providers) that relate to COVID-19 testing, treatment, and consultations during the public health emergency. Reimbursement for telehealth solutions during this time is being provided for all patients, not only those with Medicare. During the COVID-19 pandemic, many healthcare professionals are scrambling to find a HIPAA compliant telehealth software.
HHS has created new guidelines on HIPAA requirements and modified HIPAA’s Privacy Rule, which stated that healthcare organizations must use only secure methods of communication for telehealth visits. The Office for Civil Rights said that videoconferencing services normally not permitted under HIPAA may now be used by healthcare professionals for the good faith provision of telehealth solutions. This change in policy allows video conferencing platforms such as Zoom to be used during this time of crisis.
The Coronavirus pandemic has resulted in an increase in healthcare organizations leveraging video conferencing apps. In the past month, Zoom has become one of the most popular choices for teleconferencing, registering a 535% increase in traffic. Previously Zoom has maintained that they provide a HIPAA compliant telehealth software: Zoom for Telehealth. This service claims to incorporate access and authentication controls, HIPAA compliant messaging is secured with end-to-end encryption and Zoom has signed a HIPAA Business Associate Agreement (BAA).
During the last few weeks, there have been several security concerns surrounding Zoom. It has been reported that the company does not have end-to-end encryption as they previously claimed. This discovery makes Zoom decidedly NOT HIPAA compliant.
If healthcare providers want to ensure that patient privacy is respected, they should reconsider the use of Zoom as a HIPAA compliant telehealth software. Aside from the lack of end-to-end encryption, additional security concerns include videoconference hijacking, user data being shared with third parties such as Facebook, and lapses in security that make Zoom vulnerable to cybercriminals and malware. While Zoom is willing to sign a BAA, which is a crucial step towards achieving HIPAA-compliance, there are too many security issues preventing HIPAA-compliance. Until these issues are fully resolved, we do not recommend Zoom as a HIPAA compliant telehealth software.
Bridge Patient Portal is an important part of how our clients communicate with their patients. At Bridge, we think its important to share ways that Bridge Patient Portal can be used to help our clients meet their patients’ needs during this challenging time.
The Bridge team is available to help with any of the below items, AT NO COST, as part of our commitment to providing our clients the highest level of support in these situations.
Throughout Bridge, clients are able to place an “Alert Message” (see the images below) to help educate patients on any changes taking place with a client.
Homepage Alert Message:
Appointments Alert Message:
Messages Alert Message:
There is also a “Custom Widget” which can be placed on the portal home page to provide detailed information, such as links to external resources (i.e. CDC), symptom information, visit/scheduling protocol, etc.
Mass Messaging (SMS & Email)
In the Bridge admin panel, clients can filter patients by many different criteria (i.e. age, provider, active portal account, etc.) then type in a message to be sent to all patients meeting the filter criteria. The message can be sent in an SMS or Email format.
Automated Pre/Post Visit Messages
Using the Bridge admin panel, clients can create automated email notifications to be sent before and/or after a certain appointment type. This could be used, for example, to educate patients on a new visit policy.
Bridge is committed to fully developing its telemedicine solution in 2020. This has been many years in the making as the Bridge team has carefully watched the telemedicine market for trends, new innovations, and standout vendors. We will be working closely with our clients in the coming months to evaluate the best course of action for our telemedicine solution and explore partnerships with industry-leading vendors.
In the meantime, there are many features in Bridge to help our clients facilitate telemedicine encounters and online communication with their patients.
Secure Patient-Provider Messaging – Bridge supports secure messaging between patients and providers or delegated to a provider’s team. Interface permitting, messages can be received and replied to in the provider’s EHR. Many questions can be answered in this way and for providers using patient-provider messaging already, this is the most commonly used feature in the portal. Educating patients that this is a reliable way to communicate with the provider for non-emergent questions, especially defining the protocol for when a message should be sent to a provider. This protocol can be shared with the patient in the messaging feature, using the “Alert Message” feature.
Telemedicine Appointment Scheduling – Bridge offers appointment requests and self-scheduling functionality. Depending on the telemedicine program of a particular client, different options are available for helping patients schedule a telemedicine appointment. In first place, a telemedicine appointment type can be created, which would then allow better organization of provider schedules. If self-scheduling is already in use, a protocol that manages the times and providers that a telemedicine appointment can be scheduled can be created in Bridge. Again, using the “Alert Message” feature, clients can educate their patients on how to schedule a telemedicine appointment.
Facilitating Video Conferencing – Once an appointment is scheduled a message can be sent to the patient with a link to the video conference. It’s important that whichever video conferencing solution is used, that it meets HIPAA requirements. (Improving this functionality is where Bridge will be investing most of its efforts in 2020)
DISCLAIMER: Client environments and the capabilities of their environments can vary. Some functionality may not be available in certain environments. Please speak with a Bridge client manager to learn more.
Telemedicine, the use of technology for remote patient monitoring and medical consultations, is experiencing growing pains in the U.S. It’s a logical response to ballooning healthcare expenditures and an ever-increasing physician availability shortage. Integrated with patient portals, patient engagement mobile apps, remote patient monitoring software and health tracking apps, telemedicine is also part of a growing market for patient engagement solutions.
However, going virtual with healthcare has not been straightforward, and has taken longer than anyone would have expected. For telemedicine to reach its potential, we need to address lags in adoption, privacy concerns, and health policy barriers.
Adoption: Generating Physician Buy-In
There are many private companies that specialize in telemedicine, such as virtual care applications or 24-hour “ask a doctor” services. The other option is a physician who has regular appointments also checking in with patients remotely via a telemedicine portal or a similar application. In this case, many physicians don’t want to change how they do medicine. For a successful transition to a hybrid format, first and foremost, the reimbursement must be there. Reasonable reimbursement for telemedicine is still mostly limited to certain states and is simply not enticing enough to drive telemedicine. A perfect example of this would be the use of chronic care management solutions for CPT code 99490 – which has seen unexpectedly low utilization. The evidence that telemedicine andtools for patient engagement are still lacking as well.
Patients with chronic conditions that require frequent check-ins have a tremendous amount of potential to benefit from telemedicine portals. Older and typically less tech-savvy seniors, for example, it may be hard for them to connect or use remote patient monitoring devices between office visits. On-screen interaction may not be easy for those with limited vision. This makes it difficult to engage patients. These obstacles can be overcome with accessible technologies, and health IT professionals should focus on this.
Privacy: HIPAA Compliant Remote Patient Monitoring and Consultation
In telemedicine, personal health information is sent in several ways, including text, audio, video, images, and real-time remote patient data from sensors. This worries healthcare providers, who need to comply with HIPAA privacy rules. While the tools we use daily may not meet standards(video, email, SMS) there are specialized platforms out there that do, the Bridge Patient Portal platform being one of them. These are essential to best practices in telemedicine.
Policy: Taking Advantage of in Interstate Licensing
States have different requirements about where a physician needs to be licensed to provide telemedicine services: In some cases, it’s the state where the practice is located. In others, it’s the state where the patient is located. Over twenty-six states have now introduced or enacted Interstate Medical Licensure Compact legislation, which will make it easier for physicians to practice in several states. As more states join, medical practices may need to be guided on how to get their healthcare teams licensed.
Policy: Addressing Different Reimbursement Rules Across States
Reimbursement is another area of inconsistency: Rules about which telemedicine services need to be covered by Medicare, Medicaid, and private insurance vary from state to state. This is being considered at the federal level. In the meantime, healthcare providers need easy access to centralized, up-to-date information on relevant policies.
By harnessing our society’s tech habits to engage patients and help physicians do their jobs better, telemedicine has lots of potential. At this stage, it faces roadblocks like privacy concerns and policy red tape. It’s important to equip healthcare providers with resources for navigating these issues. On the product end, we need to develop technologies that make telemedicine accessible and effective for both physicians and patients.
With goods and services increasingly moving online – and with patients prioritizing other factors besides just quality care – it has become a necessity for healthcare organizations to start looking for new ways to improve the overall patient experience. Video consultations are one such solution, and they are gaining traction quickly in the healthcare space. In fact, web companies such as Teladoc, Doctor on Demand and American Well were expected to host some 1.2 million such virtual doctor visits in 2016, up 20% from 2015, according to the American Telemedicine Association. A report by IHS takes this one step further and predicts that the the U.S market alone will perform 5.4 million video consultations in the year 2020.
As part of Bridge Patient Portal’s commitment to helping healthcare organizations enhance patient care and increase revenue, we offer a secure, HIPAA-compliant eConsultation platform. Our platform is designed to bridge the gap between doctors and patients by providing high quality communication without requiring users to download additional software or install plugins. It presents an opportunity for healthcare organizations to improve treatment outcomes and deliver more efficient care by meeting patients where they are. The types of communication available in our platform are the following:
Telephone calls: Patients inform their provider of their availability and provide a phone number where they can be reached for the call. The provider will contact them at that time via the patient portal.
Secure messaging: Patients have the ability to message their providers in real time all within the confines of the portal. Communication may only be initiated by the physician or office staff, but patients can respond.
Video Consultation: While not a standard feature of the platform, Bridge does have the ability to utilize different video consultation technologies. WebRTC is an example of a technology that can be used to facilitate video consultations via the portal.
By integrating different communication technologies into our platform, we are able to provide a cost-effective solution for healthcare providers to deliver the best experience possible to their patients. We also ensure that all communication that takes place on our platform is HIPAA compliant, for example, WebRTC encrypts media streams with 128-bit Advanced Encryption Standards.
When it comes to billing, our healthcare platform can be customized to suit your needs and preferences. You can choose to set an eConsultation rate for phone calls, or set up a pre-pay credit system for patients to use towards online consults. Your patients’ credit card information can be kept on file, and billed before or after their visit.
To learn more about our platforms highly secure, eConsultation feature and how it can benefit your organization, call us at 866-838-9455