My Experience with Telemedicine
By Charles Papp, MD
During the past several years my interest in telemedicine had been minimal. I’m a colorectal surgeon and any discussion about telemedicine usually ended up with humorous dismissal. Now with the Covid-19 pandemic and the easing of telemedicine regulations, I am no longer laughing. One day a week is now dedicated to telemedicine visits. In my practice I have found there are patient encounters that are well-suited for this format. Examples include simple post-operative visits, encounters for bowel changes or bleeding that may need to be scheduled for colonoscopy, and follow-up for irritable bowel syndrome or chronic constipation. I believe most specialties will also be able to identify suitable patients.
Because of the stress placed on medical resources, the federal government has relaxed many of the restrictions placed on telemedicine services. Here is a link to the AMA’s document regarding key changes.
This makes it much easier for a practitioner to add telemedicine to their practice. Because of this nudge, I have added telemedicine and believe it will remain a part of my practice even after the Covid-19 crisis is over. Here are a few pointers I have learned in the process. They are not all inclusive, but hopefully they will be helpful.
- Pick a HIPAA compliant, easy to use telemedicine software. We use Doxy.me which is cloud based, HIPAA compliant, and free.
- Test your software before you use it. You want to get the bugs worked out before you have a frustrated patient waiting for a connection. Make sure you have the right hardware with the appropriate software plugins as well as a secure wifi connection with good bandwidth.
- Adjust your website so that patients can enter your virtual waiting room.
- Have a person familiar with IT at your side when you start. It is guaranteed you will encounter some glitches in the beginning and having an expert at your side will be like having a lifeguard nearby when you are learning to swim.
- Train key staff to do the initial contact and load the medical history. This will save you time and help you anticipate unexpected issues.
- Put in a template for a telemedicine physical exam. That way you can simply modify it rather than typing it in every time.
- Have a way to keep track of the time you spend with each visit, because this affects your billing.
- Lastly, dress like a doctor for the interviews. Put on your white coat and resist the temptation to show up overly casual. You will show respect for your patients, and they will have more confidence in what you say.