The Transition to Telehealth Involves Broad Organizational Review for Collaborative Members
Making a shift in care delivery became essential with the onset of the COVID-19 pandemic. While the need to change how patients received care was important, making the jump to telehealth represented a sea of change for many organizations.
A healthcare organization in the Northeast found the shift to telehealth challenging. Like many other providers, they knew the terminology and had a high-level understanding of the technology. But that didn’t necessarily translate to fluency in using the technology to deliver care. Telehealth wasn’t historically chargeable, and very few providers and clinical professionals nationwide used telehealth in their everyday environments.
The pandemic, however, resulted in an immediate need to shift to telehealth. In rolling out a telehealth program nearly overnight, the only option was to:
- Take what was available and make it work
- Find an application that would provide a virtual session and gather the technology that existed in the organization
- In the background, determine what workflow, tracking and billing would look like
- Factor in the consideration of HIPAA and CMS standards, regulations and ever-changing billing requirements.
This Northeastern organization was fortunate in that its members had experience using a virtual session application for a specialized purpose. With some expansion, additional licensing and upgrades to the software, that technology could form the basis for wider deployment as a web-based application.
With assistance from Huntzinger, the application was deployed to nearly 100 laptops, iPads and PCs equipped with cameras and microphones. “Quick-tip” guides were developed for end users, and more than 100 clinical and non-clinical users were trained over a three-week period. The use of the functionality for patient-provider virtual sessions for evaluations quickly evolved to include provider-to-provider capabilities as a way to improve communications during pandemic-prompted meeting restrictions.
Beyond the technical challenges resulting from an intense, high-speed roll out of telehealth, major obstacles emerged in the backend operational aspects of organizing and supporting the new initiatives. Operational issues included workflow, clinical documentation, scheduling, functionality, education, and the development of new policy and procedure documents. The scope of this challenge went beyond just the hospitals in the collaborative to nursing homes and outside agencies with which inpatient facilities interacted.
Behind the scenes, Huntzinger analysts and the business office worked together to rationalize documentation, scheduling, and billing for telehealth. They were challenged with creating, validating, and communicating standardized orders and processes that were being continually changed by health insurance companies.
For example, existing CPT (Current Procedural Terminology) and HCPC (Healthcare Common Procedural Codes) needed to be billed differently for telehealth. Codes had to be duplicated for use via telehealth; charge tiers had to be modified so the new charges dropped the correct billing code; and new codes had to be created or added consistently so workflows would have updated information. In addition, new providers entering the program had to be educated.
From this real-world experience, the health organization and Huntzinger found that the telehealth program proved to be a much more complex project than originally perceived and involved every aspect of the healthcare delivery process. It is an ever-evolving program that needs to be monitored, audited and managed very closely to provide a viable and effective solution.
The experience illustrates the challenges that every organization will face in assessing telehealth programs from beginning to end, to ensure there is a consistent and efficient solution in place. The frantic transitions to telehealth experienced because of COVID-19 will eventually grow and merge into a standard integrated solution used throughout the lifecycle of patient care.