3 Missed Opportunities in Telehealth

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Are you overlooking these ways to engage more patients remotely?

The use of telehealth skyrocketed during the COVID-19 pandemic, as both patients and doctors rapidly adopted the technology to minimize exposure risk while maintaining patients’ health. Telemedicine will likely wane after the height of the pandemic, experts predict, but usage will remain higher than before.

“What we have found since COVID is that, when telehealth went mainstream, the expectations went way up,” Mike Thompson, president and CEO of National Alliance of Healthcare Purchaser Coalitions, told HealthPayerIntelligence. “As we go forward, I think it becomes more of an integrated strategy. It becomes an expectation that this is a modality that providers will use.”

Telehealth is here to stay, yet many providers are not using it effectively. Where are the missed opportunities?

1. Not maximizing its uses

If you’re only using telehealth occasionally, or only to diagnose conjunctivitis or other minor ailments, you’re missing out.

Donna O’Shea, M.D., chief medical officer of population health management for UnitedHealthcare, told HealthPayerIntelligence: “While virtual care has historically helped address minor medical issues, including allergies, pinkeye, fevers, rashes and the regular flu, we are starting to see an expansion of the types of services being offered remotely. The most promising developments include virtual care resources to help expand access to primary care and support chronic disease management, behavioral health, and certain types of specialty care (dental, vision and hearing).”

Since March, Shalini Sood-Mendiratta, M.D., of Cleveland Clinic’s Cole Eye Institute, has seen up to 10 eye patients per day via virtual visit, including patients with glaucoma. Her colleague Rishi P. Singh, M.D., said, “At this point, we use telemedicine to visualize lids and lashes, and do an anterior segment exam—anything before the lens—the best we can. Impressively, the video capability is often sufficient for us to diagnose many red-eye issues” including dry eye, blepharitis, and subconjunctival hemorrhages. “Then we can discuss management with the patient.” Doctors can also evaluate whether an in-office visit is needed.

Telemedicine can be used for dry eye diagnosis, chronic disease management, and contact lens refills are just a few of the other types of visits that can be conducted virtually or with a hybrid appointment model.

Dry eye specialist Paul M. Karpecki, O.D., of the Kentucky Eye Institute, noted that for most eye doctors, the standard procedure for diagnosing new dry eye patients could be performed with telemedicine: symptoms, medical history, and current use of artificial tears confirmed with a slit lamp examination.

“Although some platforms have excellent capabilities (e.g. EyeCare Live), there are limitations to the video portion of the exam when it isn’t ocular surface disease-related. For one, it would be almost impossible to view the macula, retina, or optic nerve closely, but that doesn’t negate telemedicine opportunities there as well,” he said. “ECPs will have to consider hybrid models. For example, a technician can obtain the OCT, VF, hysteresis, and IOP, and the patient schedules a virtual telehealth examination to discuss the findings with the doctor.” For more on this, read “Success with the Hybrid Appointment Model.”

Dr. Karpecki follows up every virtual consult with an electronic recording or video of the findings, next steps, patient instructions, and Rendia patient education videos sent by email. “This creates a resource patients love, reduces the number of callbacks, and establishes trust and loyalty to the provider,” he said. He also noted that common follow-up exams are ideal for telemedicine, such as one-month dry eye follow-ups and contact lens refills.

2. Not engaging patients before, during, and after virtual visits

Simply having the capability to offer telemedicine is not enough to get patients to use and like it. Are you marketing your virtual offerings on your website, social media pages, emails to patients, and your practice’s answering machine? Patients may wrongly assume you are no longer offering telemedicine if COVID-19 rates are declining in your area, or they may be confused about whether virtual visits are covered by their insurance. Proactively address these concerns. Consider sharing our new video, What is Telehealth? on your social media platforms. 

If patients have never had a virtual visit, they may be unclear about how it works. Don’t assume that patients know they need a computer or smartphone, Internet connection, and a camera. For tips for a successful telehealth visit that you can share with your patients, see our previous post, “Succeeding with Telemedicine in Our ‘New Normal’.”

During virtual visits, consider ways to increase patient engagement and personalize care, such as showing patients videos and customized simulations.

During the visit, think beyond verbal interactions and consider ways to increase patient engagement. “Health consumers have expectations of how they’re going to be engaged that are influenced by factors outside of the healthcare industry itself. Netflix, for instance, knows our tastes, our preferences, and everything about us,” stated HealthcareFinanceNews.

Rendia’s Outcome Simulator can be used during virtual visits by sharing your screen with patients to show customized views of their current visual acuity along with different simulated outcomes, so that they can get a true picture of their vision, before and after cataract or refractive surgery. Plus, you can personalize it to each patient—emphasize residual astigmatism or nighttime halos, for example, to show the range of possibilities. 

After a telehealth visit, follow up with medication and treatment instructions along with relevant patient education videos.

3. Forgetting to include seniors and caregivers

Early on in the pandemic, some doctors were concerned that their older patients would not be willing or able to use the technology required for telehealth visits. But those fears turned out to be unfounded. A recent study found that nine in ten seniors who had a telehealth visit during the pandemic reported a favorable experience, and three-quarters said they would use it again.

Don’t overlook seniors and caregivers in your telehealth offerings. They are willing and able to use the technology, and it can positively affect patient outcomes.

Michael Hochman, M.D., a doctor in L.A., told AARP that although some of his senior patients initially expressed some frustration with the technology, “once they’ve done it a couple times, they’re firmly on the telemedicine bandwagon.”

To add more value to your telemedicine visits, make a point to include caregivers.

“Family members and friends who care for loved ones can help improve care management at home by playing an active role in telehealth, either through helping the patient or contributing their own insights,” according to mHealth Intelligence

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