Going Virtual—Even During Pandemic—Doesn`t Have to Be Overwhelming

Even before the current COVID-19 crisis, behavioral telehealth accounted for one of the fastest-growing areas of telemedicine, expanding access to care for thousands of Americans in underserved areas.

 Still, no one could prepare behavioral health providers, or other healthcare workers, for how the coronavirus has shifted the dynamic of medicine. Telehealth visits surged 50%  amid the coronavirus pandemic in March, much higher than projections. This growth has barely kept pace with the spread of COVID-19, for which more than 500,000 cases have been reported in the U.S. since mid-April. And that’s just the beginning.

For behavioral health providers who never intended to go virtual, however, the sudden shift is overwhelming. There’s limited guidance over how to transform to a 100% virtual practice, which technology platform to use, how to communicate with health plans or how to ensure patients get the high-quality care that they need.

In other words, behavioral health providers are rushing to move online “with little guidance on best practices or assurances that the care will continue after the coronavirus fades,” one writer noted in a recent essay for Politico.

Given that the demand for behavioral health services isn’t going to wane anytime soon—and the need for telehealth will still remain strong even as a COVID-19 vaccine is introduced—behavioral health providers need to consider the future of virtual care delivery. But that doesn’t mean they need to panic and purchase the first telehealth system advertised or stick with a less-than-ideal telehealth platform they’re using in the interim.

Now, more than ever, is the right time to brush up on best practices for telemedicine and explore new technology systems that will support patient care during this challenging time.

Crafting a virtual strategy

While the transition to virtual practice may feel forced in the current climate, providers should remember that there are a lot of benefits to these care models beyond lowering the risk of transmitting COVID-19. In fact, in many instances, telemedicine is actually preferable to in-person care.

For patients in rural or underserved areas, telehealth has been critical in alleviating the lack of basic mental health services. For patients with challenging home environments, it’s helpful for therapists to have a “window” into patients’ day-to-day lives. And for individuals who are wary about seeing a therapist because of the stigmas associated with mental healthcare, the option of a video-based consultation is especially appealing.

Amid social distancing and stay-at-home orders, the demand for behavioral healthcare is expected to escalate as experiences such as loneliness or depression flare up. If left unchecked, these symptoms could have long-term repercussions, or lead to adverse events, for many individuals.

The good news is that many of the restrictions to telehealth, which impact therapists, psychiatrists and other providers, are being lifted. In March, for example, the Drug Enforcement Administration (DEA) announced it would temporarily remove provisions of the 2008 Ryan Haight Act, a pharmaceutical law that requires healthcare providers to conduct an initial exam in person before they can e-prescribe a controlled substance. 

In going virtual, providers should first assess their existing technology solutions, patient demographic and approaches to care. Here are some questions to consider when getting started:

• Who are our patients, and how willing are they to use telehealth?
• Is a telehealth solution or application already available, but lacking?  
• What are some of the unique benefits a practice can offer patients in a virtual setting?
• Are telephone conversations an option when video-based encounters won’t work?
• What are my payer partners’ policies and concerns?
• What will documentation look like? 

The last two questions are especially important, because behavioral health providers need to familiarize themselves with health plans’ telemedicine coverage—especially if they have never conducted a virtual visit. There have been reports that some health plans still may not cover telehealth for all services or may charge different rates for virtual services and in-person visits.

Also, in an ideal scenario, a provider’s EHR should support the telehealth consultation: Healthcare providers should not have to print out notes following a video encounter, copy them and then upload a scanned image onto separate system. This increases the risk of exposing protected health information (PHI).

Elevating the patient experience

Once the decision is made to implement a telehealth platform, providers should design strategies that ensure patients receive an optimal experience. Here are four best practices for getting started:

• Test drive your system. Run a trial virtual visit before your first patient encounter—test functions to ensure calls and applications like chat are easy. Go through a mock session to make sure documenting care is a streamlined, one-step process.
• Address patient concerns in advance. Some patients may be concerned about the security of a telehealth platform or worry that cameras are recording their innermost thoughts. Listening to these concerns and assuring patients that measures are being taken to protect their privacy will put them at ease and foster trust.
• Brush up your ‘webside’ manner. While providers and patients are used to videoconferencing and using applications such as Apple’s FaceTime, conducting a video-based healthcare encounter may feel different. Consequently, having a good “webside manner” is as important as having a good bedside manner. More than ever, it is important to maintain eye contact with your desktop/device webcam and focus on the encounter with the patient. Applications such as email, social media and pop-up alerts should be minimized during a telehealth consultation so you can listen and respond without distraction. 
• Relay concerns to your vendor. If you run into any performance issues, reach out to your vendor for help early on. It’s possible you might need to update your software or adjust your screen settings for an optimal experience.  

As with any technology solution, healthcare providers will have to adapt to new workflows and a new way of doing things. But the better their virtual experience is now, the more satisfied patients will be long term, even when virtual visits are no longer needed.

Roland Therriault is president and executive vice president of sales for InSync Healthcare Solutions.