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Analysis

Coronavirus: AMA Provides Quick Guide to Establish Telemedicine Services

By Christopher Cheney  
   March 30, 2020

During the coronavirus pandemic, telemedicine is way for physician practices to offer expanded services and to interact with patients safely.

The American Medical Association (AMA) is providing guidance to physician practices to set up telemedicine services for their patients.

Telemedicine provides physician practices with a safe method to interact with patients remotely during the coronavirus disease 2019 (COVID-19) pandemic. Telemedicine also enables physician practices to expand services for patient care such as virtual patient check-in capabilities and remote patient monitoring that collects biometric data.

An overview document, "AMA quick guide helps doctors boot up the telemedicine practice," includes guidance on changes to federal telemedicine policy and privacy regulations during the COVID-19 pandemic.

"For example, the Centers for Medicare & Medicaid Services (CMS) is letting physicians provide beneficiaries a wider range of healthcare services without having to visit a healthcare facility. This CMS fact sheet explains more. Also, the Health and Human Services (HHS) Inspector General is waiving Medicare's cost-sharing requirements for COVID-19 treatment delivered via telehealth from a doctor's office or hospital emergency department," the overview document says.

In addition to the overview document, the AMA has a quick guide that features tabs for telemedicine practice implementation; policy, coding, and payment; and other helpful resources.

Telemedicine practice implementation

There are three steps to start setting up telemedicine services at a physician practice, the quick guide says:

1. Establish a team to lead the effort to implement telemedicine services and make decisions rapidly to expedite the launch.

2. Contact your malpractice insurance carrier to see whether your policy covers telemedicine services.

3. Learn about telemedicine payment and policy guidelines.

There are four steps for vendor vetting and contracting:

1. See whether your electronic health record vendor has a telemedicine capability that can be implemented.

2. Contact your state medical association to see whether it has guidance for telemedicine vendor vetting and contracting.

3. To implement telemedicine quickly, there are three primary considerations: making sure it is clear who has access to and ownership of data gathered in a patient visit, pricing structure such determining whether there is a monthly flat fee with your telemedicine vendor or a per visit fee, and Health Insurance Portability and Accountability Act compliance.

"Given the special circumstances of the COVID-19 pandemic, the federal government has announced that the Office for Civil Rights (OCR) will exercise its enforcement discretion and will not impose penalties on physicians using telehealth in the event of noncompliance with regulatory requirements under the Health Insurance Portability and Accountability Act (HIPAA) in connection with the good faith provision of telehealth during the COVID-19 national public health emergency," the AMA quick guide says.

4. Use American Telemedicine Association resources to identify possible vendors. Some vendors are offering quick implementation of telehealth services. 

There are five primary considerations for workflow and patient care:

1. Set protocols for when a telemedicine visit is appropriate, and train clinicians, other healthcare workers, and office staff. Contact your most significant commercial payers to discuss telemedicine reimbursement.

2. Set when telemedicine visits will be conducted such as throughout the day or in a block of time.

3. Establish a space in your practice to conduct telemedicine visits such as an exam room.

4. Document telemedicine visits—ideally in your existing electronic health record. The documentation should include consent from patients to receive telemedicine services.

5. Conduct patient outreach such as alerting patients that telemedicine services are available when they call your office or visit your website.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

The American Medical Association is providing physician practices guidance on implementing telemedicine as well as telemedicine policy, coding, and payment considerations.

Basic steps to launching telemedicine services include establishing a team to lead the effort.

Steps in vendor vetting and contracting include seeing whether your electronic health record has a built-in capacity to provide telemedicine services.


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