19 Essentials For Highly Productive Telehealth Programs
19 Essentials For Highly Productive Telehealth Programs
19 Essentials For Highly Productive Telehealth Programs
Matt McBride
CEO & Co-Founder of Mend
Foreword 3
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Foreword
We greatly appreciate getting the opportunity to share knowledge we
have learned over the many years helping organizations build highly
productive Telehealth programs. Our team is passionate about helping
you help more people.
We have intentionally tried to keep the content short and to the point.
We welcome any comments or questions.
Thank you,
Matt McBride
Mend CEO & Co-Founder
[email protected]
Patients Clinicians
→ Transportation → Continuity of care
→ Convenience → Improve outcomes
→ Increased access to care → Increase chronic care
→ Rural access to specialists → Monetize frequent care
→ Contain contagious disease → Coordinate care between
providers
C-Suite
→ New revenue → Community outreach goals
→ Fulfill quality measures → Expand patient base through
→ Improve efficiency access and referrals
→ Improve patient retention and → Increase data-driven care
loyalty → Increase innovation
→ Reduce no-shows or
cancellations
COVID-19 Telehealth
Impact Study
The Healthcare Coalition is composed of numerous healthcare organizations including
Mayo Clinic, MITRE Corporation, Change Healthcare, Inc., the American Medical
Association, the American Telemedicine Association, the Digital Medicine Society,
Massachusetts Health Quality Partners, and MassChallenge. It’s primary mission is to
study the impact of telehealth during the pandemic and share data with the public.
It’s clear that the collective consciousness has experienced telemedicine and other
forms of digital healthcare and the demand is only going to increase as time goes on.
91% 95%
virtual visit made it easy said they felt
to get the care they comfortable with the
needed technology
82% 93%
virtual visit was as good virtual visit clinician was
as an in-person visit by a interested in them as a
clinician person
ESSENTIAL NO. 1
This sounds commonsensical, but it can be overlooked or not properly aligned within an
organization. The organization needs to clearly define the problem to solve, goals to
accomplish, and data measures to track success. This information cannot only reside
with leadership. Every member of the team involved in your digital transformation
should clearly understand the problem, goals, and measures in place.
Here are common goals that we partner with our customers to solve:
→ Maximize productivity
▪ Reduce no-shows, cancels
▪ Improve compliance & cancellations
▪ Load balance providers across locations
→ Rapidly expand service market
▪ Increase referral sources
→ Expand business hours
→ Eliminate free work
→ Attract and retain providers with remote work
→ Increase patient & provider satisfaction
→ Reduce staff technical support burden
→ Reduce overhead
ESSENTIAL NO. 2
Develop a Telehealth
Clinical Protocol
Virtual visits may not be appropriate in certain situations. Your state may require a
frequency of in-person care if virtual visits are being offered. Clearly define your clinical
protocols for providers and staff to follow.
Problem Encounters
→ High no-show rate visit types
→ Points in care where
compliance drops
→ Infectious disease concerns
→ Transportation & other barriers
to care
Types of Visits
→ Medication management
→ Follow-up visits
→ Lab results
→ Chronic care management
→ Therapy
→ Pre- & Post-op care
→ Group education & wellness
→ Low-acuity care
→ Clinical trials
ESSENTIAL NO. 3
→ Links to connect to encounters end up being managed and sent manually by staff
and/or providers.
→ Links end up being shared across patients and if someone joins early, that is a poor
experience and a potential HIPAA concern.
→ Consents, clinical assessments, and other paperwork become a manual process to
collect.
→ Copay and payment collection issues can arise.
→ Staff and providers become technical support representatives.
At a high level, you need to think through the entire patient journey and how you will
operationalize a hybrid care strategy across the organization.
ESSENTIAL NO. 4
Other Operational
Considerations
If you imagine every step and process that takes place for an in-person encounter, this
will help you identify every operational consideration for a hybrid care delivery model.
ESSENTIAL NO. 5
Legal Considerations
Healthcare is highly regulated. Here are some important learnings to help you navigate
the regulatory and compliance landscape:
PAYER CONTRACTS
Make sure all payer contracts reimburse for telehealth at equivalent rates.
Regardless of the telemedicine laws in your state, payer contracts are where you
can control your hybrid care destiny. In most states, payment parity laws do not
have teeth and allow payers the flexibility to dictate terms via contracts.
In our experience, prior to the pandemic, we saw many customers work with their
payer representatives to secure equivalent reimbursement rates even in states
with terrible telemedicine laws. We’ve even seen customers pioneer changes in
state laws that limited access to care.
STATE LAWS
The Center for Connected Health Policy (CCHP) is the best resource for
reviewing and tracking all regulatory matters at a federal and state level. CCHP
summarizes all of the regulations and provides hyperlinks to the statutes for
further analysis. In addition to CCHP, legal counsel that specializes in telemedicine
can help navigate the regulatory landscape.
Video conferencing tools will collect terms and conditions that protect their
organization, not yours. A hybrid healthcare model with end-to-end patient
engagement needs several consents, as a best practice. Mend will provide you
with consents you can use or modify for telehealth, email, SMS, payment, and
more. These are not Mend consents. These can be modified per your legal
counsel and become your digital health consents with your patients.
ESSENTIAL NO. 6
Technology & IT
Providers
If a provider has connection issues, unlike poor patient connectivity, it
can affect every visit. Provider connectivity needs to be reviewed,
tested, and monitored. Mend has a Provider Success Team that will
test and verify Internet and equipment used by providers.
Technical Support
Are your staff and providers going to have to do technical support
in addition to their clinical work? Some patients, staff, or providers
may need technical assistance. Mend provides instant support
within 15-20 seconds to staff, providers, and patients.
Connectivity
You should plan to use existing equipment and Internet
connections. Slight firewall modifications may be required to allow
for encrypted audio/video connections. The Mend
implementation team will test your network, end-to-end and
identify any optimizations.
ESSENTIAL NO. 7
Scheduling Script
Whether staff is scheduling an appointment or you allow for online patient scheduling,
this is a very important touch point to set expectations, so that the patient has a great
virtual experience. Connectivity is still a challenge for some patients and this is your
opportunity to be proactive. If a patient is not well prepared, everyone loses. Perhaps
the encounter doesn’t happen and care is not delivered. Additionally, there is an
opportunity cost if a booked slot does not happen and then gets rescheduled into a
future slot. That single encounter consumed two slots of capacity for care to be
delivered.
The following is a checklist that your staff can use on your website, email, or flyer to
prepare patients for a virtual visit.
Set expectations
Click receive email/SMS with a secure link, enter DOB, & enter waiting
room with educational content
You will meet with front-desk, nurse, provider, and then checkout
(Modify as needed depending on your actual workflow)
ESSENTIAL NO. 8
ESSENTIAL NO. 9
ESSENTIAL NO. 10
Billing Basics
The Center for Connected Health Policy is a great billing resource. We recommend
visiting their website and joining their mailing address to receive updates. Here is a basic
overview of telehealth billing:
Modifiers
→ G0 - Telehealth services
→ GT - Critical Access Hospitals
→ GY & GQ are less common
→ FQ - Real-time audio-only
→ FR - Supervising practitioner
Mend has many other resources available that you may enjoy
including other eBooks, White Papers, Webinars, and More
ESSENTIAL NO. 11
Patient clicks link at time of visit, inputs DOB, and then enters the Enhanced
Virtual Waiting Room experience
Staff can join the visit to handle check-in, set expectations for wait times,
collect co-pays, etc.
Virtual visit set to Ready for Provider and providers can join from
anywhere when ready
Visit set to Ready for Checkout and staff can join again to provide
documents, set follow up visits, collect final payment, etc.
Mend has every virtual workflow option to support your needs today and in the future
as your business grows and evolves. In fact, you can utilize more than one workflow,
and most workflows are customizable. Mend currently supports the following
telemedicine workflows:
Visit
Transfers
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Selecting the right software partner with the right feature set can be challenging. This
section is not meant to be an advertisement for Mend, but these are features that
will make a big difference in the patient and provider experience while helping you to
run an extremely productive Telemedicine program.
As you evaluate your current vendor or look for new vendors, the problems and
solutions we’re going to address below have made significant impacts for large and
small healthcare organizations.
ESSENTIAL NO. 12
On-demand
Virtual walk-ins (on-demand queues) can fill openings, cancels, or no-shows
in the schedule. It might also allow you to add urgent care visits to your
practice, attracting more new patients.
The Nudge
Staff or Providers should connect to every scheduled encounter.
→ Mend sends nudge automatically via text & email whenever a provider or staff member joins a visit
→ Mend Dialer can be used to call the patient to nudge them to connect via the secure video link
→ Custom text message nudges can be sent from within Mend anytime
Kiosks
Mend telehealth kiosks can help you load balance across locations or allow you
to serve patients without the proper technology. Exam rooms with computers
can be used in busy locations to bring in remote providers from less busy
markets.
Kiosks are a great option for patients that don’t have access to technology or
need help with the technology. Having those patients physically come in can still
allow you to access providers from anywhere.
Mend is agnostic to the type of video technology you want to use. Mend has 100%
Web-based video for single or group appointments. However, Mend also integrates
with Zoom, WebEx, and Microsoft Teams to facilitate visits if that is better suited for your
patient panel. Enterprise vendors like Mend can support you and customize workflow
options to meet almost every need.
*Results based on 2021 Mend internal research with default options selected on all platforms.
ESSENTIAL NO. 13
Has your organization been diligent about collecting email and mobile numbers? It’s
becoming harder to reach people by phone and it’s expensive to have staff make phone
calls and play phone tag with patients.
Mend Success teams will monitor your contact profile health and provide reporting on
patients that are unreachable. While this was a bigger issue in the past, we still see 2% of
visits that fall victim to unreachable patients. Depending on the scale of your operation,
2% can mean helping many more people.
ESSENTIAL NO. 14
Staff workflow is important and your staff are likely going to want to stay in the master
schedule or EHR for the majority of their work time. Platforms like Mend focus on user
experience to create better single screen experiences. Mend Desktop Notifications alert
staff on key activities whether they are logged in or not so they don’t miss a virtual
interaction.
ESSENTIAL NO. 15
Providers typically want to stay in the patient's chart to review notes, labs, chart, etc.
Picture-in-Picture (PiP) allows for the patient video to float on top of all other
applications, creating a better single screen experience. The provider can move the
patient video stream anywhere on screen and resize to meet workflow needs.
ESSENTIAL NO. 16
Dashboard Available in
Video Visit
Patient engagement platforms like Mend might have different interactions with your
patient around scheduling, forms, payments, and more. While in a video visit with a
patient, providers, and staff have access to all Dashboards within a single screen. When
important information is needed for reference within Mend, it’s at the user’s fingertips.
ESSENTIAL NO. 17
Nudging a patient to join can lead to better productivity and providers and staff will also
need a way to bring other resources into a video visit with a patient. Inviting users with
secure links can be helpful in the following situations:
ESSENTIAL NO. 18
Having an outbound dialer that masks the provider's number with a built-in speed dial
can also be used to nudge patients to join or get important resources connected to an
encounter efficiently. It can also serve as an audio backup to finish a visit with
connectivity issues.
Dial in any phone number (Speed dial can be Patient phone is on speed dial
customized for each organization to have quick by default as a backup or
access to important resources for a visit) nudge
ESSENTIAL NO. 19
The average patient wait time across Mend for 2021 was about 14 minutes. In 2021 Mend
had a total of about 18 years of patient wait time. We saw an opportunity to educate,
inform, and entertain patients that dramatically increases patient satisfaction. Mend is
the only 5-star telemedicine experience on the planet. How do you want your patients
to spend their time while they’re waiting?
Comprehensive patient engagement platforms allow you to cover the entire patient
journey, digitally, whether it’s in-person or virtual. From scheduling to follow ups post-
visit, here is what a patient journey can look like on an affordable enterprise platform like
Mend:
NEW
FEATURE
Virtually Walk-
In with our
Schedule Patient Self- Appointment Appointment Waiting Room
Patients Scheduling Confirmation Reminders Links
Before
Visit
During
Visit
Book Follow Up Video Visits Video Content AI-Powered Payment Complete Pre-Visit
in Virtual Vitals Outstanding Forms Check-In
Waiting Room Balance
2022 2022
2022
After
Visit
Thank you
We’re extremely grateful that you took the time to
download and review our ebook. We hope you found
the information valuable. If you have any questions or
comments, please don’t hesitate to reach out to me
anytime.
Thanks,