Introduction:
We are all shook that the COVID-19 pandemic has brought down the many healthcare organizations in terms of revenue, patient volumes, operations gaps and lack of staff support. Few practices have started providing house calls for patients with chronic conditions.
But this pandemic has paved way for a technology which was been there for quite a while and was unpopular among health care professionals. The revival of the Telemedicine gave healthcare providers new hope in communicating, consulting and providing their patients with the care they need and the most great part of it is that patients do not have leave their homes for visiting the doctor’s office.
The majority of providers are using Telemedicine, out of which the most frequently visited healthcare professional is Obstetrics and gynecologists. OB/GYN providers give pre and post-natal care services for mothers on a regular basis, also other OB/GYN related symptoms and conditions. Since mothers are at risk of getting infected it is a better option for OB/GYN providers to proceed with telehealth visits.
CMS has announced that all telehealth and E-visits are covered under Medicare, Medicaid and other commercial payers. So BillingParadise would like to educate OB/GYN healthcare professionals about the benefits of telemedicine and the ways to help streamline their practices.
Immediate care & User friendly:
People in cities are nearby most specialty healthcare professionals and they could walking for a quick visit, on the other hand people living in the rural areas cannot afford to risk infection for new mothers or worsen other OB/GYN related conditions such as psychiatric disorder, postpartum depression, venous thromboembolism, gestational diabetes, preeclampsia, and family history of a genetic disorder-that may threaten the health or life of the mother or infant requires immediate attention and patients in rural areas cannot travel long distances or request an EMT, It will only endanger their condition and consume time/money.
Other reproductive health conditions which can be treated virtually are birth control, urinary tract infections, STDs, abnormal cervical mucus, rashes, bumps, abnormal bleeding etc.
Using Telemedicine/Telehealth platforms will ensure patients the immediate care they need and in few clicks away. Any OB/GYN physicians surrounding their area or their usual OB/GYN care provider can directly be connected with the use of telehealth applications. Using live audio visual feeds OB/GYN physicians can directly point out their direct problems and work out a treatment plan right away.
Features, Accessibility and Compliance:
Unlike other healthcare technologies, telemedicine applications connect doctors and patients in an environment in which they are comfortable in. Doctors can use their telehealth platforms anywhere in the world. They can use their mobile devices, tablets or laptops to quickly connect to their patients and carry out their usual day-to-day consulting. Their patient’s history, lab results and charts are directly presentable with the patients and discuss more detail on the parts of their care plan.
In order to be reimbursed for telemedicine, the remote interaction must be a real-time video visit. Telemedicine provides real-time face-to-face video and audio. Patient private health information is very secure and is HIPAA compliant. Patients and providers can manage their appointment logs virtually using the telemedicine application.
Patient eligibility checks can be done through the telemedicine application. Certain plans will not reimburse of the remote visits even though state guidelines mandated the reimbursement. Using the eligibility checks option in the telemedicine cloud based web portal or application eases patient, provider and billing/administrative burdens.
The term “Tele obstetrics” is usually referred in hospitalist programs and large health groups, the reason why is because the usual ultra sound, screening and other lab services results are usually presented to the OB/GYN specialist through manual reports. In this case the OB/GYN specialists can directly view the ultra sound, recording the baby’s heart at location and the live recording feeds can be forwarded to the OB/GYN specialist in another location.
Integration:
Telemedicine platforms especially for the OB/GYN specialty assist in collaborating with the PMS/EHR. Most of the Telemedicine platforms have lined with well-known EHRs like Advanced MD, Kareo, eCW, Drchrono etc.
Physicians may wonder why they need an integrated Telemedicine platform, because there are multiple factors at play when it comes to specialties like OB/GYN:
- Lab readings and results plays a major part in OB/GYN specialty. Doctors will like to view the patients past and present results when the Telemedicine platform is integrated with the major EHR/EMR in the industry.
- Even if patients schedule their appoints in the virtual appointment scheduler feature of the Telemedicine platform, the EHR must be notified of that appointments in order to verify patients demographic and eligibility information of other services or procedures suggested by the doctors under the treatment/care plan.
- Clinical documentation is a must in all healthcare fields regardless of in person or virtual. Integration with EMR will provide the clinical documentation specialties working with the doctors, clinics and hospitals to document the day to day consultations.
- Billing is the next major factor; most Telemedicine platforms do not contain the inbuilt billing or EDI integration. So integrating with the EHR/EMR which the doctors, clinics and hospitals use might eliminate back to back manual data entry works from one platform to the other.
- Insurance remittance and correspondence is the final important step in any reimbursed workflow, without integration between Telemedicine platforms and EHR/EMR patient or doctor cannot notify the patient of the important new or information passed on by insurance companies.
- Maintaining preexisting workflow of the administration, billing, labs and clinicians can be saved and followed as it is when integrated with EHR/EMR. Framing a whole new system just for the sake of using a virtual technology will only result in incompetency.
So choosing the right Telemedicine platform integrated with the current EHR/EMR used by doctors, clinics and hospitals will help OB/GYN healthcare practitioners and facilities to reduce cost and increase workflow efficiency accordingly.
Interoperability:
Telemedicine platforms contain various methods of interoperability which can be beneficial for both patient and provider. Some of these interoperability capabilities are as follows:
1. Clinician to Clinician:
Providers can have a conversation with the patients PCP directly through the Telemedicine platform using email, video or both.
Inter-specialty communications between other telemedicine physicians/technicians specialized in Dermatology, Radiology and other specialized clinical workers/services such as surgical peer mentoring, Emergency trauma care and ICU.
2. Clinician to Patient:
OB/GYN Providers can have their patients visit frequently during their pregnancy and after child birth. Also they can keep a close eye on the other reproductive illness if they require constant monitoring and care.
Some of the telemedicine tools used by the OB/GYN providers/clinicians are video, phone, email, remote wireless monitoring devices. This helps OB/GYN providers/clinicians to create a better care plans for patients who lack in medication management, wound care for patients after post op or other illnesses, counseling and monitoring mental health for women suffering from postpartum depression, Post-operative follow ups and other chronic reproductive illness condition management.
Other direct to patient virtual visits best suited for telemedicine is virtual home visits, Low-risk pregnancy, postpartum visits, lactation support, and routine gynecology care.
Reimbursement:
CMS has approved full reimbursement of the telemedicine services. Telemedicine existed before 2018 and was in the early stages of exploration and the validation of these services and the benefits obtained by both patient and providers.
Due to the COVID-19 pandemic more and more providers turned to the side of telemedicine because it was the most convenient way to follow up with patients and closely provide care plans. According to a survey conducted on 2019 they found 46% increase in telemedicine. Hence, CMS is now encouraging health clinicians to provide telemedicine visits unless the patient requires immediate care or needed to visit ER during life threatening conditions.
This paved way for the expansion of telemedicine with 1135 waiver. 1135 waiver was first introduced on March 6th 2020 allowing a range of healthcare professionals including OB/GYN providers utilize telemedicine and it not only increased the flexibility of the care it reduced or waived the out of pocket expenses and cost sharing in for the patients.
However, even if the federal law states that telemedicine services require reimbursement. Few state laws prevent providers from receiving reimbursement from state Medicaid payers and some local payers in specific states. Below map shows the impact of approval of the telemedicine reimbursement according to states: