5 Tactics to Tackling Rural Health Challenges with Telemedicine

By Baha Zeidan

A woman living in a rural community has a low-risk pregnancy. Unable to make her outpatient visits to see her OB, she is provided the option to leverage telehealth to safely carry to term. Throughout her pregnancy, the patient and doctor meet via a mobile-based telehealth service. Twice, a medical assistant visits the patient to obtain blood work and complete an ultrasound.

Or, a mother of four believes her child is sick; however she is hesitant to take her family to the doctor for fear of exposing the children to the flu germs that are pervasive throughout the country. She instead makes a telehealth appointment with her doctor to have her daughter’s cough evaluated.

Scenarios such as these are not uncommon in rural America. With 83 rural hospitals closing since 20101, forward-thinking hospitals are looking to alternate care options, such as telehealth, as a source of revenue and a way to provide low cost patient care. HIMSS Analytics 2016 survey2 reported that less than half of US hospitals have currently implemented a Telehealth program, and adoption is growing at a 3.5% annual rate. Telehealth is a natural progression for medical care, but many wonder – how do I build a successful telehealth program?



#1 Integrated Telehealth Platform: Recent HIMSS Analytics research3 reported that rural healthcare executives indicated telemedicine as their top clinical or technology based initiative. As with your EHR initiatives, you must consider workflow when implementing a telehealth program. With this in mind, look for telehealth platforms that are embedded or integrated within your EHR. Allow providers to initiate calls and document visits from within a patient’s record. Providers got into healthcare to deliver care, not to manage their technology.

#2 Understand Your Patients’ Technical Know-How: Having the right technology is one thing, but successfully having patients use it is another. Viewed positively by patients in general, ask your patients if they would utilize and trust the security of a telehealth visit. Create a seamless entry point for patients by leveraging your existing patient portal. Patients that can easily access their telehealth visits are more likely to use it.

#3 Make a Reimbursement Plan: With the recent focus on quality of care and lowering readmission rates, it is valuable to note hospitals have experienced 44% lower readmission rates4 among patients enrolled in telemonitoring programs. This is a key metric to track as you look to optimize reimbursements; as telehealth reimbursement varies by payor, state, and even speciality depending on your contract. In rural communities, it also can be difficult to find qualified billers as well as expensive and time intensive to properly educate staff. For these organizations, it is especially advantageous to look for a third-party revenue cycle management company to help maximize reimbursement.

Recently, United Behavioral Health Services, a telepsychiatry provider reported their use of an integrated EMR and RCM solution enabled them to increase tracking and thus billing for a specific service from 25% to 80%, decrease administrative staff by three full time headcount, and increase the overall number of patients cared for by 317%.

#4 Launch: So once you have telehealth, how do you ensure it is used? Announce your new telehealth services as patients visit your organization, inform them via emails or when they call in to schedule appointments, and update your website so the community at large is aware of the option. In an American Well’s survey5, one in five patients stated that they would switch primary care providers to one that offers telehealth visits. With the weight of this in mind, use your new telehealth program to re-engage your community, win back patients, and encourage existing patients to follow up on the specialist care they need. Implementing a telehealth plan, could be as simple as extending your office time by an hour purely for telehealth visits.

#5 Get All Benefits from Telehealth: The most obvious usage of telehealth are remote face-to-face visits. Particularly in rural settings, where there are more than three times less specialists than in urban areas6, introducing access to specialist care via telehealth allows rural hospitals and clinics to retain revenue instead of transferring patients to other specialty care. It removes the patient burden of traveling two to three hours, and also provides your hospital with a competitive advantage of providing specific specialist care. Telehealth can allow patients to do consults and even pre-operative care, all from a distance. In addition, physicians often leverage telehealth to do consultations among themselves.

All too often, telehealth is thought of as a revenue generator. For rural markets that have experienced declines, telehealth should also be viewed as a revenue protector. Healthcare is a product, and if you are not delivering the product in a way the patient needs, they will shop elsewhere.

1. http://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/

2. http://www.himssanalytics.org/news/telemedicine-adoption-growing-35-annually-2014

3. http://www.healthcareitnews.com/news/rural-hospitals-are-facing-down-connectivity-obstacles-they-deploy-telemedicine

4. https://www.aha.org/system/files/research/reports/tw/15jan-tw-telehealth.pdf

5. http://go.americanwell.com/2017ConsumerSurvey.html

6. https://mhealthintelligence.com/news/broadband-offers-a-telehealth-lifeline-to-rural-hospitals

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