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Tips on Quickly Implementing Telehealth in Your Physical Therapy Practice

Telehealth, it's the same but different

Many PT practices are scrambling to implement and operationalize telehealth. Many practices are having great success in providing patients with continuing care during the COVID-19 pandemic and that is positive news. Implementing telehealth at your practice can be done quickly by leveraging your existing processes and plans but it would be a mistake to assume that it is 100% the same.

Don't rewrite the book

The point of these tips is not to rewrite the entire playbook for your practice but rather to offer tips on things that may not be top of mind. In a lot of ways, this is trial by fire for telehealth. You need to make sure you have a good procedure in place not just to provide good service but also to make sure the path is clear to bill these visits either to insurance or to the patient, accordingly.

#1: Think about your process

All practices have a way of doing things. For some practices, these processes have been well documented and tweaked over the years. For others, processes have formed over a period of time by habit or circumstances. Practices that are just getting started up may be just getting it all figured out. Process goes into check-in, check-out, scheduling, documenting, collecting, etc.

In any case, it’s important to think about the patient flow with telehealth.

  • How will the patient register if they are a new patient?
  • How will the patient schedule visits? If they are an Medicare patient, how will you capture them initiating the visit?
  • How will you discuss with the patient that their telehealth visit will be billed and how any cost sharing will work?
  • Who in your practice will perform various tasks? Same as always or need to change (see below in step 2)
  • Do you proactively reach out to patients who have no scheduled recently? How hard would you push to schedule a telehealth visit?

#2: Have an agenda for each visit

Most PTs likely have a tried and true process for conducting visits. Guided by education and experience, it’s usually a smooth process. With telehealth, there may need to be some logistics that you add to each visit to have the smoothest experience and the best outcomes:

  • Consider a virtual check-in process at the beginning of the call. Do you have a complete demographic for the patient?
  • If you will be collecting payment for the visit on cash-basis or for an insurance copay/deductible, make sure to work that into the check-in portion of the visit
  • Ask the patient at the beginning of the session to go through a checklist with you of any equipment they may need. Make sure you have a plan if they don't have what you have asked them. Hopefully, you considered communicating clearly to the patient anything they may need.
  • At the end of each visits, have a "check-out" process whereby you may solicit feedback on the visit immediately from the patient. Consider scheduling another visit during the call or providing instructions on how the patient may do so.

Long story short is that the PT may be acting in roles typically performed by front-desk or billing staff. In a telehealth world, you have to take advantage when you have the patient before you. All of these should be asked in the context of your billing platform so that you can see how the pieces fit together.

#3: Collaborate with Staff

As a practice owner, it’s important that you check in with your staff PTs on a regular basis to hear what’s working or not working. It will also give you an opportunity to hear from staff what challenges they have been facing. Working collaboratively is key to work out kinks and to strive for the highest level of service to your patients. You may also find that patients are providing important feedback and that needs to be passed along well. You’ve worked very hard over the years to build your practice and reputation, it’s important to maintain it.

Many industries have been shifting more digitally over the years favoring work from home (“WFH”) or a hybrid policy. It seems that most companies (and employees) would agree that it’s not the same – in some ways good and in some ways bad. Your employees will also need support and encouragement during this difficult time. A weekly (virtual) roundup meeting is a good way to keep the connection and keep everyone’s spirits up.

#4: Have a plan to deal with technical issues and interruptions

We think technology is great (of course) but no technology is without its flaws. There may be audio issues, video issues and patients who just can’t figure out how to the telehealth visit technology work. You should have written guidelines for your PTs to follow to address the following things:

  • Information about the audio/video platform you are using with contact info
  • Basic troubleshooting steps that you expect the therapist to take on with the patient
  • A hard stop in terms of time when a telehealth visit should be abandoned if it's not working and a process to reschedule
  • A practice contact (e.g. owner) who should be notified when a visit does not occur because of technical issues
  • A method documenting what happened

#5: Rethink Practice Policies

Most practices have several basic policies that relate to patients:

Likely you also have a slew of employee policies on a variety of topics.

In light of telehealth, the question is – do all of your policies still make sense? Are they written in a way that accommodates telehealth? Do you need to make adjustments or does telehealth even require an entirely new set of rules for everyone to follow.

The Bottom Line

The move is on to offer telehealth services, with some foresight and thought, you can ensure the highest quality of service and avoid potential pitfalls.

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