TELEHEALTH | PRECISECAREMEDICAL.COM

 While informed consent is not always required by law for telehealth or virtual visits, from a security and compliance standpoint, it is ALWAYS a best practice to require consent for your telehealth and “virtual waiting room” visits. According to Elizabeth Krupinski, Ph.D., Associate Director of Evaluation for the Arizona Telemedicine Program and Director of the SWTRC,

 “even if your state doesn’t have specific rules on informed consent for telemedicine, keep in mind that informed consent not only informs and protects the patient, but also, according the MedPro Group, protects the provider from the risk of facing consent-based negligence claims.”

 Legal requirements vary from state to state. Some states do not require consent, while others require written or even verbal consent. Consent requirements could also be a condition of payment, depending on the payer.

 So where do I go to find out? Center of Health Connect Policy has created an easy to use Telehealth Policy Resource Map to help identify current state laws and reimbursement policies, which you can access below.

 Simply click the link and choose your state. You can further filter by category, topic, and keyword.

 First and foremost, you should check current laws and policies for telemedicine through ATA, your regional Telehealth Resource Center, or CCHP for specific guidance on what MUST be included. These organizations can also be a valuable resource in providing sample telehealth informed consent forms. Also, keep in mind to include any additional billing or scheduling policies that your hospital may have regarding telehealth visits.

 5. Inform patients of what will happen in the event of a technology or equipment failure during the virtual visit, and state a contingency plan

 7. Obtain consent before recording a virtual visit; make it known that any recording made will be available upon request and that the recording release will require written patient authorization or court order

 8. Adhere to all applicable laws and regional and local practices as to Patient Informed Consents & Disclaimers

 9. Set appropriate expectations regarding Virtual Visit to include proscribing procedures, communication, follow-up, and scope of service.

 10. Have a process in place for those who refuse to sign the consent forms or receive virtual care

 In speaking about a post-pandemic approach to healthcare IT, Randy Davis, Vice President and CIO of CGH Medical Center, says,

 At present, the virtual visit sector is dominated by paper forms that must be scanned in by the patient from home or dropped off at the hospital. This completely defeats the purpose of any total telehealth or virtual visit narrative, causing unease and dissatisfaction for patients. In addition, hospital staff then must scan a re-printed form or manually archive the form into the corresponding patient record within the EHR, delaying access and increasing unnecessary workload, not to mention wasting paper.

 No matter how you slice it, paper-based consents stand in stark contrast to the priorities of a proper Telehealth strategy. A complete telehealth strategy for hospitals must include EHR-integrated solutions, like Access eForms Impression, which paves the way for a paperless and contactless check-in process as part of a “virtual waiting room” experience for patients who must visit the hospital.

 Are patients required to print and scan in the consent form, or can they access it through their mobile device?

 Are patients required to come into the hospital to fill out the initial consents or drop them off? Do they have to spend an extended period of time in the waiting room?

 Does your HIM staff have to manually retrieve and archive the form into the EHR patient chart?

 Can staff easily access, update, and send forms to recipients? Can clinicians easily customize the form with relevant content?

 Allow your patients to electronically complete and sign forms at-home for a contactless check-in as part of your pre-registration or complete telehealth strategy

Mental Health

 WHAT IS ACCESS ANNOUNCED THE RELEASE OF IMPRESSION THE LATEST VERSION OF ITS PAPERLESS, WEB BASED EFORMS SOLUTION

 “Impression” is part of the Passport offering by Access that converts existing paper-based processes into EHR integrated paperless solutions. We have designed “Impression” to complement your telehealth strategy by enabling your hospital to extend electronic Pre-Registration forms to your patient in advance of their visit. Patients can electronically sign all Pre-Registration forms in the comfort of their own home in advance of their appointment. When patients arrive to your hospital, they are met with a contactless check-in process that is safer and faster. Not only does this facilitate a complete telehealth strategy for your hospital, it also provides the first “Impression” you want your patients to experience.

 Hospital staff access “Impression” within their EHR system, and select the desired Pre-Registration eForms to send to the patient.

 The patient receives a secure email and SMS text message for dual-authentication purposes. They then electronically sign and complete the eForms.

 The completed electronic Pre-Registration forms are automatically indexed directly into the patient’s chart within the hospitals ECM system.

 Security features – Follows HIPAA and PIPEDA regulations; offers signed BAA compliance for protected health information

 Workflow features – Invite patients via email and SMS, patient self-scheduling, triage secure webchat, cancel Appointments (patient), intake chief complaint, post-visit survey, patient visit summary notes, patient portal access, provider scheduling, file / document upload to patient portal

 Workflow features – Invite patients via email and SMS, patient self-scheduling, triage secure webchat, cancel Appointments (patient), intake chief complaint, post-visit survey, patient visit summary notes, patient portal access, provider scheduling, file / document upload to patient portal

 Workflow features – Third party workflows, scheduling, advanced notification settings, custom appointment types and routing, PredictiveIQ AI, patient self-scheduling, on-demand queue

 Workflow features – Unlimited live video visits, scheduling, automated appointment reminders, practice branded web application and communications, patient mobile apps

 Telehealth consultation locations for hospitals vary based on convenience for clinicians, department priority, space availability, and considerations for future expansion. Some providers may also have the option of delivering virtual care from their homes due to stay-at-home orders or flexible working arrangements, while others may work offsite, at a central location within the hospital, or within a specific department for convenient access. Telehealth Room Location StrategyIn any case, environmental factors such as space needed and the types of consultation to occur–which all effect room design and location–must be outlined prior to choosing a workplace.

 According to Telemedicine Workplace Environments: Designing for Success, hospitals implementing a virtual care solution should consider converting existing spaces, rather than building a new space, for telemedicine. Unused office space, previous clinical exam rooms, or even a repurposed storage room, can be potential locations. In any scenario, if the potential telehealth location meets the requirements for space, lighting, ambiance, ventilation, and has good proximity to clinical staff and hardware requirements, it should be suitable for virtual visits.

 Choosing strategic locations for telehealth positively impacts a virtual care program. For example, if you are implementing pediatric telehealth, consider visible locations within that department so that patients and clinical staff are consistently aware that virtual care is an option. You may also consider placing a telehealth consultation room near out-patient check-in to gain the most exposure. If your hospital has an overloaded ER, consider placing your telehealth within its vicinity so that patients know they can schedule an eVisit to check-in. This may to deter unnecessary ER admissions and give clinicians the opportunity to direct patients to more appropriate services. In any case, make sure your virtual care examination rooms are near clinical staff.

 “Whether a patient is seeing his or her physician in person or via telemedicine, the same standards of care must be maintained.”

 For telehealth outside of the clinical environment, including those services administered from a provider’s home, many of the same best practices apply. ATA’s Core Operational Guidelines for Telehealth Services Involving Provider-patient Interaction further states,

 “Healthcare professionals providing telehealth services should (always) ensure? that workspaces are secure, private, reasonably soundproof, and have a lockable door to prevent unexpected entry. Efforts shall be made to ensure privacy so provider discussion cannot be overheard by others outside of the room where the service is provided.”

 Whether you are building a new telehealth space or repurposing an existing room within your hospital, it is a good idea to create a floor plan to help determine your workable space. You will want to configure elements such as office furniture and different types of equipment needed to ensure it is optimal for your eVisit needs.