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Telehealth for direct-to-consumer care

Getting started: Is direct-to-consumer telehealth right for your practice?

Direct-to-consumer telehealth can increase access to care, improve efficiency and provide convenience for many patients. However, incorporating it into your practice takes planning, patience, and persistence. It offers new ways of delivering care which can be supported through new technology, staff, processes, and a revised business model.

Integrating new direct-to-consumer services

  • Decide what kinds of services you’ll provide through direct-to-consumer telehealth. Key questions to ask yourself include:
    • What are the different types of services I provide?
    • Which of these services can safely be provided through telehealth?
    • Are there certain services where telehealth might improve patient engagement (for example, preventative care, filling prescriptions, follow-up care, and monitoring chronic conditions and mental health).
  • Understand your patient population. There is no one-size-fits-all solution with telehealth. Make a plan to ensure your telehealth services are easily accessible to a diverse range of patients with different needs. Some things to consider:
    • The types of care that you provide most frequently.
    • Which patients may be most receptive to telehealth.
    • Identify potential issues for those that may be reluctant to use telehealth
    • Consider what you can do to help address patient concerns or barriers to using telehealth such as directing patients to the patient pages on Telehealth.HHS.gov.
  • Determine your budget for new technology and customer support. There are a number of costs to think about when implementing and advancing the use of telehealth. These include technology products and tools, staffing, and ongoing maintenance and technology support — for example:
  • Train the staff. Beyond the technical aspects of setting up a telehealth solution, it is important to train health care professionals so they can efficiently and effectively use telehealth to deliver care. Direct-to-consumer telehealth is more successful when the health care provider feels comfortable using the technology and encourages patients to use it when appropriate.
  • Administrative processes. In order to successfully use telehealth, it is important to think through the process for providing health care services to a patient. Some things to consider are:
    • How will the patients sign-in to their appointment?
    • Will patients receive any training on telehealth before their visit starts?
    • Can patients schedule a telehealth appointment online?
    • Will someone be available during the visit to help troubleshoot technology issues?

Did you know that a number of medical specialty societies have identified services that they believe are most appropriate for telehealth?

Exploring telehealth technology options

  • Get connected. Do your research and ensure broadband internet is available, affordable, and easily accessible in the community you plan to serve.
  • Research efficient approaches. Research and compare the features of telehealth solutions and become familiar with their functionality. Try before you buy!
  • Ensure your current and future needs will be met. Confirm that vendors provide the necessary support, updates, maintenance, or installation and meet privacy requirements for telehealth equipment.
  • Seek advice. Talk to other healthcare information technology leaders and legal counsel before making any purchasing decisions.
  • Test and retest. Make sure you test and evaluate any solutions you are interested in before deciding. Engage key stakeholders in hands-on testing of the solution.

Tip: Because direct-to-patient care is sometimes provided by a third-party company specializing in telehealth, treatment information must be shared with the patient’s primary care physician—review files with the patient’s primary-care provider before and after telehealth visits.

Understanding telehealth laws and policies

  • Get familiar with state and local laws. Since you will reach a larger patient population than a traditional brick-and-mortar practice, there are different laws for telehealth services consider including state licensure requirements. Understand the time and cost needed to stay compliant (video).
  • Research insurance reimbursement policies. Not all private insurance payers mandate coverage or reimbursement, and reimbursement rates are not always comparable to in-person care. Additionally, providers can only bill Medicare and Medicaid for certain telehealth services. Until the end of the COVID-19 public health emergency (PHE), providers can deliver telehealth to patients in a number of locations. Understand if the services you plan to offer were reimbursable before the PHE and what services are expected to remain reimbursable once the PHE ends.
  • Meeting the standard of care – It is essential that the providers for your direct-to-consumer telehealth program adhere to the same standard of care in telehealth settings as they would when delivering care in person. Labs, vital signs, physicals, and other information obtained in person should be obtained when providing care via telehealth.
  • Adhering to practice standards - Several states have developed telehealth practice standards, which are rules and requirements, providers must follow when practicing medicine via telehealth. Make sure you are familiar with the practice standards in your state and train your staff on them before starting your program.

Many policies have changed to allow for broader telehealth reimbursement during the COVID-19 public health emergency, but these policies may change again, and coverage may end for certain direct-to-consumer telehealth services.