Evaluating Telehealth Operational Models
Challenges and Barriers in End-to-End Telehealth Visits
End-to-end telehealth has its challenges, barriers, and technical difficulties. Technology always has hitches, so when it comes to providing health, it becomes more of a challenge as practitioners are doing their best to try to provide quality care. Thus, practitioners need to improve their telehealth services and be informed.
Regulatory barriers are real and prevent doing the necessary as telehealth has varying rules (Amdie & Woo, 2020). Patient care should be safe and, at best, without facing legal hurdles as another challenge. The guidelines have to be followed, especially during pandemics. Recommendations include having medical liability where telehealth has to be considered and not neglected. Practitioners have to improve on the use of equipment to avoid omissions and errors and prevent malpractice.
Comparing and Contrasting Telehealth Visit Models
Telehealth visit models include originating site providers, a coordinator-led visit, and a patient-only visit. The equipment used is managed by a coordinator in a patient-only visit. The patient alone visits the telehealth-designated room with the coordinator operating from a closed room. A coordinator-led visit involves them being responsible for support communications and operations of the telehealth equipment. They are present from the start to the completion of the patient visit. In originating site providers, the referring provider assumes the role of the telehealth coordinator, facilitating communication and operating equipment. They also need training on workflows and other telehealth procedures, which are more profound than a coordinator-led model.
Evolution of Telehealth Operations and Leadership Roles in Digital Health
Telehealth operations need more leadership to champion them to work and progress. Such services need more support, and leaders have taken more initiative to have more evaluation and implementation of telehealth programs (Tuckson et al., 2020). Leader champions have fostered telehealth partnerships and leadership teams to ensure the success of programs. They have sought more planning and execution to offer significant input in telehealth-offered services.
Comparing Telehealth Operational Models
Introduction
Telehealth operational models significantly impact payers, providers, and patients. Thus, some considerations should be reviewed and compared to determine the ones that work optimally. The models help support different clinical services to make the telehealth programs work. They support services to offer provider networks based on patient population, technology capabilities, and telehealth team sites. The operation model of choice has a significant influence on telehealth visits.
There are real-life world examples involving telehealth models for different purposes. For example, patients may need to be engaged and screened remotely before entering a care facility. During the pandemic, the example was real as it helped carry out online patient engagement and screening (Amdie & Woo, 2020). When the pandemic hit, home care organizations and hospitals monitored suspected patients with coronavirus by carrying out a questionnaire to get more information for suitable reference to a care provider.
Consequently, the engagement and screening tools continue to be of great use in current healthcare centers, engaging patients and reducing hospital stay time. In addition, telehealth operational models offer support to get medical images remotely. Providers and patients should stay connected to help give the needed support to each and minimize mishaps that come when quality care is not provided (HRSA 2, 2021). The models under research include telehealth coordinator-led visits, originating site providers, and a patient-only visit.
Coordinator-Led Visits
Telehealth coordinator-led visits are standard, most frequently used, and give a better view of a successful telehealth program. The model has its merits, as the telehealth coordinator understands their duties. They have clear roles to play in telehealth centers or clinics. For instance, they schedule telehealth services and oversee administrative duties (HRSA 2, 2021). The Telehealth coordinator is always around when the patient starts the program up to completion. In addition, they help maintain the required standards of quality care for patients from both non-clinical and clinical staff (THLTH5013 Presentations Transcript, n.d.).
For telehealth coordinators, there is more than just performing their duties, like working on implementing planned programs. They need to coordinate other activities like training in collaboration with the managers. The privacy and safety of patients matter; thus, recommending any areas of improvement is critical. A telehealth coordinator needs to have excellent organizational, communication, and multitasking skills to directly engage the providers and patients for successful telehealth visits.
Telehealth is complex and needs the coordination of patients, equipment, and multiple staff. The internal support offered must be maintained even if it means contracting outside dealers. The use of coordinators proves integral to telehealth as they ensure the success of day-to-day program operations. Furthermore, ensure smooth visits run throughout the day between the providers and the patients. Coordinators make the type of model better as they assist in troubleshooting technology and maintaining electronic health records (HRSA 1, 2021). As telehealth is all about technology and keeping records online for remote treatment, maintaining such records is a priority and critical.
Furthermore, the coordinator-led visit can give coordinated referrals. Systems are prone to failure, and once a coordinator-led visit cannot fail to have referrals to ensure the patients or people get the required services. That is why they are better than originating site providers, as the remote provider doubles the tasks of a coordinator. There is double training required for the remote provider to make the telehealth model succeed. The coordinator might conduct quality improvement and data analysis. Notably, such coordinators work alongside healthcare staff members like administrative staff, clinicians, and clinic leadership.
Originating Site Providers
Originating site providers need the patient to get the services from other locations or homes. The model was common during COVID-19 when various Medicaid and Medicare programs had such originating sites increased for patients to receive telehealth services. Most policies involving originating sites are not permanent and may expire, affecting how the telehealth services are offered. Patients must visit the originating site to get the telehealth offered through the telecommunications system (HRSA 2, 2021). They may be in the county or rural areas where the telehealth service provider qualifies for the originating site regardless of location.
In various federal telemedicine, the service provider has to be approved for them to be eligible to provide the services in the geographic sites where the sites include hospitals, rural health clinics (RHCs), and critical access hospitals (CAHs) (HRSA 1, 2021). Moreover, there are billing guidelines for telehealth services whereby the telehealth services have to meet the necessities. Based on the services, the payments are made accordingly through a payment schedule.
For the originating site, the telehealth services offered need documentation that is equal to those of face-to-face encounters. Since there is no clear telehealth coordinator, the remote provider has to provide the review of systems, the history, and the information of the visit. Notably, more information and consultative notes are needed to help make the right medical decisions for the patients (HRSA 2, 2021). Notably, the services offered through telehealth should be provided in the documentation. For instance, the details of the provider, the location, roles, and names of those participating in the telehealth services.
Day-of-visit telehealth consults for the coordinator-led visit include patient selection, visit initiation, physical assessment, and documentation. The patient has to consider suitable visit conditions for the visit that should be patient-assisted. There is a clear assessment and a proper schedule to follow. The correct setting of the visit is crucial to ensure each staff member knows about the expected appointments of the day.
Consequently, there are clear guidelines on how to go about decision-making. Prior to the day of the visit, pre-visit preparation is essential for the telehealth visit to offer the needed guidelines (HRSA 3, 2021). There is specialty-specific information that is needed, making clear the visit type, provider specialty, and instructions for diagnosis. The telehealth visit has to be a proper one that is vital to confirm the patient’s identity. The environment for the patient’s evaluation should not have any distractions.
If there are special needs for patients, the pre-visit preparation helps provide the correct information. Evaluation is important, and for the virtual visit, the activities are a collaborative effort (Amdie & Woo, 2020). The patient must be willing to follow instructions through the assessment of various body parts. The day of the visit has to end with documentation of the assessment and all the components of a report. Telehealth visit documentation has to be done appropriately to keep a better provider-patient relationship and for the health management of the patient.
The originating site has a day-of-visit procedure that has to include knowing the site location and its eligibility to provide the services. The operations may vary by state, and the documentation that guides the day’s activities is an electronic health record that involves a documentation template. The template contains informed consent that the patient has to fill in as a right. Moreover, it follows that the right modality has to be used for telehealth.
In addition, the conversation is facilitated by telehealth informed consent. There is space where patient-provided health information has to be filled to help capture the vital signs of the patient and the condition to be treated. Besides, there are clinical and practical guidelines to be followed by telehealth that include the common conditions they treat. Finally, treatment recommendations have to reflect on the necessary ways for the specific condition.
Conclusion
Conclusively, both originating site providers and coordinator-led visits help to provide the most reliable telehealth programs. They help serve with the best form of communication to provide the needed patient care and support. Visits to remote locations are made possible through the right platforms and by avoiding the limitations that come with increased demand for telehealth services and patient care worldwide (Amdie & Woo, 2020). Countries have adopted telehealth services to provide a broad range of services to patients and beneficiaries. The beneficiaries ought not to travel to healthcare facilities.
The two programs help in the exchange of critical medical information that helps them improve the health of patients. Telemedicine, or rather telehealth, has helped to deal with emergencies and maintain access to care when needed (Amdie & Woo, 2020). The programs are highly interactive and make use of telecommunications to enable top assistance for patients, thus fostering a great relationship in case of subsequent visits. Nations should support telemedicine because it helps to increase access to healthcare services. For instance, governments can set funds to address the potential issues and enlighten citizens on how they can utilize telehealth.
References
Amdie, F., & Woo, K. (2020). The use of mHealth technology for chronic disease management the challenges and opportunities for practical application. Wounds Int, 11(2), 32-38. Web.
HRSA 1. (2021). Getting patients set up with telehealth technology. Web.
HRSA 2. (2021). Helping patients prepare for their telehealth appointment. Web.
HRSA 3. (2021). Preparing patients for telehealth. Web.
THLTH5013 Presentations Transcript. (n.d.). Telehealth leadership and management. Notes.
Tuckson, R. V., Edmunds, M., & Hodgkins, M. L. (2017). Telehealth. New England Journal of Medicine, 377(16), 1585-1592. Web.