Editor's Note

What's Your Telehealth Plan?

COVID-19 is pushing U.S. healthcare to adopt practices it should have integrated years ago, and telehealth is at the top of the list.

• By David Kopf
• May 19, 2020

I’ve been thinking a good deal about what post-acute healthcare, and particularly HME, will look now that COVID-19 has become a global reality. We’ve seen a lot of rapid change in terms of Medicare policy relaxations (read our cover story, starting on page 6, for more about that) to help providers work with patients and referral partners under these circumstances. And now we’re all wondering, which policy changes are temporary and which will remain?

The one broad policy change that I’m certain will remain is telehealth. Here in HME, we’ve seen an elimination of the three-year established patient relationship requirement from telehealth provisions and the removal of the face-to-face exam requirement for items that otherwise require them due to NCD or LCD.

We’ve also seen CMS waive any limitations on the types of clinical practitioners that can furnish Medicare telehealth services. Now CMS’s telehealth list to include both two key clinical partners/staff for HME providers: Physical Therapists (PTs) and Occupational Therapists (OTs).

And when it comes to referral partners, similar policy changes have made it much easier for physicians to confer and consult with their patients via telehealth, rather than in person, to minimize contact. Now, doctors are just as likely to meet with patients on their laptop as they are in their examination rooms.

It’s important to remember one overriding factor: telehealth makes sense. Let me give you a personal example. Recently I had a six-month follow-up slated for a specialist to see how I’m doing. (It was no big thing, but the doctor wanted to be thorough.) Normally, that appointment wouldn’t have been a problem; I would have driven about 15 minutes from our offices to the doctor’s office for my appointment.

However, with California’s stay-at-home guidelines still very much in effect, I wouldn’t have driven from the office; I would have driven from home. Even with Southern California’s radically diminished traffic, I’d still face at least an hour’s worth of driving. Also, I’d be sitting in a waiting room with other patients and interacting with staff that have been engaging a wide swath of people during a disease outbreak. The entire scenario wasn’t exactly ideal.

So I asked if telehealth was an option. The office manager replied, “of course!” Within a couple of hours I was in a Zoom video conference, getting a follow-up Q&A and consultation from the physician. No muss, no fuss, and no time-wasting back-and-forth drive.

The whole arrangement made too much sense to ignore. The appointment didn’t require physical examination; it was simply some follow-up. So why mess with all the other complications that absolutely no one wants? Once patients, physicians and other players in the care continuum get exposed to how much easier and efficient that kind of appointment is, why would they ever go back to the old model?

The same goes for HME. Telehealth is radically reducing the amount of costly truck rolling and in-person consultation that providers and patients otherwise need to do. Just think of a scenario where a physician prescribes an item, recommends a provider, the patient contacts that provider via telehealth, the HME does an assessment, selects and ships the needed items, and then conducts guided set-up over the phone.

Well, that’s the reality now. For example, I spoke with Gary Sheehan, president and CEO of Cape Medical Supply and newly appointed CEO of Spiro Health, and Joe Candiano, director of operations for Hampton Homecare Inc., for the HME Business Podcast (episodes 27 and 32, respectively). Both rapidly rolled out telehealth for sleep patients. (Hampton even has a name for the service: TelePAP.) These providers see both the potential for telehealth to improve their businesses’ cost structure and efficiency, and recognize that there will be patient and referral demand for that capacity.

In many respects, COVID-19 is a grim, awful reality (as I write this, more than 85,000 Americans have perished). Still, if there is one silver lining that we can take from this experience, it will be streamlined, more efficient care through innovations such as telehealth.

This article originally appeared in the May/Jun 2020 issue of HME Business.