Did You Rapidly Adopt or Expand Telehealth for COVID-19? Here’s Our Post-Crisis Top 10 ‘To-Do’ List
The COVID-19 public health emergency has sent many PTs and PTAs scrambling to adopt and deploy telehealth or other communications-based technology in their practices. This sudden pivot brought challenges and opportunities, prompting APTA to publish a Top 10 "To-Do" List for Providing Telehealth. As the situation continues to evolve, we now offer top 10 considerations for evaluating your telehealth program and planning for the future.
- Survey your patient population.
It is important to know what your patients thought about their experiences with telehealth. Consider using a survey tool to determine what went well, what did not go well, which patients may be more appropriate for telehealth services in the future, and how you might improve the patient experience. Ask patients how well telehealth services supported their overall objectives.
- Survey your staff.
For many, the transition to telehealth was a difficult one made out of necessity. Ask your staff what skill sets and resources they felt they lacked in making that transition. What technology challenges were there? Did staff feel that patient treatment sessions were effective, or did they feel limited in their ability to support patients?
- Survey your interprofessional partners.
Identify others who are involved in the care of the patient. Ask them how well telehealth services supported their overall objectives. Was interprofessional communication maintained? Did providers avoid duplication of services? Did patients provide any feedback related to their experience?
- Collaborate with payers.
Solicit feedback on your effectiveness from the payer's perspective. If you don't have existing relationships with your payers, you should develop them. Ask payers if the billing and documentation you submitted supported the services provided. Also, communicate to payers what they did well and where you felt they could improve. Maintaining an ongoing, constructive dialogue with payers is essential to maintaining and growing your telehealth practice.
- Analyze your outcomes.
Collect objective outcomes data regarding your use of telehealth. If you didn't record any, make that a priority in your performance improvement plan. Compare patient outcomes from in-person care with those achieved via telehealth. Was there a difference between the two modes of delivery in patient outcomes?
- Identify your barriers.
Consider any barriers to your adoption of telehealth. They could be financial, technological, marketing, privacy, security, or something else. Do you have a permanent solution to those barriers, or did you develop workarounds that you now need to address? What will you do differently to make telehealth delivery more effective?
- Plan for the next public health emergency.
The rapid deployment of telehealth was only one of the challenges many providers faced during this public health emergency. What other challenges did you experience? Did you have adequate personal protective equipment? Was your electronic documentation and billing system flexible enough to support you? Did staff and patients know what to expect? What can you, your staff, and your patients do to be better prepared when faced with a similar situation? Establish or review your written disaster plan, engaging your staff in the process, and then disseminate it.
- Determine your gaps in compliance.
This health emergency prompted the temporary relaxation of many compliance standards, including the federal government's enforcement discretion of HIPAA requirements. You will need to defend any compliance lapses and ensure full compliance in the future. Perform a gap analysis and ensure that you defensively document any compliance deviations and that you have a written plan for reestablishing compliance.
- Perform chart audits.
Perform focused chart audits to identify how your systems and staff performed during this time. Do you need to make changes to your documentation systems? Do you need additional resources and policies to ensure defensible documentation when services are provided via telehealth? Do you need new informed consent resources and policies? Does your documentation support effective clinical decision-making? Was the dose of care consistent with the needs of the patient? Were the goals and plan of care supported?
- Develop a performance improvement and/or innovation plan.
Now is the time to plan for the future. How can you do better? Determine what you should continue doing after this emergency abates. Decide what systems or processes you stopped that do and do not need to be resumed. Revise or establish best practices, including policies, procedures, clinical practice guidelines, and documentation standards.
And remember to join APTA in our continued efforts to advocate for expansion of telehealth services for PTs and PTAs.