MCMS Physician Summer 2017 - 25

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Before You Get Started in Telemedicine
BY NICK HERNANDEZ

any practices are hearing about telemedicine and
becoming increasingly interested in how such a
program could be implemented in their operations.
Physicians want to start a telemedicine program quickly. Practice
managers don't want to learn by trial and error.
The biggest issue I see by far is that practices immediately
focus on the technology. This often leads to two problems: they
either become overwhelmed by the plethora of options available
and end up not pursuing telemedicine, or they choose poorly
and the technology quickly becomes unused. Consequently, I
tell clients to ignore the technology that is available for starters.
There are many more important things to consider in order to
have a successful telemedicine program, and you will then be less
likely to overspend or purchase equipment you don't need or cant
use. Here are four items practices should carefully weigh before
jumping into telemedicine by purchasing technology first.
1. LEGAL REQUIREMENTS
Because of the way telemedicine adoption is currently happening
in the United States, practices must look into a host of legal
requirements, especially as the requirements pertain to applicable
state law. Although there are some exceptions, physicians usually
must be licensed in the state where the treatment or diagnosis
is being provided. Many malpractice insurers will now cover
telemedicine, but that conversation must be had with your
particular carrier so they can look at the various risks involved.
As with other areas of healthcare, privacy, consent, and regulatory
compliance must be thoroughly evaluated by a healthcare attorney.
Additionally, I would strongly suggest that your proposed
telemedicine program be reviewed by a telemedicine consultant
and healthcare attorney to ensure it is vetted for potential fraud
and abuse.
2. REIMBURSEMENT ASSESSMENT
Currently, reimbursement (governmental and commercial)
continues to be a barrier to telemedicine adoption in some (but
not all) states. The type of telemedicine services you are proposing
as well as the type of setting need to be examined through the

lens of the state(s) where services will be rendered, as well as
the portfolio of applicable payers. Even though there may be
restrictions that affect billing practices (and thus reimbursement),
there are ways to get "paid" (e.g. subscriptions, etc.) for
telemedicine services in lieu of reimbursement.
3. MARKET ANALYSIS
Telemedicine has many applications and uses, so a first task
is to determine what the needs of your patients are and how
telemedicine could address them. This step is a very detailoriented process which will help identify potential telemedicine
opportunities. A qualified consultant will help educate you about
telemedicine technology applications which may apply to your
potential goals, as well as educate you about predictors of success
and best practices.
4. FEASIBILITY STUDY
The implementation of telemedicine services to your existing
practice will certainly impact your operations. Some items
to consider are the time you could save by implementing
telemedicine, how you expect the telemedicine program to tie into
your regular in-person practice, and what type of clinic hours you
will devote to telemedicine.
There is no such thing as a standard telemedicine program.
Consequently, it is extremely important to take the time to
develop a telemedicine strategic plan first, as there are many
nuances to consider as they relate to your particular practice.
Hiring a consultant to help guide you in the right direction will
be money well spent, especially given that such an endeavor will
change your practice operations, including your marketing and
financial operations.
Nick Hernandez, MBA, FACHE, is the CEO and founder of ABISA,
LLC, a consultancy specializing in strategic growth initiatives for
physician practices. He can be contacted at nhernandez@abisallc.com.

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