West Virginia Academy of Family Physicians
MMG TELEMEDICINE JourneyMarch 10: Started reading everything I could on Telemedicine.Checked with malpractice carrier for coverage.Chose a software technology ZOOM for Healthcare but can choose anything SKYPE, DOXY ME, DOXIMITY, CISCO WEBEX, WEB MD, NOT front facing Facetime Live or TIK TOK. Signed up for account with ZOOM and shared passwords with my staff so they could book patients with my account. At the same time, we reached out to our EHR Meditech Expanse to activate our Portal Audio Visual Platform. Hardware: Made sure I had 2 laptops: one to use for the ZOOM with camera and microphone and one to access the EHR to view chart and complete the patient note. Could use a desktop with a split screen, microphone and camera. HIGH SPEED INTERNET: Need at least 4G or 5G bandwidth and at least 3mbps up and 3mbps down. I think you need more. If patient is on dial up DSL, forget it. Pick a good spot to do conduct your visits: quiet, HIPAA compliant, good lighting. Ask the patient to do the same. AAFP recommends book, shelving in the background. Developed a very specific workflow: Formed a small team of experts in my office for the first few days: Receptionist, MA, LPN and myself. We worked through the kinks. Started seeing patients via telemedicine on March 16. Rolled out workflow to the rest of our multispecialty group starting on March 18 and then rolled it out to rest of staff and providers on March 18 including our Behavioral Health Pavilion, ENT, General Surgery, Cardiology, Urology, Neurology and Pulmonology practices. Since that time, most providers are seeing at 16 to 20 telemedicine visits a day. Some are Medicare adult wellness, transitional care, counseling and even pain management. Most visits are chronic disease management and URI/UTI or minor problems such as lesion, rashes, MSK symptoms. We still see all well child visits especially those under age 2 and those requiring a vaccine in the office in the morning. We use telemedicine to screen our potential COVID patients and do not bring them into the building. If they need to be seen, they are seen in the parking lot with full PPE.Marketing: When we felt everyone was on board and functioning well, we rolled out the announcements to our patients and the public using social media, flyers and newspaper. LOCATION, LOCATION, LOCATION: this determines billing. It is not TELEMEDICINE if the patient is at the SAME location as you are, even if you are talking to them or doing live video/audio with them in the parking lot. This is an office visit. Rolling out the Portal Audio/Visual Platform now that set up is complete and demo May 21. ................
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