Intelligent automation is the key to creating a unified telehealth experience for patients and ensures accurate reimbursement for virtual visits.
The COVID-19 pandemic pushed digital transformation in areas that were mission critical — telemedicine being the most prominent example. Almost overnight, it became obvious that health systems needed a way to see patients without having to be in person.
Initially, social distancing requirements drove urgent and unprecedented demand for telehealth. But what about once these requirements are relaxed? Even before the COVID-19 pandemic, 60% of younger patients reported that they would switch healthcare providers because of a poor digital experience. Digital transformation in healthcare has lagged behind other industries, and few providers are able to deliver virtual care experiences that meet patient expectations.
Research from Frost & Sullivan predicts telemedicine growth of nearly 700 percent by 2025 — likely due to the fact that more patients have become acclimated to the convenience of virtual visits. Now is the time for health systems to fine-tune their telehealth strategies and shift focus to enhancing the experience for both patients and providers.
The promise of telemedicine lies in its ability to become cemented as a key link in the chain of delivering care. But there are roadblocks to making telemedicine core to practice extension:
Telehealth is much more than video visits. Phone calls, video conferencing, asynchronous communication and Remote Patient Monitoring (RPM) all fall under the bucket of ‘telehealth’. Because telehealth comprises such a vast array of technologies and services, it's no surprise that challenges still remain for how to implement, operationalize and scale these services.
After meeting with a patient remotely, the provider needs to document the visit in the EHR, which involves manual data entry and takes away time with patients. Intelligent automation, the combination of AI for intelligence and RPA for integration, can eliminate this administrative workload by leveraging bots or ‘digital assistants’ that perform tasks in the EHR just like a human would — such as finding a patient record, creating a note, or submitting an order.
In doing so, these digital assistants serve as the perfect adjunct to human staff — as if there is a digital scribe in the virtual visit - allowing providers to focus less on what needs to be entered into the EHR and more on the consultation itself.
Reimbursement for telehealth services gets complex, fast. Should the reimbursement be based on the cost to provide the service to the patient? Or should it be based on the value that is created for the patient?
Telemedicine may be popular among patients, but if providers can't get paid for their services, it's unlikely they'll be able to continue to provide them. In order to create a best-in-class telehealth experience for patients, health systems will need to streamline the process on the backend.
Since the start of the COVID-19 pandemic, CMS (Centers of Medicare and Medicaid) added over 135 services to the Medicare telehealth services list — such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services. CMS and many payers have also increased the reimbursement on almost all telehealth services to pay in parity with standard E&M codes. Intelligent automation platforms like Notable automatically update these fluctuating changes to reimbursable services and their fees, to ensure optimal and accurate reimbursement.
These digital assistants work around the clock, with stunning speed and accuracy. Because of this, they can constantly scan payer guidelines/websites and alert staff if there has been any new changes to the way the payers require accounts to be coded. They can also update the coding or the claim of the telehealth service to make sure the correct procedure code, modifier, and place of service are included on the claim, based on payer guidelines. Accurate coding up front saves staff time later, without the added burden of having to work denials on the back-end.
As CMIOs and other operational leaders prepare to make telehealth a more permanent part of their care delivery models, they will need to figure out how to engage patients before, during and after virtual visits.
Intelligent automation enables automated pre- and post-visit workflows that unify the entire telehealth experience for the patient at each stage of the visit, from scheduling, registration and eligibility, to follow up and payment.
The COVID-19 pandemic taught us many things, most notably that we can use digital to deliver care virtually and instantly. However, the process of scheduling, conducting and billing for a telehealth visit can still be clunky. With Notable, health systems can use automation to bundle and connect workflows to create a cohesive, frictionless virtual experience that mirrors an in person one.
Organizations that succeed post-pandemic will be those that leverage automation to adapt to new, more flexible formats for care, like telehealth. Using automation and AI, health systems can deliver on the promise to create delightful experiences for patients, and ultimately, create new inroads for delivering safer, less expensive and satisfying care.
As you head into tradeshow season with ViVE, HIMSS, and Beckers, here are nine practical tips on healthcare technology partnership
The point solution approach is ballooning technology spending and creating more work for IT and caregivers (not less). It’s time for a change.