August 18, 2024

Why Direct Primary Care Providers Should Incorporate Telemedicine in Their Clinical Practices

You may be surprised to learn that neither telehealth nor telemedicine, more specifically, are new. The practice of providing healthcare-related services remotely goes back to the mid-19th century with the advent of the telegraph. And using two-way video technology in the provision of health information traces back to the late 1950s.

But the ability to use video conferencing to provide clinical services to patients became much more accessible with the rise of the internet and mobile devices, and its use expanded dramatically with the arrival of the COVID-19 pandemic. Then, the Centers for Medicare and Medicaid Services removed geographic restrictions and changed reimbursement requirements to encourage its use amid widespread physical distancing restrictions meant to slow the spread of the disease.

As a result, the availability of telemedicine has dramatically increased. With these platforms, healthcare providers have a versatile tool to reach patients without regard to geographical boundaries, enhancing access to care, and streamlining administrative processes.

According to the American Medical Association, only around a quarter of physicians reported that telehealth was used in their practice in 2018. By 2020, when the pandemic began, it had risen to 79%, and while adoption has fallen some since, it stood at 74.4% as of 2022, according to the group’s most recent annual benchmark survey.

Respondents said they used telehealth to help manage patients’ chronic diseases (54.9%), diagnose or treat patients (49.8%), care for patients with acute disease (44.4%), and provide preventive care (29.5%). Yet remote visits — either videoconferencing or audio-only — in 2022 constituted only 7% and 5% of average weekly patient visits, respectively, the survey found.

“Although the availability of videoconferencing and audio-only patient visits was high in 2022 and … widespread across a range of practice characteristics, remote visits accounted for a small share of weekly visits for a large majority of physicians,” the report authors wrote. “Only 10.0 percent of physicians provided more than 20 percent of their weekly patient visits via videoconference and only 5.9 percent provided that many on an audio-only basis.”

Nevertheless, there are good reasons to incorporate telemedicine into your direct primary care practice.

Click and mortar

While there will always be cases in which an in-person examination is necessary, studies show that telemedicine is a clinically viable practice.

In a study published in the Journal of the American Medical Association (JAMA) Network Open, researchers from the Mayo Clinic studied diagnoses made on nearly 2,400 patients who underwent a video telemedicine visit followed by an in-person follow-up within 90 days. They found the concordance between the telemedicine and in-person visits was 86.9%. Diagnoses made by specialists were more concordant, at 88.4%, than those made by primary care providers, at 81.3%.

For another thing, payment disparities between telemedicine and traditional, in-person visits are narrowing.

According to a report from Foley & Lardner, as of 2024:

33 states had telehealth parity payment laws requiring insurers to reimburse telehealth at the same or comparable rates as for in-person services, up from 16 in 2019, before the pandemic
Other states have laws that dictate a range for payment or how rates must be negotiated, while payment parity laws in some states like New York have expired and have not been renewed.
Another 10 states, plus Washington D.C., lacked laws specifically addressing telehealth reimbursement rates

“In the wake of the COVID-19 Public Health Emergency, we have seen significant progress in telehealth insurance coverage laws, concurrent with digital health’s journey to broad adoption among patients and health care professionals alike,” Nathaniel Lacktman, partner and chair of Foley & Lardner’s national Telemedicine & Digital Health Industry Team, said in a statement.

“Five years ago, one of the most substantial barriers to growth was the limited and uncertain insurance coverage for digital health services. Today, with improvements in telehealth practice standards and insurance coverage laws, far more organizations are implementing and expanding robust digital health services, particularly attractive when woven into traditional in-person services.

“If these ‘click and mortar’ models can deliver the right care, at the right time, to the right person, telehealth will continue its path to becoming an essential component of health care writ large.”

Congress was also weighing several proposals to make permanent telehealth flexibilities that were set to expire at the end of 2024.

“The expansion of telehealth services has transformed care delivery, expanded access for millions of Americans and increased convenience in caring for patients, especially those with transportation or mobility limitations,” the American Hospital Association said in a statement to Congress. “Given current health care challenges, including major clinician shortages nationwide, telehealth holds tremendous potential to leverage geographically dispersed provider capacity to support patient demand.”

Advantages of using telemedicine

There are several reasons direct primary care providers should incorporate telemedicine into their practices.

Enhanced access

Because they transcend geographical barriers, telehealth platforms enable healthcare providers to reach patients in remote or underserved areas. Research by the American Hospital Association (AHA) suggests that telehealth expands access to care for patients in rural communities, where access to healthcare resources is often limited.

Additionally, the National Rural Health Association notes that telehealth can play a vital role for rural hospitals during seasonal surges tied to respiratory illnesses such as influenza, RSV and COVID-19 that strain bed capacity and compound staffing shortages. The organization notes that telehealth benefits rural hospitals by:

Balancing patient loads between hospitals
Limiting leakage of patients to urban hospitals for specialized care
Broadening access to specialist health providers not always available to rural patients

By increasing accessibility to healthcare services for underserved patients, providers can help improve patient outcomes. Providers also benefit by extending their reach and enhancing their practice’s reputation.

Improved patient engagement and satisfaction

Numerous studies have found that patients appreciate the convenience and flexibility offered by telehealth appointments. Research — including from well before the pandemic — has consistently found high satisfaction rates from patients who use telemedicine technology. One JMIR study found that patient satisfaction was higher for telehealth consultations than for in-person visits. That can contribute to improved patient engagement and adherence to treatment plans.

Administrative efficiencies

Direct primary care providers already benefit from avoiding the paperwork hassles that come with accepting reimbursement from insurance plans. Telehealth platforms streamline administrative processes further by reducing the burden of paperwork and improving operational efficiency.

They offer features like order management and documentation and the ability to track medication administration, patient records, and appointments and scheduling. Additionally, features such as automated appointment scheduling and virtual waiting rooms optimize workflow management, enabling providers to see more patients in less time.

Cost savings

Telehealth platforms offer cost-effective alternatives to traditional healthcare delivery models. Research conducted by the Center for Connected Health Policy (CCHP) suggests that telehealth can generate significant cost savings for both providers and patients by reducing travel expenses, eliminating the need for physical infrastructure, and minimizing missed appointments.

Studying pandemic-era Medicare fee-for-service data from several health systems, the National Committee for Quality Assurance’s Taskforce on Telehealth Policy grouped cost-saving benefits into five categories:

Substituting for in-person care
Preventing more costly care in urgent care, emergency departments or other high-cost settings
Decreasing no-show rates
Increased use of transitional care management, which can help lower readmissions
Lowering the number of hospital transfers from skilled nursing facilities

These cost savings can help stabilize finances for resource-constrained healthcare practices.

Flexibility and work-life balance

Telehealth platforms offer obvious flexibility for patients, who don’t have to leave their homes or work, or arrange for childcare, to see a doctor.

For providers, telehealth offers greater flexibility in managing their busy schedules and achieving a better work-life balance. By reducing the need for physical presence in the clinic, telehealth allows providers to conduct consultations from virtually anywhere with an internet connection. This flexibility can be especially beneficial for providers with family commitments or those seeking to reduce commute times and administrative burdens, and it represents a key benefit at a time when surveys reflect rising levels of burnout among clinicians.

Integrating telehealth into clinical workflows

Change is always difficult, and physicians have their hands full caring for patients, managing staff, and handling administrative matters. Physicians have adapted to telehealth by integrating telehealth appointments and documentation into their workflows. This integration involves several key steps:

Preparation and training. Providers undergo training to familiarize themselves with telehealth platforms and learn best practices for conducting remote consultations, including using telehealth technology, conducting virtual exams, and ensuring patient privacy and confidentiality.
Appointment scheduling and documentation. Physicians use telehealth platforms to schedule appointments and document patient encounters electronically. Access to comprehensive health records allows them to access patient records securely and update medical documentation in real-time during telehealth consultations.
Virtual consultations. Physicians conduct virtual consultations with patients from the platforms, using video conferencing, secure messaging, chat functions, and other communication tools. During these consultations, providers can assess patient symptoms, discuss treatment options, and provide medical advice remotely.
Follow-up and coordinating care. After telehealth consultations, physicians can follow up with patients and coordinate care with other healthcare providers as needed. This may involve ordering diagnostic tests, prescribing medications, or scheduling additional appointments for in-person care if necessary.

iDirectDoc’s Healthcare-as-a-Service platform

The iDirectDoc telemedicine platform brings the focus back to healthcare and ensures a manageable quantity of patients, so physicians can focus on the quality of those interactions. It’s a turnkey direct primary care solution that connects patients directly to their physician — and not just any doctor, but the one they know and want to see.

The platform enables physicians to:

Focus on preventive care and the long-term health and wellness of patients
Extend care beyond boundaries by making it more easily accessible
Use advanced analytics and case management functions
Cultivate loyalty and patient retention
Tackle administrative tasks such as order management and documentation, medication administration, appointments and scheduling, and access physician desk references

Patients benefit by avoiding the waiting room or having to leave work or find childcare, maintaining a relationship with their chosen physician, and easy access to primary care and other needs like refilling prescriptions.

Conclusion

Telehealth platforms offer several advantages for healthcare providers, including expanded access to care, improved patient engagement, administrative efficiencies, cost savings, reimbursement opportunities, and greater flexibility in work-life balance. By integrating telehealth into their workflows, physicians can leverage technology to expand their reach, streamline patient care, and adapt to evolving healthcare delivery models.

As telehealth continues to evolve and gain widespread acceptance, and reimbursement reaches parity with in-person visits, healthcare providers stand to benefit from its transformative potential in improving healthcare access, quality, and efficiency.