Doctors - Pros & Cons of Starting Your Own Telemedicine Practice

starting your own telemedicine practice

Many doctors are asking themselves - should I start practicing telemedicine?

Telemedicine consumer adoption reached an all-time high in 2017. And the estimated adoption for 2018 may double 2017, as usage projections are off to a fast start from the epic flu season this winter.

Many medical professionals - doctors, nurse practitioners, physician assistants, & psychologists to name a few, are wondering if they should start practicing telemedicine in 2018. Then asking, "how do I get started?"

Providers should consider a variety of critical questions and weigh the pros and cons of various choices before diving-in head first.

Do I want to use telemedicine as an expansion of my current practice?

This is the hardest and first threshold question before getting started. Do you envision telemedicine as an add-on for use with your current patients? If that is your plan then you have several business decisions to ask yourself. If employed, does my current employer allow me to adopt any telemedicine practice? How will I encourage adoption by my patients? Will I make telemedicine available to all patients or only certain types of patients? How will I bill for my telemedicine services? Will I try for insurance reimbursement, or allow after hours telemedicine on a cash pay convenience payment system? How do I protect the privacy and security of my patient information? Will I only do video or allow for secured asynchronous communication, ie, text messaging? Does my current malpractice coverage include Telehealth treatment and cyber liability?

The list of uncertainty can grow, fast. In a rapidly developing industry, it's important to stay current on new developments. Here's a list of telemedicine newsletters you should be reading. But first, let's break down some of the larger fundamental questions.

What technology should I use that is safe, secure and user friendly for my patients?

If you are going solo, picking the right technology partner can check off several of the boxes reducing your uncertainty. Most virtual care products can work for an individual or across an entire practice. The frequent setup is a monthly fee which can range from $70-$500 for unlimited use of the technology platform for you and your colleagues.

And the technology partners can help make your virtual care as successful as possible. For example, Spruce Health is a virtual care platform that facilitates collaboration among your care team and allows for virtual care visits with your patients.

Spruce can help you onboard your patient population by sending secure email and text messages to your existing patients following all applicable HIPAA regulations. Spruce and other communication platforms like Medici that allow you to set your own price for consultations with patients, which can be asynchronous text or live video. You can treat your patients after hours, refill prescriptions, refer patients to colleagues, and reduce needless emergency visits by making yourself available via a smartphone app.

Does my current employer or EHR already have a virtual care tool?

Check your current options, as your EHR may already come with a virtual care tool built in. Using an existing EHR can make the process of patient communication and billing much, much easier with all of your patient profiles and contact information already built in.

Chiron Health is a telemedicine tool users of Athena Health's EMR can adopt to synchronize with other services in the practice such as scheduling and insurance reimbursement.

If your EHR or employer has a tool available, use it! In addition to the monthly fees, it saves your the headaches of integrating a new product to your workflow and can be especially advantageous for insurance billing for follow up care or monitoring chronic conditions.

How do I plan on getting reimbursed for my telehealth visits?

Your time is valuable. You need to get paid for it. If you are considering insurance reimbursement picking the right telemedicine platform can help immensely. Companies like Mend or Zipnosis work with you and your existing patient demographics to maximize your insurance reimbursement.

Many providers also elect to treat virtual care as a cash pay service. This makes sense to both sides as the provider is often allowing for night and weekend availability, and consumers are willing to pay out-of-pocket for that convenience.

Most of the platforms mentioned above facilitate per visit cash fees for virtual care visits via text or video. Another option growing in popularity by group practices, charging a flat monthly subscription which allows individuals or families to pay a monthly fee for unlimited night and weekend access to telemedicine care.

Practices that use this model rotate the provider that covers the evening shifts for any patient to access. This may be an attractive option if you work in a group setting that serves primarily a young family demographic.

Am I better off going to work part-time or full-time for a telemedicine focused company?

Tired of answering all these questions… simpler options do exists. Many telemedicine technology companies directly employ their own "virtual clinic" network of medical professionals. Doctors can work part-time or full-time seeing patients virtually from their home or from the employers corporate offices.

The pros of this approach - the telemedicine company figures out the software tools, scheduling and reimbursement model for you. This route is a good fit for doctors looking for a regularly set supplement to their existing schedule, say 20 hours a week, or looking to work from home for a few years to start a family and still want to practice medicine.

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