We will be authoring a couple of blog posts on how MediTouch EHR® can enhance revenue for your practice. Most EHR/EMR vendors publicize Meaningful Use as the sole revenue enhancement methodology related to adopting an EMR/EHR. It takes a special kind of EHR/EMR vendor to create software that goes beyond the typical tactics with regard to increasing your practices revenue line. Again, we are not speaking about ways that EHRs save money — they do, but that is not the emphasis of our next couple of blog posts, the focus is the top line.

Telemedicine, e-Visits, Virtual Office Visits — You pick the title… We have the solution

If you have read some of my previous blog posts you may have guessed that I just can’t get EHR related issues off of my mind. At a party or a barbeque I can’t help but do market research regarding how my friends and family feel about new ideas that our team is considering, regarding EHR and patient portal software. One question I like to ask people is:

“Would you pay around 2-3 times your co-pay to get medical care for certain non-emergency health issues and NOT have to visit the doctor’s office?”

I always get a yes.

So, per my very small sample size, our team concluded that if we could find a way to integrate an electronic visit or virtual office visit within the MediTouch® system, then our doctors would be able to provide a service that is in great and growing demand. And, of course we have found that method!

Regarding terminology, we will use the term virtual office visit rather than e-visit or telemedicine, because we think it best describes the services that can be provided via MediTouch EHR and the YourHealthFile® Patient Portal.

How do virtual office visits work with the MediTouch system?

Virtual office visits are provider-patient interactions that occur via our YourHealthFile Patient Portal and the MediTouch EHR. They offer patients an alternative way to communicate with their doctors regarding health issues that do not require face-to-face contact.

How do I interact with my patient?

The YourHealthFile premium portal now supports chat and computer-based, video-teleconferencing and so does MediTouch EHR. Communication can also be supplemented by a standard telephone.

How do I charge?

First of all, we always suggest that you check with your biller. Most health plans do not offer virtual visits as a benefit, therefore most providers charge patients on a “cash basis” and they do not bill the patient’s health plan; as the provider, you can set the fee that you think is fair for your virtual visits. If you and your biller decide that the patient is 100% responsible for the virtual visit, then the MediTouch system has a way for you to collect via credit card, prior to the commencement of the visit.

How about charting and scheduling?

They are both integrated into the MediTouch EHR so that scheduling patients for virtual visits, charting their encounter and prescribing are the same workflows as the ones used to record a standard office visit. If you know how to use MediTouch EHR, then you are already trained to perform virtual visits. The big difference: instead of seeing the patient in person you will see them via video conference, just like Skype® or Facetime®!

What are some of the disease states that other providers commonly treat via virtual office visits?

Prominent telemedicine companies as well as industry organizations state that several disease entities lend themselves well to virtual visits under the categories of General Medicine, Pediatrics, and Mental Health. Here are a few examples:

Acne,   Allergies,   Cold & Flu,   Constipation,   Diabetes,   Fever,   Gout,   Headache,   Joint Aches & Pains,
Nausea & Vomiting,   Pink Eye,   Rashes,   Sinus Infection,   Sore Throat,   Sunburn,   Urinary Tract Infection


Anxiety & Depression,   Child Behavior Issues,   Eating Disorders,   Marital & Relationship Issues,   Mood Swings,
Obsessive Compulsive Disorder,   Post Traumatic Stress Disorder,   Sleep Disorders,   Smoking Addiction,   Substance Abuse


When do virtual visits “come in handy?”
  • If your schedule is full and you have some time after hours to “see” some patients when you get home from the office, or when your office staff is off and you still want to see patients
  • If you’re considering sending a patient to an ER or urgent care center for a non-emergency because it is after hours
  • For patients that require monitoring of some sort prior to a medication refill
  • If your patient is traveling and in need of medical care, this works worldwide as long as you and the patient have access to the Internet
  • If you have some spare time after hours: nights, weekends, or holidays
  • During normal business hours if you have some “holes” in your schedule
What about privacy?

Our system is a point-to point communication, and does not go through social media type programs. However, any type of electronic communication can be “hacked” even a cell phone. The most secure way to interact with a patient is in the privacy of an exam room. We suggest that all practices interested in providing virtual visits make sure that the patient understands the potential risks of tele-health, and they agree in advance to participate in your virtual office visit program. There is a way in our system to post your personalized policy regarding this visit type.

What about Medicare?

Again, we always suggest you consult your biller. Unless you are a Rural Health Clinic, CMS will not reimburse your practice for a virtual visit. If you are a Rural Health Clinic you may qualify and use the standard CPT codes 99201 – 99215 for an office visit, followed by the telehealth modifier GT, “via interactive audio and video telecommunications systems” (e.g., 99201 GT).

Read More on CMS’ Website

Are there any ethical implications?

Per the American Academy of Family Practitioners (AAFP): the delivery of healthcare services via telemedicine should be consistent with the principles of ethical medical practice. The AAFP believes that payment should be made for physician services that are reasonable and necessary, safe and effective, medically appropriate, and provided in accordance with accepted standards of medical practice. They also suggest that the patient agrees in advance to visit service terms, privacy policy, and charges, and that the physician appropriately documents the visit in the patient’s medical record.

What about new patients and virtual visits?

The decision is always the providers, but many practices limit virtual visits to established patients.

Why would my patient want a virtual visit?

Simply stated: virtual visits are a very convenient way for patients to get access to their physicians for non-urgent health care or follow-up treatments. They eliminate the inconvenience of patient travel. With the YourHealthFile Portal, during the virtual visit patients can interact with their own personal health record, which includes their lab test results and medication lists.

How should I market virtual visits?

Make this new service prominent on your Website and on voicemail/on-hold messages. Hang attractive posters in the lobby and patient rooms advertising your Web site and highlight the YourHealthFile self-service features for patients. Add messaging to your patient statements, and to any newsletters or online publication you author.

What does the literature say?

There is not much but… in a published study in the Archives of Dermatology, researchers at the Center for Connected Health in Boston found that dermatologists could achieve similar outcomes for acne patients who received online care as those who came into the office. And, physicians were more likely to prefer managing them online.

A paper on Telemedicine was prepared and reviewed in the AMA News, the title of which is: Telemedicine’s Expansion a Virtual Certainty

MediTouch has the cure with our virtual office visit feature; we now provide the gateway for patient electronic access to physicians; patients will pay for it even if many insurance companies won’t.

Virtual Office Visits; a Win Win Win — Patients want them, Physicians need them, and with MediTouch you can have them!

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