Whitney Reese is a Doctor of Physical Therapy, and she’s been working diligently to build out Telehealth and E-visits amid the Covid 19 pandemic. I was very curious about the service as well as the good and bad of telehealth, so I asked Whitney. She gave me a lot to think about!
What Is Telehealth?
At its core, telehealth is a health appointment in a remote setting.
Each state defines telehealth a bit differently, though. Some states say that the doctor can cross state lines to go remotely whereas some states do not. Also, some states define that their patients can cross state lines whereas others do not. At this point, it is up to the practitioner to understand their own state laws as well as to make sure they are not crossing state boundaries with clients whose states do not allow it.
And now, with all of this difficulty in the world from the virus, Medicare is redefining telehealth in certain aspects to be called “E-visits.” The reason for that dichotomy seems to be that telehealth is the actual medical appointment whereas an E-visit may be something more akin to a call with education inside of it. An e-visit does not allow for the practitioner to diagnose on the call.
At any rate, it isn’t fully clear what the naming will be a month from now let alone two years from now. This is also the case with telemedicine. Whitney noted that right now telemedicine and telehealth are essentially the same except for semantics. She expects that the healthcare system will create more concrete guidelines as to what is what in the coming years.
What Is Whitney’s Experience With Telehealth?
Over the past four weeks - beginning March, 2020 - Whitney began to build the training platform for a provider’s staff. Whitney has been building out the assessments, systems, and relationship-building skills education that the provider’s staff will need to effectively deliver support remotely.
Whitney has also been figuring out what systems she and her fellow practitioners are allowed to use by law. All systems must be HIPAA compliant which means they must be end to end encrypted so that client’s data is not compromised. That may sound easy, but very few systems out there are HIPAA compliant because it adds complexity and costs to those systems.
You can imagine how confusing this is for practitioners to figure out because telehealth is growing so fast - even if the practitioner doesn’t want it to.
What Is Great About Telehealth?
Certainly telehealth will open up the world to capable practitioners even if they can’t travel or can’t afford to go in-person.
Additionally, with scaled up systems, it’s possible that costs could come down because the cost structures of existing facilities may be able to drop because offices can either go away or be much smaller, thus allowing the cost of the service to move lower.
For the practitioners, telehealth will help them open up better relationships and conversations because they will be forced to communicate much better online because they can’t simply do a hands on assessment and then diagnose without communicating.
What Is Bad About Telehealth?
Right now the confusion of naming, providers, exact services and payment/insurance connections is a negative because telehealth was forced to accelerate faster than it could be properly structured for patients.
Additionally, practitioners cannot get hands on with patients. In Whitney’s physical therapy world, that means that she cannot do things like certain stretch tests, palpating muscles, feeling for temperatures at muscles, etc...That makes her job harder to do, and it gives the patient less information than they would have gotten in a physical setting.
This will be a fascinating growth curve to watch over the next few years.
Thanks so much for reading.
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