Telehealth and Legislation

With telehealth services in the spotlight, we wanted to get some insight from Dr. Virk on telehealth legislation and what that means for clinicians.

1. What do you think of the call by the White House for $14 five-minute “check-in” calls between Medicare patients and doctors?

There is a great need for out of the office follow-ups and check-ins with patients. This is part of the overall proactive vs. reactive conversation that needs to be had to help fix the many issues with the healthcare system. However, the proposal should be more comprehensive to cover telehealth calls between visits that require more than 5 minutes and have a video component – there is a great deal of evidence that video calls provide a greater level of engagement.  Together with the video we will then be able to tie in other remote care options from devices, apps and sensors adding even greater pieces of information that guide better clinical decisions. We need to create a foundation for care of the future where patients can receive help from providers who they have a relationship with in a way that is convenient, reduces costs and improves continuity. So while I applaud the proposal for starting what is a necessary conversation about change, we need to make strides beyond the current limitations.

2. Are doctors already providing telemedicine for free?

I think that doctors are providing a lot of unbillable hours to our patients. On average, physicians answer 23.7 calls and 16.8 emails daily. While these administrative tasks are important, they take away from our primary objective, which is helping patients. If we don’t create a structure for providers to help their patients when they need it we won’t make the strides to reaching our potential as a healthcare system.

3. What do you think Congress’s plan for 20% patient cost-sharing charge?

While I believe it is important for patients to share in the cost of healthcare (as I believe healthcare change will be partly driven by them if they feel more invested) and I am more critical of where our healthcare spending is going, starting at 20% may be a bit too high. The shift to increasing patient responsibility for where they spend their money should be more gradual and eventually should be even greater than 20%.

4. What do I think if a telehealth bill does pass?

Any bill that advances the ability for people to get care remotely from doctors who know them is a step in the right direction. Putting structures in place that help patients access care for their needs between visits and incentivizes clinicians to improve continuity will lead to cost savings through reducing inefficiency and wasteful spending on reactive medical care that could have been avoided. I can’t tell you the number of epilepsy patients who went to the ER and ended up admitted to the hospital. I could have helped had they been able to reach out to me the week before their event and when they knew their medication was not working. We need to put legislation in place that allows these relationships to flourish, rather than the structures we currently have which are creating barriers.

5. What do you think of telemedicine as a form of health care treatment?

I believe there’s a tremendous need for telehealth and patient-driven technology in healthcare today. I think the way online banking simplified the way we interact with our banks, we have an opportunity to create a similar circumstance in healthcare making everyone’s lives easier while simultaneously improving g the quality of care. Implementing telehealth models in our practices can empower our patients to take control over their health by removing many of the barriers of care – taking time off work, travel restrictions, and more. By taking the simple medical visits (Level 1-3 CPT code visits, level 1 being simplest, level 5 being most complex) and scheduling them as video calls also allows us to keep exam room space open for more complicated patients who need time and a physical exam.

Telehealth technology also integrates with many innovative technologies to capture measurements that were once restricted to in-office visits – blood pressure and heart rate, blood sugars and oxygenation, weight and more. These data points can add tremendous value to the story during an online video call between a patient and their doctor, like adding details to a story.

Telemedicine is a key component to the future of healthcare and I strongly believe that we can provide better care and improve the relationship we have with our patients.