Common Telehealth Challenges and How to Overcome Them

By Dori Milburn, BSN, RN

From the onset of the COVID pandemic, the healthcare industry has witnessed a major rise and explosion in the use of telehealth services, as a veritable means to access and deliver care. At the height of the Covid-19 pandemic, between 50% to 80% of medical visits were conducted via telehealth. Patients and providers continue to further adopt it and to embrace technology as a means of care enablement. 

The telehealth industry also continues to expand its suite of offerings from growth in the types of use cases it can support, to a rapidly increasing number of digital gadgets that address multiple patient care needs.  However, along with the expansion of telehealth services, several challenges have emerged around the areas of licensure reimbursement, adoption, EMR integration, and patient access/awareness.

State Specific Licensure Requirements

Each US  State has its own set of unique licensure requirements and regulations. With the virtual nature of telehealth care, it is easily able to cross state lines creating licensure and regulatory implications to those providing the care. Providers looking to expand their geographical patient reach need to familiarise themselves with and follow the specific licensure policies governing telehealth care services within each patient’s state of residence.This can be time-consuming and a monetary hurdle to meet the varying licensure requirements. 

In my previous career, I served as a telehealth nurse virtually triaging and assisting patients in hospitals across the United States. In order to do that effectively, I needed to be licensed in each patient’s individual State, a lengthy and expensive process complicated by the varying State requirements.  During the pandemic and as part of the Emergency Act, many States have relaxed their licensure requirements and allowed those with licenses in their home states to cross state lines virtually, and to treat with no restrictions. As the Emergency Act draws to a close in the impending future, it will be important for providers to watch the States in which they provide telehealth care, and be prepared to meet evolving requirements accordingly.  

Telehealth Reimbursement

One of the biggest telehealth challenges has been the limited reimbursement options and amounts offered by both CMS and Commercial Payers, particularly when compared to traditional on-site visits. 28 states have passed payment parity laws, but there is no apparatus to enforce it. The Centers of Medicaid and Medicare Services have expanded reimbursement during the pandemic but the future of this temporary change is uncertain. As consumerism continues to take center-stage and evidence on the benefits of telehealth services grows, it is reasonable to expect that there will be continued expansion in benefits, coverage, and reimbursement for Telehealth services. 

There is hope that an increasing number of reimbursable codes will continue to be made available by CMS and other payers. At HRS we have reimbursement experts readily available to help clients navigate the process of obtaining reimbursement for RPM and virtual care services We are here to help you not only navigate reimbursement but also assist in finding grant funding for your telehealth initiatives. 

Patient and Provider Adoption and Engagement 

As a result of limited historical incentives and minimal experience in utilizing telehealth solutions, many providers held long-standing concerns regarding the reliability of telehealth services and largely viewed it as a cumbersome addition to their already busy schedules. Lack of optimal reimbursement and stereotypical beliefs on the age of patients that would be comfortable to use telehealth-related technology further limited the likelihood of utility. With limited experience for patients as well, the rates of adoption remained in the low numbers for years. 

In the recent past however, there has been significant growth in adoption rates as both patients and providers were forced to give it a try during the pandemic. Several previously held concerns have been debunked and evidence continues to show that telehealth is a viable and reliable mode of care delivery, able to support both young and elderly patients. 

Internet Access

Other factors that continue to limit adoption include limited access to the internet, experienced particularly in rural areas, as well as poor socioeconomic status, a well studied social determinant of health driver that hinders impacted communities from effectively accessing both telehealth and traditional care.

Electronic Medical Record Integrations

Full integration of Electronic Medical Records (EMR) with telehealth technology is generally a costly and time consuming challenge. Lack of integration demands double documentation which is not only time consuming, but leaves room for error and staff dissatisfaction. The most secure data exchange protocols must also be put in place to achieve HIPAA Compliance and to ensure protection of sensitive data. As the expansion of telehealth continues, there is a need to ensure that new systems of care sustain or improve communication between providers and patients, enhance relationships, and improve health care quality and efficiency. HRS offers a team of technical experts available to support clients with roll-out of partial or full integration into their EMR systems, creating efficiencies and reducing the burden for our clients. 

As evidence continues to indicate, the benefits of telehealth far outweigh the hurdles experienced when adopting  the technology. Enabling providers to overcome these challenges and be able to offer care to their patients while making convenient, patient-centered care more accessible to patients is core to the HRS business. We have a team of readily available experts to help you build a successful Telehealth program that keeps you at the forefront of the health industry’s future. 

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Tags: Patient Engagement, reimbursement, Patient education, Interoperability, Implementation

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