Virtual visits have long been used by healthcare providers as a tool to reduce cost of care, improve clinical efficiency, and enhance patient engagement. Over the past year, during the COVID-19 pandemic, virtual visits have become increasingly intertwined into patient care plans, proving essential to maintaining care access through public health safety precautions and restrictions. Recent studies have shown that more patients than ever before are willing to try virtual visits, leading more providers to view virtual visits as an essential service line

For organizations currently operating a telehealth program, or for those considering deploying telehealth services, it’s important to understand what specialty care providers can easily be incorporated into the telehealth program and how. For the purposes of this blog, we will focus on the different specialty care providers who can be incorporated into telehealth and RPM through virtual visits.   

Before diving into specific specialty care areas, it’s important to quickly review best practices for offering virtual visits.

  • Train all clinicians how to perform virtual visits and document each visit within the telehealth and RPM platform your organization is using. Any clinician performing a virtual visit should feel comfortable using the technology, including making small adjustments to their camera and audio. 
  • Create a private space for clinicians to perform virtual visits. Not only will the organized, quiet space allow the clinician to focus during the visit, but it will reassure patients that their visit is private.   
  • Coordinate patient schedules and visits (both in-home and virtual) across providers. Avoid multiple visits being scheduled for the same day so as not to overwhelm patients.  
  • Incorporate virtual visits from the start of care based on initial patient assessment. This will prioritize virtual visits as an essential part of the patient's care plan and help coordinate care.
  • As part of best practices for patient installation visits, review both the technology and process for virtual visits with patients when you instruct them on the telehealth and RPM platform. If possible, conduct a test visit with the patient and be sure to leave ample time to answer questions. 
  • Schedule the virtual visit and follow-up with the patient with a reminder call prior to the visit.  


Home Therapy Specialists 

Virtual visits allow home health providers to connect patients and clinicians face-to-face and in real-time, extending care services while increasing clinical efficiency and reducing cost of care. Skilled nursing (SN) virtual visits are most frequently utilized by home health agencies, used to augment in-home visits and provide an additional layer of support to patients. During SN virtual visits, clinicians should focus on engaging the patient to reinforce positive behaviors, evaluating the patient’s self-management skills, assessing the patient’s current health status, and identifying any new or worsening issues the patient is facing. 

Though the most common, SN virtual visits are not the only virtual visits that can be provided through home health to enhance patient care. Home health providers can incorporate telehealth physical therapy, occupational therapy, social work, and speech therapy.  

Incorporating Physical Therapy and Occupational Therapy 

Home health physical therapy focuses on basic exercises to help patients recover from a hospitalization and regain their strength. A particularly important aspect of home health physical therapy that can be performed through virtual visits is wound assessment and recovery. 

Occupational therapy is a crucial element to patient recovery, as it focuses on assisting patients in performing the everyday activities that allow them to maintain their independence. These activities can range from getting out of bed to showering to cooking. Performing occupational therapy virtual visits can help improve a patient’s self-esteem, reduce their stress level, and enhance communication between a patient and their providers. 

During an initial assessment, after the patient has been admitted to home health, the therapist should determine if the patient is eligible for both virtual and in-home therapy, and incorporate their findings into the patient’s plan of care. Frequently, patients initial visits are provided in-home and virtual PT/OT visits are later incorporated as in-home visits are reduced. 


Incorporating Social Work 

Medical social workers (MSW) are patient advocates. MSWs support patients in multiple facets, organizing meal deliveries, transportation services, counseling sessions, and more. With restrictions placed on social work visits for home health episodes of care, virtual visits provide a low-cost solution to increase communication between patients and MSWs to ensure they are prepared for discharge from home health and are set up with long-term services they may require. 

Download HRS’ Virtual Visit Guide for Specialty Care

Incorporating Speech Therapy

Particularly during the COVID-19 pandemic, due to social distancing and other safety measures, home health agencies have transitioned speech therapy in-home visits to virtual visits. Speech therapy helps patients with cognitive decline, communication issues, or difficulty swallowing. Similarly to other specialty care services, providing speech therapy virtually allows for greater involvement from caregivers, including additional training and education. Involving caregivers through virtual visits helps patients continue practicing after the speech pathologist has gone, and continue making progress between visits.

Bereavement and Counseling Specialists 

Grief counseling and support services are essential to hospice care patients and families. The end-of-life process can cause severe anxiety, depression, loneliness and confusion for both patients and caregivers. Hospice incorporates individual and family counseling to provide patients and caregivers with the tools to cope with grief and emotional distress. Uptake of virtual grief counseling has increased during the pandemic as hospice providers attempt to reduce risk of exposure to COVID-19, but hold numerous benefits beyond the pandemic.   

Given the multiple support services offered throughout hospice care, and the prominent role of caregivers in hospice care, virtual visits can relieve the burden on healthcare providers and families. For caregivers specifically, virtual visits ease this burden by allowing participation in important meetings and sessions with clinicians and their loved one’s care team. For healthcare providers facing increasing staffing shortages and an influx of patients, virtual visits relieve burden by decreasing windshield time, reducing patient no-shows, and cutting overhead costs.  

In addition to bereavement care services, hospice providers can leverage virtual visits to resolve medication disputes, provide educational information, assess and control symptoms, and provide pain relief.

Incorporating Bereavement Care

Bereavement care services begin with an initial assessment of family members, performed virtually, to determine where professional assistance can be offered and will be beneficial. Following an initial assessment, counseling services can be provided for weeks or months depending on the initial assessment and family needs. To participate in virtual visits patients and families use tablets provided by their hospice care team or their own personal mobile devices. At HRS, caregivers can engage in virtual visits, and in their loved-ones broader care plan, through a mobile application, CaregiverConnect

Over the past year, research on consumer demand for virtual visits has shifted from “patient accept virtual visits as part of their care” to “patient expect virtual visits as part of their care.” This demand for virtual visits has increased across the healthcare industry, impacting providers of all specialties. Throughout 2021, telehealth and RPM vendors must strive to assist providers to incorporate specialty care into existing telehealth services, creating an exceptional patient experience and seamless continuum of care. 

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