After months of disruption and uncertainty, practices are starting to contend with the idea of how to provide patients the healthcare they need, safely. Below, we outline four challenges practices may face when reopening during a pandemic and what many providers are doing to overcome them.
Ensuring safety for both patients and healthcare staff is one of the main priorities physicians share surrounding the topic of reopening. Therefore, practices are creating plans that clearly set and communicate expectations for new policies that can help minimize the spread of the virus. By having these policies set in place before interacting with patients, healthcare staff can execute them and help keep everyone safe.
Although the policies may vary depending on the practice, its specialty, and its patient population, some core recommendations are guiding physicians when reopening. For example, what steps will your practice take to redirect patient flow within your waiting room? Will they be able to sit or touch the chairs in the room? Will they call ahead to be let in when they arrive, and will they be screened for signs and symptoms of COVID-19?
Communicating these changes with proactive outreach can help avoid overwhelming patients and ease them through the transition of the practice’s new workflow. Establishing these expectations can also assist in delivering care to high-risk populations who may be postponing office visits. These specific patient populations may have conditions that need to be addressed and managed, but they could be concerned about whether to visit in-person.
One way to ensure their safety can be deciding which visits should take place in-person or via telehealth beforehand. Not only will they still receive the care they need, but providers can focus in-person visits on the ones who need it most.
At the onset of the pandemic, the demand for telehealth services rapidly increased to ensure providers could still deliver quality care while stay-at-home orders were in place. As practices start to reopen, it has become clear that telehealth solutions are here to stay. Since March 2020, half of 1,800 patients who participated in a poll by Doctor.com had used telehealth services within the last three months and 83% expected to continue to use it even after COVID-19, according to Patient Engagement HIT. This shows a growing positive trend of patient sentiment towards the solution.
While the Centers for Disease Control and Prevention still recommends the “continued use of telehealth to reduce the risk of SARS-CoV-2 transmission,” many providers found that the quick transition to adopt telehealth solutions proved to benefit patients and practices alike. For example, solutions such as chronic care management (CCM) and remote patient monitoring (RPM) can offer providers the ability to deliver quality care without face-to-face interactions, allowing asymptomatic patients to stay safe at home while managing their conditions.
RPM has been proven to have the following benefits:
CCM has been proven to have these benefits:
Practices reopening during a pandemic face several factors including the readiness of the practice, its patients, and its community.
Determining how ready the practice is to reopen can be assessed with the plan mentioned above. For example, will your practice open in phases? Do you plan to have personal protective equipment (PPE) delivered in advance to prevent shortages and has the staff been trained on exposure risks? Have you planned how you will handle staffing and cleaning if an employee or patient or visitor is diagnosed with COVID-19 after being in the clinic?
According to AAFP, a few changes that practices across the country are currently implementing to ensure safety when reopening include:
It’s also important to note that it may be helpful to identify which visits can be done via telehealth, creating a flexible daily schedule, and deciding which employees to bring in the office or work remotely.
Even though many patients are concerned about the safety of returning to in-office visits, you can gauge their readiness, and if an appointment is necessary by implementing a tele-triage program. Depending on their conditions and medical needs, patients contacting the office for an in-person visit may need to be redirected to a telehealth solution, a COVID-19 testing site, or a hospital, according to the American Medical Association. If patients do not have symptoms of COVID-19, many providers are still screening them for symptoms and advising them to wear a face mask before entering the practice.
Complying with your local and state government guidelines is another sign to look for when reopening practices during the pandemic. With this public health emergency, how is the community responding and how has the number of cases changed? For example, it may be helpful to research the number of symptom cases and hospitalizations within the local area. Depending on the data, are there certain procedures and services that are being offered within the community? Does your local specialty society have any advice to offer?
The AMA has developed a fact sheet that describes state-specific delays and where some elective or non-urgent procedures are taking place.
Patient volume has dropped about 60% for practices across the country since the start of the pandemic, causing about a 55% decrease in revenue, according to Medscape. These drastic changes have compelled providers to find new ways to regain their normal patient base including phased opening, modified patient appointments, and using telehealth services.
Many practices have found that adopting telehealth solutions have helped them retain their patient volume and keep them engaged throughout the pandemic. These solutions include CCM, RPM and transitional care management (TCM). These types of visits not only allow you the ability to advance patient outcomes but increase visibility into patient and population trends. It can also help build the relationship and rapport with your highest-risk patient population while they manage their conditions safely at home.
It can also be a good opportunity to implement these types of solutions during COVID-19 since Centers for Medicare & Medicaid Services (CMS) currently pays for virtual visits at the same rate as in-person visits because of the pandemic.
Reopening practices during a pandemic like COVID-19 has its challenges. Whether it’s ensuring patient and staff safety or restoring patient volume, it’s vital that practices set and communicate clear expectations to assist in reopening. With tactics such as executing on reopening plans and continuing to use telehealth solutions, practices can begin to recover in this uncertain atmosphere.
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