Before the World Health Organization declared the novel coronavirus, COVID-19, a global pandemic on March 11, telemedicine was an option some physicians chose to use. Now it’s becoming an essential tool and physicians will want to be sure their EHRs have the capacity of offering virtual visits, says Betty Rabinowitz, MD, FACP, chief medical officer of NextGen Healthcare, an EHR vendor in Irvine, California.
“Prior to this crisis, EHRs were used predominantly to support physicians, extending their reach into more areas or allowing patients more convenience in offering different types of interactions,” Rabinowitz says.
Now, in the midst of this crisis, she says, EHRs can help physicians identify the very sick patients who can be triaged to care centers equipped to deal with them, rather than coming into doctors’ offices.
“I think that virtual visits and telemedicine have just come of age and it couldn’t have been at a better time. I see them as part and parcel of an EHR. In this context, where physicians can see patients without risk to themselves and their front office staff and others in the waiting room, it’s invaluable.”
Fortunately, Rabinowitz says, the Centers for Medicare and Medicaid (CMS) is putting more incentives in place in their new rules for virtual visits. “I think CMS has recognized in their latest rules that there is an enhanced or at least a clear support for allowing their beneficiaries to utilize virtual visits.”
She hopes that all EHRs will be reaching out to physicians to provide enhanced support for telemedicine visits but physicians should not wait—they should check in with their own vendors if there is any doubt.
“In a time of public health crisis, [telemedicine] is clearly an enormously valuable tool that will need to be supported to allow physicians to adopt it without taking on all the risks themselves,” she says.
She does acknowledge that in the long term, a practice probably can’t sustain itself financially with only telemedicine visits, but, she says, “We are well on our way to supporting financially, in terms of reimbursement and codes for these visits, billing guidelines for these interactions.”
While most EHRs have some telemedicine capacity, she encourages physicians to make sure they are on the most recent update for their EHR. “There are a lot of risks with being on an old version, a lot of disadvantages,” she says.
If an EHR does not have telemedicine options, she recommends practices look into working with a third-party vendor to provide those capabilities. However, physicians will want to get clarity on how well that third party integrates with their existing EHR. “A third party is basically creating another universe of truth with their notes and documentation that needs to be transferred into the EHR to document the visit,” Rabinowitz says. “So having integration into your core EHR is very important for population health and patient engagement.”
Ultimately she believes that the coronavirus crisis will bring out the best in EHR technology. “We will be able to help clinicians identify patients with high risks for complications of COVID-19 and communicate with them about prevention. The silver lining, from an EHR perspective, is that all the hard work and blood and sweat that we have put into the EHR is going to shine now and make caring for patients in this crisis much easier and safer.”