Primary Care | PRECISECAREMEDICAL

 No matter how you slice it, paper-based consents stand in stark contrast to the priorities of a proper Telehealth strategy. A complete telehealth strategy for hospitals must include EHR-integrated solutions, like Access eForms Impression, which paves the way for a paperless and contactless check-in process as part of a “virtual waiting room” experience for patients who must visit the hospital.

 Are patients required to print and scan in the consent form, or can they access it through their mobile device?

 Are patients required to come into the hospital to fill out the initial consents or drop them off? Do they have to spend an extended period of time in the waiting room?

 Does your HIM staff have to manually retrieve and archive the form into the EHR patient chart?

 Can staff easily access, update, and send forms to recipients? Can clinicians easily customize the form with relevant content?

 Allow your patients to electronically complete and sign forms at-home for a contactless check-in as part of your pre-registration or complete telehealth strategy

 WHAT IS ACCESS ANNOUNCED THE RELEASE OF IMPRESSION THE LATEST VERSION OF ITS PAPERLESS, WEB BASED EFORMS SOLUTION

 “Impression” is part of the Passport offering by Access that converts existing paper-based processes into EHR integrated paperless solutions. We have designed “Impression” to complement your telehealth strategy by enabling your hospital to extend electronic Pre-Registration forms to your patient in advance of their visit. Patients can electronically sign all Pre-Registration forms in the comfort of their own home in advance of their appointment. When patients arrive to your hospital, they are met with a contactless check-in process that is safer and faster. Not only does this facilitate a complete telehealth strategy for your hospital, it also provides the first “Impression” you want your patients to experience.

 Hospital staff access “Impression” within their EHR system, and select the desired Pre-Registration eForms to send to the patient.

 The patient receives a secure email and SMS text message for dual-authentication purposes. They then electronically sign and complete the eForms.

 The completed electronic Pre-Registration forms are automatically indexed directly into the patient’s chart within the hospitals ECM system.

 Security features – Follows HIPAA and PIPEDA regulations; offers signed BAA compliance for protected health information

 Workflow features – Invite patients via email and SMS, patient self-scheduling, triage secure webchat, cancel Appointments (patient), intake chief complaint, post-visit survey, patient visit summary notes, patient portal access, provider scheduling, file / document upload to patient portal

 Workflow features – Third party workflows, scheduling, advanced notification settings, custom appointment types and routing, PredictiveIQ AI, patient self-scheduling, on-demand queue

 Workflow features – Unlimited live video visits, scheduling, automated appointment reminders, practice branded web application and communications, patient mobile apps

 Telehealth consultation locations for hospitals vary based on convenience for clinicians, department priority, space availability, and considerations for future expansion. Some providers may also have the option of delivering virtual care from their homes due to stay-at-home orders or flexible working arrangements, while others may work offsite, at a central location within the hospital, or within a specific department for convenient access. Telehealth Room Location StrategyIn any case, environmental factors such as space needed and the types of consultation to occur–which all effect room design and location–must be outlined prior to choosing a workplace.

 According to Telemedicine Workplace Environments: Designing for Success, hospitals implementing a virtual care solution should consider converting existing spaces, rather than building a new space, for telemedicine. Unused office space, previous clinical exam rooms, or even a repurposed storage room, can be potential locations. In any scenario, if the potential telehealth location meets the requirements for space, lighting, ambiance, ventilation, and has good proximity to clinical staff and hardware requirements, it should be suitable for virtual visits.

 Choosing strategic locations for telehealth positively impacts a virtual care program. For example, if you are implementing pediatric telehealth, consider visible locations within that department so that patients and clinical staff are consistently aware that virtual care is an option. You may also consider placing a telehealth consultation room near out-patient check-in to gain the most exposure. If your hospital has an overloaded ER, consider placing your telehealth within its vicinity so that patients know they can schedule an eVisit to check-in. This may to deter unnecessary ER admissions and give clinicians the opportunity to direct patients to more appropriate services. In any case, make sure your virtual care examination rooms are near clinical staff.

 “Whether a patient is seeing his or her physician in person or via telemedicine, the same standards of care must be maintained.”

Virtual Care

 For telehealth outside of the clinical environment, including those services administered from a provider’s home, many of the same best practices apply. ATA’s Core Operational Guidelines for Telehealth Services Involving Provider-patient Interaction further states,

 “Healthcare professionals providing telehealth services should (always) ensure? that workspaces are secure, private, reasonably soundproof, and have a lockable door to prevent unexpected entry. Efforts shall be made to ensure privacy so provider discussion cannot be overheard by others outside of the room where the service is provided.”

 Whether you are building a new telehealth space or repurposing an existing room within your hospital, it is a good idea to create a floor plan to help determine your workable space. You will want to configure elements such as office furniture and different types of equipment needed to ensure it is optimal for your eVisit needs.

 If patients will be entering the room at any point, you will need to make sure there is ample space to navigate, especially in the event they have specific accessibility needs or are accompanied by medical equipment. You will want to provide adequate ventilation, filtering and heat control. Telemedical equipment, including lights, computers, and docking stations, all generate heat and can be damaged by dust particles. In addition, the space should be free of any distracting outside noise and the room acoustics should facilitate clear sound and two-way communication. Visually, a background with a brightly painted wall may not show well on camera and can be distracting, so be sure to paint the room in neutral, soothing tones or use a greenscreen. According to Vantage Technology Consulting Group in Healthcare Design Question – What’s the Impact of Telehealth on the Design of Exam Rooms,

 “We implemented green screen technology on a project for the Mayo Clinic where the doctors were in a different country and time zone but didn’t want to emphasize that fact to the patient. Essentially, this turns the telehealth room into a mini-production studio.”

 According to American Telemedicine Association’s publication, Let there be Light: A Quick Guide to Telemedicine Lighting, which is a go-to resource for virtual care lighting and techniques, appropriate lighting is linked to patient satisfaction, which contributes to clinical engagement and reimbursement.

 Incorporating a natural look and feel through lighting and room design “humanizes” a virtual visit, which is important in promoting an overall positive experience, particularly for new or less familiar patients. ATA suggests the following:

 Incorporating a natural look and feel through lighting and room design “humanizes” a virtual visit, which is important in promoting an overall positive experience, particularly for new or less familiar patients. ATA suggests the following:

 Natural light – This is preferred; however, it is often impractical in a clinical environment.

 Natural artificial light – This is recommended as it is an alternative to daylight, as it is a warm white light. 3200K-4000K lumens are optimal. Avoid lighting the space with colored lightbulbs or LED lighting, — the blue hue causes an unnatural appearance.

 Fluorescent – This is preferred if done properly. Use cool white to reduce heating. Use 3500K lumens at home or 5000K lumens in a commercial setting. Use lighting fixtures specifically designed for videoconferencing if possible.

 100% indirect lighting is recommended as it allows light to be more evenly distributed without creating hotspots. Multiple frontal light sources placed for vertical illumination at 35-40% above eye-level to create a 3D effect is recommended. Fill lighting can remove shadows and balance color. You will want to void downlighting, as it can create facial shadows. The graphic below provides an appropriate lighting design for a telehealth provider’s space.

 According to American Telehealth Association, “internet-based video conferencing software programs should provide such services at a bandwidth of at least 384 Kbps in each of the downlink and uplink directions. Such services should provide a minimum of 640×480 resolution at 30 frames per second.” While there is a vast array of cameras that can be used for hospital telehealth, we will focus on a few video conferencing camera options outside the camera native to your laptop or tablet.

 As hospitals look towards the “post COVID-19” future, and shift focus to increase operational efficiencies and improve patient safety measures, the old proverb “necessity is the mother of invention” holds true more than ever.

 Patient care preference, dictated by necessary safety measures, has obligated hospital leaders to completely recalibrate how they approach healthcare visits, pushing mobile-based solutions such as Telehealth, Home Monitoring, Virtual Waiting Rooms and Virtual Visits; the list goes on and on…

 We here at Access hope this information has been helpful by providing useful information that can guide your healthcare strategies and efforts in this new era.

 Before the global pandemic, there was increased conversation in the U.S. about the growth in virtual care, due in part to advances and ubiquity in technology, but also because the Centers for Medicare and Medicaid Services (CMS) reimbursement regulations were finally catching up to available technology. According to a survey conducted by HIMSS Analytics (2017), telemedicine use rose from 54% in 2014 to 71% in 2017. Now, with the COVID-19 pandemic, we are hearing even more about the explosion in telemedicine. Regulatory waivers and the potential benefits to both patients and clinicians have fostered unprecedented growth and, importantly, acceptance (and even preference) of virtual care over face-to-face office visits. According to one report, telemedicine usage increased as much as 4,330% in the few weeks after the pandemic was recognized (Mann et al., 2020).