As a result of the COVID-19 pandemic, many clinicians are now adapting their practices to meet the needs of patients outside of a traditional office setting. Telemedicine has historically been used as an emergency response tactic to offset overutilization of health services.1 Through its capacity for effective remote assessment and triage of patients, telemedicine may decrease the number of unnecessary in-person visits, which frees up critical hospital space.1
Telemedicine services can address a number of patient needs, from acute care to primary care, while reducing time constraints. Studies suggest that telemedicine visits may be as effective as in-person consultation,2-3 and patients report high satisfaction with the quality of the communication with their clinician and their perceived time saved.4-5
In the context of community-based clinics, researchers found that patients receiving care via telemedicine were 13% less likely to miss their appointments compared to in-person absences.6 Patients with chronic illnesses who need frequent appointments reported improved care continuity when meeting with their provider virtually, as measured by higher rates of completed appointments and slightly higher rates of follow-up visits.6-8 Ongoing telemedicine visits may also reduce unnecessary prescriptions and lab test ordering,8 which can save the patient time and money.
Is telemedicine feasible as a functional medicine practitioner?
In the following video, IFM Certified Practitioner Cynthia Worden, DO, discusses her practice model and the advantages of telemedicine, for both patient and clinician.
Creating an Effective Telemedicine Practice
Functional medicine stresses the importance of a strong patient-practitioner relationship, which can facilitate the transition to telemedicine. Many touchpoints of the diagnostic workup and medical interview can be done virtually, including filling out the functional medicine timeline and matrix. Follow-up appointments can be useful to track the progress of a lifestyle or dietary change and do not require much additional time when employed through telemedicine. Clinicians have many options for conducting virtual appointments through video or phone calls, secure messaging via patient portals, and remote patient monitoring. Before adding telemedicine to your practice, here are a few key questions to consider:
Is the software I’m using compliant?
Many telemedicine platforms offer integration with patient electronic medical record portals and secure encryption to protect personal health data. Choose a software that is appropriate for the type of visit you will conduct and confirm that it meets both state medical board and HIPAA regulations. There are a variety of telehealth service providers out there; make sure that the platform you choose features a user-friendly interface that integrates with your existing software and matches your technology skill level.
Can I see patients from out of state?
Practicing telemedicine increases access to care for patients across the country, but every state has different policies and may require additional licensing. Many states make exceptions for out-of-state providers to render care specifically via telemedicine. You will also need to consider whether or not you have the authority to write prescriptions in other states and how you obtain consent for treatment as these laws also vary state to state. Review the cross-state licensing requirements from your state’s medical board.
How can I increase my practice efficiency?
Decide what kinds of patients you will see for telehealth visits. If they will require lab testing or in-depth examination, an office visit may be simpler. If they are receiving follow-up care or medication management, or present with conditions that can be easily diagnosed remotely, telemedicine may be more suitable. Allow patients to book appointments online and establish time boundaries for the type of appointment and care required. Use digital intake forms to maintain records and other electronic tools to track, analyze, and assess patient data. Automating your practice operations using a telemedicine platform can save you time and reduce the burden on your front office staff. IFM partners with LivingMatrix, a cloud-based patient information management application that works in tandem with existing electronic medical records to increase the efficiency and effectiveness of functional medicine practices, including telemedicine.
Adopting telemedicine services into a practice model may allow clinicians to expand the scope of their practices without having to relocate. This allows clinicians to scale the growth of their practices at a rate that is comfortable for them while also providing greater access to care for patients who live in rural areas. Telemedicine is a convenient way to streamline appointments with patients, and the range of digital therapeutics that can be offered has potential for significant improvements to heath and quality of life outcomes in the future.
- Portnoy J, Waller M, Elliott T. Telemedicine in the era of COVID-19. J Allergy Clin Immunol Pract. 2020;8(5):1489-1491. doi:1016/j.jaip.2020.03.008
- Speyer R, Denman D, Wilkes-Gillan S, et al. Effects of telehealth by allied health professionals and nurses in rural and remote areas: a systematic review and meta-analysis. J Rehabil Med. 2018;50(3):225-235. doi:2340/16501977-2297
- Bashshur RL, Howell JD, Krupinski EA, Harms KM, Bashshur N, Doarn CR. The empirical foundations of telemedicine interventions in primary care. Telemed J E Health. 2016;22(5):342-375. doi:1089/tmj.2016.0045
- Polinski JM, Barker T, Gagliano N, Sussman A, Brennan TA, Shrank WH. Patients’ satisfaction with and preference for telehealth visits. J Gen Intern Med. 2016;31(3):269-275. doi:1007/s11606-015-3489-x
- Kruse CS, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open. 2017;7(8):e016242. doi:1136/bmjopen-2017-016242
- Adepoju OE, Chae M, Liaw W, Angelocci T, Millard P, Matuk-Villazon O. Transition to telemedicine and its impact on missed appointments in community-based clinics. Ann Med. 2022;54(1):98-107. doi:1080/07853890.2021.2019826
- Alkilany R, Tarabichi Y, Hong R. Telemedicine visits during COVID-19 improved clinic show rates. ACR Open Rheumatol. 2022;4(2):136-141. doi:100 2/acr2.11372
- Reed M, Huang J, Graetz I, Muelly E, Millman A, Lee C. Treatment and follow-up care associated with patient-scheduled primary care telemedicine and in-person visits in a large integrated health system. JAMA Netw Open. 2021;4(11):e2132793. doi:1001/jamanetworkopen.2021.32793