Columnist Neville Bilimoria explores the high Court drama revealed last week.
Neville Bilimoria
Neville Bilimoria

I’ve been promoting, writing and speaking about telehealth in healthcare for over 20 years now.  But something has happened over the past year: a sea change. 

I recently had the pleasure of speaking at the 72nd AHCA/NCAL Annual Convention & Expo on “Telehealth In Long-Term Care:  A New Era?.”  But what I realized by attending that convention in D.C. was that now the long-term care industry is really, finally, beginning to embrace telehealth like never before.

This is for two main reasons. First, COVID-19.

Yes, the virus has a silver lining. More people, the general public and maybe even you, were forced to utilize telehealth to access medical care during the pandemic due to social distancing parameters and closed COVID-19 hospitals, etc.

When COVID-19 forced people to use telehealth and to make telehealth appointments under relaxed HIPAA and reimbursement rules that made it easy, safe and worthwhile for providers, something amazing happened: patients loved it! They didn’t have to wait in line at a doctor’s office, they didn’t have to (and didn’t want to) sit in a crowded doctor’s office waiting room with potentially COVID-19-infectious people. And the care they received was quick and efficient.

The second reason why the long-term care industry is embracing telehealth is because long-term care operators are now flooded with more and varied choices for telehealth as was evidenced at the recent convention and expo in D.C. When there, I was amazed at the telehealth exhibits and other digital platforms available to assist nursing homes and assisted living facilities on the showroom floor. There were more technology solutions at the convention than ever before, in spades. 

This signals that nursing home operators are becoming more comfortable with technology in healthcare. Instead of being afraid of an uncertain techno world, more and more facilities are embracing telehealth than ever before, and who can blame them…

After all, telehealth platforms for skilled nursing care are not as daunting as they were before.  The set-up is easier and the interoperability and customization for nursing homes are getting better — the technology is improving.

Also, have you heard of the current staffing shortages in the industry? Of course you have, and we all know that the pandemic has made staffing exponentially harder. So, for example, if a telehealth company can tell you that it can shave minutes off of a provider taking vital signs per resident, why wouldn’t that be attractive to help solve the staffing shortages?

Moreover, long-term care providers realize that these telehealth platforms are now, today, easier to implement than ever before. You still need proper contracting to protect you should something go wrong, and to guard against your liability. But the ramp up time for telehealth platform implementation has been significantly reduced for nursing homes compared to prior years or compared to implementing an electronic health record, which was daunting for facilities years ago. That ease of implementation makes telehealth that much more exciting and attractive for long-term care providers today.

Finally, we talked about saving staff time, but when telehealth couples saving staff time with higher quality (and statistically keeping more residents out of the hospital readmission process), it’s a no-brainer. Now telehealth platforms can better care for our residents because we have more data on each resident, which helps facilities to be more proactive with care and to prevent illness and bad outcomes before they even happen. 

Also, the speed advantage at which folks are notified of a resident’s condition on telehealth platforms is often overlooked.  No more nurses or CNAs missing a change in condition. Now, with telehealth platforms, the nurse can be notified quicker — but also the physician, the administrator, director of nursing and the physician assistant can be notified instantly by the telehealth platform when there is a change in condition or other warning signs, so there are fewer chances of a resident falling through the cracks.  

But embracing telehealth doesn’t mean you should blindly embrace telehealth contracts. Making sure the nuts and bolts of your contract are in place is important to reduce your liability. Here is my short list of items that nursing homes and assisted living facilities need to focus on in negotiating any fair telehealth contract:

  • Pay attention to the Limitation on Liability clauses;
  • Pay attention to the Indemnification provisions;
  • Pay attention to the HIPAA Privacy and Security Rule compliance, as well as cybersecurity insurance issues;
  • Pay attention to any statements of work, and the details in them. In particular, what are the guaranteed service levels (uptime) for the telehealth system or platform for your facility?;
  • Pay attention to arbitration clauses for any disputes;
  • Focus on timelines, support, and maintenance of the telehealth platforms.

While these are just some of the many other issues we consider when telehealth contracting, the above are a good start. A qualified attorney should be used to review facility telehealth contracts for other important contract items and issues that are too numerous to mention here. 

But overall, the telehealth benefits and advances in technology are changing the tide from fearing technology to embracing it. After all, if the top problems are staffing and operating income, a telehealth solution can help solve those issues for facilities, while improving quality at the same time. 

I’ve been touting the benefits of telehealth for years, but now providers are realizing on their own that telehealth is needed now, more than ever before.  

 Neville M. Bilimoria is a partner in the Chicago office of the Health Law Practice Group and member of the Post-Acute Care And Senior Services Subgroup at Duane Morris LLP; [email protected].

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.