How To Start A Telemedicine Practice – in 12 steps

Preparation stage (1-7)

1. Identify the need

Make an assessment of your clinic’s or hospital’s practice and workflows with feedback from frontline staff to identify issues such as: 

• Missed appointments or late cancellations
• Barriers to in-person visits
• Inefficient use of time, clinic or staff resources
• Areas where patient compliance could be improved
• Disruption in continuity of care
• Staff shortages
• Revenue loss

Determine which issues can most likely be addressed by utilising telemedicine. 

2. Decide on the scope of your telemedicine services

Telemedicine is most effective when used strategically, in combination with traditional methods of healthcare delivery. Both staff and patients will benefit from a phased introduction, with ongoing evaluation, rather than rushing to implement virtual care for all patients at once. 

Consider which services best match certain telehealth technologies, and for which patient groups. 

3. Legal and regulatory considerations

Before deciding on a telemedicine solution, it is vital to consider the relevant laws and regulations for your country/state and type of practice, including:

• Licensing laws for practicing telemedicine 
• Data protection and security regulations (such as  HIPAA and GDPR)
• Malpractice insurance cover for telemedicine
• How to obtain informed patient consent 
• Reimbursement – whether insurance or direct payment
• E-prescribing regulations

This will involve liaising with your legal and billing team, and malpractice insurance carrier.

4. Evaluate technology required

Consider what hardware and software is required to upgrade your current technological capacity. If an externally provided solution is preferred, evaluating platform and vendors by asking for a demonstration or trial.  

5. Plan your business case

Starting a telemedicine practice requires an initial financial investment. You will need to create a realistic business plan by factoring in all expenses, and likely return on investment over the short and long-term.

This will involve assessing the availability and level of insurance reimbursement. For direct payments, determine optimal pricing by analyzing your key competitors’ offerings.

6. Design your workflow

Plan your workflows and procedures to balance in-clinic and telemedicine appointments and provide an optimal experience for both patients and staff. 

Points to consider:

• How to set clear patient and provider expectations on the use of telemedicine
• How to ensure telemedicine  is used for clinically relevant purposes and adheres to legal and regulatory requirements
• Which time of day is preferred to schedule telemedicine appointments
• What role each member of staff will play

To streamline telemedicine consultations, you will need to set up:

• Your physical workspace, whether in clinic or at home
• Appointment scheduling procedure
• Automated appointment reminders
• Online messaging feature
• Document uploading, storage and sharing
• Interfacing with electronic health records (EHR)
• Integration of health monitoring devices
• Virtual waiting room with patient check-in and verification
• Online consent process
• Invoicing and reimbursement
• E-prescribing

If using an externally developed telemedicine platform, look for one that has these features built into the platform.

7. Prepare your care team

Successful implementation of telehealth is a team effort. Provide adequate training and ongoing support to frontline staff. Trained staff can then assist patients in setting up their accounts, scheduling appointments, and managing any issues that arise.