Telemedicine Expands Healthcare Access for Chronic Pain Treatment

Telemedicine Doctor Visits Meet Patients’ Remote Needs

by Dr. James Fricton

 

Telemedicine services are real time, remote, face-to-face health care video or visual interactions for our chronic pain patients.

 

Minnesota Head and Neck Pain Clinic (MHNPC) telemedicine expands healthcare access to key pain management information, gain diagnostic and remote patient consultations from the comfort of you home. The current COVID-19 pandemic infection is causing higher stress levels for people throughout Minnesota and the world. Stress causes an increase in the severity of pain conditions. The MHNPC has always followed the core values of providing access to high quality safe-care for our patients.

 

What is Telemedicine?

 

Telemedicine refers to the medical practice of caring for patients using remote access. It is also often referred to as a TeleMed visit. This means that the provider and patient are not in physical physician-to-patient space with each other. Modern technology has enabled doctors to consult patients by using HIPAA compliant video-conferencing tools.

We want to continue this for all of our patients to avoid going to the Emergency rooms or other health professionals un-necessarily to deal with their pain. Thus, to ensure access to safe care from our patients, we offer telehealth visits for those patients with pain conditions such as TMJ disorders, headache, neck pain, orofacial pain, and others. Here is a summary of the benefits and steps involved in use of telemedicine visits.

 

Are Telemedicine Technologies Capable of Being HIPAA Compliant?

 

Telemedicine technologies include the use of secure HIPAA compliant electronic communication and information exchange between a healthcare provider in one location and a patient in another location. Telemedicine does not consist of audio-only communication, but should also include the use of video technology which allows the healthcare provider to match the quality of in-person, health professional-patient encounters. Modes of communication used by healthcare providers to interact with patients comply with HIPAA regulations and allow for verification of the individuals transmitting and receiving information.

Telemedicine has the potential to improve access to medical care, particularly in situations such as this pandemic of the COVID-19. It will facilitate health professional-patient communication, monitoring treatment of chronic conditions, and help ensure patient-safety and privacy of health information.

At our clinic, we implement measures that safeguard the privacy and integrity of the care they provide to patients. We also ensure that their recommendations and treatment plans are feasible based on the resources available to our patients. It is also important that telemedicine providers get feedback from their patients regarding what they expect during these encounters and the aspects of telemedicine in which they wish to participate.

 

What are the Advantages of Telemedicine Over Traditional Patient Care?

 

  • Shorter wait times: With the additional option of Telemedicine appointments, you may gain faster access to our team of pain specialists. For new patients or complex patient pain management this helps when the need is urgent and there is a pain physician shortage.
  • Easy Pain Patient Care: Patients can receive expert care accesssed from the comfort of thier couch when risks of having a contagious illness or person-to-person contact are present. Sometimes less travel also eases the patient family and support systems.
  • No Greater Cost to Patients: The typical costs for Telemedicine visits are similar to traditional health care office appointments and are commonly covered by medical insurance policies.

 

Telemedicine policies and procedures address the following:

 

  • State licensure
  • Establishment of the health professional-patient relationship
  • Evaluation and treatment
  • Informed consent
  • Continuity of care
  • Referrals for emergency services
  • Medical record documentation
  • Privacy and security of the patient records and exchange of information
  • Disclosures and functionality of online services
  • Self-management training with telehealth coaching support, and prescribing of medications, as needed.

 

Each of our MN Head and Neck Pain Clinic locations follow the Federation of State Medical Boards (FSMB) guidelines for the practice of telemedicine to ensure that telemedicine E-Visit meets standards consistent with the current practice of healthcare. We will ensure that we follow these guidelines and all state laws since some states require a pre-existing relationship or an in-person physical exam, in addition to an exam conducted via telemedicine.

 

A. Pain Evaluation and treatment

 

The standard of care for practicing telemedicine is the same as that of traditional in-office health care. Ensure that your evaluation, consultation and prescribed treatment are all thoroughly documented in the patient’s electronic health record (EHR). Here are the steps we will follow to help our patients gain access to care for pain conditions.

 

B. Informed consent

 

State requirements for obtaining informed consent to practice telemedicine vary. The FSMB recommends that health professionals obtain informed consent for using telemedicine technologies (e.g. video-conferencing, e-visits, or text-messaging). The informed consent will be sent to you via email prior to the visit and each patient needs to respond back with a statement of: “Yes, I do consent to a Minnesota telemedicine (video/phone) visits to be performed by Minnesota Head & Neck Pain Clinic and bill my insurance for these visits consistent with in-person visits.”

 

C. Continuity of pain treatment care

 

Follow-up care should be readily available to all of our patients, either from the health professional conducting telemedicine or a provider designated by the health professional. If the patient-health professional encounters are done exclusively using telemedicine, then all documentation must be accessible to the patient consistent with in-person visits. Patients may also request that the information be provided to their other healthcare providers.

 

D. Referrals for emergency pain care services

 

We also have established an emergency plan that can be implemented when the information obtained (via telemedicine) indicates that the patient requires referral. The health professional will provide the patient with an emergency plan and including a formal, written protocol in the EMR that is appropriate to the services being rendered via telemedicine.

 

E. Medical records

 

The medical record for telemedicine are consistent with standards required for documentation in traditional in person care. Medical records for telemedicine include copies of all patient-related electronic communications, laboratory tests and results, evaluations and consultations, prescriptions, records of past care and any instructions produced in connection with telemedicine.

 

F. Privacy and security of the patient records and exchange of information

 

All applicable federal and state legal requirements for the privacy and security of medical records and health information are met or exceeded. This includes compliance with HIPAA, HITECH, and state privacy, security, confidentiality and medical record retention rules and laws. All data transmitted by healthcare providers electronically (audio, video, written etc.) should be sent via use of encryption that meets current standards. Devices used to transmit protected health information should have up-to-date security software to guard against cyber-attacks.

 

G. Self-management training with telehealth coaching support

 

We provide telemedicine support for Minnesota Head &NecK Clinic patients to learn self-management action plans to relieve pain conditions. If needed, we may recommend additional services at the on-line patient engagement pactforpain.com platform. Once enrolled by your provider and matched to one of our health coaches, you will receive an email to register, complete the risk assessments, and schedule a visit with the telehealth coach. You can begin learning how to reduce the factors that cause your pain. Key information to help relieve pain and prevent chronic pain and addiction is provided. 80% of our success in long-term relief of pain is with self-management strategies. If you have not enrolled yet, please talk to your provider.

 

H. Telemedicine expands healthcare Access When Prescribing Pain Medications is Needed

 

When prescribing via telemedicine, we take all precautions needed to ensure patient safety in the absence of a traditional physical examination including an informed, accurate and error-prevention practices. Medications prescribed using telemedicine technologies include only those medications is currently on or considered safe by the state medical or dental board.

In addition, any medications prescribed are done at the discretion of the health professional. We use our current EMR to ensure the availability of medications in the patient’s geographic location. Care is coordinated with what other providers are offering the patient. We will not prescribe medications that require close monitoring or have a high risk of leading to side effects in a patient’s condition. This is particularly applies if the patient is not in close proximity to a health facility or healthcare provider.

 

Medicare and Health Insurance Coverage for Remote Healthcare E-Visits

 

Many health plans have expanded its coverage of telehealth services to respond to the current Public Health Emergency of COVID-19. These services expand the current telehealth covered services, to help patients have access from more places (including patients home), with a wider range of communication tools (including smartphones), to interact with a range of providers (such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social worker).

During this time, patients will be able to receive a specific set of services through telemedicine including evaluation and management visits (common office visits), mental health counseling, severe sleep disorder help, self-management training, telehealth coaching, and preventive medicine counseling and screenings. This will help ensure patients are able to visit with their doctor from their home, without having to go to a doctor’s office or hospital, which puts them and others at risk of exposure to COVID-19.

  • Patients may be able to communicate with your doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit. Medicare and other health plans pay for “virtual check-ins”—brief, virtual services with your established health professional where the communication is not related to a medical visit within the previous 7 days.
  • Medicare and other health plans also pay for patients to communicate with doctors using online patient portals such as www.doxy.me without going to the doctor’s office. Like the virtual check-ins, you must initiate these individual communications.
  • If patients live in a rural area, they may use communication technology will also allow you to have full visits with the doctors and get services using a real-time audio and video communication system at the site to communicate with a remotely located doctor or certain other types of practitioners. Medicare and other plans pay for many medical visits through this telemedicine benefit.

If you are interested in a telemedicine visit with your pain doctor, listed below is a clear path you can take for our viritual healthcare access.

 

Steps to Gain a Telemedicine E-Visit

1. Start by calling our clinic front desk staff at MHNPC to schedule.

2. The scheduling coordinator will contact you on the day of their visit to make sure that we have your medical information, health history, and reason for visit up to date. Then the staff will describe how the visit works and check you in for the visit.

3. You will receive an email from your provider with an “invite” using the specific providers link.

4. Our Treatment Coordinator will contact you by telephone and ensure that you know how to access our virtual visit waiting room. Once you log in, the staff can help to make sure you activate your video and microphone.

5. The Treatment Coordinator will complete a standard intake just as they would for an in-office visit.

6. The doctor will then open up the telemedicine visit with you and begin our usual consult or office visit with you. We want to make sure the visit meets the expectations and needs for each patient to continue to help improve and heal the pain condition.

What should I expect during a virtual doctor consultation?

We make every effort to provide telemedicine visits that follow quality core principles including:

  • Practices implemented should ensure patient-safety
  • Communication methods are secure and effective
  • Treatment options recommended should be appropriate and practical
  • Self-care strategies are implemented with each patient
  • Mechanisms that allow for patient feedback and testimonials are in place
  • Strategies are being taken to ensure patient satisfaction

Feel free to call our front desk and our pain clinic office manager will align a call from a pain specialist that aligns with your needs. We want you sleep well at night by knowing that we are here for you!

Summary

The practice of telemedicine at the Minnesota Head and Neck Pain Clinic is consistent with current standards that exist for traditional medicine. Telemedicine visits are intended to improve the accessibility and delivery of healthcare but, based on inherent limitations, is not expected to completely replace our in-person visits.

Schedule your E-Visit pain consultation by calling (763) 577-2484 or Request A Telemedicine Visit

 

About the Author

James Fricton DDS, MS, co-founder of the clinic, takes great joy in helping patients with simple to complex head, neck, orofacial, and TMJ pain conditions as well as obstructive sleep disorders. He also founded pactforpain.com.

References:

Federation of State Medical Boards’ Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine – www.fsmb.org/Media/Default/PDF/FSMB/Advocacy/FSMB_Telemedicine_Policy.pdf

American Telemedicine Association – www.americantelemed.org/about-telemedicine/what-is-telemedicine#.V_JJQE0VCic

Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions – www.americantelemed.org/docs/default-source/standards/core-operational-guidelines-for-telehealth-services.pdf

Resources:

State Telemedicine Gaps Analysis. Health professional Practice Standards & Licensure, May 2015 – www.americantelemed.org/docs/default-source/policy/50-state-telemedicine-gaps-analysis–health professional-practice-standards-licensure

Center for Connected Heath Policy. The National Telehealth Resource Center. State Telehealth Laws and Medicaid Program Policies. A Comprehensive Scan of the 50 States and District of Columbia. March 2016. – cchpca.org/sites/default/files/resources/50%20State%20FINAL%20April%202016.pdf

Telehealth Resource Centers – www.telehealthresourcecenter.org

4. Our Treatment Coordinator will contact you by telephone and ensure that you know how to access our virtual visit waiting room. Once you log in, the staff can help to make sure you activate your video and microphone.

5. The Treatment Coordinator will complete a standard intake just as they would for an in-office visit.

6. The doctor will then open up the telemedicine visit with you and begin our usual consult or office visit with you. We want to make sure the visit meets the expectations and needs for each patient to continue to help improve and heal the pain condition.

What should I expect during a viritual doctor consultation?

We make every effort to provide telemedicine visits that follow quality core principles including:

  • Practices implemented should ensure patient-safety
  • Communication methods are secure and effective
  • Treatment options recommended should be appropriate and practical
  • Self-care strategies are implemented with each patient
  • Mechanisms that allow for patient feedback are in place
  • Strategies are being taken to ensure patient satisfaction

Feel free to call our front desk and our pain clinic office manager will align a call from a pain specialist that aligns with your needs.

Summary

The practice of telemedicine at the Minnesota Head and Neck Pain Clinic is consistent with current standards that exist for traditional medicine. Telemedicine visits are intended to improve the accessibility and delivery of healthcare but, based on inherent limitations, is not expected to completely replace our in-person visits.

Request our telemedicine expanded healthcare access by calling (763) 577-2484 or Schedule A Clinic Visit

 

About the Author

James Fricton DDS, MS, co-founder of the clinic, takes great joy in helping patients with simple to complex head, neck, orofacial, and TMJ pain conditions as well as obstructive sleep disorders. He also founded and runs pactforpain.com .

References:

Federation of State Medical Boards’ Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine – www.fsmb.org/Media/Default/PDF/FSMB/Advocacy/FSMB_Telemedicine_Policy.pdf

American Telemedicine Association – www.americantelemed.org/about-telemedicine/what-is-telemedicine#.V_JJQE0VCic

Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions – www.americantelemed.org/docs/default-source/standards/core-operational-guidelines-for-telehealth-services.pdf

Resources:

State Telemedicine Gaps Analysis. Health professional Practice Standards & Licensure, May 2015 – www.americantelemed.org/docs/default-source/policy/50-state-telemedicine-gaps-analysis–health professional-practice-standards-licensure

Center for Connected Heath Policy. The National Telehealth Resource Center. State Telehealth Laws and Medicaid Program Policies. A Comprehensive Scan of the 50 States and District of Columbia. March 2016. – cchpca.org/sites/default/files/resources/50%20State%20FINAL%20April%202016.pdf

Telehealth Resource Centers – www.telehealthresourcecenter.org

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Our mission is to provide high-quality, effective patient care for head and neck disorders through a multispecialty, interdisciplinary approach designed to reduce pain and improve function for all our patients.

3475 Plymouth Blvd # 200, Minneapolis, MN 55447

Locations

Plymouth: (763) 577-2484
Fax: (763) 577-1375

St. Paul: (651) 332-7474
Fax: (651) 332-7475

Burnsville: (952) 892-6222
Fax: (952) 892-6477

St. Cloud: (763) 233-7252
Fax: (952) 892-6477

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