How to Provide a Valuable Orthopedic Telemedicine Experience

Like most orthopedic surgeons, you’re probably used to a physical examination with palpitations and manual resistance. Evaluating mobility issues, joint pain, and other orthopedic injuries are usually pretty hands-on, but advancements in telehealth mean clinical assessment is no longer limited to in-person contact. Researchers compared patient satisfaction with orthopedic telemedicine care to in-person visits and found that both groups were equally likely to be satisfied with their care.

Through orthopedic telemedicine, you can save time before and after appointments, see more patients, and even generate more revenue for your practice. By using telehealth to make your practice more efficient and profitable, you will undoubtedly see a fast return on your investment.

Create different strategies for new and established patients

Despite the rapid growth of telehealth during the COVID-19 pandemic, at first, orthopedic surgeons often limited their virtual care options to follow-up appointments for existing patients. As both doctors and patients have become more accustomed to telehealth, these services have expanded to include new patients as well.

Approaches to take before meeting new patients

Telehealth options like consultations and early-stage treatment don’t necessarily require a physical exam. But you might have a hard time connecting with a new patient if the first time you meet is on a video visit. Before meeting new patients, consider the following approaches:

• Consult with another physician who has an established relationship with the patient. By talking with another healthcare provider who already knows the patient, you can learn more about their medical history, including relevant radiology and pathology. This saves time during the pre-appointment process, so your first appointment will be more productive.
• Remind patients that if they don’t respond to treatment, they will need an in-person appointment. Sprains and arthritic flare-ups can often be diagnosed and treated early via video conference, but that might not be enough. Set realistic expectations with patients so they don’t end up dissatisfied with their experience.

Order any radiological imaging, like X-rays or MRIs, ahead of time. After collecting information from a patient during the pre-appointment assessment, you will likely need medical imaging to better diagnose their condition. Refer your patients to an imaging lab and review the results prior to the appointment so you can focus on patient education during your telemedicine visit. This also gives the patient more time to ask questions about their treatment plan, like a joint replacement or rehabilitation schedule.

Strategies to employ with established patients

Established patients, particularly those in postoperative recovery, often do not require further examination. This makes them an ideal fit for orthopedic telehealth care — here’s how to do it:

• Provide extensive patient education before the procedure to reduce the risk of postoperative complications. Educating patients before you operate helps them understand what to expect during the healing process, so they can maximize their outcomes. Keep things simple, so you don’t overwhelm your patients before they even get the procedure. For example, to reduce the risk of deep vein thrombosis, explain the importance of early mobilization, which can be as simple as getting out of bed or walking short distances.
• Request videos or images of the surgical site. Ask your patients to send clear, well-lit images so you can more accurately assess the surgical site and pinpoint anything that isn’t healing right. Patients who get an infection within 30 days after surgery are over three times more likely to contract another infection in the first year. When you identify a surgical site infection early on, you can treat it faster and potentially avoid a worse situation down the line.

Provide directions to prepare patients before their orthopedic telemedicine appointment

The orthopedic telehealth experience differs from other specialties because you often need full visibility of a patient to accurately assess their movements. Take the time to create a pre-appointment checklist for your patients and ensure that both you and your patient get the most out of your telehealth visit.

Explain any physical or spatial requirements 

You need full visibility of the patient to take accurate measurements with virtual tools. When demonstrating their mobility, patients should stand at least six feet away from the camera so you can fully see their body, whether they’re standing, sitting, or lying down. Patients should wear clothes that don’t cover the area of concern (like shorts for knee or ankle problems and sleeveless shirts for shoulder issues), so you can clearly see their movements.

Create a list of common household items that can be used during an orthopedic telemedicine appointment 

Since you can’t provide the resistance for muscle strength testing, patients will need to do it themselves. They can use things they probably already have to test their ability to bear weight. Some suggestions are:

• A cup of sugar: 0.5 lb
• A can of soup, a block of butter, or a 16-oz bottle of water: 1 lb
• A quart of milk or a 1-liter bottle of soda: 2 lb
• A bag of sugar or a 2-liter bottle of soda: 5 lb
• A gallon of milk or a large bag of potatoes: 9 lb

Take note of potential areas of improvement during your telehealth visits 

This might include recommended camera angles, lighting, and additional pre-appointment questions. That way, you can update your pre-appointment directions accordingly and constantly improve the telehealth experience.

Add remote therapeutic monitoring to generate more revenue

Remote therapeutic monitoring (RTM) is billed separately from in-office services so you can get reimbursed by insurance companies even within the postoperative 90-day global period. By collecting RTM data from your patients, you can closely follow their recovery, even if you go weeks between appointments.

Send frequent surveys to measure patient-reported outcomes (PROs) 

Gathering self-reported data like pain levels daily or weekly gives you a fuller picture of a patient’s response to treatment. If the patient isn’t progressing as expected or experiencing unusual pain levels, you can quickly intervene and adjust their treatment plan. This helps to avoid further injury and a prolonged rehabilitation process, which leads to higher patient satisfaction.

Use a tool like Exer Physio to accurately record RTM data

Exer Health uses artificial intelligence to take highly accurate patient performance measurements, like range of motion and treatment adherence, as your patients perform their at-home exercises. Objective data about your patient’s rehabilitation enables you to make informed recommendations — like increasing physical therapy or trying another mobility aid — that further support their recovery between appointments.

Supplement your orthopedic telemedicine services with asynchronous options

Most people imagine a telehealth visit as a direct call between patient and provider, but asynchronous telehealth has other benefits too. Instead of being limited to a time slot on a calendar, you and your patients can ask questions and respond at your convenience. This will increase your availability for office visits and improve access for new patients.

Share clinical assessment tools with patients 

Rather than performing a virtual assessment in real-time, provide patients with a guide to self-evaluation at their convenience. They can fill out a questionnaire, like the Shoulder Telehealth Assessment Tool (STAT), or record a video demonstrating their mobility according to specific instructions. Log this information in your electronic health records (EHR) system for easier reimbursement from Medicare and other insurance providers and quick access during your next appointment.

Offer virtual ancillary services like second opinions and imaging review 

Many services don’t actually require an in-office visit or even a real-time conversation. Ask the patient to send you a video and share medical records, like radiological images or lab results, so they can explain their issues in as much detail as they’d like. Once you review the information, you then respond with a video message with your own assessment and recommendations, like a prescription or a referral to physical therapy.

Invest in the latest developments in orthopedic telemedicine to upgrade your patient care

Telehealth is here to stay, so why not make the most of it and use orthopedic telemedicine to expand your business? Virtual consultations allow you to reach patients who can’t come into the office, whether it’s because they live too far or have limited mobility. You can even offer telehealth services to patients who live out of state, as long as you comply with any regulations from state licensing boards. With the flexibility of orthopedic telehealth care, you can drive revenue to your practice without drastically altering your business model.

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Photo by National Cancer Institute