On March 17th, CMS released new guidelines on Telehealth. One important pieces of information in that providers can now use apps like FaceTime, Skype or Facebook messenger video for virtual visits. (Please read full details here and FAQs here). Key points include:
- Providers should only use “non-public facing” communication software. These include software which allow 1:1 interactions. Some of these software listed on CMS guidance include:
- Apple FaceTime
- Facebook Messenger video chat
- Google Hangouts video
- Whatsapp video chat
- Skype
- Texting applications such as Signal, Jabber, Facebook Messenger, Google Hangouts, Whatsapp, or iMessage.
- Providers should NOT use “public-facing” communications such as TikTok or Facebook Live.
Before using any of the methods used in this post, please check with your hospital leadership and policies regarding virtual visits. This article is intended to help providers and patients. My intentions are not to get anyone in trouble.
DOXY.me
Most likely this is the best way to implement video visits easily in your practice. Doxy.me website allows providers to send a link to the patient via email (free and paid account) or text message (paid accounts only). Patients click the link and are placed in a virtual waiting room. Physician can see their virtual schedule as well the patients in the waiting room.
Physician practices can start by creating an account with Doxy.me. During the account setup, each physician is prompted to pick a unique name which is used to create your own personal virtual office. To schedule patient visit, all you have to do is send them this link along with the date/time of their visit. Your office staff could presumable help you with this task.
On the day of the visit, you log in to your account and see patients waiting in the virtual waiting room.
Here is YouTube playlist to get you going with Doxy.me
Using Apple FaceTime
This is probably the easiest method for virtual visits, provided the patient has access to an Apple device. Advantages include:
- Most Apple device owners are familiar to the functionality of FaceTime
- No additional software needs to be installed
- Both iMessages and FaceTime have end-to-end encryptions therefore ideal for protecting patient privacy.
If you are considering the use of FaceTime calls, there a few things to consider.
AppleID
If you have an iPhone or iPad, chances are that you are logged in using your AppleID. If you make FaceTime calls with your own device, you will be sharing your personal phone number or AppleID with patients. If you want to avoid this, there is a simple fix to the problem.
Create a New AppleID and use an old iPhone/iPad
If you have an old iPhone or iPad, use these steps to prepare these devices for your virtual visits:
- Reset your device:Follow these instruction to Reset your device
- Create New AppleID: Follow these instructions on your iPad/iPhone to create a new AppleID
Make FaceTime Calls
Potential Pitfalls
There are some issues with FaceTime calls. First, this excludes patients/providers with Android devices. Second, the necessity for a second device or sharing your own AppleID can be significant barrier.
Using WhatsApp
Over a Billion people worldwide use WhatsApp. This app can be installed on iPhone/iPad as well as Android devices.
Installing WhatsApp
Here is a great guide on installing WhatsApp by WikiHow. Consider sending this link to your patients if you would like them to use WhatsApp for video calls (especially android users)
Using WhatsApp without revealing your personal phone number
If you want to use WhatsApp on your personal device, after installation you will have to activate the app using a validation phone number. If you enter your own cellphone number, this number will be revealed to patients.
However, there is a workaround to prevent that from happening. In order to not display your phone number, you can use GOOGLE VOICE phone number to activate WhatsApp. Here is an excellent guide on how to accomplish this https://www.wikihow.com/Use-WhatsApp-Without-a-Phone-Number
Other Apps
Providers can decide on video app of choice for their office.
Billing and other issues
The American Medical Association (AMA) has created a Telehealth guide with a comprehensive guide on billing.
Link to AMA guide on Telehealth
Changing visit type to VIDEO visit in EPIC
To successfully accomplish video visit (and bill for it), you will need to setup the visit type in EPIC as VIDEO visit.
This can be done by either reaching out to your clinic administrator or you can download and follow the steps outlined here:
gynecologic-oncology.org 