Telemed System Improves Profitability, Reduces Liability

July 5, 2011
Ed Rabinowitz

A new system allows doctors to document after-hours phone calls so they can choose to bill patients if they want, but also protect the practice from legal issues.

With reduced reimbursement and increased overhead, physicians often find themselves tapped out. They can’t work harder, and they can’t see any more patients; yet, they consult with patients over the phone but do not bill for their time. Paul Guillory, MD, a Louisiana-based otolaryngologist, doesn’t understand that line of thinking.

“If you call your attorney, you can’t get free time with them on the phone,” Guillory says. “So, why is a physician’s time less valuable? Why are physicians giving away their services on the telephone?”

Rather than waste time trying to answer those questions, Guillory has developed PhoneMyDoctor, a telemed solution that documents physician-patient phone encounters to help reduce liability, improve profitability and enhance patient care.

Integration and documentation

PhoneMyDoctor integrates patient calls, physician feedback, pharmacy ordering, follow-ups and instruction into one documented record of the entire transaction — and all using the existing phone equipment and processes in physicians’ offices.

“There’s no software, no hardware and no learning curve,” Guillory explains. “In less than 15 minutes you can have your own 800 number, your own security code and be on the system.”

At the end of the day, the medical practice phone is forwarded to the PhoneMyDoctor system. When patients phone the practice after hours, the system provides a series of prompted questions to help assess the level of need and capture key information. A notification is then sent to the physician that a message is waiting. From any phone, the physician is able to securely access the system, receive a detailed account of the patient’s call, and contact the patient to provide medical advice. Physicians can also add their own notes to the patient’s medical record, as well as contact the patient’s pharmacy should a prescription be required. Comprehensive reports detailing the entire encounter are sent daily to the practice to integrate into patient records.

“[The system] documents the complete after-hours encounter,” says Guillory, which is a practice physicians usually do not adhere to.

Those undocumented calls can pose a problem should a lawsuit arise and a patient says he or she was just following what the doctor told them to do. If there’s no documentation of the phone call conversation, it can become a legal problem.

“And because the call is completely documented, it’s a billable encounter should the doctor so elect to bill,” Guillory says.

The system in action

Christian Wold, MD, with Red River ENT in Alexandria, La., has been using the PhoneMyDoctor system for the past six months. He says the practice’s goal was to capture after-hours phone conversations in a more permanent manner, both for medical and legal purposes. Thus far, he’s very satisfied with the results.

“It was a relatively inexpensive and easy alternative for answering after-hours phone calls without affecting patient perception of how the practice was handling things,” Wold explains. “Patients have not commented negatively about [the system], and it has made our handling of after-hours phone calls more efficient.”

Wold says that prior to implementing the PhoneMyDoctor system, physicians at the practice were receiving a page or a text message to return a call to an answering service. Now, messages are still received to return a phone call, but they get more information about the nature of the phone call and don’t have to write down information because the entire encounter is documented.

“I think after the first weekend I started using it on calls, it took a couple of calls to kind of get into the scheme of things, but in this day and age, it’s pretty simple and intuitive to those things we’re already doing on phones,” Wold says.

He adds that it’s nice to implement a new technology without having to dole out significant dollars.

“If you don’t like [the system], you don’t feel like you’ve shot yourself in the foot. It makes a trial basis easier.”

Wold’s practice has not yet begun billing for the after-hours phone encounter. “I think that in our community, one of the things that’s important is to be available all the time. We don’t want to be the first office to start doing those things.”

But, he adds, the day is coming when billing for phone encounters with patients will become a more regular occurrence.

“Some insurance companies are starting to accept those charges and pay claims on them,” Wold says. “We feel like we’re poised to do that, but haven’t begun that practice yet.”