HCA 120 Module 4 Telehealth and Support Staff Example

The Visit Without a Waiting Room: What Telehealth Changed for Support Staff

Student Name

Health Care Administration Program, Aspen University

HCA 120: Healthcare Information Systems

Instructor Name

Month Day, Year

The Visit Without a Waiting Room: What Telehealth Changed for Support Staff

Telehealth is usually discussed in terms of patients and providers, but much of the work that makes a video visit happen falls on support staff. Schedulers, medical assistants and billing staff all had to change how they worked when telehealth grew suddenly in 2020. This paper describes how telehealth expanded, what it changed for the support staff of a composite family practice and what the practice learned about which patients it served well and which it did not.

How Fast It Grew

Telehealth existed for years before 2020 but was little used. When the COVID-19 pandemic began, federal and state rules were relaxed and patients avoided offices. Data from four large telehealth providers showed that visits in the first quarter of 2020 were 50% higher than in the same period of 2019, and 154% higher in the last week of March (Koonin et al., 2020). In a database of 16.7 million commercially insured and Medicare Advantage enrollees, 30.1% of all visits from January to June 2020 were delivered by telemedicine (Patel et al., 2021).

The Practice's Shift

The composite practice moved from almost no video visits to about 40% of its visits within three weeks in spring 2020, then settled at around 15% as in-person care resumed. Behavioral health follow-ups, medication checks and results discussions stayed largely virtual, while physicals and visits needing an exam returned to the office. Each change required support staff to adjust.

Scheduling Changes

Schedulers had to decide which visits suited video, often with a nurse's help. The practice created visit types in its scheduling system for video and phone visits, with their own lengths and templates, and a short list of reasons that should always be seen in person, such as chest pain or a new lump. Schedulers also asked whether the patient had a device, internet access and a private place for the visit.

Task Comparison

The table compares support staff tasks for an in-person visit and a video visit.

The Medical Assistant's Role

Medical assistants became the visit's technical guide. Fifteen minutes before each video visit, the assistant called or messaged the patient, confirmed the link worked, reviewed medications and asked for home readings such as blood pressure or weight. When a patient could not connect, the assistant converted the visit to a phone call or rescheduled. This pre-visit check kept providers from losing time to technical problems.

Billing Changes

Billing staff had to learn new codes, modifiers and place-of-service values, and track rules that changed several times as temporary policies were extended or ended. Payers differed in whether they paid video and phone visits at the same rate as in-person visits. The billing lead kept a one-page table of current rules by payer and updated it monthly, which reduced telehealth denials.

Who Was Left Out

Telehealth did not reach all patients equally. In the national claims study, telemedicine use was lower in communities with higher poverty rates, and use varied widely by specialty (Patel et al., 2021). In the composite practice, older patients without smartphones and patients with limited English or unstable internet had the most trouble. The practice kept phone visits available, offered interpreters on video calls and let patients choose in-person care whenever they preferred.

Documentation and Consent

Each telehealth note records the modality, the patient's location, who was present, the patient's consent and any technical problems. Location matters because providers must generally be licensed in the state where the patient is during the visit. Staff remind patients who travel that a video visit from another state may not be possible.

Privacy

Video visits must use platforms that protect patient information, and staff must conduct calls from private spaces. Patients are asked whether they can talk privately, and providers watch for signs that someone else is listening in, which matters especially in behavioral health and in situations of possible abuse.

Measuring Telehealth

The practice tracks the share of visits delivered by video and phone, the rate of video visits converted to phone because of technical problems, no-show rates by visit type, telehealth claim denials and patient comments. In the first year, video visits had a lower no-show rate than in-person visits, but about one in eight had to be converted to phone, most often for patients over 70. That figure guided where the medical assistants focused their pre-visit help. Each video visit reminder is sent by text with the link, a cheap step that trials show raises attendance (Gurol-Urganci et al., 2013).

What Stayed

After the emergency, the practice kept video visits for follow-ups that do not need an exam, kept the pre-visit technology check and made online check-in available for in-person visits as well. Support staff roles changed permanently: schedulers now triage visit type, medical assistants guide technology, and billing staff track a shifting set of rules.

Training Staff

Support staff learned telehealth work mostly on the job during a crisis. The practice later wrote short guides for each role: how schedulers decide visit type, how medical assistants run the pre-visit check, how billing staff code video and phone visits and what to do when a connection fails. New employees now train on these guides in their first week, so telehealth no longer depends on the few people who learned it in 2020.

Costs to the Practice

Telehealth brought costs as well: a platform subscription, headsets and cameras, staff time for pre-visit checks and a share of visits that had to be repeated in person. The practice judged these costs worthwhile for follow-ups and behavioral health.

Conclusion

Telehealth grew within weeks in 2020 and settled into a lasting share of visits. For support staff, it meant new scheduling decisions, a technology check before each visit, new billing rules and new ways of protecting privacy. It also showed that some patients are left out unless the practice keeps other options open. Telehealth works well when support staff are recognized as part of the visit.

References

Gurol-Urganci, I., de Jongh, T., Vodopivec-Jamsek, V., Atun, R., & Car, J. (2013). Mobile phone messaging reminders for attendance at healthcare appointments. Cochrane Database of Systematic Reviews, (12), Article CD007458. https://doi.org/10.1002/14651858.CD007458.pub3

Koonin, L. M., Hoots, B., Tsang, C. A., Leroy, Z., Farris, K., Jolly, T., Antall, P., McCabe, B., Zelis, C. B. R., Tong, I., & Harris, A. M. (2020). Trends in the use of telehealth during the emergence of the COVID-19 pandemic: United States, January-March 2020. MMWR. Morbidity and Mortality Weekly Report, 69(43), 1595-1599. https://doi.org/10.15585/mmwr.mm6943a3

Patel, S. Y., Mehrotra, A., Huskamp, H. A., Uscher-Pines, L., Ganguli, I., & Barnett, M. L. (2021). Variation in telemedicine use and outpatient care during the COVID-19 pandemic in the United States. Health Affairs, 40(2), 349-358. https://doi.org/10.1377/hlthaff.2020.01786