Telemedicine, also called telehealth, is the practice of communicating with patients virtually. It includes everything from holding appointments over video to answering patient questions through a messaging portal. 

You may think telemedicine doesn’t apply to you as a chiropractor because patients need to come in for adjustments. However, there are use cases for it, especially in regards to following up on those adjustments.

Keep reading to learn more about chiropractic telemedicine. In this comprehensive guide, we explain the types of telemedicine, its specific chiropractic uses, its pros and cons, and the process for implementing it.

What Is Telemedicine?

There are three types of telemedicine: synchronous, asynchronous, and remote patient monitoring. The two types that apply to licensed chiropractors are synchronous and asynchronous telehealth.

Synchronous Telehealth

Synchronous telemedicine is real-time communication between you and your patient. Most chiropractors conduct these interactions over a video call, but you can also use a phone call.

Asynchronous Telehealth

Asynchronous telemedicine is also called store-and-forward telemedicine. It is communication between you and your patient that doesn’t happen in real time, such as messaging or emailing. 

Remote Patient Monitoring

Remote patient monitoring (RPM) isn’t particularly relevant for chiropractors, but we are including it to give you a complete picture of what telemedicine is. RPM is when a patient uses technology to track their nutrition, their blood pressure, or other aspects of their health at home. They often report the data they collect to their healthcare provider.

The Impact of the COVID-19 Pandemic on Telehealth

The rise of telehealth started with the COVID-19 pandemic. Before the pandemic, telemedicine was seeing a slow, steady increase in adoption, but adoption rates jumped significantly when the population was encouraged to limit in-person interactions. 

At the start of the COVID-19 pandemic in March 2020, Congress made major adjustments to Medicare, which further encouraged telehealth use. The specific requirements for Medicare coverage changed, increasing who could receive and who could give telehealth care and what telemedicine services could be reimbursed. These changes encouraged states and private insurers to follow suit and increase their telehealth coverage.

Here are some facts on what telehealth has looked like during and after the pandemic:

• The number of healthcare providers who offer telemedicine in some capacity has at least doubled.
• Most healthcare providers use telehealth to manage chronic conditions, such as kidney disease and heart disease. It is also used for diagnosis and treatment of acute conditions, such as upper respiratory infections.
• Most of the patients who use telehealth services are White, young, wealthy, and located in urban areas.
• Patients who use telemedicine generally report positive experiences with it.

Now that the COVID-19 pandemic is over, there is still some work that needs to be done to get more healthcare providers to offer telehealth and more of the population to take advantage of it. Lack of knowledge on how telemedicine technology works has been cited as a main reason for why some physicians and patients don’t utilize it, so education and training are needed to make it more widespread. 

However, it is clear that telehealth is here to stay. And as more and more patients expect this new technology to be available, it’s important to consider offering it at your chiropractic practice.

Telehealth Use Cases for Chiropractors

Now that you know what telehealth is, we can get more specific about how chiropractors might use it. Here are three scenarios where telemedicine services may be helpful:

• Initial consultations: You can make your initial appointment with a potential patient virtual. That way, you can conduct an assessment of their symptoms and determine whether you can help before having them come into your office.
• Follow-up appointments: A few days or weeks after an in-office appointment, you can reach out to the patient to determine if the adjustments you made helped with their pain and/or other symptoms.
• At-home exercises: If your treatment plan for a patient centers around at-home exercises, you can explain how those exercises work during a virtual appointment.

Benefits of Chiropractic Telemedicine

Telemedicine offers many benefits for both chiropractors and patients. Starting with patients, telehealth makes chiropractic care available for those who may struggle to get to your office for various reasons. For example, they might live too far away or not be able to take the time off work. If you open up your schedule to telehealth sessions—at least for certain ailments and situations—you can serve more of these patients.

Even patients who can get to your office may prefer virtual appointments because they get more time back in their day. They also save on travel expenses to and from your office. By meeting with them virtually, you improve their quality of life.

Making care more accessible and convenient for patients leads to the biggest benefit for chiropractors—improved patient satisfaction. When you accommodate how patients want to receive treatment, they are happier with your chiropractic services. And when they’re happy, they are more likely to return to your clinic again and again to address their pain or other health concerns. They may even leave you positive reviews online, which can help you attract the attention of new patients.

Here are some other telemedicine advantages for your practice:

• Larger scheduling capacity: It takes less time and effort to transition between virtual appointments because you don’t have to worry about turning over exam rooms like you do with in-person appointments. This means you can schedule back-to-back telehealth sessions to serve more patients.
• Cost savings: Virtual appointments are cheaper because you don’t have the cost of office space, staff, and equipment that in-office visits require. This allows you to grow your practice without increasing your operating costs. It also means you can charge patients less for these telemedicine visits, which feeds back into the patient satisfaction benefit.

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Limitations of Chiropractic Telemedicine

As previously mentioned, telehealth isn’t right for patients who require physical exams or hands-on treatments. Here are some other limitations to be aware of:

• Limited capacity for observation: Chiropractors rely on non-verbal cues, such as wincing, limping, or other signs of pain, to assess symptoms and determine proper diagnosis and treatment. Your ability to read these cues is limited with telemedicine because you can’t see a patient over the phone, and you can only see the top half of a patient’s body during a video call.
• Technical barriers: Telehealth is dependent on technology, and technology sometimes glitches, leading to a delayed or missed virtual appointment here and there. You also have to factor in how tech-savvy your patients are to determine whether they would be able to use a telehealth system.
• At-home distractions: When a patient has an in-person appointment, you can control the clinical setting to make it soothing and distraction-free. You don’t have that option with a virtual visit, which means your patient may get interrupted by pets, children, deliveries, or other aspects of their home environment.

How Does Telehealth Work With Insurance?

Just like with in-person care, insurance coverage for telehealth care varies. Generally speaking, though, insurers do cover telehealth services. 

Here are some factors that affect how much telemedicine coverage insurance providers offer:

• Provider: Patients can get insurance coverage through Medicare, Medicaid, or private insurers. Many states have what are called parity laws, which have specific requirements around private insurers covering telemedicine care to the same extent as in-person care. Medicare and Medicaid are government programs, so they’re subject to different federal and state laws than private insurers.
• Plan: Private insurers often offer multiple healthcare plans for patients to choose from. A patient is likely to get access to more telehealth coverage if they opt for a more comprehensive insurance plan.
• Service: Basic telehealth services from a primary care physician are usually covered with insurance. However, insurance coverage gets more limited when patients require treatment from specialists, such as chiropractors.  

You may be wondering why this is important knowledge for you to have. Well, if a patient gets limited telehealth coverage for chiropractic care through their insurance provider, they have a few options:

• Pay for your telehealth services out of pocket
• Opt for in-person appointments that are covered
• Try to find another chiropractic practice that has covered telehealth services

All of these options affect how you handle the assessment, diagnosis, and treatment for the patient. They also play a role in how you manage billing for your chiropractic services. For example, you may bill the patient for the entirety of the visit rather than filing a claim with their insurer if they go for the first option.

How To Choose Telehealth Software

Telehealth technology can be a hefty investment for your practice, which is why we recommend taking the time and effort to do thorough research into software that’s right for your clinic. Below is a step-by-step guide on what to consider during your search.

#1: Make a List of Desired Features

The basic tenet of telehealth is being able to communicate with patients virtually, which means the top functionality you can expect with all telehealth software is calling and messaging. Aside from that, there are a couple other features that you may want to consider.

Here is a complete list of telehealth features:

• Video conferencing: Most telehealth sessions happen over video, so you need video conferencing software. You can’t use Skype, FaceTime, or other non-encrypted software, as it leaves patient data vulnerable.
• Messaging: As with video conferencing, messaging should be secure to protect private patient information. Messaging is useful for quick questions from patients that don’t warrant an appointment.
• Audio-only calling: A phone call is a good option to have in case a patient feels more comfortable not showing themselves on the screen—as long as seeing them isn’t necessary to treat them. It’s also useful if you have a virtual visit scheduled, but video isn’t working. You can call them instead of rescheduling the appointment.
• Appointment scheduling: This feature allows patients to schedule appointments with you online as opposed to calling your practice. Patients usually get email or text reminders leading up to their appointments.
• Payment processing: Patients sometimes pay for some or all of their appointments out of pocket, depending on how billing and reimbursement works with their insurance provider—and whether the provider covers telemedicine at all. Telehealth software can manage online billing.

#2: Choose Between Standalone or Integrated Functionality

Many chiropractors use other technology, such as electronic health record (EHR) software, to manage their practices. EHR software stores digital copies of patient medical records, replacing the need to have folders of physical patient charts in your office.

Many EHR solutions also have built-in telemedicine functionality. If you already have EHR software, this may be worth checking out because you wouldn’t have to learn how to use two different tools, and you can guarantee that your telehealth system integrates with your electronic records.

However, there are times when it may make more sense to have separate EHR and telehealth software. Here are two examples of that:

• No telehealth feature: EHR software is a beast, which makes setting it up and teaching it to your staff a big task. If your EHR solution doesn’t have a telehealth feature, it may be easier to find a separate tool just for telemedicine rather than searching for an entirely new EHR tool with built-in telehealth.
• Expensive telemedicine feature: Some EHR solutions may charge an additional fee to use their telehealth feature. If that fee is too hefty, it may be cheaper to find a separate telehealth solution.

If you decide to use separate telehealth and EHR solutions, make sure that they are compatible with each other so that you can seamlessly transmit important patient data between them.

#3: Set a Budget

Whether your plan is to use the add-on telemedicine feature with your EHR software or to find a separate telehealth tool, be sure to set a budget for how much you want to spend on this technology. To determine what your budget should be, we recommend considering the return on investment (ROI).

ROI measures the profit your practice makes by offering telemedicine in relation to the cost of the telemedicine software. In other words, you have to think about whether you have enough of a demand for telemedicine with your current patients to justify paying for technology. Or, if you don’t have enough demand with current patients, ask yourself if offering telemedicine would help you reach enough new patients to at least cover the cost of the technology.

Aside from cost, there are other factors that can affect the overall financial toll telehealth software takes on your clinic. You also want to ask yourself:

• Am I locked into a contract for a certain length of time?
• Am I charged on a monthly or annual basis?
• Does the cost increase as my practice grows?

#4: Prioritize Data Security

As a chiropractor, you have a legal obligation under the Health Insurance Portability and Accountability Act (HIPAA) to protect patient data. HIPAA guidance applies to telehealth just like it does to other forms of communication. 

It is essential that whatever telemedicine technology you use is HIPAA-compliant. It’s not enough to take the software provider at face value when they claim they’re compliant. You should do your own research to make sure that they have the proper level of encryption required (at least 128 bits). You also want to verify that they update their software regularly to address any security risks that may put your data in danger.

#5: Read Online Reviews

The best way to determine what a telehealth tool is like is to hear from real users. We recommend reading online reviews on Google or the Better Business Bureau, paying particular attention to patterns in the following areas:

• Ease of use: You want software that’s easy to use with minimal training. Look at reviews that mention patient experience—not just user experience from the practice side.
• Customer support: As we previously mentioned, issues are bound to come up when technology is involved. You want a software provider that is quick to help you when something goes wrong. You can assess this based on what users say in their reviews, but you can also look for responses to these reviews. If the provider replies to a user offering to right a wrong mentioned in the review, that’s a good sign that they care about their customers.
• Hidden fees: Hidden fees are additional costs that a provider tacks onto the advertised price of their software. Oftentimes, customers won’t know about these fees until they’re late in the buying process or locked into a contract. Keep an eye out for mentions of extra fees when you’re reading online reviews to prevent this from happening to you.

#6: Narrow Down Providers

Now that you have done thorough research into what your practice wants and what providers are out there, you can create a list with a few top contenders that: 

• Offer all the features you’re looking for
• Fit within your budget
• Implement proper security measures
• Have positive reviews

Limit your list to a maximum of five providers. The next step in the buying process involves testing each software personally, and you don’t want to have to reach out to 10 or 15 providers.

#7: Sign Up for a Free Trial or Live Demo

Contact the sales team for each of your top contenders. Ask if you can sign up for a free trial or attend a live demo of the technology to see it in action. If a provider can’t give you access to a demo or trial, this may be a red flag that warrants removing them from your list. They should know how much of an investment this type of software is and understand the desire to test it before fully committing.

During your trial or demo, take the opportunity to assess for yourself whether the product is easy to use and the team is friendly and helpful. Keep in mind, though, that you will only get a taste of what the product is like, which is why it’s still important to read reviews from customers who have been using it for months or years.

#8: Make a Final Decision

Testing the available software options was the last step in the research process. Equipped with your personal experience, you’re now ready to choose a telehealth solution for your practice. Whatever software you choose, we hope it helps you deliver better patient care.

Final Thoughts

As the world becomes more and more reliant on technology, you don’t want your chiropractic practice falling behind. That’s why we recommend considering offering telehealth services to your patients. Perfect for initial consultations and follow-up appointments, telemedicine helps your patients get the chiropractic care they need without disrupting their day with in-person visits.

If you’re ready to start researching telehealth solutions, consider including Online Chiro on your list of providers. Contact us today to learn more about our chiropractic telemedicine solution.