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Add digital signature Professional Physical Therapy Consent Template

welcome everyone to today's webinar covent 19 takes the waiting room virtual patient intake and informed consent for telehealth i am laura dierda with becker's hospital review we will begin today's webinar with a presentation and will have time at the end of the hour for a question and answer session you can submit any questions you have throughout the webinar by typing them into your q a box that you see on your screen we are looking forward to hearing your questions today's session is being recorded and will be available after the event you can use the link you used to log into to today's webinar to access the recording at this time i am pleased to introduce our presenters teresa moss is a solution marketing manager at interlaced health teresa is a background has a background in hospital outpatient radiology and operations management in her spare time she enjoys cooking gardening and barbell training ann hill is a solution architect at interlaced health and has 25 plus years of experience designing health care solutions to solve complex clinical and administrative workflow challenges she lives south of boston with her husband and three children and enjoys boating paddle boarding and spending time at the beach at this time i am pleased to turn the floor over to teresa to begin today's presentation thank you so much laura so i appreciate you all joining us today as we talk about this very timely subject when the first coronavirus case was discovered in the united states earlier this year a host of concerns from health care providers followed providing high quality care keeping up to date on emergency merging information and of course reducing patient and staff exposure to the virus were a growing concern the health care industry historically slow to turn the ship and adopt new technologies quickly pivoted to find solutions that kept patients physically out of healthcare buildings virtual collaboration data tracking and of course telehealth has stepped up to help address the virus and flatten the curve the healthcare industry has seen an enormous increase in telehealth utilization while it used to account for just one percent of care delivery during the nationwide shutdown 30 percent of all ambulatory care visits were conducted using health telehealth and federal health official officials who had long placed technological and privacy restrictions on the delivery of health telehealth services moved to empower providers to serve their patients wherever they might be before the pandemic there were challenges around telehealth reimbursement payment was often at a lower rate than an in-person visit and in some cases payers would only reimburse for telehealth visits if the patient was located in an area underserved by medical professionals plus each payer and each state had different regulations around how the patient could consent to the telehealth visit in some areas there are regulations requiring an informed consent be collected in person from the patient before the first telehealth visit could be offered luckily we have a temporary and hopefully at least partially permanent relaxation of some of these barriers and now that both providers and patients have had an incentive to use telehealth we believe this method of care delivery is here to stay as sema verma director of cms put it the genie is out of the bottle on this one it's taken this crisis to push us to a new frontier but there is absolutely no going back now coming along for this wild ride has been patient intake patient intake of course is the process we use to register a patient for their visit collect insurance cards and photo ids and collect general consents from the patient like consent to bill and consent to treat we also frequently collect information that's needed by clinical staff during this time like health histories signs and symptoms medications and allergy lists risk assessments and the like the days of handing every patient a pen and clipboard are behind us for a while that tried and trued process just doesn't fit anymore it doesn't fit with the telehealth visit for obvious reasons but it's not even a good fit for an in-person visit anymore both patients and staff are concerned about the potential for infection that passing items back and forth or having prolonged face face-to-face conversations pose but some things never change or at least they haven't yet we've still got to submit a claim in order to be reimbursed for those visits in order to do that accurately and completely we need to be able to collect demographic information from our patients we need to look at insurance cards driver's license and other physical artifacts a patient has we need to collect our patients health history in order to get a clear view of their situation we need to know about their medications and allergies so that we can administer care safely we still have the ethical obligation to gather consent from a patient whether that be informed consent where a treatment or procedure is explained to the patient or just more general consent such as consent to treat or consent to release information and then of course we still need to be able to gather co-pays co-insurance from our patients all that presents a challenge during the telehealth visit how can we make sure we're collecting all the information that helps us submit claims and deliver excellent care when the patient isn't physically with us now most hospitals and health systems have an ehr and some offer a patient portal that has options around remote intake and while some of these offerings are more robust than others there are still challenges patient portals often require an initial in-person visit to the provider so that the patient can be given a code to sign up and given that the amount of hipaa sensitive material that a patient portal serves up this sort of requirement makes a lot of sense but in a situation where a telehealth visit is a good fit for a new patient how can they register for the visit if they can't use the patient portal also many hospital services require specialized forms that help the providers understand the patient situation and contribute to accurate documentation getting those forms served up to patients inside the patient portal can be difficult or impossible they generally focus on grabbing gathering demographic information and stopping there and then finally often the ehr is delivering a one-size-fits-all solution have your own portal or app that you've developed for your health system and your patients are using your own texting vendor your own payment processor the ehr usually wants to completely replace some of these or is at least unlikely to offer much help when it comes to working with what you already have so given all the changes in the way we deliver care it's time to rethink our patient intake processes interlace health offers a remote patient intake solution that can deliver all the intake steps you're currently using using a mobile friendly intake process you can take your steps and deliver them to a patient for them to complete on their computer or mobile device and the solution easily handles new patients you can send us a scheduling message that contains information about the patient and appointment and we use that logic to select all the correct intake steps for that particular patient that includes filling out forms taking a picture of driver's license and insurance card payment processing and links to external resources like outside content or educational material this allows patients to complete all their steps prior to their visit whether it be virtual or in person we offer a highly configurable dashboard that your staff can use to monitor progress make edits to form data and counter sign if needed as well as discrete data integration with your ehr as well as sending a traditional looking version of your form to the ehr top that off with best in class services custom configuration and you have a highly tailored solution that works for you i just want to switch gears for a moment from the patient intake topic to talk about how all those pieces enable other health care process to happen virtually in this case remote inform consent our solution is flexible enough that we can help take processes that we've never been able to accomplish remotely and allow them to be accomplished in a telehealth setting imagine this scenario imagine a provider and patient are having a conversation about an upcoming procedure both provider and patient want to minimize any risks ahead of the procedure so they agreed that it makes sense to meet via telehealth the provider explains the procedure as well as its risks benefits and alternatives and the patient has a chance to ask questions once they fully understand the patient can sense the procedure they've just performed in a remote informed consent the only trouble is that we have to document that that consent took place so to do this we use a form that outlines all the information discussed the patient signs it and then the provider counter signs it but how can this happen in a virtual setting well using our solution the form can be delivered to the patient's mobile device they can sign it on their smartphone or tablet and once they've submitted the signed copy the provider can access the form via the dashboard and apply their own signature the provider then archives it sending the data form back to the ehr and ensuring that it's available to the entire care team and will be in the right place at the right time on the day of the procedure and delays caused by missing consents can be eliminated so with that i want to turn it over to my wonderful colleague ann hill who's going to take us through an overview of our solution in action and great thank you teresa i just want to make sure you can all please you can hear me okay we can great great um so during our conversation today um i'm going to show you how our remote patient intake solution really complements your current ehr environment leveraging interlaced health form and electronic signature capabilities outside of your organization's walls allows your staff to gather patient information ahead of the data service just as teresa mentioned you know reducing wait times avoiding those crowded waiting rooms and supporting your organization's telehealth initiatives so in this scenario my patient mr allard is scheduled for let's say an mri appointment over the phone and among the information collected or confirmed if he's an existing patient at the time of scheduling is his email address and that scheduled appointment automatically triggers an email such as the one you are seeing here with a link that includes the correct forms or package of forms for that specific appointment to be presented to the patient when the site is accessed from the email link as you can see here i'm accessing um email on an iphone as the patient but just just note that this could really be on any type of device that the patient is using whether it be a smartphone a tablet laptop home computer etc so then you know at a time that is convenient for him charles um would access the email click on um the link in the email and um to sign in if this was the first time that mr allard was logging in he would have been prompted to validate his identity with something like date of birth or you know last four digits of social security number but mr allard will use the saved password he has on his device and he is presented with a welcome message and taps the go to checklist button to access his checklist um so as i mentioned charles has an upcoming visit an uh mri exam and several pre-registration items are waiting for him to complete items can either require input from the patient such as a form or you know a signature or could be reminder or informational type of items such as directions or a link to a short video like you see on the bottom of the screen here or even an opportunity to submit payment information the due dates that you see here on the screen are automatically defined in relation to the date of the appointment i'm going to go ahead and load the mri exam history form by tapping the pen icon next to that form the type of form that you see here has really been optimized toward a mobile solution understanding that the majority of the time patients will be accessing their documents on a mobile device so instead of presenting you know an entire eight and a half by 11 inch form and trying to have the patient read that on a mobile device we allow the data to really be chunked out in a way that's easily navigated by the patient really contributing to a positive customer experience and when completed all of that data collected on this form will be mapped back onto that standard eight and a half by 11 inch type of form for archival to your ehr you'll see here that some information is defaulting onto the form so the pieces of information you know collected at the time of scheduling or that are already on file in your ehr can default onto the form via an edt hl7 message so avoiding um the patient having to you know enter in their name date of birth etc every time they are filling out paperwork and then patient can also easily enter additional demographic information and then using the next button at the bottom patient can navigate through the form mr allard can easily answer simple medical history questions by toggling the yes no button here and notice on the diabetes question on the bottom here if the patient responds no they you know they don't have diabetes they are not prompted for additional information however if uh charles said yes i have diabetes he is prompted with some additional information pertaining to that uh diabetes you know on paper there are likely many forms i'm sorry many fields or questions that just don't pertain to the patient with an electronic solution patient no longer has to be presented with that entire form uh with many questions that might not be relevant uh really streamlining the data input using conditional logic to only present relevant questions to the patient patient can also answer questions specific to the mri appointment asked about his prior surgeries or if he's ever had any problems during an mri exam um also um patients can in this particular form patient has indicated that there is a pin in his left knee and i'll show you in a moment how that information is relayed back to your staff members moving through the document if the patient attempts to advance through the form without scrolling all the way to the bottom and they're therefore viewing all of the contents on the particular page they will be presented with an error message that forces them to scroll to the bottom um so you really can be certain that patients aren't just rapidly scrolling through the form or but without reviewing although all of the contents on each page using the click here to sign button mr allen can apply his signature to the document also has an opportunity to convert to a typed signature if necessary and when this form is signed a date and time stamp will automatically be included on the document image and then that form image is submitted back to your um admin panel where it can be pushed through to the emr or it can go directly to the emr depending on your particular setup um moving on to the insurance card image upload item i'm going to access that item so patients can leverage the camera option of their mobile device or browse out to their device to include an image that might already be saved to their device to capture digital images this can be used for things like driver's license insurance card maybe even an opportunity to take a picture of a prescription label on their pill bottle so where it says click here to take a picture of the front this is an insurance card example i'm going to tap on the take photo patient can easily take a picture of the front and back of their insurance card and there would be an opportunity if they took the picture and it was blurry or didn't come out right to go ahead and retake that image if needed and then the digital image will be attached to the document when submitted back to your staff let's shift focus um for a minute to your your staff your backend uh experience administrative dashboards are available and customizable and really can be configured according to the needs of your users or groups of users for example patients can be sorted by things like location or reason for visit or modality here you're viewing a dashboard that has been configured to look at care events or appointments scheduled for this week maybe in reality depending on the volume of your particular you know area um you may your staff may be just looking at what do i have today or what do i have today and tomorrow coming up and your users can see um the name of the patient in this particular dashboard the name of the patient the name of the caravan or appointment when it is scheduled the status of the patient facing items related to the event and also any alerts that have been identified from this particular dashboard i can easily see that there is a clinical alert um that was triggered off of one of the items that mr allard submitted and i'll show you what that looks like in a minute i can also quickly and easily see where my patients are at with completing their forms you'll notice mr allard here on the top here is in progress meaning he submitted some of his paperwork but but he hasn't submitted all of it yet while others you know you can see haven't started their paperwork or maybe even already completed all of their paperwork so we've color-coded it to make it visually easy for your staff members to you know have a quick look at the dashboard um and you know really get a gauge for the um the completion of forms for their particular patients i also have the ability to drill in right from here into um to obtain additional information about the packet of forms or or the patient for that matter you can see that the different statuses have been color coded to quickly identify outstanding items so those items in green have been completed um you know red that are over overdue and um those yellow are coming up due soon i can also see from that um clinical form alert on the previous page that mr allard has indicated that there are um an object or uh in his body or device in his body so by mr allard indicating on his form that there is a pin in his knee it has triggered an alert which then bubbled to the top of that dashboard so now my staff can easily and quickly see that mr allen has some metal in his body he is coming in for an mri and i know that maybe now i need to reschedule that for a different machine um and i'm i'm knowing that information well before mr allen is standing in front of me and i may lose you know revenue on that machine or i have to send the patient away if i can't accommodate a different type of appointment at that time i can see that the mri history exam form has been completed and i have an opportunity right from the screen to drill in and see that that form that the patient submitted so this is the information that was mapped back to that standard looking form um that mr alex completed on his mobile device at home you know in a parking lot while he was waiting for his wife in the grocery store or wherever that patient may have been and i can see the signature that mr allard applied so let's say for a moment that i am um the mri technician reviewing this form with mr allard and i realized that you know in talking with mr allard that maybe a response needs to be updated um maybe he has had you know some sort of a reaction before and he neglected to indicate that on on this form your staff members can interact with these forms in a number of different ways so as that mri text i could use the clear signatures function at the top of the screen here to go ahead and clear mr allen's temperature out make any um modifications to the form that are needed and then i can apply my name as the technician my initials and present the form to mr allard to resign based on you know after the modifications to the form were made and as teresa was mentioning you know this may be the opportunity for that provider to you know access the form and apply their their counterfeiter signature to that consent form finally just wanted to talk about um options for when the patient does arrive to the facility you see that not all of their forms have been completed you can generate a patient-specific qr code that can be scanned to transfer um that registration process to either a facility owned tablet or device so you can have the patient use their own device right so let's say patient comes in um you know walks up to the counter or lets you know that they're that they're there and you notice not all their forms have been completed you can do a couple of things right you can say oh mr allen do you have your mobile phone do you still have that email we sent you oh you do great you know can you go have a seat and access that email access the link complete those forms and then you know come back up and let me know when you're ready or mr allard says no i don't have a device you can use the um patient qr code flow here to generate a like i said a patient specific code to the screen here i can then take maybe a facility tablet let's say an ipad use the camera to scan that barcode and have the um the the forms load directly onto the device hand the device to mr alex he can go then sit down complete on that facility-owned device and then bring it back up when he's done really giving yours your patients the opportunity to have the same experience whether they are at home or whether they arrive um to the office and have not completed all their forms um oops sorry i i went on with before you theresa but that was all i had theresa and i'll hit it back to you okay thank you so much anne great job um so you know i wanted to talk a little bit about why interlace health you know interlace health offers a comprehensive platform to meet many of our of your digital needs including bedside informed consent downtime solutions in addition to the remote patient intake and remote informed consent solution that we talked about today we can help you transform your workflows by enabling seamless data capture and information exchange among your providers staff and patients you can gain the efficiencies and overhead reductions without the expense or disruption of transitioning to a different ehr or adopting new software everything interlaced health health provides comes with perfectly seamless integration and customization all within your existing system and interlace health has been around for nearly 28 years sorry has been around for nearly 28 years and our customized solutions are at work in over 1 100 healthcare organizations helping them reduce costs accelerate revenue cycle and improve the experience for patients and staff so with that i thank you for your time and attention and let's get started with some questions thank you theresa and anne for that fantastic presentation we will now begin today's question and answer session please submit any questions you have about typing them into the q a box that you see on your dashboard we will try to get through as many questions as we have time for we do have several questions already so should be a great discussion first question here is either teresa and anne feel free to answer this one um where does the dashboard live is in the ehr or in a separate tool sure i can take that one um oh you go ahead teresa i'll let you sorry um so it actually lives in it's a browser-based dashboard so it's not inside the ehr but it can um it can be displayed on on your browser on on your workstation perfect and the next question is the similar logistical question we have here how is the payment or card accepted in advance so we can either integrate with your payment processor if you already have one or we can recommend a payment processor partner in order to reduce our pci scope we link out to that payment processor they actually can collect that credit card information directly so that we're not storing it inside of our system thank you for explaining that to us the next question i have here is what if the patient put in wrong information and if the patient has a pin um in his leg or um how would he put in the information i guess is the question sure and i get that my my background is in radiology and so i totally understand the question um what typically is done as a review right with a technologist and because our software allows editing of the information after its initial submission by the patient um we can still support that workflow right so the technologist can go through verify the information with the patient and if they've made some sort of mistake on their form there's an opportunity for that to be corrected and then re-signed by the patient and counter-signed by the technologist i see and if the patient updates demo on the form with this feedback go to the ehr yep so all the information we collect from the patient on the form can be sent to the ehr both as discrete data and as and as a traditional form image got it thank you for explaining that the next question i have here is does this tool allow for integration that will allow automated consents based on the verification results posting schedule and yes um go ahead i'll go ahead i'm going to say the question around the information my apologies must have a delay i will let you continue with the response there i apologize so i think the question was um are we able to automatically assign forms consents etc based on information about the patient or their appointment so if a patient is self-pay you may want some particular form served to that patient that is different than um if they have private insurance or if the patient is coming in for one type of visit you may want a different form based on that visit type and and we can do that right so imagine you know on a paper-based process the the registrar would be building a little packet based on information about the visit or the patient we can actually do this automatically with logic so we get a scheduling message from you we analyze that message to decide which forms we're going to send to that patient or which steps we're going to send to the patient to fill out great thank you for that explanation the next question is does informed consent need to be obtained every telehealth visit or just once a year that depends a lot on your area so there are 30 at 39 different different districts have individual informed consent policies and then the payers may have specific policies around um telehealth consents right so um it would really depend on your specific area exactly what would be required i will say that right now these um these restrictions have been greatly relaxed in order to facilitate as much telehealth as as we can provide and i don't know in the future if they're going to be re-implemented but for right now it's it's not requiring as much consent as it did before the the pandemic that's good to know the next question i have here do providers build their own forms or does your database provide forms and which forms are linked to certain types of appointments so we take your forms right so we take your forms and and digitize them we don't have right now a library of standard forms we find that our customers have already done this work to get their forms approved and are not asking for their forms to be scratched and new ones to be brought in so we take your forms we put them in an electronic format and then we also take that and put that in a mobile-friendly format to collect information from the patient got it and how is security of the patient handled with so many different types we do our platform is built on salesforce and salesforce has a service card shield that helps make sure that everything is fully hipaa compliant and is encrypted at rest and and all that kind of stuff so uh it's all all logging into the same platform regardless of your mobile device type and so it has that same security regardless of what device you use to access it i see that's helpful to know and our next attendee question is how are administrators or providers notified of clinical or administrative alerts do they get an email or do they have to constantly monitor the dashboard the alerts do show display on the dashboard they update in real time so when they go to look at that patient they can see right right there on the dashboard that there is an alert click on it and find out more information got it the next attendee question we have is what ehrs do you work with we are ehr agnostic so we can work with any ehr we have customers using a wide variety of ehrs and so we are able to work with whatever you've got good to know our next question is does this require another login for patients and staff there is a login for for the patient for the staff and sorry the patient we make it as easy as possible using like a two-factor authentication um process so that they don't have to come up with the username and password for you know for security and and hipaa reasons we do want um staff to have an individual login so that we can keep track of who is looking at what information got it that's very helpful the next question is is the staff able to review the information patients have entered before it's added to the ehr yeah so we can send information using a ccd format which a lot of times and most dhrs support reviewing that information before it's committed to the ehr so that's one method another method is that they could look at the forms that the patient is filled out inside the dashboard and and look at that as well before it's sent over to the ehr got it and this may be kind of looped into what you've discussed already but we did have an attendee ask or mention that they have a cerner emr how does all the information get into that medical record so we are able to use all um the standard methods of sending discrete data whether it be hs7 the smart on fire model so we use just the communication standards that that allow the systems to interoperate okay that's helpful another attendee wanted to know do providers normally need training to be able to implement this tool in their clinic we do provide training we strive to make it as easy to use as possible because we understand there's a lot of challenge around you know turnover or you know we just don't want a high learning curve on our software so we make it as easy to use as possible but we also provide training for staff who would use the software got it and how far in advance does an appointment need to be scheduled for the forms to get sent to the patients this attendee's wanting to know if the information is sent from the ehr in a batch in advance or whether they receive real-time information from the ehr we send it out in real time so if you schedule an appointment right now like a patient who has a walk-in or something like that that information or that that that form packet that sort of digital packet is built and sent immediately to the patient and we can also accommodate so if a person has a an appointment scheduled a year in advance and you don't want to send their forms to them a year in advance but you'd rather be say five days before their appointment we could hold off on sending it as well i see good to know um the next attendee question here is do you integrate with crms yes so again we're built on salesforce so it's um it's our own platform out on salesforce and so we have customers who are using salesforce as well and so yes that's our that's our basis is on salesforce got it and then another attendee is asking what types of devices does your software work on because we're browser-based we're pretty um device independent right so you know your mobile devices your desktop computers laptops all that stuff we work with any any browser that uh that your device has so we can be pretty broadly used across devices it's very helpful our next question is are the forms placed into the ehr in the form of a scan or a photo so the the forms go to the ehr they're like a pdf so um they're just a form image but the data that's on that forum is also can also separately be sent as discrete data so that way you have the data update that you want but also have a form that looks familiar to you and everything is in the place you expect it to be on the forum great thank you so much that's very helpful and i appreciate your time here at teresa do you have any closing words before we um finish up the webinar i just want to thank everybody for for tuning in and i want to thank you for the hard work that you're doing every day for our patients i appreciate your time and attention fantastic well that is all the time we have for today i know if there are any attendees with additional questions for anna teresa feel free to reach out to everybody's health and they will definitely be able to address them i want to thank theresa and anne for their excellent presentation in interlaced health for sponsoring today's webinar enjoy the rest of your day and we look forward to having you join us for future webinars you