Telehealth

Q:  Do residents and fellows require approval to provide telemedicine?

A: Yes.  Telehealth Privileges are required for all providers (including residents and fellows) to perform telemedicine.  For those residents and fellows who will provide telemedicine at a non-UW Medicine site, there may be additional requirements and training at that site (i.e., VA, Seattle Children’s).  If you have questions regarding telemedicine, please contact your program director.

SCCA will recognize UW Medicine telemedicine and privileging requirements; additional telemedicine setup at SCCA will be required. For more information, please ask the manager of the clinic.

Q:  How do I register for training?

A: As of AY22, all incoming residents and fellows are assigned the Telehealth training as part of the June 1 eLearning launch.

Q: How long is the training?

A: The training takes approximately 30 minutes.

Q:  What privilege form needs to be completed?

A: A training attestation button has been added to the training module in the UW Medicine Learning Hub.  Once signed, completion of training will be recorded.

Q: How do I ensure I am setup for telemedicine in the appropriate clinic(s)?

A: Providers need to be setup for telemedicine visits for each clinic where they see patients.  Clinic managers/leadership are responsible submitting the required telemedicine implementation request form for all providers in their clinic to Telehealth Services.  Questions about setup need to be directed to the respective clinic manager, who will coordinate with Telehealth Services

Q: What if I have questions about the training registration process and privilege form?

A: Please email telehealth@uw.edu.

Q: How do I know when I have been approved for telemedicine?

A: Once you complete the training, the Telehealth Services Department will submit a request to IT to release the visit type. This should be available to you in Epic within 24 hours. You can check the status of your LMS training at the following link: Provider LMS Status Report.

Q: What if I have questions about the specific workflows in my clinic?

A:  Questions should be directed to the respective clinic manager.

Q: Where do I direct my questions about training and access to telemedicine?

A:  Questions should be directed to the respective clinic manager.

Q:  Do residents and fellows providing telemedicine need to be supervised by an attending privileged in telemedicine?

A: Yes

Q: Do attending physicians need to be in the same physical location of a resident/fellow providing telemedicine?

A: No.  Attendings can be in a different physical location but on the same video conferencing platform.

Q:  Is Direct or Indirect Supervision required by the ACGME?

A:  ACGME released guidance on telemedicine visits on March 20, 2020.  In response to the COVID-19 pandemic, the definition of Direct and Indirect Supervision now includes telemedicine.  ACGME allows programs to decide how to implement this at the program level, including the availability of the supervising physician during the patient encounter.

However, in order for an attending to bill for the patient encounter, they must be on the same teleconference as the resident/fellow, and therefore provide direct supervision.

Q: Can residents see primary care patients via telemedicine?

A: CMS has not addressed this in any recent policy documents so we’re operating that attending needs to be on the teleconference w/ resident and patient in order to bill.

Q: Can residents provide care allowed under the primary care exception (PCE) via telemedicine/telehealth?

A: Yes, as long as the appropriate level of supervision is in place for all residents based on each resident’s level of education/training and ability, as well as patient complexity and acuity. The teaching physician may provide supervision in-person or remotely via technology. This is true as of 3/25/20.

Q: Can the institution bill for a phone visit if a resident was the one who conducted the phone visit?

A: Not unless the attending is also on the line.  This is obviously challenging technically and logistically. This is a fast changing situation; for the latest information, please contact your clinic manager/supervisor or program director.

Q: What are the documentation and compliance requirements during COVID-19?

A: UW Medicine Compliance guidelines for documenting during COVID-19 are on the UW Medicine Compliance website.  This includes CMS updates for telemedicine and teaching physician rules.

Q: Can I provide a telemedicine visit from my home?

A: Yes, In order to support social distancing providers may provide telemedicine services from their home in a quiet, professional, HIPAA compliant space during this COVID-19 response. Please continue to document where you are located and this service is being performed from home.