The Per-Consult Model of Telehealth Services: Sustaining Specialized Care while Controlling Costs

The Per-Consult Model of Telehealth Services: Sustaining Specialized Care while Controlling Costs

Interruptions abound in specialized medical care. Between a national healthcare labor shortage affecting hospitals and clinics alike, and the growing trend of specialization amongst providers, medical facilities are finding it harder to have every kind of specialist on-hand for every scenario. One innovation that shows promise for healthcare organizations and patients alike is the Telehealth Per-Consult Model, an approach that brings in the services of specialists as the needs arise, and enables facilities to offer treatment at the location, even when the specialist is not.

Staffing for Specialized Care Needs

Many hospitals and clinics do not have the proper volume of patients to require full-time or even part-time employment of specialists and often these services, when required, are needed urgently. Traditionally, hospitals faced the dilemma of either maintaining specialists on staff, which can be expensive and inefficient, or sending patients elsewhere for specialized care. Innovating by combining two strategies can address these challenges:

• Per-Consult: Tagging in specialists when they are needed rather than having them on-hand in a full-time or part-time capacity.
• Telehealth: Utilizing the services of a healthcare provider who is not physically present.

Adoption of telehealth models is growing, and when combined with the per-consult service model, healthcare organizations can tap into specialized care on an as-needed basis.

Understanding the Per-Consult Model

The per-consult model operates on the principle that specialized care providers are billed on a per-consultation basis rather than being employed full-time. Here's how it works:

1. Consultation Request: When a specialized consultation is needed, the hospital submits a request to the provider.

2. Response Time: The provider responds within an agreed upon timeframe for the consultation.

3. Provider and onsite staff work together to determine whether a peer-to-peer consult or a virtual patient visit is needed to deliver highest quality of care.

4. Consultation is completed and provider either makes recommendations to the ordering provider or enters orders for patient care in the site’s EHR.

5. Plan of care is established between specialist and onsite team to determine whether a follow up visit needs to be scheduled with the specialist.

Two Approaches to Per-Consult Telehealth

There are two distinct approaches to this model of patient interaction:

1. Peer-to-Peer Request: Specialists connect remotely and provide guidance to on-location physicians, ensuring patients receive timely and expert care.

2. Virtual Patient Consultation: Specialists join a call with the patient and on-site medical staff, interacting directly with the patient and offering real-time assessments, prescriptions, and recommendations.

Specialties with Successful Per-Consult Telehealth Models

• Tele-Cardiology: Patients consult remotely with offsite cardiologists for specific cardiac concerns.
• Tele-Nephrology: Nephrologists are brought in remotely for consultations regarding dialysis and kidney-related issues with patients.
• Tele-Infectious Disease: Infectious disease specialists provide remote consultations to address antibiotic stewardship and proper plans of care.
• Tele-Psychiatry: As the specialty most widely embraced in telehealth, patients receive on-demand psychiatric consultations or therapy, allowing very timely access to mental health expertise.
• Tele-Pulmonology: Pulmonologists remotely assist with respiratory concerns, enabling a case-specific approach.

The per-consult model of telehealth services is a forward-thinking solution that assists healthcare organizations in reducing patient transfers, increasing the comfort of on-site staff when dealing with specialty issues, and providing patients with access to specialized care.

For healthcare organizations suffering under a labor shortage, embracing innovative strategies such as telehealth and the per-consult model means sustaining specialized care while efficiently managing costs.