Simple Steps for OB Telehealth Implementation

Those of you who know me well know that I have been advocating for the use of OB Telemedicine since 2001. I’d like to share some inexpensive but innovative ways of conducting prenatal visits in your office or institution.  You do not have to contract with “virtual” companies that have overinflated prices and are trying to make profits for their shareholders rather than administer quality care to your patients. Your hard-earned money would be better spent taking care of your families and office staff, so please read on:

 

Is Telemedicine approved by ACOG?

 

Yes, please see Implementing Telehealth in Practice Committee Opinion #798, 2/2020

 

What is the best way to conduct a Telemedicine visit?

 

If your patient is greater than 12 weeks, a virtual exam is preferable over a telephone “visit” because you are able to document more objective evidence in real time, i.e., visual inspection of pt’s extremities and face to r/o edema, size of abdomen, etc.


How can a virtual visit be accomplished?

 

There are many platforms but Doxy.me is FREE, HIPPA complaint and no downloads are necessary. The downside is that it does not have a practice management component so you will have to manually integrate your office visits (videos) into your EHR in a store and forward manner.

 

How can I auscultate the fetal heart?

 

You will be surprised at how many patients have already purchased fetal dopplers and in the setting of COVID, this will happen more frequently. I came across one that is fairly inexpensive by a company named Wellue Baby Tone. It’s associated with an app and not only auscultates the FHT but displays the recording on Blue Tooth which can then be transferred, so theoretically, you could do a mini-NST.

 

Will insurance companies pay for a fetal doppler?

 

I’m not sure but I would advocate for it as a physician and if your patients have Medicaid, you could attempt to write a prescription for them as a DME since insurance companies pay for breast pumps, why not fetal dopplers?

 

What about the urine analysis?

 

1.    Google companies that sell UA strips wholesale and either send them to the patient or advise the patient where she can go to purchase them.

 

2.    Instruct the patient on how to dipstick and check her urine; you can then record the result in your chart

 

What about blood pressure recording?

 

Advise your patients to purchase a BP machine; some have Blue Tooth capability. If possible, have her record her BP during your virtual exam or have her take a screenshot of the recording if she’s using her smartphone. You would, of course, give her parameters and instructions regarding abnormal readings in your absence.

 

Ask her about fetal movement and any other questions you deem pertinent, then document.

 

 These protocols meet the SOC regarding prenatal assessment and you should be able to bill appropriately because you have the objective evidence to support your findings.

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Follow Dr. Linda on Facebook | Order your copy of The Smart Mother’s Guide to a Better Pregnancy: How to Minimize Risks, Avoid Complications, and Have a Healthy Baby | Dr. Linda is a board certified Ob/Gyn and an expert in the area of pre-eclampsia and high-risk pregnancies. Contact Dr. Linda about an appearance at your next event or media placement opportunities.

 

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