Professional Healthcare—Connected Wherever the Patient May Be
Hospitals Without Walls™ uses telehealth and virtual care technologies to help qualified healthcare professionals connect with patients, caregivers, facilities, and collaborating providers beyond the traditional medical office.
Virtual care may improve access and continuity when it is clinically appropriate, technically feasible, legally permitted, and supported by a responsible care team.
What Is Telehealth?
Healthcare Delivered Through Communication Technology
Telehealth is the delivery or support of healthcare services through electronic communication technologies when the patient and healthcare professional are in different locations.
Depending on the program, telehealth may include:
- Live video visits
- Audio only services when permitted
- Secure patient messaging
- Electronic exchange of clinical information
- Virtual care conferences
- Remote patient monitoring
- Patient and caregiver education
- Coordination among authorized healthcare professionals
- Follow up after hospitalization or another transition of care
Telehealth is a method of delivering or supporting care. It is not a separate medical specialty and does not reduce the professional standards applicable to the service provided.
The Role of Virtual Care
Extending Appropriate Care Beyond Physical Walls
Telehealth may help patients:
- Connect with qualified professionals from home or another appropriate location
- Receive selected follow-up services without unnecessary travel
- Discuss symptoms, medications, and treatment questions
- Participate in chronic disease management
- Receive behavioral-health or supportive care services
- Include authorized family members or caregivers
- Participate in care planning
- Maintain contact during transitions between care settings
- Connect with specialists or other members of the care team when available
Virtual care should be used when the treating professional determines that the patient's needs can be addressed safely and effectively through the available technology.
Who May Benefit?
Care Based on Need—not Technology Alone
Telehealth may be useful for selected patients who:
- Have difficulty traveling to a medical office
- Live far from an appropriate healthcare professional
- Have mobility or transportation limitations
- Require follow up for an acute or chronic condition
- Need medication, symptom, or treatment review
- Are transitioning home after hospitalization or facility care
- Require behavioral health, palliative, or caregiver support
- Benefit from coordinated participation by several professionals
- Need interpretation or accessibility assistance
- Prefer virtual care when clinically appropriate
Telehealth may not be appropriate when a patient requires a physical examination, procedure, diagnostic testing, emergency evaluation, hands on treatment, or another service that cannot be delivered safely at a distance.
Our Virtual-Care Process
A Structured Clinical Encounter
- 1
Eligibility and Appropriateness
The organization evaluates whether the requested service is available and whether telehealth appears appropriate for the patient's needs.
- 2
Identity, Location, and Contact Information
The care team may verify the identities and locations of the patient and healthcare professional, the patient's callback information, and the physical address needed if emergency assistance becomes necessary.
- 3
Consent and Privacy
The patient or legally authorized representative receives appropriate information about telehealth and provides any consent required by law, payer policy, or organizational procedure.
- 4
Clinical Evaluation
The qualified professional obtains relevant history, observes what can reasonably be assessed through the technology, reviews available information, and determines whether the virtual encounter is sufficient.
- 5
Care Plan and Communication
The professional explains the assessment, recommendations, limitations, follow-up needs, warning signs, and any referrals or additional services.
- 6
Documentation and Coordination
The encounter and resulting actions are documented according to applicable clinical, legal, organizational, and payer requirements. Authorized information may be communicated to other involved providers.
Clinical Services That May Be Supported
Virtual Care Across the Continuum
Depending on professional availability, patient need, program design, and applicable law, telehealth may support:
- Primary and specialty consultations
- Chronic disease follow up
- Medication review
- Transitional care follow up
- Palliative and serious illness support
- Behavioral and PsychoSpiritual health services
- Geriatric assessment and care planning
- Caregiver education and support
- Rehabilitation-related consultation
- Nutrition education
- Wound related follow up when virtual evaluation is appropriate
- Advance care planning
- Interdisciplinary care conferences
- Review of remotely collected health information
Availability of a service does not mean that telehealth will be appropriate for every patient or every encounter.
When In-Person Care Is Needed
Recognizing the Limits of a Virtual Encounter
A telehealth professional may determine that the patient requires:
- An in person examination
- Laboratory testing
- Diagnostic imaging
- Vital sign measurement
- A procedure or hands-on treatment
- Evaluation by another professional
- Urgent care
- Emergency department assessment
- Emergency medical services
A virtual encounter may be ended, deferred, or converted to another form of care if the technology is inadequate, the patient's condition cannot be evaluated safely, privacy cannot be maintained, or required information is unavailable.
Telehealth is not a guarantee that an in person visit, urgent-care visit, emergency department visit, or hospitalization can be avoided.
Telehealth and Emergencies
Virtual Care Does Not Replace 911
Routine telehealth platforms, patient portals, emails, text messages, and remote monitoring systems are not emergency response systems unless expressly designed and represented as such.
Patients should not wait for a virtual appointment or electronic response when they believe they may be experiencing a medical emergency.
If a patient may be experiencing a medical emergency, call 911 or seek immediate emergency assistance.
Quality and Professional Responsibility
The Same Duty to Provide Appropriate Care
Healthcare professionals delivering telehealth services must practice within their education, training, licensure, credentialing, privileges, scope of practice, and applicable professional standards.
The responsible professional must determine:
- Whether telehealth is appropriate
- Whether available information is sufficient
- Whether an in person examination is required
- Whether additional testing or consultation is necessary
- What treatment or follow up is appropriate
- When escalation to urgent or emergency care is needed
Technology does not independently diagnose, prescribe, or replace professional clinical judgment.
Licensure and the Patient's Location
Virtual Care Still Occurs Within a Legal Jurisdiction
Professional licensure and telehealth requirements may depend on where the patient is physically located at the time of service.
Before providing care, participating professionals and organizations must evaluate applicable requirements concerning:
- State professional licensure
- Interstate practice
- Telehealth registration
- Credentialing and privileging
- Scope of practice
- Establishment of the professional patient relationship
- Informed consent
- Prescribing
- Professional liability coverage
- Documentation and record retention
A professional's license in one jurisdiction does not automatically authorize practice in every other jurisdiction.
Prescribing Through Telehealth
Prescribing Requires Independent Legal and Clinical Authority
A qualified prescriber may prescribe through telehealth only when the prescription is clinically appropriate and all applicable federal and state requirements have been satisfied.
Requirements may differ based on:
- The patient's location
- The prescriber's licensure
- The medication involved
- Whether the medication is controlled
- The professional patient relationship
- Required examinations or evaluations
- Federal and state prescribing laws
- Current emergency or temporary policies
Telehealth availability does not guarantee that a prescription will be issued. No patient is entitled to a particular medication solely because a virtual visit occurred.
Privacy and Security
Protecting Information During Virtual Care
Telehealth may involve video platforms, telephones, mobile applications, patient portals, electronic health records, connected devices, and third-party technology vendors.
Participating organizations should implement appropriate safeguards addressing:
- Patient identity verification
- Secure access and authentication
- Authorized users and participants
- Private locations for communication
- Encryption and secure transmission
- Minimum necessary access to information
- Documentation and record retention
- Vendor responsibilities
- Business associate agreements when required
- Device and software security
- Incident and breach response
- Patient privacy and security education
No electronic communication system is completely free from privacy, cybersecurity, transmission, or technical risk.
Patients should identify anyone present during the encounter and avoid participating where unauthorized people may overhear or view private information whenever reasonably possible.
Accessibility and Equity
Virtual Care Must Remain Person-Centered
Telehealth programs should consider whether patients have:
- Reliable telephone or internet access
- Appropriate equipment
- Adequate vision, hearing, dexterity, or cognition
- Accessible technology
- Language assistance
- Digital literacy
- A private location
- Caregiver or technical support
- The ability to afford necessary connectivity
Reasonable modifications, auxiliary aids, interpretation, or alternative methods of communication should be provided when required by law and appropriate to the patient's needs.
A patient should not be denied clinically necessary in-person care merely because virtual care is available or organizationally convenient.
Telehealth, Remote Monitoring, and Mobile Care
Connected Services With Distinct Purposes
Telehealth, remote patient monitoring, and mobile healthcare may work together, but they are not interchangeable.
- Telehealth connects patients and professionals through communication technology.
- Remote patient monitoring electronically transmits selected physiologic information for review and management.
- Mobile healthcare brings qualified personnel or services to the patient's location.
- In person facility care provides examinations, testing, procedures, and treatment that require a physical clinical setting.
The patient's condition and care plan should determine the appropriate combination of services.
Medicare and Insurance Coverage
Coverage Depends on Current Requirements
Medicare and other payers may cover qualifying telehealth services when applicable requirements are satisfied.
Coverage and payment may depend on:
- The specific service provided
- The patient's eligibility
- Medical necessity
- The type and qualifications of the practitioner
- The patient's and practitioner's locations
- The communication method
- Current payer policies
- Documentation, coding, and billing requirements
- Federal and state law
Telehealth coverage rules may change. Each billing provider remains responsible for confirming current requirements and submitting accurate claims supported by the services actually provided.
Participation in a Hospitals Without Walls™ virtual care program does not guarantee insurance coverage or reimbursement.
Organizational Partnerships
Building Virtual Care Around Defined Needs
Hospitals Without Walls™ may develop telehealth and virtual care arrangements with:
- Hospitals and health systems
- Health plans and insurance companies
- Government and military healthcare programs
- Physician groups and medical practices
- Skilled nursing and post acute facilities
- Assisted living and senior communities
- Home health and community healthcare organizations
- Employers and other qualified organizations
Written agreements should define the eligible population, services, staffing, professional responsibilities, technology, patient consent, licensure, privacy, security, escalation, billing, quality measurement, and governance.
Quality and Performance Measurement
Measuring Access, Experience, Safety, and Outcomes
Depending on program objectives and reliable data availability, measures may include:
- Appointment availability and completion
- Connection or technical failure rates
- Time to professional response
- Conversion to in person, urgent, or emergency care
- Follow up and referral completion
- Patient and caregiver experience
- Clinician experience
- Accessibility and language assistance
- Clinical or condition-specific outcomes
- Emergency department visits and hospitalizations
- Healthcare utilization and program cost
Measures should define:
- The population
- Data source
- Baseline
- Exclusions
- Reporting period
- Analytical method
- Risk adjustment when appropriate
- Limitations
Research suggests that telehealth can improve access and may support selected clinical outcomes in certain populations and programs. Results vary by condition, patient population, technology, service design, comparison group, and study quality. No specific clinical, access, utilization, or financial result is guaranteed.
Request Telehealth or Virtual Care
Connect the Patient With Appropriate Care
Patients, caregivers, clinicians, and organizations may contact Hospitals Without Walls™ to discuss available virtual scare services.
Organizations seeking a contract should be prepared to describe:
- The population to be served
- The requested clinical services
- Geographic locations
- Professional staffing and licensure
- Technology and integration requirements
- Accessibility and language needs
- Privacy and security responsibilities
- Payer and billing arrangements
- Escalation and in person referral capabilities
- Desired performance measures
Important Notice
Telehealth is not appropriate for every patient, condition, or service. Availability depends on the patient's location, clinical need, professional licensure, provider availability, technology, connectivity, consent, payer authorization, program requirements, and applicable law.
Technical quality may affect what a healthcare professional can observe or evaluate. Telehealth does not guarantee a diagnosis, prescription, coverage, reimbursement, avoidance of in person care, or improvement in clinical or financial outcomes.
This page provides general information and does not constitute individualized medical, legal, regulatory, billing, coding, licensure, privacy, cybersecurity, or reimbursement advice. If a patient may be experiencing a medical emergency, call 911.
If a patient may be experiencing a medical emergency, call 911.