Sample Allergy and Immunology Telehealth Workflow
Telehealth (TH) visits may be conducted on site or at a remote location (check your company and state requirements). Regulations regarding interstate telehealth activities vary from state to state. Be sure you know the regulations for your state and the state where the patient is located at the time of the telehealth visit. The patient’s state of residence is not controlling, it is where the patient is located at the time of the visit that matters.
Regulatory Considerations
• Location: The provider must be licensed in the state where the patient is physically located at the time of the telehealth visit, regardless of the patient’s state of residence.
• Platform: Use a HIPAA-compliant telehealth platform. Confirm that both provider and patient have access and are familiar with the technology.
• Documentation: Ensure all telehealth encounters are documented in the EMR per state and payer requirements.
1. Scheduling & Pre-Visit Preparation
Patient Initiation
• Patient requests a telehealth (TH) appointment via phone or patient portal.
• Staff screens requests using a practice-specific algorithm to determine telehealth eligibility (e.g., follow-up for asthma, eczema, medication management, review of test results).
• Provider approval as needed, based on staff training and protocols.
Pre-Visit Communication
• Two days prior: Automated text/email or staff call reminds patient to complete pre-visit interval history and symptom questionnaires online.
• One day prior: Staff contacts patient to:
• Update medication and allergy lists in the EMR.
• Confirm completion of online forms.
• Ensure patient has the telehealth link and can access the platform (offer a test run if needed).
2. Day of Visit
Patient
• Logs into the telehealth platform 5–10 minutes before the scheduled time.
Provider/Staff
• Load the standard visit template in the EMR.
• Open a secondary device or window for charting (recommended: one device for video, one for documentation).
• Optional: Open a text document or have a notepad for quick notes.
Telehealth Encounter
• Provider joins the virtual room, confirms patient identity and reviews consent for telehealth.
• Conducts the visit, including:
• Interval history and symptom review.
• Medication/allergy reconciliation.
• Visual exam (as feasible via video).
• Review of action plans (asthma, food allergy, anaphylaxis).
• Education and counseling.
• Document findings and plan in the EMR during or immediately after the visit.
3. Immediate Post-Visit Actions
Provider
• Enter orders for labs, imaging or procedures as indicated.
• Prescribe medications electronically.
• Complete and document patient-specific instructions, action plans and follow-up recommendations.
• Complete the electronic superbill and follow-up scheduling in the EMR.
Staff (Medical Assistant/Nurse)
• Assemble and send after-visit summary, educational handouts and action plans via the patient portal.
• Process electronic prescriptions and lab/test orders.
• Ensure all charges are entered and processed.
4. Deferred Provider Activities
• Review and finalize documentation: history, exam, medical decision-making and plan.
• Generate and send post-visit correspondence (e.g., consult letters, school forms) as needed.
• Complete and sign the visit note in the EMR.
5. Best Practices & Tips
• Dual Devices: Use one device for video and another for charting to streamline workflow and maintain eye contact.
• Patient Engagement: Encourage patients to prepare questions and have medications/devices on hand for demonstration.
• Technical Support: Provide clear instructions and support for patients unfamiliar with telehealth platforms.
• Action Plans: Review and update asthma or allergy action plans during the visit; send updated plans via the portal.
• Follow-Up: Schedule next appointments (in-person or telehealth) before ending the visit.
Note: Always verify payer-specific telehealth requirements and billing codes, as these may change periodically.
11/11/2025