Stuck At Home Guide: Telemedicine


Note: On Friday, April 17, 3-4pm EST, Senior Planet will host Dr. Michael Spertus, a family doctor and instructor at Harvard Medical School, to talk about how people can stay connected to their doctors through different platforms and video chat options. He will also talk about when he must see a patient in person vs. doing a virtual check-in. Learn how to join the online class here

Right after she was done with her annual checkup last year, Gina Cella, 58, of Boston, made her appointment for this year’s. However, this visit will be different. Due to the COVID-19 pandemic, her doctor has switched her to a telemedicine appointment, her first. And that’s fine with her. “I’m very comfortable with that,” she says, ”especially in this uncertain time.”

Telemedicine appointments are becoming more and more popular, and are especially fitting during the COVID-19 pandemic, when we’re all being urged to stay home as much as possible.  

Cella knows more about telemedicine than the average American, as she handles communications for the American Telemedicine Association. Thinking long-term, she says virtual visits, when appropriate, will probably become a habit. “After this crisis is over, I would still be comfortable handling some of my appointments by telemedicine.”

If you’re about to have your first appointment via telemedicine, also called telehealth, or just want to know more about it, here is your crash course. You might want to read it before you head for the virtual ”waiting room.”

Telemedicine Isn’t New

Reports of the history of telemedicine vary, but can be traced back to at least the late 50’s; in 1959 the University of Nebraska Medical Center psychiatry department conducted group therapy and instructed medical students by linking classrooms and clinics via telemedicine. 

Joseph C. Kvedar, MD professor at Harvard Medical School and president-elect of the American Telemedicine Association, has used telemedicine for nearly 30 years.  As an early adopter, trying to persuade colleagues to think about telemedicine, he would say: “Think about the interactions you have with your patients where you don’t need to touch them. This is the advice I gave before the pandemic and people laughed.” No longer. Of course, he says, sometimes your physician really does need to see you, face to face. But telemedicine can handle a lot, especially as we work our way through the pandemic.

Telemedicine & Its Many Forms

If your doctor suggests a visit by telemedicine, it could take many forms:

  • Email messages through your health plan’s patient portal
  • An old-fashioned telephone call
  • A Face Time or Zoom conversation
  • A Google Hangouts video appointment
  • Whatsapp video or other chat
  • A virtual visit on your doctor’s ”platform.” 

To find out if you have access to telemedicine, ask your primary care provider, Dr. Kvedar says. He or she may already have access to a telemedicine platform through the group practice. If not, you and your doctor can decide on a system.

Speak up about your preferences. Shahrzad Akbary, DO, a dermatologist with the Facey Medical Group in Los Angeles, is using Zoom to care for her non-emergency patients. But if a patient is not comfortable with that, ”we are setting up a phone visit if they prefer.” If privacy is the issue, she tells them that each doctor has a private Zoom link. Her staff works newcomers though the process so they will know what to expect. Her patients, for instance, first go to their patient portal or ”chart” online, and click a link to enter the visit. 

Medicare, Health Plans & Telemedicine

The U.S. Department of Health and Human Services has made it easier for physicians to provide telemedicine services, and the Centers for Medicare & Medicaid Services have loosened regulations for telemedicine due to the COVID-19 pandemic. According to Medicare, coinsurance and deductibles may apply, but some healthcare providers are reducing or waiving the fees for telemedicine visits. Many health plans are also waiving copays, Dr. Akbary says. You can inquire ahead.

Doctors can even help patients concerned about COViD-19 by obtaining their temperature or other vital signs remotely, according to the Department of Health and Human Services.

Getting Ready for Your Closeup

Prepare for a virtual visit in much the same way as for your in-person one, says Jill Butler, MD, FACP, an internist with VNAHG Visiting Physician Services, Holmdel, NJ. Organize your questions; have your medications at hand; pick a quiet place in your house or home office. 

For a video visit, ”make sure you are in a well-lit room,” says Todd Czartoski, MD, chief medical technology officer and a neurologist at Providence Health System in Renton, WA. “Have a solid wall behind you.”   

Be patient, as your health care provider may be learning right along with you. “A lot of people are coming on these platforms who have never used t hem before,” Dr. Kvedar says. “You might have to wait in a [virtual] waiting room environment.”

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