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Tuning In to Telemedicine

Virtual visits surge during the COVID-19 pandemic as experts recommend them in place of in-person appointments.

Patient has a virtual doctor visit using mobile phone

During the COVID-19 pandemic, more people than ever are seeing the doctor without leaving home.

Telemedicine, already a trend before the pandemic hit, allows patients to consult with their healthcare providers without risking exposure to the virus at the doctor’s office or clinic. That’s especially important for people living with rare and chronic diseases that could make them more vulnerable to the worst impacts of the novel coronavirus.

Knowing how to access telemedicine services was among the suggestions recently given by Dr. Marshall Summar, a physician who’s an expert on rare diseases and board chairman of the National Organization for Rare Disorders (NORD). NORD recently shared a Children’s National Hospital study that is using telemedicine to reach patients with genetic disorders. For the rare disease community, online doctor visits can be especially helpful for patients who live far away from specialists at major medical centers.

Before the COVID-19 crisis began, only about 10 percent of Americans had used telemedicine, according to a July 2019 J.D. Power survey. Now, medical facilities such as Mount Sinai Medical Center report their telemedicine volume has increased tenfold. More than 90 percent of primary care clinics in the United Kingdom now offer the service. Analysts predict one billion virtual medicine visits by the end of 2020. 

“I’ve always felt telemedicine had an important role in healthcare, and now the COVID-19 pandemic has catapulted virtual visits into the mainstream,” says Dr. Bruce Irwin, founder of American Family Care, which recently introduced telemedicine at 230 primary care clinics in 24 states.

As the use of telehealth services surges, a new study finds that the majority of healthcare visits conducted via telemedicine are an appropriate replacement for in-person care. More than 81 percent of telemedicine consults were considered useful, with psychiatry visits having the highest satisfaction rating.  

As promising as telemedicine seems to be, it’s a big change from the traditional office visit. Here are answers to common questions:

How do I know if I’m eligible for a telemedicine visit? Is it covered by insurance in the U.S. and government-sponsored healthcare in other countries?

Telemedicine is covered by government-sponsored health plans, as well as most private insurers. The Centers for Medicare & Medicaid Services (CMS) allows healthcare providers to bill for telemedicine visits at the same rate as office visits. So, if you pay a co-pay when you see your doctor, physician assistant or nurse practitioner in person, you also will be charged a co-pay when you receive care remotely. Government-sponsored healthcare in other countries also covers telemedicine. For specifics about billing or coverage, contact your providers’ office before your virtual appointment.

What do I need to conduct a telemedicine visit?

You will communicate with your healthcare provider via a desktop computer, laptop, tablet or smart phone. You might have to go online to your provider’s website to set up a telemedicine account. Typically, the provider emails the patient a link, the patients clicks on it at the scheduled appointment time and a window opens that allows patient and provider to see and talk with one another.

Don’t have a smart phone? You can still talk to a healthcare provider. Under new rules by the CMS, providers also can evaluate patients who only have audio phones. You won’t be able to see one another but you can have a conversation.

What can be handled via a telemedicine visit?

Telemedicine allows patients to get routine care, acute care and checkups while sheltering from home. The nurse or doctor you meet with can prescribe medications, advise you on how to care for yourself at home, and recommend further medical attention, as needed.

Telemedicine also allows physicians to check up daily on patients with chronic conditions who need extra help, as needed. People with acute or chronic conditions can be equipped with remote services, such as a pulse oximeter to remotely monitor a patient's oxygen saturation level.

What kind of healthcare providers are available through telemedicine?

Hospitals and a range of healthcare providers can use telemedicine, including doctors, nurse practitioners, behavioral health professionals and nutrition professionals. Telemedicine provides primary care, as well as a range of specialty care, including dermatology, pediatrics and psychiatry. You also can access providers who aren’t in your immediate area. The CMS has waived its requirement that the practitioner be licensed in the state where the patient is located. 

What are the limitations of telemedicine visits?

While telemedicine can be effective, there are limits. The doctor can’t touch the patient, draw blood or conduct other tests.

What are some tips for having a productive telemedicine visit?

  • Before your visit, write down symptoms, as well as any medications you are taking. The more details you provide, the better your provider can evaluate your health.
  • Be prepared. If you are able, take your temperature and your blood pressure. If you are concerned about a lump, bump or bruise, measure it.
  • Make a list of questions and concerns. Keep your questions relevant to your medical condition.

What if I’m not comfortable with technology?

Ask for help and be open to creative ways of optimizing the virtual doctor visit. The New York Times reported that a family doctor in England asked a patient’s granddaughter to click a link to activate a telemedicine visit via a smartphone. The physician then asked her to touch her grandfather’s legs to determine if they felt warm, which helped the doctor to diagnosis an infection called cellulitis.