En español | One of the challenging aspects of the COVID-19 pandemic is that social distancing and stay-at-home orders have made it more difficult to have a face-to-face meeting with your doctor.
For many physicians and patients, the remedy is increasingly telemedicine: the ability to remotely connect with a health care provider in real time, often over video, and sometimes via telephone, email, app or online patient portal.
While telemedicine isn't new — it's been deployed, for example, to connect rural patients with distant health care services or providers or to monitor ongoing conditions like diabetes — its use has spiked dramatically during the current crisis.
Telemedicine or telehealth — the terms are often used interchangeably — isn't a perfect solution for every wellness-related scenario. A medical emergency or a case too difficult to diagnose from afar still requires a visit to the doctor or hospital. “But to me this is going to be a very desirable thing for patients,” says Stephen Schloss, a urologist at Emerson Hospital in Concord, Massachusetts, whose office uses a telemedicine solution called doxy.me. “They love it. They didn't have to drive, they didn't have to park, they didn't have to go through all the hassle to go see a doctor."
The protocol for arranging telemedicine sessions varies by location, by practice specialty and by your ongoing history with a physician. Here are some common steps and tips to prepare for such a virtual visit.
1. Make sure you are tech-ready. You will need a decent smartphone, tablet or PC for a remote consultation, along with a reliable broadband or cellular connection to the internet, especially for video.
2. Check your insurance. Not every private insurer will cover telemedicine sessions in every locale, and the type of coverage varies among those that do. States have different regulations. Consult your provider to find out what's covered under your plan.
Medicare can pay for telehealth services to treat COVID-19 and “other medically reasonable purposes,” from common office visits to mental health consultations. Typical coinsurance and deductibles apply, though some providers are reducing or waiving them for such services.
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3. Make an appointment. Call your doctor's office or visit the practice's patient portal (a portal is a website that provides 24/7 access to your personal health information) or app to make a virtual appointment. The office may have you download an app, and/or will email or text you a link to click on about 10 minutes before your designated appointment time. In advance of the virtual visit, you may also have to digitally sign HIPAA (Health Insurance Portability and Accountability Act) and other consent forms on the screen, though regulations have been relaxed during the pandemic, and some providers may just ask you to verbally agree.
If you do not have an established provider, companies such as Teladoc Health, Amwell, PlushCare, Doctor On Demand and MDLIVE offer virtual visits. Be prepared to wait because of the excess demand.
4. Describe your symptoms. Depending on the app, you may be asked to fill in or check off symptoms.
5. Practice good security. Ask your medical provider about the steps taken to ensure your privacy. Choose a unique password that cannot be easily guessed and is not the same as you use elsewhere. “Approach it like how you protect your financial information,” says Mei Wa Kwong, executive director of the Center for Connected Health Policy. If possible, go someplace private in your home during the session.
The Department of Health & Human Services (HHS) says covered health care providers may use Apple FaceTime, Facebook Messenger video chat, Google Hangouts, Zoom or Skype during the crisis, while having providers notify patients of any privacy or security risks.
"Don't be afraid to say to the doctor, ‘I am very comfortable using FaceTime [or whatever favorite you have]. Would you be?'” says Joe Kvedar, a Boston-based dermatologist and president-elect of the American Telemedicine Association.
6. Be prepared to wait. You may be placed in a digital waiting room before the session with a doctor begins. (Bring your own magazine.)
7. The doctor is in. When your appointment begins, the doctor will be seen on the screen (or heard on a phone) and will ask questions like in a typical examination.
8. Video can help virtual exam. With video a doctor can have you stick out your tongue, walk around and so on. Kvedar asks patients to upload pictures of skin conditions so he can have a look. And while having a phone call with a mental health professional can be beneficial for a patient suffering from anxiety, using video may help the psychologist observe body language or other visual cues.
9. You still may need to be seen in person. Only so much can be done remotely. Do you need blood drawn, an X-ray, biopsy or strep test? “If we need more information than we can glean from you over this medium,” we may ask you to come in, Kvedar says. But given the risks during the crisis, “we're making some very thoughtful trade-offs of who we invite into the office or lab."
10. Get prescriptions filled. Based on the virtual session, your provider can call in a prescription or refill to your pharmacy and follow up as needed.