telehealth – virtual doctor appointments

The doctor will see you now. Virtually. Since the coronavirus outbreak started, you may be hearing from friends, family and colleagues about their virtual visits with their health care provider(s).

These televisits, which connect you with your doctor by video using your smart device (smartphone or tablet) or computer, have become much more popular since the pandemic began.

“The trend was already growing, but COVID-19 gave it a huge shove forward,” says Dr. Brian Blaufeux, MD, regional chief medical informatics officer covering Westchester County for Northwell Health. “The technology was there and some health care organizations and patients were more eager to institute it than others. But with the pandemic, it really took off.” And for now, he adds, Medicare beneficiaries can use telehealth for common office visits.

For patients, the pros are many. “In the age of coronavirus, you save yourself potential exposure to illness,” Dr. Blaufeux says. “While medical practices are making it safer for patients to come into the office, televisits remain a definite pro. Also, since you don’t have to travel to the office, you save time and money.”

The cons? “The main con is that the physical examination part of the visit is not the same as if the health care provider was right there,” admits Dr. Blaufeux. “And the patient is not having quite the same face-to-face experience.”
Telehealth visits are secure because the software platforms used for them are encrypted, Dr. Blaufeux explains. “They meet all the requirements for being secure,” he says. “And if you have visited your doctor before, your chart can most likely be open on one screen and the visit will be open on another screen.” This way, during your virtual visit, your doctor can view your medical records and any prescriptions you may be taking.

What a virtual visit covers
You can schedule a virtual visit for a wide range of health conditions, says Scarsdale Medical Group’s Dr. Bradley Adler. Conjunctivitis, skin rashes, and mental health conditions like anxiety, depression and sleep disorders all may be treated with a telehealth visit. “For a condition like tendonitis, during a televisit, I can have the patient press on a particular joint or move their joints so I can see what is going on,” Dr. Adler says. For skin rashes, the patient can take a photo and the health care provider can view it.
Some conditions don’t lend themselves to televisits, says Dr. Adler. If someone needs to have blood work, for instance, they would need to come into the office. It’s also difficult to diagnose a condition like strep throat, which requires a test.

“For now, most of the time with a televisit, the physical examination will be what the doctor can see on the screen, like whether you are breathing fast, something on your skin, and what you tell the doctor,” says Dr. Blaufeux. “But companies are developing devices such as stethoscopes that you put on your heart or your chest at home and that transmit the information to your doctor.”

Also in the works from tech companies are devices like use-at-home otoscopes and tongue depressors that will make it easier for diagnosing a variety of medical conditions during a televisit, he says.

Virtual visits do not replace your primary care doctor, says Dr. Caroline DeFilippo, MD, MPH, FACP, assistant medical director of Caremount Medical Group. “They should be used when you need care for non-emergent medical issues and routine/follow up care,” she cautions. “If an issue arises during a virtual visit, we have brought people into the office that same day for further testing or examination as needed.”

Preparing for a virtual visit
In order to have a televisit with your health care provider, you may need to download an app to your smart phone or iPad, then establish an account and create a password. Once you make an appointment, you’ll log in to the app shortly before the appointment time, says Dr. Adler. And you don’t have to be a real “techie” to set this up, he says. “If you run into any glitches, we troubleshoot on how to get help and walk them [patients] through the steps.”

Make sure you have a strong Internet connection and your technology is working properly, with the camera and volume turned on. It’s a good idea to have a backup device, too, in case your technology fails, says Dr. DeFilippo. You may need to give permission to use the camera and microphone on your device, she says. Sit in a well-lit private room and have a flashlight with you, if possible. Have your prescription medications in front of you during your visit so these can be reviewed with your provider.

The future of televisits
Dr. Adler says he feels that televisits will continue to be popular, although they won’t replace face-to-face visits. “Telehealth is a tremendous tool that offers opportunity on some levels for patients to access their physicians and get the care they need,” he says. “But patients should not underestimate the value of a personal interaction, too, when a patient comes to see me directly.”

As for the future of telehealth, Dr. DeFilippo says it’s on an upward trend. “In the future, I anticipate that we will use telehealth for some of our chronic disease management – replacing some, but not all, of the in-office visits, especially as patients have more ‘tools’ at home such as blood pressure cuffs and heart rate monitors,” she says.

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