The COVID-19 pandemic has changed our world in a short matter of months. We in the New York and New Jersey area experienced the pandemic with a complete shutdown. The medical world was focused on the mounting and overwhelming cases of this horrible COVID-19 disease. Most other treatments, surgeries, screenings, and physician visits were put on hold.
Here at Healthlink Advocates, we have assisted many clients navigate these new waters of a telemedicine physician visit. We participate in them to ensure that the patients needs and questions are addressed as well as prepare them for the technical side of the set up of these visits and how it all works. If you need assistance, we can help.
Telemedicine Became a Need During the Pandemic
This opened our world to a greater need for telemedicine. Telemedicine refers to the practice of caring for patients remotely when the provider and patient are not physically present with each other. Modern technology has enabled doctors to consult patients by using HIPAA compliant video-conferencing tools like Zoom or Microsoft Teams or even using Facetime on your iPhone. The provider can be your physician, nurse practitioner, therapist, or a specialist consult.
More and more patients are collecting medical data at home with apps that track blood pressures, weights, fitness goals, and more and can be sent electronically to the physician for review and discussion during a telemedicine visit.
A Bit of History
Historically, telemedicine has been around for a long time. Even as far back as Alexandar Graham Bell’s time when they decided that they could use the phone for remote health communicating. It was also used in the Mercury space program when NASA began performing physiologic monitoring over a distance on their astronauts. NASA further developed this technology with a pilot with the Papago Indians. Rural areas have benefited for quite a while with telemedicine since they are many miles from direct healthcare providers. Telemedicine has also been used for decades in clinical settings. For instance, EKG and other tests can be transmitted electronically.
Insurance On Board!
COVID-19 has changed everything. Medicare quickly hopped on board with telemedicine. In the past, Medicare had many limits related to HIPAA/licensing regulations and physical location, that only very rural areas of the country regularly practiced telemedicine with Medicare/Medicaid. Starting on March 6, 2020, Medicare started to cover these visits as if they were in-person visits in any location.
How It Works
During this pandemic, these telemedicine visits have taken place on an iPhone Facetime app, a Zoom call, Microsoft Teams application, and more. It can be used for follow-up visits, managing a chronic disease, medication management, a specialist consultation, and a host of other clinical services. These are provided remotely with the patient at their home via a secure video and/or audio connection to their provider. This has been used in the past but in a limited way. Due to the restrictions brought on by the COVID-19 pandemic, the use of Telemedicine has exploded.
I believe that telemedicine is here to stay. As nurse advocates, we have participated in many telemedicine calls with our clients and their providers to offer the needed assistance.
Benefits
Using telemedicine as an alternative to in-person visits has a host of benefits for patients and providers alike. Patients enjoy:
Less time away from work or home responsibilities
No travel expenses
Less interference with child and elder care responsibilities
Privacy
No exposure to other potentially contagious patients in a waiting room
Providers enjoy:
Improved office efficiency
It provides an answer to the competitive threat of retail health clinics and online-only providers potentially improved health outcomes
Fewer missed appointments and cancellations
Private payer reimbursement – due to COVID-19 insurance companies are reimbursing telemedicine visits.
Increased revenue
Can it work as well as in-person care? NYU Langone reported on their experience in a 6 weeks time period. They conducted 144,940 video visits involving 115,789 unique patients and 2,656 unique providers. They found that 56% of those visits were for urgent care and 18% were non-urgent COVID-19 related visits. Patient satisfaction ratings with telemedicine visits were positive.
When you think about the things that create anxiety regarding a physician visit like travel and getting there on time as well as the wait times, concerns about exposure to contagious illnesses, the telemedicine visit can reduce all of those concerns. I feel the visits are more beneficial if you have a prior relationship with the physician, although I have had many people say that if it is a minor illness or problem the insurance MD line can be enough.
As a nurse advocate and health coach, I have spent many years interacting with patients and clients face to face. When I became certified as a health and wellness coach, the coaching was all by phone. I found that this was more effective and beneficial than in-person interactions.
A virtual visit with your physician will never substitute for the need to do an in-person physical exam but used appropriately it can a great option in certain situations. We will need to wait for the studies to be done on the quality of telemedicine visits versus the in-person visit to be able to assess this properly.
Be Prepared for Your Telemedicine Visit
What can you do as the patient to prepare for the telemedicine visit? Here is a list to review and consider:
Be prepared with the correct technology needed and the steps required to connect to the visit ahead of time. Plan to do a “dry run” if it is the first time using the technology. Make sure your audio and video are working.
Obtain/download any needed apps ahead of time.
Find a quiet space and good lighting ahead of time
For any physician visit, have your list of symptoms, medical history, medication listing, outcomes of any test results you need to discuss, and all of your questions. It is best to write this all down, so it is readily available for the call.
Have a family member or friend assist if the technology is challenging.