Telemedicine: The Doctor Will ‘Screen’ You Now?>

Telemedicine: The Doctor Will ‘Screen’ You Now

by Tim Gower

The Covid-19 pandemic has undoubtedly taught you some new ways to stay connected with the outside world while staying home—and for many people, that’s meant swapping office visits with doctors and other health care providers in favor of “virtual” visits over interactive video platforms like Zoom, FaceTime, and Skype.

Telemedicine—using telecommunications technology to let doctors interact with patients from a distance—isn’t new, but it’s rapidly becoming an essential tool in health care. Once primarily used to link doctors to patients residing in remote areas, telemedicine emerged this year as a way to keep people out of packed waiting rooms in doctors’ offices and clinics, where they might pick up or spread the new coronavirus.

Telemedicine got a boost in March 2020 when the Centers for Medicare & Medicaid Services (CMS) announced it would temporarily reimburse health care providers for virtual visits across the United States. Some major insurers cover the cost of telemedicine, too. Telemedicine is a critical feature of telehealth, a broad term for all uses of telecommunications to deliver health care, which includes the use of wearable devices and apps to collect patients’ medical data at home and transmit it to providers electronically (known as mobile health or mHealth).

Some doctors think telemedicine appointments could replace many in-office meetings. If you haven’t had a virtual visit with your doctor yet, here’s what to expect.

Medicine in your living room

Until recently, CMS reimbursed doctors for conducting telemedicine appointments only when they used them to provide care for people in rural communities who often lack access to medical specialists. Even then, the patient had to participate in the virtual appointment at a local medical facility—receiving telemedicine services in his or her home was generally not allowed. CMS waived those criteria during the pandemic, opening the door for patients all over the country to have telemedicine appointments with doctors, nurse practitioners, psychologists, and other health care providers.

The telemedicine process is fairly simple. Typically, your provider’s office will call or email you a few days in advance with instructions on how to participate. You’ll need a reliable internet connection or, if using a smartphone, dependable wireless service. Be sure to test your device’s camera, microphone, and speakers. If your provider instructed you to download an app to your device, do that beforehand, too.

How to Make a Virtual Medical Appointment

A number of direct-to-consumer telemedicine services can arrange a live video consultation between you and a doctor, a psychotherapist, or certain other providers, often within minutes.

Find a quiet, private part of your home for the appointment, if possible, and be ready to start 15 minutes beforehand. At the appointed time, follow the instructions (such as clicking on an email link to connect to the website hosting the session) and wait for the appointment to begin. If you don’t have internet access, CMS allows you and your doctor to conduct telemedicine appointments over the telephone.

In addition to interactive video, other high-tech tools are helping to make telemedicine an acceptable alternative to office visits for certain conditions. If you have diabetes, for example, you can monitor your blood sugar levels at home and upload the readings to your doctor’s computer. If you have high blood pressure, you can wear a monitor that tracks your blood pressure daily and transmits your results to your medical record.

What conditions is telemedicine best for?

Studies show that telemedicine can be just as effective as in-office care for some chronic conditions. A 2015 analysis of 93 clinical trials published in the Cochrane Database of Systematic Reviews found that people treated with telemedicine for heart failure, diabetes, high blood pressure, cholesterol, and mental health and substance abuse problems fared just as well, or better, than others receiving traditional face-to-face care in a clinic.

More recent studies have found that telemedicine is equal to office-based care for managing patients with insomnia, non-acute headaches and migraines, and depression. With the high quality of cameras on computers and smartphones, dermatologists can even treat some skin conditions from afar.

Obviously, medical emergencies can’t be addressed in a Zoom session—a broken bone or chest pain requires a trip to the hospital as soon as possible. What’s more, telemedicine doesn’t permit a doctor to use instruments to examine you, including his or her hands. If you have rheumatoid arthritis, for instance, your doctor can inquire about your pain and stiffness, but can’t palpate your affected joints.

Nonetheless, surveys find that most patients are satisfied with telemedicine visits, even if many still prefer in-person care. It’s easy to see why: There’s no need to fight traffic, pay for parking, or arrange transportation if needed. And you can relax in your own home while waiting for your appointment to begin, instead of in a busy waiting room and browsing an outdated (and possibly germ-laden) magazine.

This article first appeared in the July 2020 issue of UC Berkeley Health After 50.

Also see Coping with Covid-19 Isolation.