Op-Med is a collection of original articles contributed by Doximity members.
It’s 2020 and doctors are doing house calls again. No, we didn’t step back in time; instead, we’ve moved forward. Rather than knocking on a patient’s door with a stethoscope and wooden tongue depressor in tow, today’s house calls require no face-to-face appointments, only a smartphone with an internet connection. Telemedicine has arrived.
Telemedicine has fast become an important part of our new normal, owing to its convenience, as well as the growing need to provide continuity of care to patients with chronic conditions in the face of a global pandemic. Moving forward, there will be a significant number of patients where it will not make sense to have them physically come into your office when they can get the same level of care by simply doing a video visit. This, in part, accounts for the meteoric rise of telehealth.
Moreover, public health researchers have long understood that health care outcomes are different across various ethnic and socioeconomic groups. Now, many in the medical community are starting to realize that the broad adoption of telemedicine across the system could be a great “equalizer.” This is particularly true for communities that have historically struggled to access care — remote rural or underserved urban communities. There’s great hope that telemedicine could be one development that helps bridge a persistent divide in outcomes, so long as accessing it is easy and inexpensive for patients.
Despite the many positives, there are likely some patients who have yet to have their first telemedicine visit. And it’s understandable that some may view telemedicine as a challenge, due to either their lack of confidence with technology or not feeling that they have the resources to connect with their doctor remotely. These concerns are valid but the various telemedicine options available today make it a simple and reliable option for the broadest possible number of patients.
As a practicing internist, I’ve conducted many telehealth visits, and see the potential for telemedicine directly in my own practice. I’ve also had the privilege of helping patients with the basics of getting started with their first telehealth appointment.
Here are five things you can tell your patients to do to help them prepare for their first virtual visit:
- Test your tech: Patients don’t need much to get started but virtual visits will require a basic familiarity with video conferencing on a device or smartphone. Telemedicine at its core is simply a video call with a doctor and though the device they use is up to them, it’s important that their internet connection — either WiFi or cellular — is fast enough to do the call. Urge your patient to give it a test before their first appointment. If they need to download an app, they should do it prior to the visit. Depending on the platform you use, your patient may need to have the app already downloaded on their phone and be registered as a new user. There are multiple platforms to use, and every one of them is different, so make sure to tell your patients in advance if there are any special requirements. For example, some require downloading an app, whereas others, like Doximity Dialer Video, only require the patient to open a text and tap a link. Every platform is different, so make sure to tell your patient in advance if there are any special requirements.
- Prepare questions in advance: Telemedicine visits are typically about 20% shorter than in-person appointments. As with any in-person doctor visit, patients will want to maximize their time by preparing questions they have in advance of the appointment. Encourage them to set an agenda and have questions handy during the call to ensure they get everything answered.
- Check coverage and co-pays with your insurance provider: Insurance coverage for telemedicine visits vary. Medicare, for example, covers all COVID-19-related telemedicine visits, yet some private insurers may not. Efforts by insurance providers to update coverage policies amidst the surge in telemedicine has created a patchwork of policies that aren’t always clear. Have your patients contact your office before their first telemedicine visit to double check what’s covered under their plan.
- Get comfortable: Physicians try to make our offices and clinics as inviting as possible but patients are likely most comfortable in their home. That said, telemedicine visits are subject to HIPAA and are private matters, so make sure your patients are aware and have a quiet, discreet space to have the call and use headphones or earbuds if possible. Good lighting is also important for any visible concerns they may have. Ask them to wear clothing that is easy to move in so they are best able to participate in a physical exam.
- Be prepared to talk about follow-up care: Before ending the video call, make sure that they understand next steps and follow-up. Patients should have a clear understanding of how to get in touch with you and understand where and how to get necessary prescriptions. They can always check in with the staff at your office after their telehealth visit if they are interested in written paperwork for follow-up purposes.
House calls are back and are here to stay — but they aren’t the kind our grandparents had. Research shows telemedicine offers a wide range of efficiency and accessibility benefits for both patients and physicians. The first visit can seem daunting for patients but by offering this advice and treating the virtual visit as an extension of in-person care, it can be an easy and efficient way to conduct an appointment.
Peter Alperin, MD, is a practicing internist and vice president at Doximity.
Previously published in Medical Economics.