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Telemedicine

How Does Telemedicine Work?

Dr. Joe Pazona

Telemedicine is here to stay. One benefit of the COVID-19 pandemic has been the increased utilization of virtual healthcare. Over half the U.S. population have already completed a telemedicine visit with a healthcare provider.

Physicians are on board with the revolution as well. A recent report on telemedicine shows:

  • 50% of U.S. physicians are currently seeing patients via telemedicine.
  • Over a third of doctors have room in their schedule to see more patients via telemedicine.

 

Anything new can be scary however. Especially when it comes to your health. Privacy, affordable cost and quality of care are of the utmost importance.

If you’re new to telemedicine, I bet you have a lot of questions. Such as:

  • What is telemedicine?
  • How does telemedicine work?
  • What technology do I need for a telemedicine visit?

 

Don’t worry, we are here to help. Our team at VirtuCare are experts in telemedicine and can guide you through this process. We want you to feel confident that you are receiving exceptional care from the comfort of your home.

Here’s your complete telemedicine guide!

What is telemedicine?

Telemedicine is no different than any other medical visit that you’ve had with a doctor or provider with one big exception. You’re not physically in the same room as the doctor. Think of telemedicine as a virtual house call.

Instead of driving to the medical office, parking, sitting in the waiting room and seeing the doctor in an exam room, the doctor will come to you virtually. You’ll visit from the comfort of your home, while the doctor is in a secure, private location.

Telemedicine in this manner is described as synchronous telemedicine. It’s occurring in real time.

Telemedicine can also work in an asynchronous fashion. For example, check out this awesome teledermatology company Cortina Health. You can take a selfie, upload your picture, and a dermatologist can diagnose your skin condition. They even use artificial intelligence (AI) for a more accurate diagnosis. How cool is that!

Lastly, telemedicine can be utilized to monitor our friends and family with chronic health conditions like high blood pressure and diabetes. Remote patient monitoring allows physicians to review critical health data from afar on multiple patients at once.

What is the difference between telemedicine and telehealth?

You may have heard of the term telehealth as well and wondered “well what’s the difference?” Think of telehealth as a more inclusive word that encompasses telemedicine along with healthcare related:

  • Education of patients
  • Training of clinical staff
  • Peer-to-peer conferences
  • Delivery of prescriptions

 

Telehealth is at the top of the hierarchy and encompasses telemedicine (the doctor-patient interaction) and everything else tech-related in healthcare.

If you’re visiting with a doctor electronically, then that’s telemedicine.

How does a telemedicine visit work?

Most telemedicine platforms make it relatively easy to visit with the doctor. If you’ve used Zoom for a business meeting or to see your grandkids, then a telemedicine visit should be no problem.

Let’s walk through the steps of how a telemedicine visit works:

  1. Find a telehealth provider

If your current in-person physician offers telemedicine then congratulations! Take them up on the offer and enjoy your visit from home. While everyone else sits in traffic, crowded waiting rooms and uncomfortable exam rooms, you will be in your slippers on the couch.

On the other hand, if you are struggling to find an in-person provider, then you’ve probably turned to Dr. Google for a recommendation. Here’s a list of independent telemedicine providers and services who may be able to help you directly:

 

 

  1. Decide on direct pay vs. insurance

Telemedicine has helped to promote transparent pricing in healthcare. It used to be impossible to find the costs of medical services on-line, whereas many telemedicine companies openly list their cash fees. This is great for everyone involved.

A visit with VirtuCare costs $89. No hidden fees and no upselling. What you see is what you get. Feel free to use your HSA card if you have money set aside for healthcare expenditures.

However we don’t accept insurance. Why is that? Insurance companies profit when they take your money and don’t pay out claims. They create barriers to providing care. Telemedicine is about making healthcare easier, not giving you the same headaches as going to see your doctor in-person.

If you’re still interested in using your insurance for a telemedicine visit, then be sure to confirm the following:

 

  • The telemedicine provider is in-network with your insurance plan.
  • Your out-of-pocket cost estimate for telemedicine services. Many insurance companies have separate deductibles for telemedicine (as I said, they look for reasons to keep your money).

 

  1. Schedule an appointment

Now it’s time for you to schedule your appointment. Many telemedicine practices allow you to be in charge of setting up your appointment. With one-click, you’ve just saved yourself 30 minutes of aggravation playing phone-tag with a medical office.

Telemedicine visits may also be available 24/7. If you need help on a night or weekend, is your personal physician going to make a house call? I think not (unless they are part of the awesome direct primary care revolution). Request a virtual house call instead of fighting the COVID lines at an urgent care or ER.

  1. Login to the patient portal

If possible before your visit, you should login to the patient portal to become familiar with the site. This is the patient facing side of the electronic medical record. Some telemedicine platforms don’t offer this feature and instead you’ll click on the hyperlink at the time of your visit.

  1. Fill out your forms

Sometimes the worst part about going to the doctor’s office is the volume of paperwork required to see the physician. Luckily, telemedicine works much easier as these visits tend to require fewer forms. You’ll probably click on “agree” to the terms and conditions, then briefly describe the main purpose of the visit. We don’t need your whole medical history upfront, just the important details.

  1. Wait for the doctor to check-in

You shouldn’t be surprised that you have to wait for the doctor LOL. But don’t get too comfy in our virtual waiting room, because doctors tend to run on schedule for telemedicine visits. With fewer distractions and paperwork, physicians are very efficient with telemedicine.

That being said, please log-in 5-10 minutes before your visit. Please don’t log off either if we’re running 5-10 minutes behind. Many telemedicine platforms have secure messaging capabilities so the doctor should text you if they are going to be late.

  1. Provide a brief history 

Now it’s “go” time! The doctor is ready to listen to your concerns, and deliver the care you deserve. But please keep it brief! We do not need to know about your knee surgery or grandfather’s colon cancer if we are discussing your ED or overactive bladder. Telemedicine visits are more problem focused than traditional in-person visits. Be sure to stay on topic so the doctor can help you with the primary problem. If they need further detail, then they will ask the appropriate follow-up questions.

  1. Be ready for a video exam

Depending on the reason for your visit, you may need to play Stephen Spielberg and work your video camera to the area of interest. If you’re wondering about the red spot “down there”, then we need to look “down there.” If this is something you’re not comfortable with, then maybe you need an in-person visit.

There are many cool tools being developed for telemedicine visits. We now have the ability to remotely listen to your heart and lungs, look inside your ears/throat and examine your eyes. Don’t worry, we don’t expect you to go buy a telemedicine stethoscope on Amazon. These devices are typically situated at rural health clinics for communities without access to specialists.

  1. Perform labs/tests, receive prescriptions

After your telemedicine visit is completed, the physician may want you to have further testing. Not all telemedicine providers have this option, but at VirtuCare, we can order or coordinate blood draws and imaging. If a medication was prescribed, be certain to confirm the correct pharmacy details if the telemedicine platform doesn’t ship the medication directly.

  1. Referral to in-person colleague

Telemedicine does have it’s limitations (see below). Some medical ailments require an in-person evaluation. VirtuCare won’t leave you hanging. We have a robust network of colleagues and can help you find the right physician for the next step of your evaluation.

What can I virtually see a physician for?

Telemedicine works best when you’re seeing the right physician for the right problem. Obviously a urologist isn’t the best person to counsel you on that nagging cough you’ve had for 6 days. But it’s also important to recognize which medical conditions are best suited for remote evaluation.

Telemedicine visits are great for the following situations:

Second opinions

When you’ve already had a complete in-person evaluation, but you’re still struggling with some aspect of the care plan, telemedicine is a great option. Telemedicine works best in this situation if you provide copies of the relevant medical records to the telemedicine physician. With your outside medical details reviewed, a more accurate opinion can be given.

You shouldn’t feel guilty about getting another opinion. Especially if it’s something serious or if your symptoms are not improving. We all need reassurance that we’re on the right path whether it’s our healthcare or deciding which house to buy.

Telemedicine allows you to shop around. Take advantage of the opportunity.

Lack of access to specialists

Only 38% of U.S. counties have a practicing urologist. So unless you are in or around a mid-size to major city, you may not have access to a urologist. Even in larger markets, the waiting time to see a urologist can be 4-6 months. Your penis or bladder can’t wait that long.

A major benefit of telemedicine is accelerating access to specialists. Without geographic or insurance barriers, you can access a board-certified specialist from the comfort of your home. It sure beats driving 2 hours for a 5 minute visit with an in-person doctor who’s too busy to listen to your concerns.

You might be asking yourself, “you can’t see a specialist with telemedicine, they have to do an examination!” Not true. Although a physical exam is important for feeling lumps and bumps, here’s a list of urological conditions that we can initially manage remotely:

  • Overactive bladder (frequency, urgency, bladder leakage)
  • Enlarged prostate (BPH)
  • Erectile dysfunction (ED)
  • Male and female sexual dysfunction
  • Kidney stone prevention
  • 2nd opinions for prostate, kidney, bladder cancer
  • Urinary tract infections (UTIs)

 

When and if you need a personal touch, we can also refer you to an in-person colleague who can take over your care.

Medication requests

Depending on the telemedicine platform, access to prescription medications is a major benefit of telemedicine. All you have to do is turn on your TV and see all of the ads for Roman, Hims and GoodRx. Online pharmacies are a big business.

The only downside to this model is that you receive very little healthcare with these medication requests. Wouldn’t it be nice to know why you have erectile dysfunction? A telemedicine visit with a specialist can provide the missing details to your medical condition that pill requests won’t cover. Don’t worry, you can still receive the “little blue pill.”

Disease education

Educating yourself about your medical condition will empower you to receive better care. Knowledge is power. The problem is that Dr. Google has a lot of inaccurate information. Instead, why not go right to the source and dial up a real-life expert.

Telemedicine works great for learning more about your ailment. You ask questions and get accurate answers. End any confusion today.

Common ailments

Common colds, UTIs, and kidney stones are some of the most common ailments seen at urgent care centers. Rather than expose yourself to COVID or an astronomical bill, why not have a telemedicine first and avoid the hassles. Telemedicine works great for “bread and butter” medical conditions.

No, we don’t always have immediate access to diagnostic tools like a throat swab. However, a detailed accurate history often provides the diagnosis. And let’s be honest, plenty of in-person evaluations lead to misdiagnoses and inappropriate antibiotic use. Seeing a skilled medical professional is more important than having access to tests.

What technology do I need for a visit?

New technology services can be intimidating for some people, especially for seniors. Luckily, for a telemedicine visit to work, all you need is:

  • Internet access
  • Video capabilities on phone, tablet or computer
  • Audio with speakers or headphones

 

Where would one get all this “fancy” technology? On your smartphone. 85% of Americans now own a smartphone. This includes 61% of people over the age of 65.

Video conferences were the only way to see grandma or grandpa during the pandemic. As a result, seniors are not as intimidated by this technology anymore.

In fact 30% of people over the age of 65 have already had a telemedicine visit and 91% reported that connecting with their doctor was “easy”. If you’re new to telemedicine, don’t be intimidated. You have everything you need for your visit in your pocket.

Is telemedicine private and safe?

One of the biggest concerns that patients have regarding telemedicine is privacy. The last thing you want to worry about is the leakage of your personal health information. The good news is that telemedicine is quite safe, and I’d argue safer than in-person visits.

The next time you go to a medical office, take note of each time you:

 

  • Hear other patient conversations through thin walls.
  • Hear staff members talking about patients.
  • See lab or imaging reports lying on a counter for anyone to grab.
  • See computer screens with open patient charts.

 

Do you really think your in-person visit is that private? Because it is not.

Now consider a telemedicine visit. The physician is in a private room with no one else around. You choose who’s in earshot of your visit. If you really want privacy, then put on headphones.

Telemedicine platforms are required to be HIPAA compliant. This means they have the most stringent criteria for protecting privacy with double encryption. Good luck hacking into one of our patient visits.

Also let’s be honest, with financial institutions and pornography online, I imagine hackers are more concerned with stealing money and watching sultry videos then they are with listening to me help you prevent kidney stones.

What happens during a telemedicine appointment?

Let’s not complicate telemedicine. Remember, telemedicine works no different than an in-person visit with your doctor, except you get to keep your clothes on. You talk, they listen, and you receive care. Simple, direct care.

Do you know what also happens during a telemedicine appointment? You begin to ask yourself “absurd” questions such as:

 

  • Why should I drive an hour to see my doctor when I can visit with her from home?
  • Why do I tolerate rude office staff when I could avoid them with telemedicine?
  • Why do I still have expensive medical bills if I have insurance? What’s the point of insurance?

 

Hopefully you’re sensing the sarcasm. You should also by now be sensing . . .

The benefits of telemedicine services

Healthcare shouldn’t be more difficult than it has to be. Feeling pain, fear and frustration from medical conditions are bad enough. Insurance companies, physicians, and hospitals shouldn’t be adding to these negative feelings.

Telemedicine strips down many barriers to traditional healthcare delivery. Benefits of telemedicine include:

Accelerating access to care

Get the care you deserve today. Stop tolerating 6 week or 6 month wait times to see the specialist. Stop calling medical offices 4 times a day only to get an automated operator and leave unanswered voicemails. Skip all of that nonsense and speak with a telemedicine doctor today.

Convenience

With quicker access comes convenience. It’s like skipping the lines at Disney while wearing your pajamas. Because nothing is more convenient than receiving healthcare from your couch.

Save time

Time is our most valuable resource. Everyone from Jeff Bezos to your bank teller gets 24 hours in a day. If you have the ability to buy back your time, then do it. It’s an investment you’ll never regret.

Telemedicine visits save 100 minutes compared to in-person visits! Think about how many episodes of Schitts Creek you could be watching instead of sitting in a doctor’s waiting room with 1980’s decor.

Save money

According to one study, the average cost of a telemedicine visit is $79. Think about how much money you spend to take the family to a decent dinner. Or how much the plumber costs for spending 15 minutes on a leaky faucet. $79 is a bargain for visiting with a medical professional.

But what about insurance you ask? What about it? With rising deductibles, co-pays, and denials you still may end up spending thousands of dollars a year despite the outrageous premiums you’re already paying.

Eliminate headaches

Useless paperwork, rude staff, and hidden costs are just a few of the headaches we tolerate in the U.S. healthcare system. We say “no more!” Telemedicine is working to usher in a new era of healthcare which focuses on the doctor-patient relationship at an affordable, transparent cost.

What are the downsides of telemedicine services?

Not to end on a down note, but telemedicine does have its downsides. We told you this would be a complete guide to telemedicine, warts and all.

Telemedicine does not work best for:

Conditions requiring a full physical exam

Although we can gather a lot of information from a video exam, without the ability to press on your belly or feel that lump, a telemedicine visit may limit an accurate diagnosis. Lumps and bumps are best left for an in-person evaluation.

Rashes or skin lesions require some camera work. If you’re not a blossoming film major in college, or if the spot is tiny, then telemedicine may not be the best choice for all skin conditions.

As we stated earlier, the technology exists to look in your ears and throat or listen to your heart and lungs, but unless you have this at home, then ear pain, heart palpitations or persistent coughs probably need an in-person visit as well.

Conditions requiring an invasive procedure

Trust me, when they develop the technology to look in patient’s bladders from the comfort of MY home, then I’ll be the first in line. Until then, endoscopies and surgical procedures require a human touch.

Now we don’t expect you to know if an invasive procedure is necessary for your medical condition. You can start with a telemedicine evaluation, just don’t be frustrated if the physician recommends further in-person testing or therapies.

Patients expecting insurance to cover their visits

Although some telemedicine companies and providers still bill insurance companies, many like VirtuCare do not. Why is this? Because we’re trying to make healthcare easier and insurance companies are anything but easy.

This is not to say that insurance companies deny or cover all telemedicine services. But, they are not transparent about coverage and how much you may owe. Unless of course you want to spend 45 minutes on the phone speaking “Bob from Indiana.” Like that’s really where you live, “Bob”. Shame on you.

Doctors who are unwilling to perform remote visits

Some time during COVID, all of us physicians were forced to utilize telemedicine to visit with patients. While many physicians embraced telemedicine, some went back to their old ways as soon as possible. Why you may ask?

As a physician myself, I have no problem admitting that many of my colleagues are stubborn and set in their ways. As long as the old way is working, why change? I’d argue that if you don’t change as a healthcare professional then you’re in danger of becoming extinct. Do you want to go to a doctor who’s practicing medicine like it’s 1992? I think not.

Also, many doctors make money by doing more “things” to patients. More tests, more money. More procedures, more money. It’s sad but true. Telemedicine forces these doctors to actually just sit and listen to patients. Not their strong suit.

Conclusions

Telemedicine is here to stay. Now that you know how telemedicine works, I’m confident that you’re better prepared for a virtual visit. Once you experience care from the comfort of your home, you may never want to walk into a doctor’s office again.

ABOUT THE AUTHOR

Dr. Joe Pazona

Dr. Joseph Pazona is the founder and President of VirtuCare, a telemedicine solution for connecting patients with physician experts.
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