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Monday, May 13, 2024

How to Get the Most Out of Virtual Doctors' Visits

Covid or not, people still need to see their doctor. As a neurosurgery coordinator for a hospital, I educate patients on treatments, schedule visits, and retrieve records. Some of those visits are telemedicine (online video) appointments. Virtual health care has become a necessity but also a choice. Yet many still don’t understand what online medical charts are or how to best use them. It’s not just for simple scheduling with your primary care doc or meds refill requests.

Contrary to what some may think, telemedicine is not FaceTime or Zoom. Yes, it’s a video chat, but your doctor can also store and view x-rays, MRIs, bloodwork, and other notes all via one encrypted portal. You, the patient, can become an active participant in your own care by uploading or sharing information via this portal, including messages to your doctor. You can also give access to your online chart to other hospitals, so that more than one facility can access your information. It saves a lot of phone calls and faxes for everyone, including you.

For Covid patients, telemed has been a huge assist in monitoring those too weak to travel to an office.

Jeff Langello, an IT consultant, spoke to his primary doctor from home after being diagnosed with Covid and then suffering chills, fevers, and hallucinations. He was too weak to move for days. He was able to log on from his couch. I asked him if he preferred in person or virtual appointments.

“Normally, I like in-person appointments, but I couldn’t move. The doctor saw me and asked me questions regarding my breathing, fever. There wasn’t much he could do with a virus, but I felt better talking to him.”

Jeff also mentioned that for first time users, it can be a little tricky but not difficult if patients are given instructions and walked through the process.

According to Dr. David Shapiro, an orthopedic surgeon at the Cleveland Clinic, online care is not just for the tech savvy or for younger generations:

“Despite minor tech issues, and first navigating through an app, we have not really found age limitations. It’s less of a difference than I would have expected. There are younger people who are not able to connect to the internet and older patients who are more tech-savvy than I appreciated. It was really a question of which patients were a good or bad fit for online care and how we could figure out a baseline for treatment. But when Covid hit, we all just jumped in.”

Dr. Jesse Green is a professor of clinical medicine in gastroenterology at the University of Pennsylvania. Like Dr. Shapiro, he mentioned the push for telemed appointments at the start of the pandemic, but also noted the speed in which physicians and patients adjusted.

“For my patients around 85 percent across all age groups can do it very well. Older patients in their eighties and nineties typically have children or other relatives help set up the tech. Our office walks them through it and we have a helpline. A majority of my patients have chronic diseases or issues that need several follow-up visits a year. With telemed, we can still garner that info on video and make adjustments to medications. It’s true access to care.”

When I asked both docs what they wanted patients to know first, both mentioned the ease of flexibility for scheduling and the ability to see patient information all in one space. For my job, getting that information from patients is first-priority.

Here are 5 tips that will help you get the most out of your telemedicine appointment with your doctor, including appointments with specialists:

1. Check Your Tech

I can’t tell you how many times I’ve called patients who had a telemed appointment but they never finished setting up their online account or waited too long and now needed a new activation code. I can’t get that for them, it’s secure. I’ve had to tell them to call our IT department and they were given a different password to access the system. Most hospitals or private offices use large medical portals like MyChart or BlueJeans, which encrypts information and allows patients to create a secure online account. It’s through this account and their private email where the video link is set on a calendar for each appointment. So make sure whoever your provider uses for telemedicine has you set up: Necessary app downloaded, correct password set, and test it out. It will save you and your doctor aggravation when both of you can’t figure out why you each are staring at a blank screen for fifteen minutes waiting for someone to appear.

2. Gather Thy Records

If you were referred to a specialist (like my group) from your primary care doctor, we will need their office notes and your history. Mostly, it’s about knowing in advance why you are coming to us. We need a documented reason to see you and the notes will be loaded for review prior to your appointment. It saves both of us time calling other doctors for that information. We’ve had to cancel appointments because we can’t take your word for it though we know you are telling us the truth. We simply don’t want to waste your time coming in or logging on with no documentation to give us a clearer picture.

3. Have X-rays or MRIs? Grab Them

Speaking of images, depending on your doctor’s office, it’s wise to have your films on CD and sent to the office prior to your visit. So, when you get them done, ask for a copy of the films before you leave the radiology office. They will give you one. We can upload it on our end once we get it. If you have an external disc drive or a computer that still has a disc drive, by all means let us know. Some offices use a service called LifeImage where you’ll receive an emailed link to upload films directly from your computer. So ask. Otherwise, send us the CDs and track it. The mail is slow and we still need to see you on the inside. We can’t see through you—not yet anyway.

4. Medications? We Don’t Judge

Doctors and staff have heard everything-especially those who have patients in pain. So, if you were on Oxy for a couple of years and stopped taking it, it’s fine. Just tell us your history. We have to know and don’t care if you were on Zoloft, Lexapro, or Wellbutrin either. It’s about your safety. It’s better for us to know all of your history now, rather than find out later and have to cancel a procedure or write a new med script because we didn’t know you were on two drugs that may interact. Tell us and we can work to figure it out.

5. List Your Contacts. Other Than Family

If you want to list your best friend as caretaker or emergency contact instead of mom and dad it’s okay. We just need to be able to notify someone if we can’t reach you. Contacts can also be other doctors you see for whatever reason-psych, cardiology, it doesn’t matter. We’d like to know a few folks just in case we have a question like did you stop taking your cholesterol or blood pressure meds in time for surgery? We don’t want you bleeding too much from a minor procedure. It matters.

In addition to the facts and figures, I asked Dr. Shapiro if there were other things patients should consider when setting up their online care. He mentioned the drive through window-as in not doing your appointment in the car and asking the physician to hold on while you order fries. This really happened as his team was waiting in clinic on video. Aside from that, online appointments have worked well and he and his colleagues only see it growing.

“Initially, providers and colleagues were nervous. You just don’t how it will work out. Most of us were pleasantly surprised at what we can accomplish if not more in the future.”

When I asked what he wanted all patients to know about using technology in health care, he said: “It’s easier than they think.”

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