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Giving Telemedicine A Try



Here's what you need to know so you can see your doctor without leaving home.


Article originally featured on Harvard Health


Remember when "virtual" doctor visits became available a few years ago? Being able to chat with a doctor on a video call instead of an in-person office exam was novel, but it never caught on as a mainstay of treatment.


That changed in the spring of 2020, when the pandemic hit and telemedicine rocketed from novelty to necessity. "At Massachusetts General Hospital and Brigham and Women's Hospital, we did 1,600 virtual encounters across the system in February. In March it was 89,000, and in April it was 242,000. That's the kind of growth we're experiencing," says Dr. Joseph Kvedar, a dermatologist with Harvard-affiliated Massachusetts General Hospital, senior advisor for virtual care at -Partners HealthCare, and president of the American Telemedicine Association.


Dr. Kvedar believes telemedicine's popularity will continue after the pandemic. "Patients love that they don't have to get in a car, hassle with parking, and wait in a waiting room for something as simple as getting a medication changed," he says.


Here's how the visits work and what to expect.


Types of visits


Initially, virtual visits were limited to urgent care — a sudden, minor, temporary illness such as a cold, sore throat, rash, diarrhea and vomiting, or conjunctivitis.


Increasingly, doctors conduct virtual visits for not just for urgent care, but also mental health care and chronic illness management, such as follow-ups for diabetes, allergies, high blood pressure, heart conditions, post-operative wound care, or skin conditions.


"For dermatology, it's easy to take images and send them to me, and we can adjust your medications without you coming to the office," he says. "It's the same if you see your doctor for diabetes — you can measure your blood sugar, share those numbers, and have a dialogue about your diet, exercise level, and medication. You don't always need to go to an office," Dr. Kvedar says.


How it works


You'll need an Internet connection and a device — home computer, tablet, or smartphone — that has a camera and a microphone.


Just like an in-patient exam, a virtual visit requires an appointment. You may be asked to answer questions online in advance (on your doctor's secure website, called a patient portal).


At the appointed time, you'll log on to the patient portal and a video call will begin. Your doctor will appear in a video box on your screen, and you'll begin chatting. If you want the doctor to see something (like a rash), you'll need to hold it up to the camera or send the doctor a picture taken by your cellphone.


Expect efficiency: visits last about 10 minutes, and there isn't time for small talk. If the doctor adjusts or prescribes a medication, the prescription will be sent electronically to your pharmacy.


Preparing


Just like an in-person visit, a virtual visit requires you to do your homework in advance. Because electronics and cameras are involved, you'll have to take a few extra steps.


Be sure to

  • Make a list of questions you want to ask your doctor

  • Have all of your medications with you, in their original containers

  • Measure your blood pressure, blood sugar, and weight (if you have home devices to do so)

  • Have a pen and paper handy for notes

  • Have a family member or buddy with you to take notes or listen to instructions

  • Make sure your device is well charged or plugged in, and the microphone is working

  • Download an electronic app (program) if your doctor's office requires that for visits

  • Set up your device in a quiet, well-lit room

  • Angle the camera so your doctor can see you well


Make the most of the visit


You'll have a little work to do during the call as well. Speak loud enough for your doctor to hear you, ask all of your questions, and describe your symptoms or concerns with as much detail as possible.


"Without interacting with you in person, I'm getting less of you, and it's harder to make a diagnosis. It's a little like looking through a keyhole. Whatever you can do to provide information will help," Dr. Kvedar says.


If your doctor feels you need additional evaluation, particularly a physical examination, he or she might ask you to come to the office in person.


What if you aren't comfortable with technology and the telemedicine medium? Give it time, but take heart: standard telephone calls are also considered a type of telemedicine, and they can be used for official doctor visits, if necessary. "If we have the right information," says Dr. Kvedar, "we can still do a lot over the phone."

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