FAQ: Do You Fully Understand Telemedicine?

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Since March, the pandemic has altered healthcare drastically. Telemedicine, or telehealth, has been around since. Telehealth has never been considered the preferred way of medical treatment, but since COVID-19, many seniors have seen this as the safest way to see their doctors. 

As a result of U.S. doctors limiting the number of in-person appointments and many patients avoiding doctor’s offices in fear of infection, telemedicine has peaked in its popularity among seniors. The result was a huge increase in the volume of remote medical and behavioral health visits.

For those who have not yet had experiences with telemedicine, here are some common questions those hesitant about telemedicine are asking. We have the answers for you!

Are people satisfied with telemedicine?

Studies show patient satisfaction with telehealth is high. And for physicians who previously were skeptical of remote care, necessity has been the mother of invention.

“There are still a few doubting (telehealth), but now that we’ve run our practices this way for three months, people have learned that it’s pretty useful,” says Dr. Joseph Kvedar, president of the American Telemedicine Association and a practicing dermatologist who teaches at Harvard Medical School in Boston.

Does Medicare cover telemedicine?

Yes! Virtual medical care is covered by Medicare due to the critical time caused by the COVID-19 pandemic. There have been Medicare rule changes, including reimbursements for doctors who charge the same rate as in-person care as they do for telemedicine. You can find what services are covered on this expanded list. Also, state regulators and commercial health plans have loosened their telehealth policies in order to provide further financial aid to Medicare beneficiaries. 

In California, the Department of Managed Health Care, which regulates health plans covering the vast majority of the state’s insured residents, requires commercial plans and most Medi-Cal managed care plans during the pandemic to pay providers for telehealth at parity with regular appointments and limit cost-sharing by patients to no more than what they would pay for in-person visits. Starting Jan. 1, a state law — AB-744 — will make that permanent for commercial plans. If you are one of the 13 million enrolled in Medi-Cal, the state’s Medicaid program, you can get telehealth services at little to no cost.

Other states: Delaware, Georgia, Hawaii, Minnesota, and New Mexico, have pay-parity laws already in effect. Washington state has one that also will begin January 1.

What is the best telehealth company?

If you are planning a telehealth appointment, be sure to ask your health plan if it is covered and how much the copay or coinsurance will be. The appointment may be through your in-network provider or a telehealth company your insurer contracts with, such as Teladoc, Doctor On Demand, or MD Live.

You can also contact one of those companies directly for a medical consultation if you don’t have insurance, and pay between $75 and $82 for a regular doctor visit.

What are some advantages of telehealth?

There are clear advantages of telemedicine. You typically can get an appointment sooner, in the comfort and safety of your own home, while saving time and money on gas and crazy hospital parking. In a lot of cases, you can even avoid a loss in wages for missing work.

Take James Wolfrom for example! The 69-year-old retired postal executive in San Francisco has had mostly virtual health care appointments since the pandemic started. He particularly appreciates the video visits.

“It’s just like I’m in the room with the doctor, with all of the benefits and none of the disadvantages of having to haul my body over to the facility,” says Wolfrom, who has Type 2 diabetes. “Even after the pandemic, I’m going to prefer doing the video conferencing over having to go there.”

Telemedicine also provides care for people in rural areas who live far from medical facilities.

The growth of virtual care has been facilitated by Medicare rule changes for the COVID-19 emergency, including one that reimburses doctors for telemedicine at the same rate as in-person care for an expanded list of services. State regulators and commercial health plans also loosened their telehealth policies.

What are some disadvantages to telemedicine?

Telemedicine has some serious disadvantages. For one thing, the less formal setting can allow some routine medical practices to slip through the cracks.

In the second quarter of this year, blood pressure was recorded in 70 percent of doctor office visits compared with about 10 percent of telemedicine visits, according to a study published early this month.

Elsa Pearson, a resident of Dedham, Massachusetts, had a medical appointment scheduled in March, which was switched to a telephone call because of the pandemic-induced lockdown.

Perhaps the biggest pitfall in telehealth is the loss of a more intimate and valuable doctor-patient relationship.

In a recent essay, Dr. Paul Hyman, a Maine physician, reflected on the times when an unexpected discovery during an in-person examination had possibly saved a patient’s life: “A discovery of an irregular mole, a soft tissue mass, or a new murmur — I do not forget these cases, and I do not think the patients do either.”

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What technology do I need to access telemedicine?

Large medical offices and health systems usually have their own telemedicine platforms. In other cases, your provider may use a publicly available platform such as FaceTime, Skype, or Zoom. Either way, you will need access to a laptop, tablet, or smartphone — though, for a phone conversation, a landline or simple cellphone will suffice.

Smartphones with good cameras can be particularly useful in telemedicine because high-resolution photos can help doctors see certain medical problems more clearly. For example, a photo from a good smartphone camera usually provides enough detail for a dermatologist to determine whether a mole requires further attention, Kvedar said.

Relatively inexpensive apps and at-home tools enable you to measure your own blood pressure, pulse rate, oxygen saturation level, and blood sugar. It’s a good idea to monitor your vitals and have the numbers ready before you start a virtual visit.

Is telehealth good for every type of doctor’s visit?

The short answer is no. Be aware that a remote visit is not right for every situation. In the case of serious injury, severe chest pain, or a drug overdose, for example, you should call 911 or get to the ER as quickly as possible.

Virtual visits also are not recommended in other cases for which the doctor needs to lay hands on you.

BUT telemedicine is effective in cases that would typically send you to an urgent care clinic, such as minor injuries or flu-like symptoms, including fever, cough, and sore throat.

It is also increasingly used for post-surgical follow-ups. Telemedicine can be a godsend for geriatric or disabled patients with reduced mobility. And it’s a no-brainer for mental health care, which is mostly talking anyway.

Is telemedicine here to stay?

Experts say, yes! Doctors, hospitals, and mental health providers across the country report a 50- to 175-fold rise in the number of virtual visits, according to a report released in May by the consulting firm McKinsey & Co.

The COVID-fueled surge has tapered off as patients venture back to doctors’ offices. But medical professionals and health experts predict that when the pandemic is over, telehealth will still play a much larger role than before.

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