Your doctor’s visit from the comfort of your home
The idea of telemedicine has been around for decades, but it took COVID-19 to push it into the mainstream. Cape Cod Healthcare primary care offices have instituted the practice and nearly all visits are now done via your smart phone.
“From a primary care point of view, it’s unbelievably incredible what Cape Cod Healthcare did in the last three weeks. They transformed the way we practice medicine in a matter of days,” said Primary Care Physician Thomas Hanna, MD.
Part of the reason it has taken so long for telemedicine to catch on is that, in the past, insurers only paid about half of the amount as an in-patient visit. Now, as a result of the coronavirus outbreak, government and private insurers have increased the reimbursement amount for telemedicine visits to be comparable to an office visit.
Telemedicine has a lot of advantages right now. It allows doctors and patients to practice physical distancing, which helps reduce the spread of the disease. It also protects healthcare workers.
Cape Cod Healthcare (CCHC) has provided each doctor with an iPad so they can continue to see patients using telemedicine. It’s kind of like having an electronic house call. CCHC chose the platform Doxy.me because anyone with any kind of smart phone can access it. Plus, Doxy.me is HIPPA-compliant to protect patients’ privacy.
How to Prepare for Your Appointment
Get to know your smart phone.
The first thing to do is make sure you have provided the correct cell phone number to your primary care office, said Dr. Hanna who practices at Stoneman Primary Care in Sandwich. The next thing is make sure you know how to use your phone.
“They have to know how to turn on the mic and how to access the camera. That’s very important. They also have to know how to look for and access a text message.”
Doxy.me has a help page for patients who need instructions on how to access their appointment. Basically, what happens is doctors send patients a text message inviting them to their appointment. The patients then click on the link and type in their name. That places them in a virtual waiting room. On the other end, the doctor clicks on the patient’s name to start the appointment. The patient has to hit a button to give permission to allow the browser to enable the webcam and the microphone.
“The other problem is that not everybody has a smart phone,” Dr. Hanna said. “Some people still have landlines and flip phones. But most older people will at least have a relative who has an iPhone and they’ll show them how to use it.”
More than once, Dr. Hanna has had to help his patients figure it out by calling them on their landline to talk them through the process.
Take your vital signs and gather your medications.
Another important way to prepare for your appointment is to take any vital signs you can. For example, if you have a blood pressure machine, take your blood pressure and pulse so you can share that information. If you are feeling sick, and you have a thermometer, it’s a good idea to take your temperature. You will also need a list of current medications you are taking.
In general, the video visits are scaled down to just handle simple problems, Dr. Hanna said. Types of appointments include follow-up visits, physicals, annual wellness visits, and diagnosing colds, sinus infections, urinary tract infections, flu and viruses.
“It’s limited but we go over their conditions; we go over their labs; we go over medications and change them if we have to and we schedule follow-ups,” Dr. Hanna said. “We can still order things like lab tests, X-rays and medications. We do all of that through the computer, which is useful.”
For those who suspect they have COVID-19, there is a checklist doctors go through before ordering a test. You have to have the major symptoms, but should also be aware of lesser symptoms.
Major Symptoms of COVID-19:
- A fever greater than 100 degrees
- A productive cough
- Shortness of breath
Other Common Symptoms:
- Loss of smell and taste
- Sore or scratchy throat
- Muscle aches
- Joint pains
As always, anyone who is experiencing chest pains, heart palpitations or other symptoms of heart attack or stroke should call 911 immediately to be taken to the Emergency Room. Those with lacerations needing stitches, or possible broken bones, should call an Urgent Care facility to arrange a visit.
If you have a question about whether your symptoms are serious enough for follow-up care at the emergency room or urgent care, call to discuss it with your primary care doctor, Dr. Hanna said.
But for ordinary things that most people see their primary care doctor for, telemedicine is working so well that Dr. Hanna thinks a lot of doctors, including him, will consider continuing to use it after the pandemic crisis is over. It is especially useful for older patients who have mobility issues, patients in wheelchairs, patients too sick to leave their homes and those in hospice care. Whether that happens depends on whether insurers continue to reimburse.
“There is no reason to put this back on the back burner,” he said. “I think we should continue it, as needed. For me, telemedicine is working very well. I’m able to see an average of 80 patients in a four-day week. I think that is pretty good. All three of us are still here and we are all still seeing patients. It’s on a screen but we are still doing it.”