Virtual appointments and medical visits during the Covid Pandemic

In an effort to keep people safe and social distancing, there has become a rapid increase in telemedicine or virtual medicine as people are on “Stay at Home” (SAH) orders due to Covid-19. Chances are good that this will continue to remain in place, long after we’re able to be out and about.

One of the things that has come up again and again through the course of the pandemic, you can’t get a test without a doctor’s order. If you don’t have a primary care provider, get one. As it is, while many states are still on SAH, a number of health centers and other providers are willing to do a first “telemedicine” visit, having you come in after SAH has been lifted.

Some people are avoiding going to emergency rooms or hospitals for fear of contracting Covid-19. Please know that ERs and hospitals treat Covid-19 patients separately so you should not have contact with them. For a true emergency, the best place is the ER.

If you are experiencing any of these symptoms, Sudden chest pain; Weakness in one side of the face or body; Difficulty breathing or catching your breath; Thunder-clap headache; or Sudden confusion, call 911 immediately as the quicker you get professional help the better.

If it’s urgent: Such as a new pain, reaction to a medication, high fever, or injury, call your primary care provider for advise as how to proceed. Note that if you are having Covid-19 symptoms: fever, dry cough, tiredness and you want to be tested, you’ll need your provider to order it. You can’t just show up at a testing facility. If you are having trouble breathing, another symptom, call 911 immediately.

 For urgent not emergent situations, call your provider. You will most likely be ‘triaged,” where a nurse or other staff will determine how urgent your situation is. You can help this process by summarizing your concern in a few brief sentences, e.g. I’ve been taking the medication for four days and I started noticing a rash last night. If triage says you need to go to the ER, please act promptly. In spite of Covid-19, the ER is the best place for a real emergency.

Medication Refills/Notes from the Doctor: This generally will not require a telemedicine appointment and can be handled by a call to the office. If you doctor has an online patient portal, you can renew prescriptions in that manner. Note that many pharmacists are providing 90 day supplies to reduce the need for going out.

GETTING SET UP FOR TELEMEDICINE  

• Before you set up a telemedicine appointment, make sure you have sufficient Internet connectivity to make this happen. You’ll need about 15 Mbps.

• For the best video quality and reliability, use a wired connection if available. Wi-Fi and 4G/LTE are also acceptable. Avoid using a Wi-Fi hot spot if at all possible, as these are often not secure.

• For best audio, use earphones.

• Video takes up a lot of data, so if you have a data limit on your cellular plan, make sure to connect with Wi-Fi.

• Make sure mobile devices (cell phone, tablet, lap top) are charged to at least 50% before the appointment

• Make sure your webcam works and is of sufficient quality for your provider to see you. Most devises now come with this feature.

• Find a dedicated space to have your visit and set the camera at eye level so it’s easy for your provider to see you. Make sure you are in a well-lit room free of distractions.

• Close all unnecessary programs. If you have too many things running on your device it can reduce the quality of your video chat.

• Have your doctor’s number handy: If a technical issue comes up you can quickly place a call if need be.

• Prepare to answer at the appointed time. Avoid phone tag. Make sure you've disabled any spam blockers or functions that reject calls from private numbers.

PREPARE FOR YOUR APPOINTMENT

• Write down questions

• Identify any changes you’ve had since your last appointment-listing your most urgent symptoms first.

•  Be clear what you want out of the visit.

If your provider is amenable, e-mail them a copy so you are both literally, “working off the same page.” Include photographs of areas that are of concern, such as a rash, mole, incision that may appear infected etc. If you have a rash, draw a circle around it with a sharpie. If it spreads, continue to photograph providing estimated times between pics.

ASSEMBLE ITEMS YOUR PROVIDER MAY NEED FOR YOUR VISIT: This may include thermometer, bathroom scale, home blood pressure monitor, glucometer etc.

There are now a variety of digital technologies that can help you access and manage your health care, and will be useful during a virtual visit. Talk to your provider about Smartphones, Fitness trackers, special Apps and other resources that can help you manage your health.