Say Ahh? Patients, docs see place for telemedicine

Photo illustration by Cynthia Prairie

By Christian Avard
©2020 Telegraph Publishing LLC

Since the coronavirus outbreak, doctors and patients are adapting to new ways of meeting, diagnosing and treating illnesses that don’t pose the potential health risks to their patients and themselves of in-person visits.

Telemedicine for many is becoming the go-to method for conducting patient visits during the pandemic. And with an emergency order in March from Gov. Phil Scott, insurance providers must pay for most remote services.

It can be done through portal messages between a healthcare provider and the patient, via telephone communication for people who do not have access to computers or mobile phones, or it can also be done in the hospital or clinic setting where remote specialists can communicate with a patient directly when they are not locally available.

According to Summer Burch, family nurse practitioner at Grace Cottage Hospital in Townshend, telemedicine has been in use in rural areas for a few years now. Rural intensive care units and emergency rooms use telemedicine by incorporating live video feeds into the patient’s room to be able to consult with  specialists who can be available at the bedside 24 hours a day, she said.

Now, Burch says, she’s using telemedicine more than ever.

“Since the beginning of the Covid-19 pandemic, approximately 75 percent of my visits used telemedicine services,” Burch says.

Patients see quicker, more focused online visits

Telemedicine has had some positive results for some area residents.

Recently, Linda Diak of Chester made an appointment to see her new doctor, Susanne Booth, a naturopathic physician at Sojourns Community Clinic in Westminster. Her previous doctor had retired and Diak intended to meet Booth in person.

However, that all changed with Covid-19, so they met instead via video conference. Diak says it was a different experience but also a positive one. “I was able to take notes, which I couldn’t necessarily do face-to-face,” Diak says. “The doctor was focused on me and I was more focused on her. I was more included.” She adds, “No one was taking my blood pressure or temperature, recording anything, no distraction from in-office screens. So I felt we paid more attention to one another.”

Eleven-year-old Graham Long of Londonderry contracted a plantar wart this winter. His mother, Tammy Long, tried all kinds of over-the-counter treatment with little success.

Graham needed medical attention, but because of coronavirus, they went the telemedicine route. Via video, they met with Dr. Sandy Hoyt at Mountain Valley Health Center. Long says the visit was quick and efficient, saving time for both Tammy and Graham and Hoyt.

Since it wasn’t an emergency or actual illness, it saved us the time of going to the office, waiting. The whole thermometer, blood pressure, height, weight was eliminated.  … it’s a wart but we would have had to do all that more waiting — for the same result,” says Tammy Long. “It was just like FaceTime. Easy Peasy. I thought this could be helpful in the future for non-emergency situations. … I think it could be incorporated in future health care.”

Scroll down for A Patient’s Guide to Telemedicine

Telemedicine a complement to, won’t replace face-to-face visits

Will this be the future of medicine? According to local health officials, telemedicine will complement but not replace face-to-face visits.

Dr. Katrina Taylor, chief medical officer at Springfield Hospital, said she has seen an increase in telemedicine at the hospital and at the affiliated health centers in Bellows Falls, Londonderry, Ludlow and Springfield and Charlestown, N.H. Taylor agreed telemedicine is largely beneficial, especially during the coronavirus pandemic, but there are some things that telemedicine cannot replace.

“If a patient is dealing with high blood pressure or congestive heart failure or if they need vaccinations and the like, that is something we cannot do via video,” Taylor said.

Telemedicine also has another limitation – reliable Wi-Fi service. “That’s a challenge,” Taylor added. “Not everyone has access to a smartphone or Wi-Fi. Technology is expensive. It will grow but there are still barriers we’re dealing with.”

If patients do not have Wi-Fi services or if they do not have the means to travel to their doctor’s appointments, telephone appointments are also available upon request.

“There are really no good or bad patients as long as they are willing to be honest about what their symptoms are,” Burch said. “Things that make telemedicine easier include high-speed Internet, good lighting, minimizing distractions, if possible, such as multiple people or animals in the room. If this is not possible, converting a video visit to a telephone visit to minimize frustration is always best.”

“While telemedicine is convenient and is certainly helping us flatten the curve,” Burch said, “it will never replace a good face-to-face visit for the people who need it most.”

A Patient's Guide to Telemedicine

To take full advantage of your telehealth visit and to help the provider evaluate your condition, Healthcare Information and Management Systems Society Inc. offers steps you can take to prepare:

  • Make a list of your current symptoms, when they started and how severe they are. For instance, do you have difficulty breathing or pain in your chest? Do you have fatigue? If so, how severe and for how long? Do you have stomach pain or diarrhea?
  • Keep track of your data. Do you have a temperature? If so, what is it, and has it changed? Do you have a blood pressure monitor? If so, what is your blood pressure today?
  • Are others in your home ill? If so, for how long?
  • Make a list of any chronic conditions you have and list of medication you are on. Have you been tested for COVID-19? If so, what were the results?
  • If you are a patient of the health system you’re using for this telehealth visit, have your medical record number or other identifying information available so they can look up your Electronic Medical Record.
  • In case you are asked to go to the Emergency Room or clinic, make sure you know the location of the closest one.

Also in preparation, make sure your technology is ready:

  • Are you going to use your phone, tablet or computer for the visit?
  • Is the device fully charged or plugged in?
  • Do you have a reliable internet connection?
  • Does your health system use an app for telehealth visits? If so, download it in advance.
  • Make sure you have a comfortable place to sit for the visit and that your camera gives a clear view of you for the provider.
  • Have paper and a pen ready to take notes during the call.

During the call:

  • Be aware that there may be a high volume of calls, so you may have to wait to be connected.
  • Talk clearly, making sure the provider can hear you. Make sure they can see you through your camera.
  • Give identifying information about yourself or your family member.
  • Clearly present your symptoms.
  • Answer the provider’s questions as clearly and to the point as possible.
  • Make notes of the provider’s recommendations and ask questions if something is unclear.

Overall, a virtual visit is similar to visiting a doctor’s office, but in these unusual times, more meticulous preparation is helpful. You may or may not receive notes from your call through your patient portal. If you have a portal for this provider, check it after the call to review any recommendations.

Copyright: Healthcare Information and Management Systems Society Inc.

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Filed Under: CommunityCovid 19 CoverageFeaturedLatest NewsSouthern Vermont activity

About the Author: Christian Avard has been a journalist for more than 15 years, having written for Vermont publications such as The Deerfield Valley News, The Rutland Herald, The Commons and The Chester Telegraph. He also edited The Message for the Week and The Vermont Standard. Avard, who currently lives in Lebanon, N.H., is also a sports correspondent with The Barre-Montpelier Times-Argus.

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