A Patient’s Guide to Telemedicine: What to Do When Your Doctor Calls or Video-Chats with You

By John Sharp, MSSA, PMP, FHIMSS, Director, Thought Advisory, Personal Connected Health Alliance; HIMSS

Telehealth visits are quickly becoming a mainstay of healthcare during the COVID-19 pandemic. Many health systems encourage patients to shift to telehealth as a first choice to discuss possible symptoms, rather than going to the hospital emergency room. Some states have ordered health systems and insurers to move all possible coronavirus-related visits to telehealth. But what is the best way for a patient or family caregiver to prepare for a video visit, especially the first time?

You may want to know if your insurance will cover a telemedicine visit. This depends on your insurance. While Medicare has expanded the coverage for telehealth visits, private insurers vary on this benefit. Some state orders require insurers to cover telehealth visits during this health emergency. Check the website of your state health department, your insurance carrier, or your employee benefits page from your employer. If telemedicine is not covered, a telehealth visit may cost around $50 to $80, according to a recent Wall Street Journal report.

You may also be concerned about the security of the health information you share on the call. Since you are talking to a healthcare provider, the information will be covered by HIPAA, meaning that it stays with the provider and can only be shared with your insurer, for instance, for the purpose of payment. The telehealth provider will likely record your information in an electronic health record, which is kept securely by the health system.

Finally, you may want to know if a telemedicine visit is as effective as an in-person appointment with a doctor. There are limitations to a telehealth visit – the doctor cannot touch your body or listen to your heart or lungs. However, you will be able to adequately describe many symptoms to help your doctor decide if you need to be in-person.

To take full advantage of your telehealth visit and to help the provider evaluate your condition, there are several steps you can take to prepare:

1. 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?
2. 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?
3. Are others in your home ill? If so, for how long?
4. Make a list of any chronic conditions you have and list of medication you are on.
5. Have you been tested for COVID-19? If so, what were the results?
6. 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.
7. 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:

1. Are you going to use your phone, tablet or computer for the visit?
2. Is the device fully charged or plugged in?
3. Do you have a reliable internet connection?
4. Does your health system use an app for telehealth visits? If so, download it in advance.
5. 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.
6. Have paper and a pen ready to take notes during the call.

During the call:

1. Be aware that there may be a high volume of calls, so you may have to wait to be connected.
2. Talk clearly, making sure the provider can hear you. Make sure they can see you through your camera.
3. Give identifying information about yourself or your family member.
4. Clearly present your symptoms.
5. Answer the provider’s questions as clearly and to the point as possible.
6. 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.