Insider's Guide to Telehealth

Telehealth is a virtual service that lets patients interact with a healthcare professional online. This lets doctors and patients connect without being in the same room, or even the same city. Some of these appointments can replace office visits, which can have many benefits. Studies of people with migraine, diabetes, and other chronic health conditions show that virtual care can improve people’s health. Studies also show telehealth can make it quicker and less costly to get care.1,2 This may be especially helpful for people living in rural areas or who have a rare condition with few specialists nearby. During a public health crisis, like a pandemic, telehealth can be used to help prevent even more infections. However, not every medical visit can be replaced with an online chat, email, or text. So, there are some limits to what telehealth can do. What is telehealth (virtual care)? Telehealth includes any health service delivered using digital technology. It is sometimes called telemedicine or virtual health visits. This includes digital image sharing, videoconferences, texts, and smartphone apps. Telehealth lets patients connect with doctors, nurses, physical therapists, speech therapists, or mental health professionals. There are 2 main types of virtual health visits: Services used to diagnose, monitor, and treat a condition Services used for prevention, training, and health education3,4 How does telehealth work? Virtual health visits are offered by hospitals, clinics, and private companies like American Well and Teladoc.5 The patient or the doctor can suggest the use of telehealth. There are 4 ways to use this technology: Live videoconference A live video conference allows you to interact in real-time with a doctor or therapist. Store-and-forward Both the doctor and patient do not need to be together at the same time for this type of telehealth. With store-and-forward telehealth, you collect your medical data and transmit it to the doctor. The doctor can review the data and call, email, or text you as needed. This is used often in dermatology to show changes in the skin, or in other conditions to share test results. Remote patient monitoring (RPM) With RPM, you collect your personal health data at home, using a specific device, and send it to a doctor. This is used to manage chronic diseases such as heart disease, diabetes, or asthma. Mobile health (mHealth) You can access care and health education using mobile devices. This includes cell phones, tablets, and smartwatches. One example are texts that encourage someone to quit or reduce smoking.6 What are the benefits of telehealth? The benefits of virtual health visits include: Better health People can be diagnosed and treated earlier, even if they live far from a hospital or medical specialist. This can benefit people’s health and may lower treatment costs. Hospital ICUs that use virtual health visits have lower death rates. Research shows that telemedicine can improve recovery from strokes and heart failure.7 Increased access to care Virtual health visits can help remove the barriers of time, distance, and doctor shortages. This can help people in rural areas and underserved urban areas. It may also help people who have problems getting to a doctor’s office. Many telehealth systems offer 24-hour access to doctors. In times like a public health emergency, telehealth lets people access care while reducing demand on emergency rooms. Lower costs Remote patient monitoring reduces hospital visits and ambulance trips. It lets doctors and pharmacists manage prescriptions from anywhere. Plus, it reduces hospital transfers during certain emergencies.7 What are some limits of virtual health visits? Telehealth was invented years ago but is relatively new to the U.S. Because of this, there are some potential challenges for people who want to use these services, including: Outdated laws and guidelines Possible threats to patient privacy and safety Problems with what insurance will cover and how doctors will get paid for services Problems when telehealth crosses state lines, if those states have different rules Cost of investing in technology and training for healthcare workers and patients Limits to what health conditions can be diagnosed and treated People’s access to and comfort with the internet and technology8 Will my insurance pay for virtual care? It depends on what insurance you have. Medicare, Medicaid, Veterans Affairs, and many health insurance companies have recently agreed to cover more telehealth services than before. The federal government also recently lifted some privacy regulations that make telehealth easier to use. The types of telehealth services available, and how they can be provided, can change often. Virtual health visits that were not paid by insurance in the past, may now be covered. Check with your insurance company first before using these services.6,9 [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"] At-home monitoring can help you better manage chronic health conditions. It can also aid in your recovery after medical procedures. Using this technology, you can regularly record your health data at home. Nurses and doctors then monitor these data to identify problems and intervene earlier. This results in lower costs to you and our healthcare system. The devices you should use depend on what information you and your doctor need to track. Talk to your doctor to discuss what is right for you. You should also ask your insurance provider if the devices are covered. Types of at-home monitoring devices Many vital signs can be monitored at home and remotely examined by your doctor. Some of these are also called wearable devices. Here are a few of the most common remote devices: Blood pressure cuffs Digital weight scales Glucose monitors (measures blood sugar levels) Pulse oximeters (measures blood oxygen levels) ECG monitors Pacemakers Thermometers Digital stethoscopes and otoscopes Pedometers (to record steps or walking) Peak flow meters (to measure breathing) Mobility sensors to predict or detect falls Tracking devices to locate wandering elders Medicine reminder alerts Some technologies integrate a few of these devices into one system. They may also include written or verbal questions that monitor mental and physical health. They may provide educational information directly to the person. Some devices support virtual contact with a doctor for real-time treatment.1,2 The right device depends on the individual. Some people only need a simple, portable technology such as an app that reminds them to take medicine at a certain time. Other people may need a comprehensive home-based system to monitor their heart, blood pressure, oxygen levels, and blood sugar.3 Benefits of at-home health monitoring Using these devices, doctors monitor your health data remotely using a phone or internet connection. This improves access to care, especially in rural communities. Doctors also have access to more data to make more informed decisions about your care. They can see what behaviors cause problems and identify practical solutions.2 They can also intervene earlier when problems arise. For example, they can provide medical advice or modify treatments more quickly than if you had to wait for an office visit. Early intervention improves care and reduces costly hospital visits. This is particularly useful for chronic diseases like asthma, diabetes, heart disease, or COPD. It also reduces hospital readmissions after medical procedures.2,4 Monitoring health at home also empowers you to take a more active role in managing your health. It can help you understand practical ways to stay healthy. For example, you may see how certain foods or activities increase your blood pressure. Users of at-home monitoring devices also report better relationships with their doctors.2 The Veterans Health Administration (VHA) showed these benefits for people enrolled in their VHA Care Coordination/Home Telehealth (CCHT) program. They used several technologies to provide care for people with diverse chronic diseases. Users showed 25 percent fewer hospital bed days and 20 percent fewer hospital admissions compared to before enrollment.1,4 Limitations of using at-home health monitors Some obstacles limit our ability to use remote health monitoring, including: Lack of cellular coverage or internet access for some patients Patients and doctors comfort with technology Cost of the devices and whether insurance will pay for newer technology Doctors’ concerns about liability Protection of private health information Accidental breakage of the device However, many people agree that the health benefits outweigh the risks. Continuing to lift insurance and legal restrictions will also improve access to telehealth services and devices.2 [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"] It can be overwhelming to figure out how to find telehealth services, especially if you do not already have a doctor. But many companies offer a range of virtual health care services. Your doctor can help identify which one is right for you. And your insurance provider can help you pick the most cost-effective one. If you cannot access telehealth through your doctor or insurance, you can still find services online. Here are some easy ways to compare services and costs to see what works for you. Where do I start my search for virtual care? The best place to start is with your doctor. They may be able to set you up with their preferred telehealth platform. Many clinics have partnerships with certain virtual care companies. Or your doctor can refer you to a platform suitable for your needs. You should also talk to your insurance provider. Many companies and employers partner with specific telehealth companies. Since coverage varies from provider to provider, be sure to ask your insurance if the service you need is covered. Many telehealth services are also accessible without insurance. A good place to start your search for these is through online marketplaces on GoodRx and Walgreens. You can search for treatments for many different conditions on these sites. Then you can also compare the price and service information for each telehealth company.1 What are some companies that provide telehealth services? There are many companies that provide these services, and many more are branching out to provide online services. Your doctor or insurance company may have a preferred or specialty service they use. Below we highlight several companies that have a long track record of providing a range of telehealth services. Doctor on Demand Doctor on Demand provides telehealth services through its mobile app. It connects you to licensed doctors for a video appointment based on your schedule. It can provide access to a doctor within minutes, but increased telehealth demand may cause longer wait times.2 They can help treat many acute and chronic conditions, such as cold and flu, asthma, allergies, and diabetes. They also provide behavioral and preventive health services. Their services are available with or without insurance. MDLIVE MDLIVE provides virtual doctor visits via their mobile app, website, or phone call. Their licensed doctors can treat many non-emergency conditions. This includes acute conditions like cold and flu, pink eye, and ear problems. They also provide behavioral health and dermatology services. It is free to set up an account and input your medical history, and services are available with or without insurance. Teladoc Teladoc connects you to a doctor by phone or video. Once you set up an account and fill out a brief medical history, you can connect quickly with doctors or specialists. You can find everyday care for urgent care needs like the flu, stomachaches, and skin conditions. You can also speak with pediatricians, therapists, medical experts, and wellness experts. Services may vary depending on your health plan or employer. American Well American Well connects you to doctors, therapists, and specialists on your computer, tablet, or phone. Most doctor visits take about 10 minutes. They review your medical history, answer questions, diagnose, treat, and prescribe medications. Their services include urgent care, cardiology, dermatology, neurology, and therapy. They accept insurance from many providers. But even without insurance, you can still see a doctor and pay directly. Other options There are many telehealth companies now that can provide services.3 As technology improves, more services become available through telehealth. For example, Apple and FitBit enable remote monitoring of health conditions using their wearable devices. The best service for you depends on your specific situation and insurance coverage. Your doctor and insurance provider can help you find the right one. [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"] Visiting your doctor online is a great way to get healthcare if you are not able to go in person. You can get medical advice, visual assessments, treatments, or update your doctor about a long-term issue. This can happen over a video chat, phone call, email, or text. However it happens, a virtual visit lets you get care from the comfort of your own home without having to travel. If virtual care is new to you and your doctor, you may need to prepare yourself. Knowing what to expect and what to have with you will make your first virtual visit go more smoothly. It will also help you get the most out of the call. Scheduling a healthcare video chat Check with your doctor’s office first to see what options are available. They can tell you if a video chat appointment is appropriate for the service you need. They can also explain which video conference service they use and how you can get and use it. This may include: What devices you need for video calling How to download and start using the program How to use any features of the program How to schedule and start video chat appointments How long video chats usually last Many healthcare professionals now include video calls in their services. But if your doctor or therapist does not, there are other options. One example is Doctor on Demand. This is an online service available 24/7. You can use it to connect to doctors for many services. You can then visit them over live video through an internet browser or app.1 What you need to video chat with your doctor You will need a device that can access an internet connection. This could be a laptop, tablet, or smartphone. Most of these devices have great built-in cameras, microphones, and speakers. But if you need to, you can connect external webcams, headsets, earbuds, or speakers. During the visit, your doctor will ask you about symptoms, allergies, and any drugs and supplements you take. Make sure you have this information ready, including the contact information for your pharmacy. If this is a doctor you see regularly, they may already have this information and ask you to confirm if anything has changed. If you have any medical equipment at home, move it close to you so you can access it easily during the visit. Examples include a thermometer, personal EKG monitor, asthma inhaler, blood pressure machine, or a peak flow meter. Here are some additional things you may want to have with you: Doctor’s office phone number, in case you have problems connecting to the chat List of questions you have for your doctor Paper and pen for taking notes1 Preparing for a video chat with your doctor You may want to prepare for a video chat the day before so you can make your visit more comfortable and successful. Here are a few tips: Find a quiet, private place away from distractions Make sure the room is well-lit (but avoid bright lights behind your head) Test your microphone and camera by video chatting with a friend or family member If you are using wireless internet, sit near the internet source If possible, consider using an ethernet cable to plug directly into the internet Close unnecessary programs running in the background Make sure the device you will be using is charged or plugged in2,3 Now you are all set up and you can start your video chat! Usually, your doctor or therapist will email or text you a link that you click to join your doctor. Sometimes a password will be included. Once you join the call, your visit will be very similar to an in-person office visit. At the end, you will discuss next steps, such as whether you need a follow-up visit. You can always ask your doctor questions during the meeting or call them later. [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"],Telehealth or virtual care can be used to access many different types of health services. To get started, talk to your doctor to find out which virtual services are right for you. And be sure to speak with your insurance provider to see what is covered under your plan before any services are performed. There may also be cost-effective options that do not require insurance. Which chronic health conditions can be treated using telehealth? Almost every medical field uses telehealth to provide virtual healthcare. In the sections below, you can see examples of how virtual care is used for different health conditions. Cancers Telehealth can be used to improve care in all sorts of cancer settings. Local doctors may share images with out-of-state specialists to diagnose people faster. Many times, doctors will also communicate with faraway specialists about treatment options for a patient. Mobile health makes it easier to contact a doctor to refill prescriptions, show a doctor the results from a medical device in the home, or ask for medical advice. Home monitoring technology can also help support lifestyle changes and wellness activities.1 Skin and eye conditions Telehealth technology can be used for early diagnosis of conditions like eczema, plaque psoriasis, and macular degeneration. Personal doctors can send images to distant specialists. This makes it easier to decide whether further examination is needed. Plus, it is easier to check in on progress from treatments.2,3 Neurological conditions Mobile technology is often used to diagnose stroke, Parkinson’s disease, and multiple sclerosis. Telehealth services increase access to education and consultations, especially for people living in rural places with fewer specialist doctors. Mobile technology can also make it possible to have home monitoring of motor function and tremors.4 Lung conditions People with asthma, cystic fibrosis, or other lung conditions can use devices to monitor breathing and lung function. This allows remote specialists to better manage and treat symptoms. It can also help with better self-management of symptoms.5 Rheumatic conditions People with rheumatic conditions like lupus or rheumatoid arthritis can get specialized care through video chat appointments. This is particularly helpful in areas with a shortage of rheumatologists and other specialists. Onsite doctors call remote specialists to complete examinations and discuss treatment options.6 Other chronic conditions There are other telehealth services that are helpful for people with chronic health conditions. Virtual home care may be especially useful for people with COPD, diabetes, heart disease, or Alzheimer’s disease. A nurse or other approved care provider can regularly visit, can help set up monitoring equipment, and can assist as needed during video calls.7 Pharmacies also deliver services virtually. “Telepharmacy” lets pharmacists answer patient questions about medicines or review all the drugs and supplements a patient is taking. Other services include treatment monitoring, counseling, prescription authorization, and remote dispensing. This has increased access to specialty pharmacy services in rural communities.8 Mental health therapy sessions can take place over live video calls.9 Even physical, speech, and occupational therapy sessions can be done by live video. What telehealth services are provided for acute health conditions? Virtual care works well for acute conditions, such as cold or flu symptoms. It also can be used to diagnose or treat other common health issues, including: Sinus and upper respiratory infections Urinary tract infections Pink eye Bronchitis Skin rashes such as poison ivy (allergic contact dermatitis) Ear pain Virtual care for these non-urgent conditions may be easier than healthcare provided in-person. And it is generally cheaper than care given at health clinics, urgent care centers, or primary care offices.10,11 Is virtual care covered by insurance? Insurance providers vary greatly in their coverage of telehealth services. However, they continue to expand coverage. The number of insurance providers that will pay for these services is increasing as well as the range of services that are covered. Contact your provider to get up-to-date information about the services you need. Here are just a few of the telehealth services covered by Medicare: Annual wellness visit Medication management Diabetes self-management training Lung cancer screening eligibility Counseling to stop using tobacco or alcohol Virtual visit for evaluation and disease management Planning for chronic care management Annual mental health screening Individual or family talk therapy12 [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"]

Insider's Guide to Telehealth

Telehealth 101: How to Visit Your Doctor Online

How to Monitor Your Health with At-Home Devices

How Do I Find Virtual Health Services?

Preparing for a Virtual Visit with Your Doctor

A Look at the Services Virtual Care Offers

Privacy Concerns When Going Virtual