Arranging and attending our doctor’s appointments can be difficult as we age. The time it takes to call in, set up an appointment, drive to the doctor, and sit in the waiting room can be longer than the time we spend with our actual doctor. This can also be challenging if you no longer drive and have to arrange transportation with loved ones or through ride sharing services. Telehealth can save you time and stress surrounding your health care appointments because it uses telecommunications technologies to support and promote long-distance clinical health care (FAQs on Telehealth, 2020). Telehealth services include video calls, phone calls, and emails with your doctor as well as access to medical records, test results, and appointment scheduling.
There are various benefits to using telehealth services, such as making health care more accessible and helping you save time and money by avoiding a trip to the doctor’s office. (Fact Sheet, n.d.). By utilizing telehealth services such as brief check-ins, you can determine if an in-person visit is necessary (Medicare Telemedicine, 2020). Wearable technology can also be used in conjunction with telehealth. You can share health data with your doctors to help supplement telehealth visits. This can be especially useful to help manage chronic conditions such as diabetes. For instance, a patient who has diabetes can track daily food intake and share that information with their doctor (Telehealth and Seniors, 2020). This also allows the patient to take a greater role in their own health and wellness. Similarly, telehealth is especially helpful for post-surgery or recovery follow up, and health issues that can be diagnosed through symptoms alone (Telehealth and Seniors, 2020). Finally, telehealth can increase communication between patients and doctors. Instead of waiting for the next appointment, patients can ask their doctors questions and discuss test results through messaging portals or other applications.
How to Use Telehealth
A majority of clinics and health care systems provide a free web portal service where their patients can see test results, medical records, schedule appointments, and message their doctor (Telehealth and Seniors, 2020). Find out if your health care provider offers a web portal service and sign up for it. Also, find out if your health insurance plan covers telehealth options. There is more information on this for Medicare and Medicaid beneficiaries in the sections below.
Telehealth does not necessarily replace in person appointments. They can supplement your health care routine without having to go into a physical appointment. Telehealth visits should still be conducted similarly to in person appointments. Here are some steps to take to prepare for your telehealth visit (Fleisher, 2020).
- Set up the appointment
- Speak to your doctor to determine which platform you will use for your visit. This can be through telephone, portal service, or another platform.
- Confirm the date and time for your visit. If your visit is taking place over the phone, remember that your doctor may be calling from their home phone or private number. Pick up any call that comes in at your scheduled appointment time.
- Know how to log in
- Be sure to have access to your log in information and password prior to signing into the web portal.
- Keep your log in information in a safe and accessible place.
- You may also want to practice logging in the day before your appointment.
- If you have trouble logging in, call your doctor’s office to ask for help guiding you through the log in process.
- Set up your space
- Predetermine where you will be for your telehealth visit.
- Choose a quiet space close to your computer or internet router for better connection.
- Aim to have adequate lighting in your area in case your doctor needs to get a closer look at you.
- If you are using a phone or tablet for your video call, set up some books or something heavy to lean your device against so you can use both of your hands.
- Include family
- You do not have to be in your telehealth visit alone. Consider asking a family member or caregiver to sit in on your visit. They can help you set up your visit as well as take notes during the visit.
- Be prepared
- Prior to your appointment, write down any specific health questions you have for your doctor. Prioritize your questions in order or importance to you because not all of your questions may be answered during the visit.
- Have a list of all of your medications and supplements as well as their dosages next to you. Your doctor may ask what you are taking or adjust your medications.
- Your doctor may also ask you to have other supplies on hand. These can include a thermometer, scale, blood pressure cuff, tissues, pen and paper, and a flashlight. These are not required, but can help measure any dexterity issues or give your doctor better lighting to see certain parts of your body.
- Follow up
- If you or a loved one are taking notes during the appointment, repeat any instructions or information back to your doctor to ensure that you have the correct information.
- If you are not taking notes, ask your doctor if any recommendations they made will be emailed, mailed, or provided in the web portal.
Although telehealth may offer more convenience, there may be some drawbacks or barriers to using telehealth. To utilize telehealth, patients must be comfortable using a computer or smartphone (Telehealth and Seniors, 2020). Ask a friend or family member to help navigate setting up a telehealth appointment. If you do not have a computer or smartphone, ask to see if a telehealth visit can be done over the phone. There are also concerns about security and privacy while using telehealth services (Telehealth and Seniors, 2020). To address this concern, make sure that telehealth visits are done on personal computers in a private location. Your doctor can also address any other privacy or security concerns.
Telehealth appointments can be conducted using videoconferencing, internet, streaming media, and landline or wireless communications. Doctors providing telehealth visits provide these visits in private settings and follow Health Insurance Portability and Accountability Act (HIPAA) safeguards to limit the disclosure of protected health information (FAQs on Telehealth, 2020). Also, for privacy and security reasons, telehealth visits are not recorded (Fleisher, 2020). HIPAA-compliant video communication tools include:
- Skype for Business
- Microsoft Teams
- Zoom for Healthcare
- Google G Suite Hangouts Meet
- Cisco Webex Meetings
- Webex Teams
- Amazon Chime
- Spruce Health Care Messenger
Other videoconferencing platforms available to be used for telehealth visits, but are not HIPAA-compliant include:
- Google Hangouts
- Facebook Messenger video chat
- WhatsApp video chat
Messaging or texting applications that are available but not HIPAA compliant include:
- Facebook Messenger
- Google Hangouts
- Other commonly used texting applications (FAQs on Telehealth, 2020).
If you are concerned about privacy or security while using telehealth services, ask your doctor about the service they use and what precautions are in place to protect your information. If you are using a non-HIPAA compliant platform, your health care provider should advise you of potential privacy risks and should enable any available privacy modes when using these applications (Telehealth Toolkit, 2020). If you have questions regarding the platform you are using, be sure to voice your concerns to your doctor.
Due to the recent COVID-19 pandemic, there are a few changes to the payment options for telehealth, especially for those who receive Medicare benefits. As of March 6, 2020, Medicare can now pay for telehealth visits from any health care facility as well as the patient’s place of residence (Medicare Telemedicine, 2020). Medicare beneficiaries will be able to receive specific services through telehealth visits including common in-person visits, mental health counseling, and preventive health screenings. These visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits. The Medicare coinsurance and deductible would generally apply to these services. However, there is some flexibility for health care providers to reduce or waive cost-sharing for telehealth visits paid by federal health care programs (Medicare Telemedicine, 2020).
As of March 19, 2020, the Department of Health Care Services (DHCS) requires Medi-Cal managed care plans to begin reimbursing for telehealth services at the same rate as those provided in person (Telehealth Toolkit, 2020). Similarly, commercial health plans regulated by the Department of Managed Health Care (DMHC) is reimbursing for telehealth services at the same rate as those provided in person. These plans include all HMOs and most of the Blue Cross and Blue Shield PPO products (Telehealth Toolkit, 2020).
Call to Action
Telehealth services allow you to continue your routine health care appointments. Especially during the COVID-19 pandemic, telehealth allows you to avoid public spaces and protect yourself as well as your health care provider. Understand the potential privacy risks if you use a platform that is not HIPAA-compliant. Ask your friends and family if they have used telehealth services before so they can give you advice. If you have an upcoming appointment, ask your doctor what telehealth options are available to you and if possible, transition your appointment to a telehealth visit.
Fact Sheet: Telehealth. (n.d.). Retrieved from https://www.aha.org/factsheet/telehealth
FAQs on Telehealth and HIPAA during the COVID-19 nationwide public health emergency. (2020). Retrieved from https://www.hhs.gov/sites/default/files/telehealth-faqs-508.pdf
Fleisher, J. (2020). How to Prepare for a Telehealth Appointment. Retrieved from https://www.brainandlife.org/the-magazine/online-exclusives/how-to-prepare-for-a-telehealth-appointment/
Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency. (2020). Retrieved from https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html
Telehealth and Seniors. (2020). Retrieved from https://www.aginginplace.org/telehealth-and-seniors/
Telehealth Toolkit for Medical Practices. (2020). Retrieved from https://www.cmadocs.org/Portals/CMA/files/public/CMA%20COVID-19%20Telehealth%20Overview.pdf