AARP is focusing its weekly TeleTown Hall this week on Telehealth. Please join the AARP Coronavirus Q & A on Thursday, April 16 at 1pm ET. Experts will share the basics of electronic and virtual telehealth services and how to access them. The discussion will also include how Medicare and private insurers have adjusted and expanded their rules for testing, prescriptions and out-of-network care during the pandemic.
Here’s how to join:
Date: April 16
Time: 1pm ET
Call-in: 855-274-9507 (toll free)
You can listen to the livestream or find more information here. Call recordings will be posted on AARP.org/coronavirus and on the Volunteer Portal in the TTH Library under Coronavirus TTH.
On March 6, the Coronavirus Preparedness and Response Supplemental Appropriations Act was signed into law, which among other things gives the U.S. Department of Health and Human Services (HHS) the authority to temporarily waive certain Medicare requirements for telehealth services. “If a Medicare beneficiary is looking for advice, they can call their doctor and receive medical direction on whether they should come into the office for an exam,” explained CMS Administrator Seema Verma during a recent AARP town hall.
Then on March 17, CMS announced that Medicare will now cover telemedicine for routine follow-up visits as well — so if you need to check in with your doctor for a chronic condition such as high blood pressure or type 2 diabetes, for example, you’ll be able to do it via Skype instead of schlepping in for an in-person visit.
“It helps us prevent the spread of the virus,” Verma explained at a press conference announcing the news, pointing out that the benefits go beyond individual welfare to stemming the tide of coronavirus infections overall.
Physicians who take care of older adults, including geriatricians, are thrilled with this development. “With the advent of the coronavirus pandemic, there’s greater urgency because we do not want to expose our older patients who are more vulnerable to its complications the risk of illness,” explains Ronan Factora, M.D., a geriatrician at the Cleveland Clinic. Like many doctors, he is calling his patients to encourage them to book a virtual visit whenever possible.
What to expect in a virtual visit
In reality, a telehealth appointment is very similar to what would happen in person, Michael Hochman, M.D, a physician at the University of Southern California, explains. Patients have a scheduled time where they phone in, followed by an email link that takes them to a computer check-in. (USC uses the software program OneTouch.) When the physician is ready to see a patient, both parties are connected via videoconference so that they can see each other.
“I have their chart in front of me, and we do a medical history, just as we would in a typical visit,” Hochman says.
Have a pen and paper handy so you can jot down notes during a telemedicine visit with your doctor.
If patients are complaining of cold or flu-like symptoms, for example, Hochman has them take their temperature and talks them through measuring their heart rate. If the patient has an at-home blood pressure monitor, he’ll ask him to use it while he’s watching in order to make sure he’s operating it correctly.
“You’re definitely limited as to what you can do, compared with a physical exam. But you can tell a lot about a patient by how they look,” he explains. “Are they breathing hard? Do they look like they are in distress? It won’t be as thorough as a physical exam because you can’t do things like listen to a person’s lungs or feel their abdomen or examine their skin. But 90 percent of a diagnosis is observation and taking a careful history.”
Expanding use of telehealth in the future
One reason why many hospitals have not invested too much in telemedicine is because many patients, including older ones who may not be as well-versed in technology, have initially been suspicious of it.
“They’ve had difficulty embracing new technology in the past, but now coronavirus fears have propelled our patients to be more accepting of it,” explains Stephanie Chow, M.D., assistant professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York City.
The hope is, Chow says, that the restrictions on telemedicine for insurance coverage will be loosened and hospitals will be able to continue doing it long-term. “We have patients who are isolated from their communities, with no family or health aides to help them. And those are the ones we really do worry about, because they have no easy way to get in to see us,” she adds. “This is an extraordinary opportunity to get them on board with it.”
As for launching telemedicine in his practice, Hochman says that although some of his patients have initially expressed some frustration, once they’ve done it a couple times, they’re firmly on the telemedicine bandwagon.