What to Expect During a Telemedicine Visit

Wanda Ryan, MD, FACE
woman sitting in front of laptop

Telemedicine is commonly defined as the delivery of medical care from a distant location. Live long-distance communication began with the invention of the telephone in the late 1800s and since then rapid advances in digital technology have made audio and video communication an integral part of our daily lives. This technology is now being used to provide remote access to medical care, including specialty visits with an endocrinologist.

Accessing telemedicine. Traditional telemedicine provides real-time audio/visual interaction with a remote medical provider via a secure online portal and video application at a medical site in your local community. This site may be located in a community hospital, a local clinic, or a physician’s office. Medical staff will facilitate your scheduled visit, including measuring your own vitals, reviewing medications, and managing all of the technology required for your remote visit. You will be able to see your provider on a computer screen and they will be able to see you through use of a webcam. The video images are transmitted securely in real time and are not recorded. You will also be able to discuss freely with each other as you would in a face-to-face visit.

Preparing for your visit. To get the most out of your visit be prepared. Write down any questions you may have so you do not forget them once you are on camera speaking with your provider. Have a list of your medications and any recent test results at hand, as they may not be available to the remote provider. If you have diabetes, have your glucometer with you. Check with the site in advance to see if they are using a web-based platform such as Tidepool or Glooko that will enable you to upload and share data from your glucose meter, continuous glucose monitor (CGM) or insulin pump in advance of your visit. If not, your device can often be downloaded on site with data then scanned to your provider, or you can call in or send data securely via a patient portal. For further help preparing for your visit, read AACE's telemedicine checklist.

In order to prepare for a limited remote physical exam, wear loose fitting clothing. Digital equipment may vary by site but usually includes a high definition portable webcam to visualize specific body sites of interest or concern. For example, if you have diabetes be prepared to remove your shoes and socks for a visual examination of your feet. If requested, pictures of a rash or wound can be taken and stored in your medical record. A digital stethoscope may be used to listen remotely to your heart and lungs.

Lab work and imaging studies can be ordered to be done locally. Referrals can be provided for diabetes education, eye exams, podiatry visits, or other consultation if needed. Medication prescriptions can be sent electronically to your local pharmacy.

Billing. Many insurance plans including Medicare and Medicaid are now providing some coverage for telemedicine visits. It is best to check with your insurance carrier regarding any restrictions that may apply and to clarify your specific benefits, noting reimbursement may also vary by state. During the recent COVID-19 pandemic many patients and physicians relied on the use of at home tele-visits using smartphones, tablets or computers to provide virtual care. Insurers temporarily expanded coverage and waived many of the restrictions governing traditional telemedicine services during this pandemic but it remains to be seen what future rules governing these services will be.

While face-to-face visits are needed for conditions requiring hands-on examination or a medical procedure, advanced technology enables many visits to be done using telemedicine, providing evaluation, diagnosis and treatment in your local community. Telemedicine can now bring the doctor to you, improving your access to specialty care while saving time and travel costs.

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