Telemedicine: How to make the most of a virtual doctor visit

Posted by John, Volunteer Mentor @johnbishop, Mar 24, 2020

With all of the advances in medicine over the years it only takes a health crisis like COVID-19 to push us to new frontiers in treating our health conditions. I recently read an interesting article by Dr. Edward Creagan with some good sound tips on the basics.
- Mouse-calls: How to Meet with Your Doctor Virtually https://www.askdoctored.com/post/mouse-calls-how-to-meet-with-your-doctor-virtually

If you are a Mayo Clinic patient you are probably already enjoying the Mayo Clinic Patient Portal which makes appointments, treatment followup and asking none critical questions from your health care team easy. Here are a few more articles that you may find interesting.
- Telemedicine Advances https://www.mayoclinic.org/tests-procedures/stroke-and-telemedicine/multimedia/vid-20078196
- Telehealth: Technology meets health care -- See how technology can improve your health care. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878

Do you have any tips, fears or information to share on Telemedicine?

Interested in more discussions like this? Go to the Visiting Mayo Clinic Support Group.

@mermaid7272

I see nothing here about the fact that many people in the U.S. are not able to do this magical tele-doctor-thing!
We do not have high speed broadband computer access. Nope. many of us rural folks have very limited computer access. Kids
can't do homework, people can't "work from home", we are lucky to be able to simply read & write our emails, period.
We do have telephones, and can just talk to a dr. or nurse, but that's all.
So you people with all the fancy-schmancy devices and unlimited access are lucky, but remember not all of our country is hooked up!

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Thanks for bringing us back to the reality that folks in rural environments face, @mermaid7272. You make a good point that not everyone can easily access the internet. How are you doing during this COVID-19 situation?

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@mermaid7272

I see nothing here about the fact that many people in the U.S. are not able to do this magical tele-doctor-thing!
We do not have high speed broadband computer access. Nope. many of us rural folks have very limited computer access. Kids
can't do homework, people can't "work from home", we are lucky to be able to simply read & write our emails, period.
We do have telephones, and can just talk to a dr. or nurse, but that's all.
So you people with all the fancy-schmancy devices and unlimited access are lucky, but remember not all of our country is hooked up!

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@mermaid7272, a lot of the small local telephone companies in our state (Minnesota) have been working with the state to provide more rural access to high speed Internet. A lot of the problems are related to financing the infrastructure. The state has given matching grants to help the phone companies bring fiber Internet to some of our rural areas. The company I just retired from is providing free installation and Internet for people that have kids and no Internet so they can do homework, including those in the rural areas they service. I would think other states would have similar programs.

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@hopeful33250

I will be having my first video appointment on May 19 with my doctor from the University of Michigan. I'm supposed to get a lot of support and somehow it will come through the My Chart patient portal. I must admit that I'm glad to not have to make the 50-minute drive to the U of Michigan. I just hope I can handle the technical stuff well enough to have the appointment.

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John & Teresa:
We must live close to each other Teresa, but my area-- in between Ann Arbor & Jackson is a "dead" zone. We are eventually in the far future supposed to have broadband access, but it has stalled and the company in charge was fired & the new company is slow as molasses. Maybe next year!
The infrastructure is of course a big problem, we have no grants, just an expensive tax to do the start up. But so many foul-ups and bad weather & now the "Death Virus", has caused numerous delays. I really don't expect it for a long time, if at all.
I spent much time at the U of M, & the best part was the long drive. (Won't go into my problems with their Cancer Clinic.) Good luck with the magic tele-visit!

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@hopeful33250

I will be having my first video appointment on May 19 with my doctor from the University of Michigan. I'm supposed to get a lot of support and somehow it will come through the My Chart patient portal. I must admit that I'm glad to not have to make the 50-minute drive to the U of Michigan. I just hope I can handle the technical stuff well enough to have the appointment.

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@hopeful33250 You will , you did mine . lol Im as technical as you are . I do love the patient portals. I have to telemeds coming up in May . Hope you are all doing well , I am staying home ,washing hands , wearing mask and gloves here as I touch so many things here in my sr. building .

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@mermaid7272

John & Teresa:
We must live close to each other Teresa, but my area-- in between Ann Arbor & Jackson is a "dead" zone. We are eventually in the far future supposed to have broadband access, but it has stalled and the company in charge was fired & the new company is slow as molasses. Maybe next year!
The infrastructure is of course a big problem, we have no grants, just an expensive tax to do the start up. But so many foul-ups and bad weather & now the "Death Virus", has caused numerous delays. I really don't expect it for a long time, if at all.
I spent much time at the U of M, & the best part was the long drive. (Won't go into my problems with their Cancer Clinic.) Good luck with the magic tele-visit!

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Thanks for your comments, @mermaid7272. Yes, we must live close-by. I am sorry to hear about your "dead" zone. That must be frustrating to be so close to a big city and unable to get good internet service.

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Good afternoon everyone. I am joining you in this telemedicine discussion. After reading the links and following the guidelines, I had my annual PCP visit this week with a video call. I have another scheduled with a different provider on May 14 and am waiting for confirmation of one more. At first, I was hesitant that the opportunities for progress might be limited and that I might forget something even with prepared notes.

Two days before, I filled out the forms and they were the same as last year's in-person questions. The COVID-19 questions have been added. An assistant called for the walkthrough about connecting and technological issues.'

On the day, the NP did the same thing she would have done if I was there. The only thing I forgot was a blood pressure machine. I left mine in CA and haven't purchased another one. When the doctor came in she asked a lot of questions about the last time the BP was taken, higher or lower than before, etc. I promised that it would be on my next Amazon order.

The rest of our time together was more like a friendly discussion. We were both at ease and we both knew what decisions had to be made. It was at this time that the two of us were "connected" even more authentically than we would have been in the exam room. My "caregiver" joined us to record the important routines or tasks that might be necessary.

For me, this was a pretty darn good example of shared decision making between the patient, provider, and caregiver/family member. Our shared decision was to give my body time to adjust to the tapering changes, and effect no change in medication for six months. We spelled out options for those changes just to be prepared.

The only thing I missed was the hug I usually get. She asked me to review her notes on the portal before they were filed. Her words at the bottom were quite a compliment, "She does aging well".

May you find yourself content and at ease today.
Chris

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@artscaping

Good afternoon everyone. I am joining you in this telemedicine discussion. After reading the links and following the guidelines, I had my annual PCP visit this week with a video call. I have another scheduled with a different provider on May 14 and am waiting for confirmation of one more. At first, I was hesitant that the opportunities for progress might be limited and that I might forget something even with prepared notes.

Two days before, I filled out the forms and they were the same as last year's in-person questions. The COVID-19 questions have been added. An assistant called for the walkthrough about connecting and technological issues.'

On the day, the NP did the same thing she would have done if I was there. The only thing I forgot was a blood pressure machine. I left mine in CA and haven't purchased another one. When the doctor came in she asked a lot of questions about the last time the BP was taken, higher or lower than before, etc. I promised that it would be on my next Amazon order.

The rest of our time together was more like a friendly discussion. We were both at ease and we both knew what decisions had to be made. It was at this time that the two of us were "connected" even more authentically than we would have been in the exam room. My "caregiver" joined us to record the important routines or tasks that might be necessary.

For me, this was a pretty darn good example of shared decision making between the patient, provider, and caregiver/family member. Our shared decision was to give my body time to adjust to the tapering changes, and effect no change in medication for six months. We spelled out options for those changes just to be prepared.

The only thing I missed was the hug I usually get. She asked me to review her notes on the portal before they were filed. Her words at the bottom were quite a compliment, "She does aging well".

May you find yourself content and at ease today.
Chris

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@artscaping Glad to hear your video call went well. It's on my bucket list for as soon as I can get one setup. I'm still working on my list of questions/concerns I want to discuss with my primary care doc. If you haven't chosen a BP monitor yet I am really happy with the one I have - an Omron Evolv bluetooth wireless upper arm cuff BP monitor. It's easy to use and has a fairly easy to understand app that can sync your phone to the monitor and keep track of the history. https://omronhealthcare.com/products/evolv-wireless-upper-arm-blood-pressure-monitor-bp7000/

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@elizm

@colleenyoung
Colleen has listed important points regarding preparing for and engaging in tele-visits. At a tele-visit, however, there is no one to alert you to anomalies in your BP, pulse, temperature, and weight... important information for any doctor visit. As much as we patients may want to resist it, it's time to start taking responsibility for tracking and conveying this information to our healthcare providers. Cancer patients are particularly vulnerable to all sorts of downstream issues.

Omron makes an excellent home blood pressure cuff. If you have ever had a blood pressure issue, you need to make an effort to see how you're doing. If it appears too high or too low, log it daily and convey the results during your tele-visit. CVS has a good digital thermometer worth obtaining, especially in light of the Covid-19 news. Keep it handy and just make sure, now and then, that your temperature is normal. If you have a respiratory issue (from radiation, or past pneumonia events, asthma, etc.), get a good pulse/oximeter which monitors the oxygen saturation of your blood. If it registers below 95, note that to your doctor. Get a good bathroom scale and weigh yourself weekly; be honest with your doctor if you have lost or put on pounds. In other words, become your own physician's assistant... help him/her help you.

And please note, any one particular abnormality which you convey, may or may not be of concern to your doctor, but it will help him/her ask you appropriate questions, and better understand what's going on inside you.

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Thanks for this information....my wife and I have both recently had tele-Med visits with our Primary Care Manager....basically he goes over questions about how we feel, how we are doing overall, physically and mentally, and BP lab results etc.

But it is not the same as looking at touching the patient....however, he is very good and thorough and we are grateful for him, since we are 75 miles away from Walter Reed/Bethesda....we also have curb side Meds pickup in the Ft.Belvoir garage which is so weird, but for now, it works.......you bring out some wonderful points and medical devices to have...we still use the old mercury thermometer, but do have the BP and electronic thermometer you mentioned.....Thanks for your post.

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@hopeful33250

I will be having my first video appointment on May 19 with my doctor from the University of Michigan. I'm supposed to get a lot of support and somehow it will come through the My Chart patient portal. I must admit that I'm glad to not have to make the 50-minute drive to the U of Michigan. I just hope I can handle the technical stuff well enough to have the appointment.

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@hopeful33250 Let's see how we can avoid you getting stressed out over the technology. Actually, if you handle this Connect site and all of the ins and outs and unders and overs then you can handle your appointment. If not, I hear that John recently retired. (teasing). Sometimes, you can go through the technical stuff a day or two ahead of time. My memory issues would step up and wipe it out if it were any longer. Good luck Teresa.
May you be content and at ease today.
Chris

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@johnbishop

@artscaping Glad to hear your video call went well. It's on my bucket list for as soon as I can get one setup. I'm still working on my list of questions/concerns I want to discuss with my primary care doc. If you haven't chosen a BP monitor yet I am really happy with the one I have - an Omron Evolv bluetooth wireless upper arm cuff BP monitor. It's easy to use and has a fairly easy to understand app that can sync your phone to the monitor and keep track of the history. https://omronhealthcare.com/products/evolv-wireless-upper-arm-blood-pressure-monitor-bp7000/

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@johnbishop.....I got an Omron on amazon. It was $50 and I liked the color better. (HaHa).
Chris

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