PRIMARY CARE | PRECISECAREMEDICAL

 Telemedicine is the practice of connecting with a healthcare provider for a virtual visit through your computer, tablet, or smartphone. Doctors can provide information, diagnose conditions, recommend treatments, provide mental health counseling, and prescribe medication via a telemedicine appointment.

 With more and more medical practices offering virtual care options, you may want to check first with your primary care doctor, if you have one, or a group medical practice with which you already have a relationship, to see if they’re using phone calls, video chats, or other online methods to conduct remote patient visits.

 Pediatricians are also increasingly offering telemedicine, and many specialists, such as cardiologists, neurologists, obstetricians, and oncologists, are also offering care to their existing patients via telemedicine.

 You may also want to check with your health insurance plan to see whether it has its own telemedicine interface, has partnered with a telemedicine company, or has preferred services. Using a telemedicine plan that accepts your insurance is one way to keep your costs down.

 Another option, if you’re employed, is to ask your human resources department if the company has a preferred telemedicine provider — and whether there’s a cost savings to you in using it.

 Medicaid covers some telehealth services, although the specifics vary from state to state. You should contact your healthcare provider if you have Medicaid to ask what services are available to you.

 Medicare beneficiaries also now have broader access to virtual visits, following changes to federal rules in March 2020, according to the Center for Medicare and Medicaid Services (PDF).

 Some physical urgent care centers are offering telehealth, and at the very least, most will speak to you on the phone about whether or not to come to the center. If you have any upper respiratory symptoms or other symptoms suggesting possible COVID-19, they likely will have special instructions for your visit.

 Telemedicine apps are another option. Many apps offer basic primary and urgent care, and some offer additional services, such as dermatology, nutrition counseling, or mental health help.

 A Charged, Plugged-In Device With a Strong Signal You don’t want to run out of power or lose your connection during your appointment! Use Wi-Fi if your cellular data plan is limited.

 Ear Buds With a Built-in Microphone It will be easier to hear the healthcare provider, and for them to hear you.

 A Quiet Location With Good Lighting Turn off the TV, mute notifications on your phone, and tell others in your house you’ll be busy for the next 15 to 20 minutes before you start your visit. Make sure there’s enough light for the health professional to see your face — and any rashes or other physical problems you want to show them.

 If you’re not at home during the virtual visit, find a quiet, private spot where you can shut the door. “I’ve had people try to do virtual urgent care visits while they’re driving a car. We tell them to hang up and we’ll reschedule later,” Dr. Bishop says.

 A Flashlight You may need extra light to give the doctor a clear view of your sore throat, a mouth problem, or even a skin problem. “That’s a big one for our urgent care service at Mount Sinai,” says telemedicine expert Brendan Carr, MD, system chair of emergency medicine for the Mount Sinai Health System in New York City. “People often call for sore throat, but it’s hard to see back of a throat without a flashlight.”

 A List of Your Medication and Supplements, Health History, and Questions A telemedicine doctor who’s seeing you for the first time can better help you if they know about any chronic health conditions or other important health issues you have, as well as the prescription and over-the-counter drugs and supplements you currently take. It’s also smart to jot down your questions ahead of time, Bishop suggests.

 If you’re seeing your usual doctor via telehealth instead of in-person, be sure to mention any new symptoms you may be having, any new over-the-counter products you may be using, and any prescriptions you need to have refilled.

 Hospitals across the United States have been offering telehealth coronavirus assessments since the pandemic began, says Dr. Carr. However, in-person visits have resumed to some degree. “We still do a lot of telemedicine visits. But now that we understand the virus a bit better, we evaluate patients in real life in a much more traditional way (face-to-face with masks on),” he explains.

 Even now, there are still some benefits to telehealth coronavirus assessments, he notes. “We evaluate lots of people over telemedicine and then refer them for an outpatient test. Telemedicine allows us to deconstruct the traditional visit — the medical evaluation can happen virtually, and then you can swing by a lab and drop off a saliva sample to test for COVID without seeing a doctor again.”

 If you're worried that you might have coronavirus symptoms, which include fever, cough, and shortness of breath, you can also use the free online Coronavirus Self-Checker from the Centers for Disease Control and Prevention (CDC), which can’t connect you with a doctor but can help you decide whether to contact one yourself. You can also consult one of the private telemedicine companies offering free online assessments, such as Doctor on Demand.

Telehealth

 There are also many ways to obtain free at-home COVID-19 tests, including from the U.S. government and through your health insurance.

 Under normal, nonpandemic circumstances, virtual urgent care may be the best way to deal with non-life-threatening health concerns that crop up in the middle of the night, while you’re on vacation, or when you can’t get to your primary care doctor’s office for some other reason. For symptoms that suggest a sinus infection, urinary tract infection, or pink eye — the same types of issues you’d take to a local urgent care center — a virtual urgent care visit with a doctor can lead to a diagnosis, at-home treatment suggestions, a prescription for medication if needed, and, if necessary, recommendations for tests and follow-ups with an in-person health professional.

 Who Provides Virtual Urgent Care A growing number of hospitals, healthcare systems, health insurance companies, and private, direct-to-consumer telemedicine companies all offer urgent care services. Virtual urgent care companies include Amwell, Doctor On Demand, MDLIVE, PlushCare, Teladoc, and others.

 Cost of Virtual Urgent Care A telemedicine urgent care visit could cost as little as $20 — the self-pay rate for anyone who uses Houston Methodist’s urgent care service, according to Bishop. Houston Methodist also accepts insurance for virtual urgent care visits; benefits vary based on patient coverage.

 Other urgent care services have varying fees. For example, you may pay more if you use a company that doesn’t take your health insurance (or you don’t have health insurance), and you may pay less if you use a service covered by your health plan or by your employer.

 How Virtual Urgent Care Works You need audio and video for this type of telehealth visit, so use a smartphone, tablet, or laptop or desktop computer with a video camera. Download the app for the urgent care service you want to use, and follow the directions for scheduling an appointment and providing credit card information for payment. You can usually meet with a doctor online within minutes.

 The Telemedicine Tipping Point Is Here, and Laws Have Changed to Make It Easier to Access

 The Telemedicine Tipping Point Is Here, and Laws Have Changed to Make It Easier to Access

 The Telemedicine Tipping Point Is Here, and Laws Have Changed to Make It Easier to Access

 When it comes to telemedicine, different primary care practices do it differently. Some practices, such as Parsley Health, offer the option of in-person visits but are able to conduct all care via telehealth — although you will likely still need to visit a physical facility for such things as lab tests, imaging tests, vaccines, and certain procedures.

 Other practices may offer only certain types of interactions online. For example, you doctor may be able to review your lab test results or check on your progress after some procedures via phone, video, email, or secure online messaging but still want to see you in the office for other types of care.

 In some cases, you’ll need to provide certain data before a virtual visit, such as readings you upload from your glucose meter to your doctor’s patient portal, if you have diabetes, or from a blood pressure monitor if you have high blood pressure.

 In rural areas, your family doctor may be able to help you access online health services, such as mental health appointments and visits with specialists. Indeed, video conferencing with specialists is an important way that rural patients and their doctors can get help managing complex chronic diseases.

 Major medical centers, including the Cleveland Clinic, Stanford, and Harvard-affiliated Partners Healthcare, offer virtual second-opinion programs that give you access to top specialists who can review a medical diagnosis or treatment plan online.

 If you’d like to try an online consultation with a doctor you currently see, ask the doctor, or their office assistant, if this service is available and right for you.

 “A consult or scheduled virtual visit with your own doctor means you’re working with someone who knows you and your health history,” Bishop says. “Some doctors in our system will also do on-demand urgent care visits for their own patients, so it’s worth asking.”

 Generally, you pay the same price for a virtual visit with your doctor as an in-person visit. But pricing and availability vary among doctors, health systems, health insurers, and states, so it’s worth checking with your doctor and with your health insurer to find out what’s available to you, Bishop adds.