Summer Burch: Graceful Health | How does telehealth work?

Summer Burch

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Telehealth, sometimes called telemedicine, has been in the news a lot lately, as medical providers increasingly are using digital tools to "see" their patients who are staying home due to COVID-19 social distancing.

With all this focus, it might seem that telehealth is something brand new, but actually this technology has been in use for the past few years.

Telehealth is the use of technology, such as a computer or telephone, to access healthcare services remotely. This can be done in a variety of ways. It can be done using a landline telephone by those who do not have access to a computer or mobile phone. It can be done through a safe-and-secure email-system. For example, Grace Cottage has a Patient Portal for sending private messages between healthcare provider and patient. Telehealth is also done as bedside monitoring by a specialist (available in some hospitals, but not at Grace Cottage), or when a medical specialist at one location consults with a patient or a provider at another location. Lately, though, the most common form of telehealth has been "Zoom" or "FaceTime" patient-to-provider visits.

When social distancing measures were implemented in March due to COVID-19, Grace Cottage Family Health quickly adopted the use of remote video telehealth via Zoom or FaceTime, with the option of telephone visits for those without high-speed Internet or computers. Many Grace Cottage patients have been using telehealth.

Approximately 50-75 percent of my patient visits are now being conducted via telehealth. During the COVID-19 pandemic, I am offering all of my patients video visits if they have the technology, or telephone calls if they do not.

So, you might be wondering, what is it like to be a telehealth patient, and what makes a telehealth visit successful?

I tell my patients who are hesitant about telehealth that there are really no good or bad telehealth patients, as long as they are willing to be honest about their symptoms. This, of course, is also important for in-person visits, but during telehealth, it is harder for the provider to see the whole person at once, so the patient has to explain what the provider cannot see.

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Other things that make telehealth easier include good lighting and minimizing distractions. It's best to avoid multiple people or animals in the room while you are visiting with the provider. It is also very helpful to have handy a list of all of your medicines, including doses and schedules. This is particularly true if you are seeing a provider for the first time.

Telehealth is a great option, but at Grace Cottage Family Health, we want to encourage people not to delay care, even when they need to be seen face-to-face.

It is safe to come to Grace Cottage for a provider visit. We are following careful procedures and protocols to keep everyone as safe as possible. We have divided our clinic into two areas, one for people with respiratory symptoms, and another for other patients. In the respiratory area, all providers wear full Personal Protective Gear, including N95 respirators and eye protection. Providers in the non-respiratory area all wear surgical masks and face shields. All patients are screened at the front desk for symptoms and provided with a cloth or paper mask. They are then examined in the appropriate area. We thoroughly disinfect our rooms and equipment between visits, and we offer to see older or more fragile patients first thing in the morning if they prefer.

As always, children who need immunizations should not delay. The CDC recommends that every child stay on schedule. Parents should call to make an appointment when immunizations are due. We must minimize the risk of other infectious diseases that are preventable, especially during the COVID-19 pandemic.

Telehealth is definitely here to stay. It is a convenient and valuable tool, helping us flatten the curve, but it will never replace a face-to-face visit for the patients who need it most. While I appreciate the usefulness of telehealth, especially in times like this, I'm not sure that any healthcare provider or patient would fully want to convert to telehealth. There are some subtle medical findings that can only be elicited by the physical exam, and a special rapport that comes from seeing your provider in person.

Summer Burch, Certified Family Nurse Practitioner, joined the Grace Cottage Family Health staff in 2019. She started her healthcare career in 2004 as a mental health worker at the Brattleboro Retreat, then earned her M.S. in nursing and her board certification as an FNP-C from the American Association of Nurse Practitioners. She also holds certification as a Critical Care Registered Nurse from the American Association of Critical Care Nurses.