Top Docs: Telemedicine Do’s and Don’ts
The latest buzzword in healthcare is telemedicine. A new Indiana law that took effect in July made it legal for doctors to prescribe medicine without laying hands on a patient. The change acted as a green light for healthcare providers to launch telemedicine services—routine appointments via a webcam or an app.
Hospital executives and many physicians are excited by the potential of telemedicine to extend treatment to rural areas of Indiana, all the way from primary care (some counties lack the services of a general practitioner) to consultations requiring a specialist. For city-dwellers, though, the law means they can start “going to the doctor” without leaving the house. On-demand options let you see a doctor immediately if you aren’t choosy about who it is. If you prefer your primary-care physician, you still might be able to schedule a virtual appointment. “In the future, I foresee one of my visits every hour will be a virtual visit,” says Kevin Gebke, IU Health’s chairman of the Department of Family Medicine. Gebke is involved with launching the new Indiana University Health Video Visits program, which is making more and more of IU Health’s primary-care physicians available for instant online appointments. Every other major healthcare system in Indianapolis is developing or investigating its own telemedicine options, too. The fee? Per the Indiana statute, insurance companies must cover online appointments just as they do office visits. A typical co-pay for an in-network telemedicine appointment should cost less than going to a drugstore clinic or the emergency room.
But exactly when—cough, sniffle—is the right time to videoconference with your doctor, and when should you opt for the old-fashioned type of face time? Gebke consulted on these scenarios:
Your kid gets a rash on vacation.
“Skin conditions, absolutely, with the images and the context of someone’s medical history, are fine for a video visit. The history is 90 percent of what we need to make a diagnosis.”
You cut yourself while cooking and think you could use stitches.
“This is reasonable for a video visit. If I look at something in a picture, I can tell if it needs to be closed.”
You have chest pain.
“If someone is 50 years old and diabetic and has a constellation of symptoms, that is concerning. But if a 22-year-old’s chest pain started after they tumbled on a basketball court, I can have them press on a certain place and discern that they aren’t having a heart attack.”
You run a high fever.
This also depends on the person’s overall health. “I might need to listen to the heart to see if there’s something that looks and sounds like pneumonia.”
Your throat’s on fire.
“We can look into someone’s throat with the camera.”
You sprained your ankle on A weekend.
“Video. Musculoskeletal injuries are a little difficult early on, but we can prevent a high-cost emergency-room visit if I can tell whether the sprain is minor or complex. You might be able to go get crutches and do a lot of ice and elevation.”
You recently began taking medication for chronic depression or anxiety.
“I see follow-ups for chronic care transitioning to video visits. We can ask people how they are doing on their medication or sleep. In primary care, we provide lots of mental-health care. There aren’t enough psychologists to go around.”
