Diabetes Forecast

Get the Most Out of Telemedicine

Staying home doesn’t mean you should miss your doctor’s appointment. Here’s what you need to know about telemedicine

Haleigh Eason/Mittera

In-person office visits have long been the way doctors and patients communicate, but thanks to COVID-19, that’s changing fast. Health care providers, hoping to curb the spread of the virus, are urging people with nonemergency issues to stay home and make virtual appointments instead.

Telemedicine is pretty simple: Instead of driving to your doctor or endocrinologist’s office, you use your smartphone, tablet, or computer. You might use a telemedicine app, such as MDLive, or a tool you already know well, such as FaceTime, Zoom, or Google Meet. And if you don’t have a smartphone or computer, you could even keep your appointment over the telephone. (Don’t confuse telemedicine with telehealth, which includes health-promoting tech such as step-tracking bracelets.)

In the past, telemedicine has been used mostly in rural areas where people have less access to specialists. “Where I am, in North Dakota, we had patients driving hundreds of miles to come to our diabetes clinic,” says Eric Johnson, MD, a family medicine physician who specializes in treating diabetes. “There has long been a demand for telemedicine, and we’ve been using it for six years now,” he says.

In recent weeks, telemedicine appointments rapidly replaced in-person office visits in most places. According to research from Frost & Sullivan consultants, virtual visits increased by 50 percent in March. People have been videoconferencing with health care providers for routine check-ups, diagnoses, medication troubleshooting, and reviews of blood glucose trends.

Now more than ever, it’s important for people with diabetes to keep up with their scheduled appointments. Check-ins can help you keep your blood glucose in your target range, and that can help you stay healthy. Though you’re no more likely to contract COVID-19 than someone without diabetes, if your glucose levels are too high and you get the virus, you could become very sick.

Talk to Your Team 

You aren’t limited to seeing only your endocrinologist or family doctor during this time when office visits are out of bounds. A range of providers offer care via telemedicine, and many are covered entirely or in part by health insurance. (More on that below.)

Some telemedicine services have health care providers on staff so they can match you with the type of provider you need. But before you start sharing your private health data through a service you found through a Google search, check with your health insurance company. It’ll steer you to a reputable service that’s covered by your plan.  

It’s very common to experience low mood during this stressful and isolating time. Ruth Weinstock, MD, PhD, medical director at the Joslin Diabetes Center at Upstate University Hospital in Syracuse, New York, has been screening patients for depression during telemedicine appointments. If the patient is struggling, she has a social worker or other health care professional follow up so they can get the care they need from home.

Look Into Insurance

The biggest change to telemedicine brought about by the COVID-19 crisis is a loosening of regulations when it comes to providers billing insurance companies for your treatment. In the past, only a specific set of HIPAA-compliant platforms could be used. Now, any way you and your doctor want to connect is fair game (yes, even FaceTime).

Most major insurance companies cover some form of telemedicine, though when you investigate, you might find it categorized as “policy dependent,” which means some plans include it while others do not. Your best bet is to call your insurance company to find out the nitty-gritty of what your plan includes.

In response to COVID-19, Medicare has temporarily expanded its telemedicine coverage, including mental health counseling and preventive screenings. Medicaid coverage of telemedicine varies from state to state; click on your state to learn details.

Consider Privacy Concerns

If privacy is a concern, ask your doctor in advance if the tool you’re planning to use is HIPAA compliant, but remember to keep things in perspective if it isn’t. “During this time, patients use whatever they can,” says Weinstock. “HIPAA compliant is what we prefer. If someone can’t have that, they need to weigh the risks and benefits. If you can’t do the A-plus method, do the A or the B method.” 

Plan Ahead

Your first step for any telemedicine appointment is thorough preparation.

Discuss logistics with your doctor’s office.

“A lot of people might be intimidated by the tech at first, or they think it will just be strange. But typically once the visit starts, a lot of those barriers fall away,” says Johnson, who adds that many patients now prefer it for most visits. To make sure your appointment goes as smoothly as possible, reach out to your doctor’s office in advance. You’ll want to ask:

  • Is there a particular app I need to install or a website to bookmark?
  • Will I need to register for any new accounts?

Settle on a device.

Smartphone, tablet, or computer? Pick the one you’re most comfortable with and make sure your health care provider’s telemedicine program is compatible.

Prevent tech glitches.

Check the bandwidth requirements for your upcoming visit to make sure you won’t have connection issues during your appointment. It can help to close any extraneous tabs you have open on your browser and shut down any other apps that are running.

Do a test run.

If your doctor’s office doesn’t suggest doing a practice session to make sure you’re comfortable using the online tools, ask for one. It takes time up front but will ultimately allow you to devote the precious minutes of your appointment to discussing your health, not ironing out tech wrinkles. If you live with someone more tech-savvy than yourself, ask them to be with you during your appointment to troubleshoot if need be.

On the day of your appointment, log onto your session a few minutes in advance in case you have any issues connecting to the system.

Collect your health data.

Send your health care provider all of the information he or she will need in advance.

“It’s really important to get your glucose data uploaded before the visit,” says Weinstock. Devices can have different platforms for uploading data, and it can be complicated, she says. “If for some reason you can’t upload, take a picture of the glucose log or ambulatory glucose profile, or write down your most recent numbers and send them ahead,” she suggests.

Other pieces of information to gather: your weight, blood pressure, and prescription information. If you’re seeing a dietitian, you can also share any recent food logs. “The more information you can get to the provider ahead of time, the more you’ll get out of the visit,” says Weinstock.

Make a list of questions.

As with any appointment, you’ll want to write down your questions and concerns beforehand to ensure nothing slips your mind.

The day of the appointment, take 30 minutes or so before the start time to set yourself up for success. Find a quiet room where you won’t be disturbed. If kids or pets are in the house, do your best to make sure they won’t intrude. Review the questions and issues you want to discuss, adding any last-minute issues on your mind.

Press record.

It’s always a good idea to take notes during an office visit, but for a telemedicine visit, you may not need to. If you have the option, record your visit so you can review it later if questions come up. Some apps, such as Skype and Zoom, make it easy to record your session with a mouse click.

You may find that you appreciate the convenience more than you expected. Veterans of telemedicine appointments will tell you that waiting in your own living room beats driving in traffic and sitting in a cold exam room. “Telemedicine has been coming for a long time, and COVID-19 just accelerated it,” says Kellie Antinori-Lent, MSN, RN, ACNS-BC, BC-ADM, president of the Association of Diabetes Care and Education Specialists. “It won’t totally replace all face-to-face visits, but it’s definitely the wave of the future.” And the future is right now.

Learn more about how telemedicine can help you manage your diabetes.

 

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