Maggie McKay (Host): Welcome to Total Health Talks, your Cook County Health podcast, where we empower your journey to better health. I'm your host, Maggie McKay, and today we're going to talk with Tricia Cipolla, a Physician Assistant in the Department of Emergency Medicine about at home First Aid and ExpressCare. Thank you so much for joining us, Tricia.

Patricia Cipolla, MPAS, PA-C: Thanks so much for having me. 

Host: So in addition to emergency rooms and urgent care facilities, virtual doctor visits are becoming more common nowadays. So what's the basic difference between those three?

Patricia Cipolla, MPAS, PA-C: So this is a question a lot of our patients are asking us because it can be difficult to know where to go when you want to be seen by a medical provider. Emergency departments are always going to have the most capabilities. They're typically associated with a hospital or with a larger health system. They can provide life-saving management as well as have access to advanced diagnostic imaging, such as CT scans or sometimes MRIs. They have the ability to do rapid blood and urine tests, or even admit you to the hospital or discuss your case with a specialist if necessary.

An urgent care is going to have some, but not all of those same capabilities. They're typically used for lower acuity emergencies. They can do x-rays, basic blood or urine tests, and small procedures such as abscesses or stitches or sutures for small cuts or lacerations.

Now virtual care is a little bit different. So this is a type of visit where you'll be connected to a medical provider, using either a smartphone or a computer. On this type of visit, you'll be able to be evaluated by a provider using their gross assessment skills, by discussing your symptoms with them or showing them things through the video camera, but they're unlikely to do rapid testing like the x-rays or blood tests that other settings are able to do.

Host: And what are symptoms that require emergency care? When should you call 9-1-1?

Patricia Cipolla, MPAS, PA-C: So if you, or if a loved one is experiencing a life-threatening health emergency, we want you to call 9-1-1 or go directly to your nearest emergency department. So this might look like difficulty breathing, intense chest pain, symptoms of a stroke, such as slurred speech, a droop of the mouth or the face, difficulty ambulating or unconsciousness. Definitely call 9-1-1.

Host: You mentioned low acuity. What low acuity non-emergencies do immediate care services treat?

Patricia Cipolla, MPAS, PA-C: So low acuity health conditions would look like things like rashes, cold symptoms, sinus congestion, urinary tract infections, even allergies or dental concerns, sometimes minor strains or sprains or even sexually transmitted diseases, or discussion of a emergency contraception.

Host: And what is Cook County Health ExpressCare?

Patricia Cipolla, MPAS, PA-C: Cook County Health ExpressCare is a virtual immediate care service, so this allows patients to be seen and evaluated by a licensed medical provider, using their smartphone or their computer. It's not the same as a virtual care appointment that you might have with your primary care provider. ExpressCare does not require an appointment.

It's available Monday through Friday from seven o'clock in the morning until seven o'clock at night, and you can start an ExpressCare visit, with a CCH or Cook County health provider for any basic health concerns like cold, rashes or other non-emergent medical conditions. You don't have to be a Cook County Health patient.

You just have to be located in the state of Illinois and be able to go to the Cook County Health website, which is cookcountyhealth.org/expresscare to be connected with a provider. 

Host: So you mentioned, for instance, a common cold or a virus. What about infection or maybe getting medication prescribed or refilled? How about those things?

Patricia Cipolla, MPAS, PA-C: Absolutely. Those are all appropriate reasons to call into the Cook County Health ExpressCare. Providers are happy to see you for common colds, viruses, advice on treatment or management. They can even provide work notes for you. Your ExpressCare provider can and if appropriate, will prescribe medications for you, but routine medication refills are more likely to come from your primary care provider.

Host: And what about my child? Can I call with concerns about my child?

Patricia Cipolla, MPAS, PA-C: Absolutely. We're happy to see children on ExpressCare. However, children who are less than five years old, or those who have been having symptoms for more than a few days, we're likely to recommend an in-person evaluation for.

Host: And how can somebody make the most of a virtual visit, like so they don't waste the time?

Patricia Cipolla, MPAS, PA-C: This is a great question and it's important for patients who are interested in ExpressCare to understand. To get the most from your visit, we want you to have secure connection to the internet. You have to be located in the state of Illinois, and then ideally, you'll be somewhere that's well lit and private, somewhere that you feel comfortable discussing your health concerns and your medical history with.

Having a good camera or a well-lit environment will allow you to show areas of concern to the provider using your video camera. It can be helpful to have a list of your medications or your medication allergies handy, to provide to your provider. If possible, they might ask you to do things like a home pregnancy test or a home COVID and flu test that can be helpful information for them.

And then some patients, if you have the ability to check your blood pressure, check your temperature, check your blood sugar, those types of things can be helpful as well.

Host: So you should be prepared and probably not do it at work because you need privacy. Walk us through the process of using virtual care. I suppose it can be done on someone's laptop, tablet, or phone, whatever device they use. And is it even doable and easy for those that aren't tech savvy, like me?

Patricia Cipolla, MPAS, PA-C: Yes. Incredibly easy to use. So anybody with a laptop, a tablet, a cell phone, will be able to download the ExpressCare application through the App Store. It's available for free. If you don't want to download a new app onto your cell phone, you can access it through the Cook County Health website. I said before, cookcountyhealth.org/expresscare.

 The first thing you should expect to do is to fill out a questionnaire. This questionnaire is available in English, but also Polish, Arabic, Spanish, and Mandarin. They'll ask you some basic questions. Your name, your date of birth, and what you're seeking evaluation for. After filling out the questionnaire, you'll be connected with an ExpressCare nurse who can confirm your information and start a basic triage process. If appropriate, they're ultimately going to connect you to a navigator and then to a physician assistant, but sometimes they'll direct you to the emergency department or to your primary care office.

Host: Tricia, what is a physician assistant?

Patricia Cipolla, MPAS, PA-C: I'm glad you asked. So a PA like myself is a licensed medical provider. We are able to evaluate, to treat, to diagnose, and even prescribe medications for you. You might have seen physician assistants in other healthcare settings, such as your primary care office, in urgent care, in emergency care, sometimes even your specialist care office working alongside physicians.

All of the physician assistants that provide care on Cook County Health ExpressCare are emergency department trained PAs, and we have several years experience managing both acute and chronic medical conditions.

Host: That covers a lot. Does an immediate care visit replace your primary care physician?

Patricia Cipolla, MPAS, PA-C: No, an immediate care visit is not going to replace your primary care appointments. It's still important to follow up with your primary care doctor who is responsible for managing your medications, ordering your routine blood tests, your routine blood work, as well as managing your routine health maintenance, things like your colonoscopies and mammograms.

Host: If you're in doubt where to go, what should you do?

Patricia Cipolla, MPAS, PA-C: If you're in doubt, we're always happy to talk to you on the Cook County Health ExpressCare. Our staff can help guide you to the best place to be seen. But that being said, anybody with a life-threatening health emergency, please call 9-1-1 or go directly to your nearest emergency department.

Host: Well, thank you so much for sharing your expertise. This has been so informative and very useful information.

Patricia Cipolla, MPAS, PA-C: Thank you so much for having me.

Host: Again, that's Patricia Cipolla. As we wrap up another insightful episode of Total Health Talks, make sure to visit cookcountyhealth.org/podcast and subscribe to our podcast, share and connect with us on social media.

Stay tuned for more engaging discussions. This is Maggie McKay signing off from Total Health Talks. Stay well.