Transcription:

Scott Webb: Whether they're referred to as telehealth, telemedicine or virtual visits, communicating with our doctors via phones, tablets or computers during the pandemic has caught on and almost everybody is loving it. And joining me today to discuss how and when telemedicine might save us a trip to urgent care is Dr. Linda Williams.

She's board certified in family medicine, preventative medicine and immediate care.

This is the Franciscan Health Doc Pod. I'm Scott Webb. Dr. Williams, thanks so much for joining me. We're discussing telemedicine today as an option for non-urgent conditions where we might otherwise go to urgent care, but let's set the scene here. Let's set the stage a little bit for listeners. What exactly does this mean? Telemedicine, telehealth, virtual visit, what are those visits?

Dr. Linda Williams: Well, essentially those visits are where you are not going into your doctor's office for the visit, but you're using a mode of technology such as your telephone. Sometimes it's even more convenient if you use your smartphone or a tablet to do a video visit or a computer with a camera, but that's not always required. Just as simple telephone, you can have an adequate telephone visit with your doctor. You can cover so many medical conditions such as acute conditions, primary care such as a sinus infection or chronic disease management can be covered during that telephone call.

Scott Webb: Let's talk about primary care and how telemedicine, telehealth, virtual visits fit in nicely with basic, you know, primary care with your primary care doctors.

Dr. Linda Williams: Hypertension, we can help you manage your hypertension. Followup, management as well as provide refills. Simply, you having a blood pressure cuff at home and logging your blood pressures and then discussing with your doctor the numbers. And from there, that's almost a complete doctor's visit. If you have a scale at home, you can measure your weight and giving your doctor that feedback as well. Some people do have pulse oximeters where they can check the oxygen in their blood and that gives us good feedback and the heart rates gives us excellent feedback.

Scott Webb: So let's talk about some of the other areas of medicine where telehealth may be an advantage as something like, I think you mentioned this earlier, chronic disease management.

Dr. Linda Williams: Congestive heart failure is one. That's very important to follow and for the patients and primary care physicians to connect on a regular basis. And sometimes it takes more than just a nurse visit on the telephone, but actually having a face-to-face video visit with your doctor or having a telephone visit to give feedback regarding how you're responding to your medication, what your feelings are about your condition as you're progressing.

Certainly, coming into the office would be optimum, but you can't come into the office all the time and, with COVID here right now, a lot of people with chronic diseases don't feel safe to come into the office. And we're finding that we're able to do quite a bit on the telephone and it's actually helped us open our minds to the benefits of virtual visits for those who don't have transportation, who might live in rural areas and, like I said, who just might be a little uncertain about going to the doctor's office at this time.

Scott Webb: Providers are loving it. Patients are loving it. And as you say, people who are at higher risk, people with chronic diseases, they may just not feel comfortable coming into the office, despite the fact that everybody's wearing PPE and all the precautions are being taken. So when we talk about other things like diabetes, hypertension, obesity management. How does telemedicine fit in there as well?

Dr. Linda Williams: It fits in with each one of those diseases. In terms of diabetes, I've had my patients keep records and logs of their blood sugars, and sometimes they fax them in or provide them during the visit, and that's been very helpful. And discussing medication management, that can be done on a telephone as well.

Scott Webb: Yeah, that's one of the things that I've done during this. I did a video visit with my doctor and I just sat in my kitchen. She was on my phone. I talked to her, she talked to me. And I've also heard providers, doctors say that it's kind of interesting to see people in their homes and to check things out and that there's some real advantages for patients to just be comfortable to be at home. Maybe that their blood pressure doesn't go up because they haven't had to walk into the office and they're not as worried as they might be. Have you found that as well that it's a nice to be able to just see where people live?

Dr. Linda Williams: It is nice to see where people live, but it's important for the patient and the physician to have a type of telemedicine etiquette. Have a quiet place. If you have lots of noise around, try to be in a quiet place where we both can focus on your visit. Have adequate lighting if you can. Yes, you're relaxed in your home, but also I can see your face. And I can tell if you're in pain and I can tell if you're happy, sad. We've not only done visits regarding physical disease, but mental health diseases as well. And so counseling during these times over the telephone in terms of anxiety, in terms of depression, we can see a lot. And yes, people are more comfortable in their homes and we can pick up a lot there.

Scott Webb: Yeah. That's such a good point that you bring up about the netiquette, if you will, or etiquette that there are just some kind of basic things that people would need to know before they do a visit like this and just having that privacy. And I'm sure that’s a factor as well, as you mentioned, talking about mental health and anxiety and stress. And so I'm sure privacy is a factor as well.

Dr. Linda Williams: It is. And so like that's why I emphasize try to do it in your home. I even had a patient do it. They were at work and they wanted a little more privacy. So they went and sat in their car and we got the visit done, and the person went back to work.

Scott Webb: Yeah, I'm thinking you definitely don't want to do a telemedicine visit at the local coffee shop, right? You should probably keep your business private. It allows you and your provider to focus on each other and get through it as quickly as possible.

A few other things on my list to talk to you about are preventative medicine and how telemedicine factors into that as well.

Dr. Linda Williams: One thing that's come about is now insurance companies are much more open to paying for preventative medicine visits via video over the telephone. When before earlier this year, they were not, such as the Medicare wellness visit or the Medicare annual visit. If my patient has MyChart, they can assess the questionnaires, complete the questionnaires. I can see them, we review them and the Medicare wellness visit is completed. And it includes so many preventative medicine measures such as discussing the colonoscopy and colon cancer screening or discussing what labs they need. And many times, in fact, I can order those labs before the visit and discuss that during the visit as well.

Scott Webb: I like to talk about women's health, menopause. You know, we've been talking about things like privacy and patient comfort, and maybe there are just some things that people are more comfortable discussing when it's just them and their doctor on their phone, right?

Dr. Linda Williams: That's correct. There are several topics that people feel more comfortable discussing one-on-one with their physician on the telephone. And now the physician can feel quite comfortable doing that, and being able to take care of medical conditions. They take a little more time than just answering a question on the telephone. Now I know I can do a telephone visit. We can talk about the issues surrounding the symptoms of menopause or the concerns and everybody's happy in terms of time spent on each end and you develop your assessment and plan.

Scott Webb: Yeah. And maybe the patients feel like they have a doctor's undivided attention when that's just the two of them on the phone or through a video call where they feel like they're not going to be interrupted or they don't feel like somebody’s right next door listening to them. So I imagine there's a real comfort there, maybe for the doctors as well.

Dr. Linda Williams: There is. And so I have found that some of my patients prefer these telephone visits and I do now try to intersperse them more between the in-office visit and the telephone visit.

Scott Webb: And one of the things that I know that you're into, that's a part of your life or part of your work is academic teaching. And though it's not a major, you know, component of this, I did want to have you talk a little bit about that and how you've been able to do some of that through whether it's Zoom or other technologies.

Dr. Linda Williams: Well, certainly directly teaching residents and specialties and medical students, we've been using Zoom more just as the whole world has been using Zoom for church meetings or for community meetings. We've been utilizing it to keep our doctors aware of what's new in medicine and what's happening. And also at the same time, we are teaching these new physicians more about telemedicine and video visits and it's really taking off. So I really do think virtual visits are here to stay.

Scott Webb: Anything else you want to tell people about telemedicine, telehealth, virtual visits, the value to both them, patients, and providers. Anything else we can tell people today?

Dr. Linda Williams: I just want to encourage patients and individuals to be open to the telemedicine visit, the virtual visit. And, if you're hesitant, just try it out at least one or two times. Some of our seniors are a little afraid of technology, some are very savvy. But if you're a little afraid, just start out with the telephone visit. And I'm sure your healthcare provider will support you in getting connected and learning how to use it.

Scott Webb: Yeah, that's a great way to wrap up. And I think that there is a lot of support out there. And as you say, give it a shot, be open-minded. You can start slow. You can start with a telephone call and maybe work your way up to a video visit. But there's a lot of value in telemedicine right now moving forward. I think, you know, we both and a lot of providers hope that this is here to stay. Doctor, thank you so much for your time and you stay well.

Dr. Linda Williams: Thank you. You too.

Scott Webb: For more information on virtual visits at Franciscan Health, go to FranciscanHealth.org/virtualvisit. And we hope you found this podcast to be helpful and informative. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well.