Transcription:
Is Telemedicine Right For Me

Prakash Chandran: Welcome to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. This episode is sponsored by University of Maryland Urgent Care. Offering care for a variety of non-emergency illnesses and injuries, UM Urgent Care focuses on providing a superior patient experience. The caring team at UM Urgent Care ensures that patients receive high quality healthcare that is convenient and affordable. With multiple locations throughout Maryland, you can find an urgent care center near you or schedule a telemedicine visit today.

I'm Prakash Chandran. Today, Dr. Scott Burger, Interim Chief Medical Officer for University of Maryland urgent Care, will be talking with me about telemedicine. Dr. Burger. It's so great to have you here today. Thank you so much for joining me. Now, I know that telemedicine is healthcare from a distance, and that means that the patient doesn't have to go into the office to get care. Can you talk to us a little bit about how that exactly works and is it safe?

Dr. Scott Burger: Yeah, you got it exactly right in terms of the logistics. The patients don't have to go into the clinic. So any patient that wants to be seen by telemedicine simply needs to go to our website, umurgentcare.com and schedule a reservation for one of our telemedicine providers to take care of them. At that point, a team member from within the system will contact the patient and help them get registered and set up for their appointments. They'll verify that they have the equipment that they need to be able to be seen, and then we'll connect them with the provider at a time that's convenient for the patient. Patients are able to speak and see the provider. And it's a two-way communication, so it really helps to establish that connection between the two. It's completely secure and safe and HIPAA compliant, so there are no issues about safety and privacy there.

Prakash Chandran: Understood. And is this kind of like a Zoom call that so many of us are doing these days or is it different?

Dr. Scott Burger: It's very much like the Zoom calls that we're all doing with family, friends, coworkers, you name it. It works along the same sort of technology to make those video and audio connection.

Prakash Chandran: Okay. But talk to us a little bit more about why a patient should choose a telemedicine visit versus one that's in office.

Dr. Scott Burger: It's another great question. You know, we think about society today and we are all so busy, right? And while urgent cares they've served an incredible need for the community in terms of that you can walk in and be seen the same day. For some people and for some of the demands that we have in our life, that's still not enough. There are times that people need to be seen and maybe they're at work and they can't get out of work to come be seen or they're on vacation and they can't get back to see their doctor or they're in a rural or remote area and care just isn't conveniently located. These are some of the reasons why people are choosing telemedicine as an option for them. And just in general, people are getting more comfortable with it.

Prakash Chandran: Yeah, absolutely. You know, just to expand on that a little bit, many people go to urgent care for these acute minor illnesses and injuries. But maybe tell us a little bit more about the kinds of conditions that are recommended for urgent care and which would be ideal for telemedicine.

Dr. Scott Burger: Absolutely. So first I'd like us to focus on the types of conditions that are appropriate for telemedicine. How I would encourage anybody who's listening to this podcast to think about telemedicine is to consider conditions that would only require a conversation or, at most, the provider to look at them, and anything that the patient could do on their side of the video screen to demonstrate certain things.

So, if the problem needs a more specific examination, and I'll give you an example. Somebody has an earache and we need to look inside their ear. That's not something that we can do with the camera on somebody's phone or a webcam connected to their computer. But if somebody has a skin rash, if somebody's having seasonal allergies, if somebody's having minor eye infection, bug bites, minor coughs and colds, sprains and strains, these are things that are really fairly straightforward for somebody to be able to take care of through conversation and then examination using that camera.

Another area would be prescription refills. For urgent care, they can manage all the same sorts of problems as I just referrenced. But you've got the added advantage that's obvious, in that you're in front of the healthcare provider. So if you need a diagnostic test, whether it's a laboratory test, an x-ray, an EKG, that can be done, if you need a more detailed physical examination where we're looking in your ears, listening to your lungs; if we need to splint something, because maybe you might've broken a bone; if you have a wound that, you know, you cut your hand and you need some stitches or you've got a skin infection that we've got to take care of by opening up, those are the sorts of things where it would be most appropriate for you to go directly to the urgent care.

Prakash Chandran: Okay, that makes sense. So, you know, just listening to all of this, this really sounds like a net value add, because there have been times where even myself, I've had like a cut or I just wanted the doctor to look at something and I felt like my only option was to go into urgent care. Sometimes I would have to wait a long time to be seen. But now, it really seems like I can do it on my time, on my schedule. Is that correct?

Dr. Scott Burger: Absolutely. It allows you to engage with them and get their expertise and advice without having to leave the comfort of your home or taking part of a day off from work or, if you're at school, missing a class, or you're on vacation, you don't have to leave whatever you're doing on your vacation. You can connect with us that way.

Prakash Chandran: Got it. So, you know, we talked a little bit about how this was very similar to a Zoom call. Tell me, do you need a certain kind of device or application to make this work? So for example, if you don't have a computer with a camera, are you still able to do a telemedicine visit?

Dr. Scott Burger: So there's a couple of things that are critical for a telemedicine visit to be successful. The first is your internet access. And that will come through either high-speed WiFi or strong cellular service, right? You need one of those two things. The other component is you either need to have a smartphone that has a camera on it or a computer that has a webcam. Those are the critical elements. And obviously, if you have the computer with a webcam, you need the strong WiFi. If you have the phone with cellular service, that can be the limit of what you need. You don't necessarily have to connect your phone to WiFi. And for the telemedicine visits, you don't have to install a specific application, you know, go to the app store on your phone and install something or installing an application on your computer, you can link directly through a browser.

Prakash Chandran: Okay, that's great. That sounds nice and easy. This even sounds like something that even my father who's in his 80s can do.

Dr. Scott Burger: You know, my 87-year-old mother has done it many times now. And it absolutely works and it's not restricted to the tech savvy segment of the population.

Prakash Chandran: Yeah, absolutely. So let's talk about prescriptions, let's say on a visit. it's found out that I might need to get a prescription for something. Is that something that I can still get even though it's a telemedicine visit?

Dr. Scott Burger: Yep. Absolutely. We send all of our prescriptions in electronically. So, at the end of the visit, it's determined that you need a prescription, we'll just confirm with you what is the pharmacy that's most convenient to you. Whether you're at home and it's your regular pharmacy or you're someplace remote, we'll help find the pharmacy for you and then we'll send the prescription in to that pharmacy, you don't have to get a hard copy of it.

The caveat with that is that we cannot fill prescriptions for what are controlled medications, scheduled narcotics, so prescription pain medication or medications for ADHD. Those medications can't be done via telehealth visit.

Prakash Chandran: Okay. Understood. And what about copay and insurance? How does that work with telemedicine?

Dr. Scott Burger: It works pretty much the same way a person's co-pay and insurance works when they come into the urgent care center. Everybody's co-pay is different. It's determined by their plan, how their plan is set up. But what we're seeing more and more is that the insurance companies are embracing this and employers who are setting up large plans are embracing this. So they're lowering the copays, they're making the services more available to their patients. So most people who are using telemedicine are seeing that their cost for care is decreasing, because the insurance companies see that, as you said, this is a value add for the patients.

Prakash Chandran: Yeah, absolutely. So, you know, just thinking about telemedicine itself, this really feels like something that was introduced during the height of COVID-19, during this pandemic, but maybe you can tell us a little bit more about how common throughout the United States and across the world.

Dr. Scott Burger: If you look at the statistics of it, it was really very low adoption, very low utilization of telemedicine prior to the pandemic. The pandemic shot up utilization through the roof in the spring of 2020, when case counts were going up and people were just staying home. And that's not just in the United States, that's around the world, both the developing world, as well as Western European countries and Canada, you saw places adopting this. As the summer and fall came about and case counts started to drop, utilization started to decrease of telemedicine, but it didn't go away. We didn't return to the levels that we were pre-pandemic, which were minuscule. It's terrible that it required a pandemic to introduce telemedicine to so many people, but it did. And the end result is that many people have developed a lot more comfort with telemedicine and seen the value of it as a result of their use of it during the pandemic.

Prakash Chandran: Right. And I wanted to get your opinion on something. Do you think that the use of telemedicine will increase in popularity as time goes on? Or do you think that people will start going back to the healthcare providers' offices once the COVID-19 pandemic is over?

Dr. Scott Burger: I think we're going to see both. I don't think telemedicine is going to go away after the pandemic, that people will continue to use it. There's a recent survey that showed that before the pandemic 55% of the population in the United States did not think that they could receive similar type of care via telemedicine. And now most recently, as they repeated that, 80% of US respondents thought that they could receive similar care via telemedicine as in-person. So you can see that's a pretty dramatic shift in terms of the comfort level that people are developing with telemedicine. So I think it's here to stay.

And I think as large academic health systems, like the University of Maryland Medical System, they're going to be looking for new and novel ways to increase the services that are available via telemedicine. We're already starting to see that with the ability to monitor some chronic diseases remotely so that patients aren't necessarily having to come in to see their doctor all the time. They brought remote tools to their home. The doctor can tap into those to see the results that they need, then connect with the patient via telemedicine appointment to discuss the results, make changes to therapies, medications, you name it. And I think we're just going to see more and more of that as time goes by.

Prakash Chandran: Yeah, I couldn't agree more. And it seems like as technology improves, the fidelity or the quality of that telemedicine visit will only improve over time, wouldn't you say?

Dr. Scott Burger: Absolutely. And barriers to access will be broken down. We'll see technology that becomes much more affordable. We'll see this is a disruptor to healthcare in general and places will figure out ways to deliver the care to their patients. And I think it's just going to improve the overall care of our patients with population health strategies. You need to be able to connect with the patients to make sure that you can address their medical problems. And this is just another tool for us to be able to do that.

Prakash Chandran: Love it. Well, Dr. Burger, I think this has been a fascinating conversation. Is there anything else that you'd like to share with our audience today about telemedicine?

Dr. Scott Burger: I would just encourage patients if they think they might need a telemedicine visit, to visit our website, umurgentcare.com. We've got information there about what types of conditions we're able to treat. Go ahead and sign up for an appointment and one of our staff members will reach out to you. If during the course of that conversation it is determined that you are appropriate, we'll take care of the right of way. If we think you need to be seen, we'll help you make that reservation to be seen in one of our clinics right away.

Prakash Chandran: Well, fantastic. Thank you so much again, Dr. Burger. I really appreciate it.

Dr. Scott Burger: Thank you.

Prakash Chandran: To schedule a telemedicine visit, go to umurgent care.com. Find more shows just like this one at umms.org/podcast. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.