A Virtual Visit to the Doctor’s Office: How Telemedicine Works

In the midst of the coronavirus pandemic, Illinois doctors are increasingly seeing their patients online.

Rush University Hospital physician Anthony Perry says last month, about 60 patients visited their doctors via videoconference; so far in March that figure’s at least 1,100 – 700 of whom went to Rush with concerns about COVID-19.

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“It protects patients, it protects family members who might be driving them in to see us in person. It protects our providers on our end as well,” Perry said. “It really is a beautiful way to minimize risk of transmission in the environment.”

Executive actions last week by President Donald Trump and Gov. J.B. Pritzker cleared some procedural and payment hurdles, making it easier than ever for patients with private insurance or Medicaid to utilize telehealth options.

“Beginning March 19, 2020 and continuing for the duration of the Gubernatorial Disaster Proclamation, in order to protect the public’s health … all health insurers regulated by the Department of Insurance are hereby required to cover the costs of Telehealth services,” Pritzker’s executive order reads.

The order also covers those on Medicaid.

“This order will allow more providers to get reimbursed for those service and allow patients more flexibility and safety in getting the medical guidance and care that they need,” the governor said last week.

But it’s been easy to get a coronavirus-related telehealth appointment with a Rush doctor since the new coronavirus came to Chicago. The hospital has been offering visits for free, and that remains the case for anyone without insurance. Typically, an asynchronous appointment – which involves a patient with common ailments like red eyes or a cold answering questions online which the doctor assesses – runs $30, while a video appointment costs $49.

“We have patients that pay us $30 for an asynchronous visit,” Perry said. "Our average turnaround time on those visits is 20 minutes. So by the time the patient gives us their information they literally have an answer in their inbox within 20 minutes. And our patients love it.”

Sometimes it’s a matter of convenience: A web visit can fit into a busy day at the office, or can be done even when you’re on vacation outside of the country.

But for some patients, like those with Parkinson’s, it can be a far easier way for regular follow-up appointments.

“You can be right here in Chicago and the logistics to get from your home to a provider, who’s maybe not even physically that far from you, can really be mountainous. Telemedicine can really bridge that gap for some people,” Perry said.

For those with flu-like symptoms who fear they could have COVID-19, it’s also reassuring.

“It’s really remarkable. You can see the anxiety that exists in people, in the general public around this topic,” Perry said. “You can see, literally, good information causing somebody to be able to wind down and actually feel like they have more understanding of what’s going on with them, with their loved ones that they’re concerned about. You can just kind of see people de-escalate as you’re talking to them.”

The visits can also potentially prevent someone from spreading the highly contagious virus.

“We have stories like a gentleman who literally was driving to work, connected with us on a video platform, pulled his car off to the side of the road and parked and talked to us and we literally turned him around from going to work and said you should be back at home, you should be isolated in your home and got him good information about it and got him to testing,” Perry said.

The man was tested, but Perry said results have not yet come back on whether he had COVID-19.

Perry admits that telemedicine isn’t everything; sometimes it’s best for a doctor to see a patient in real life.

“It’s a different type of care that we provide to people. There’s things that are a perfect fit for it and there’s things that are not a perfect fit for it,” he said.

While Pritkzer’s telehealth executive order is only temporary – it will hold for 30 days but may be extended if the coronavirus pandemic is not contained – Perry said he hopes that one of the lasting legacies of the outbreak will be a recognition of the power of telemedicine.

Follow Amanda Vinicky on Twitter: @AmandaVinicky

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