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How physicians can manage virtual healthcare visits

With Covid-19 continuing to spread and telemedicine visits on the rise, dermatologists are sharing tips for doctors and patients on ways to get the most out of virtual health appointments.

Telemedicine appointments have presented challenges for both doctors and patients as medicine adapts to healthcare visits through video conferencing, submitting photos and other virtual tools, notes the American Academy of Dermatology (AAD).

According to the AAD, the field of dermatology has over two decades of experience in telemedicine. As a result, the AAD released a list of tips to help both doctors and patients deal with the evolving nature of telemedicine.

“Dermatologists have been using telehealth since the 1990s as a way to provide specialized care to patients in rural and underserved areas of the U.S.,” said Dr. Bruce H. Thiers, president of the AAD, in a press release. “Currently, we are seeing telemedicine hit unprecedented levels during the pandemic as it enables physicians to care for their patients while keeping them safe and conserving personal protective equipment, including masks, gowns and gloves. During this public health emergency, our top priority is ensuring that patients continue to receive safe, high-quality access to health care, and telemedicine is a great way to achieve that.”

Dr. Carrie L. Kovarik, a member of the AAD’s ad hoc task force on Covid-19, believes telemedicine will continue to serve patients well after the coronavirus pandemic is over.

“Dermatologists have long been considered pioneers in telemedicine due to the visible nature of skin, hair and nail conditions,” Dr. Kovarik said. “However, amid the coronavirus pandemic and social distancing measures, telemedicine has expanded across numerous medical fields and specialties and become critical to maintaining the health of Americans. As dermatologists, we feel compelled to share what we have learned throughout the years to help patients navigate these changes and stay their healthiest during a time of great uncertainty and beyond.”

A telemedicine appointment might include:

  • A video conference.

  • A telephone call.

  • A patient sending their doctor information—such as pictures of their condition along with written descriptions—through a medical record, patient portal or email.

In order for doctors and patients to get the most out of telemedicine appointments, Dr. Thiers and Dr. Kovarik shared the following tips:

  1. Check coverage for telemedicine appointments. Doctors should check with their licensing body to see whether they are allowed to bill for telemedicine visits while patients should check to ensure their insurance covers virtual health appointments.

  2. Gather essential information. For patients who have not seen the doctor before, it is important to have your medical history ready for the doctor as it will assist with treatment options and the prescribing of medications.

Doctors should also make sure patients provide the following:

  • Medications they are currently taking

  • Major illnesses or surgeries they have undergone

  • Prior health issues

  • When their current symptoms began

  • Allergies they have

  • Prior health problems or illnesses in the patient’s family, such as cancer, heart disease, or diabetes

Doctors should provide the patient with information on how the telemedicine appointment will be conducted:

  • For video visits, doctors should send the patient a website link to connect at for the visit.

  • For telephone visits, patients should be sent instructions on when the doctor will call.

  • For visits through photos only, doctors should have the patient contact the office to arrange for the sending of pictures.

3. Prepare questions. Doctors should instruct patients to develop a list of questions prior to the appointment so that virtual health visits can be the most productive for both the patient and the doctor.

4. Take pictures. If the patient’s concern is something that can be seen on the skin, hair or nails, doctors should instruct the patient to take clear pictures of the area which needs to be examined.

To Take pictures in the highest possible quality, the AAD suggests these tips for patients:

  • Make sure the photos are well lit. Take pictures in natural light. When natural light is unavailable, use another light source such as a flashlight. Patients should be aware of shadows or glare on the area(s) of interest.

  • Take multiple photos. Make sure the entire body part or area that is affected is displayed clearly in the photos.

  • Take photos to compare. For example, if there is a spot on the patient’s hand, instruct them to take photos of both hands so the doctor can see how the area usually looks.

  • Get help. When possible, instruct the patient to have someone else take photos of hard-to-reach areas such as the back.

  • Instruct the patient to ensure the photos are not blurry as they can be critical for virtual health appointments.

5. Avoid irritating the skin. Patients should be instructed to avoid doing things that could change the appearance of their skin prior to the telemedicine appointment. Patients should avoid things such as taking a hot shower, rubbing or picking at the skin or applying skincare products.

6. Find a quiet, private, space for the appointment. Doctors should have patients find a quite space where they can connect to the internet while also limiting background distractions. If the patient’s concern is visible, they should make sure the space has adequate lighting.

“Telemedicine is a valuable lifeline in times like these,” said Dr. Kovarik. “Whether you need to maintain treatment for a chronic condition or you have a new concern, contact your doctor to see if telemedicine is right for you. By receiving care virtually instead of in person, you can stay safe and help slow the spread of the coronavirus.”

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