It has been over half a year since many countries first started taking public health measures to control the spread of COVID-19 and implementing new policies to manage the mass congregation of people, especially in public spaces. Excluding essential work, almost every aspect of life has been moved onto virtual platforms — education, business, social events, and even medicine. Still, doesn’t it seem a little ironic that we’re being discouraged to visit our healthcare providers in person? During a public health crisis? To alleviate some of the confusion, here’s a brief FAQ about telehealth.
Virtual health appointments?! How does that even work?
Telemedicine, also known as distance medicine, is an emerging platform that makes healthcare accessible to patients through the use of technology. Appointments typically take place over a phone or video call with your provider. Some may even allow you to type in a live chat. You’ll also be able to meet with your primary care physician as well as clinical specialists such as counselors, physical therapists, dermatologists, urologists, etc. Not all communities have access to these services in-person. While urban areas are concentrated with medical facilities and specialty clinics, people that live outside of the city may have to drive over an hour to see their specialist. Virtual meetings can fill the geographical gaps in healthcare distribution between regions of the country and beyond international boundaries. In the context of global health, it is always be possible for doctors to cross borders and treat communities in different countries, especially given the current travel restrictions in place due to the COVID-19 pandemic. Technological advances allow for instant communication between physicians and local health workers in these communities.
While the benefits of telehealth are undeniable, this system is not without its faults. One major caveat is the accessibility of technology itself. While telehealth sounds convenient for people with smartphones and computers, not everyone has a compatible electronic device or a stable connection to the internet. As of 2019, the Pew Research Center found that 90% of U.S. adults use the internet, but only about 73% of adults have high-speed broadband service at home. 17% of adults rely on smartphones as their primary means of online access but they do not have traditional home broadband service. On average, vulnerable populations are hit the hardest by these disparities. For families with annual household incomes below $30,000, the internet usage is closer to 82%. In rural areas, internet usage is about 85%. Fortunately, there has been a rising trend in internet accessibility for all populations over the past 20 years. According to the Agency for Healthcare Research and Quality (AHRQ), telehealth improves healthcare quality, particularly in rural settings.
Seeing a healthcare provider in person may put you at a greater risk for contracting COVID-19. If telehealth isn’t an option for you, the Centers for Disease Control and Prevention offers safety guidelines for in-person visits.
Despite any current disparities in the availability of technology, telehealth remains a frontrunner pandemic response. The goal of this new approach is to minimize the amount of people in clinics, diagnostic centers, and hospitals. After all, even though electronic devices can get viruses, at least it’s not COVID-19!
What makes telehealth so beneficial?
Scheduling and time management
Waiting rooms simply don’t make sense! For in-person visits, you are expected to arrive for an appointment 15 minutes early but then you’re stuck in the waiting room for half an hour! Telehealth eliminates these unnecessary delays. Just like regular appointments, there are time slots you sign up for. However, healthcare providers are able to cut down on logistical but time consuming processes such as cleaning up examination rooms after every patient. You can expect to actually meet with your physician at the time you signed up for.
One problem that healthcare providers face are patients that are “no-shows” for their in-person visits. There are many reasons that a patient may not be able to show up for their scheduled appointment due unavoidable conflicts. Telehealth alleviates many challenges posed by these circumstances. Canceling appointments is made a lot easier as well as the scheduling process for virtual appointments allows you more flexibility and compatibility with your lifestyle.
Access
It is important to stay informed of your health conditions and treatments. Sometimes your symptoms may worsen or your treatment may seem to be effective. You may forget how to perform the treatment regimen or the amount of medications you’re supposed to take are certain times of the day. Just listening to your healthcare provider talk about your treatment or reading a pamphlet about it is often not helpful. Telehealth allows you to access instructions for your treatment or information about your health condition. There are already existing hotlines that can connect you to healthcare professionals 24/7 if you have any concerns. Say goodbye to the alarming search results of WebMD!
Cost
Researchers are currently departing the true cost effectiveness of telehealth. Upfront costs are usually less expensive for virtual visits, averaging about $40-$80, compared to in-person visits, which cost over $100 more on average. One investment for patients is an electronic device and a means of stable internet connection. However, there are other factors of telehealth that reduce costs for things like gas for transportation to a hospital or clinic and loss of productivity and income from missing work due to check-ups and treatments. Finally, a brief virtual consultation can save thousands of dollars by curtailing unnecessary in-person visits to an emergency department at the hospital.
What is the role of telehealth for women’s health and reproductive health?
Just as any other consultation with a primary care physician or specialist, you can meet with an OB-GYN. Since women’s health is sometimes regarded more sensitively, telehealth in sexual reproductive care can be alarming to some people. These visits, however, are just as accommodating and vital as any other medical visit.
These are health issues that can be diagnosed and treated online
- Sexually transmitted diseases (STDs), sexually transmitted infections (STIs), urinary tract infections (UTIs), and other vaginal infections
- This may come as a surprise, but initial screenings for STDs/STIs and UTIs can actually be done virtually. If more than one infection is suspected, your healthcare provider may prescribe you with several medications to treat all/any at once. This is common practice even with in-person visits.
- Your healthcare provider will determine if you need to visit a laboratory for follow-up sampling to confirm a diagnosis
- There are already commercially available at-home tests for STDs/STIs, and your healthcare provider may be able to order laboratory-grade at-home sampling kits for other infections
- Abnormal cervical mucus
- Rashes, bumps, and other uncomfortable issues
- It is always at your discretion whether or not to share pictures or videos of your condition.
- Abnormal bleeding
- Spotting and irregular menstrual cycles can usually be treated without laboratory testing, even when you visit your healthcare provider in person
- Hormone therapy
- Birth control
Here are several websites that offer online birth control (most don’t even require insurance!)
These health issues have recognizable signs and symptoms; descriptions of your condition may be enough for a diagnosis. Your healthcare provider may even recommend treatment with just over-the-counter drugs, which is more affordable than lab testing and prescribed medication.
According to the American College of Obstetricians and Gynecologists (ACOG), these are health issues that usually require in-person visits
- Fever (unrelated to COVID-19)
- Vaginal infection (unrelated to COVID-19)
- Severe vaginal bleeding
- Symptoms of an ectopic pregnancy
- Pelvic pain
- Abdominal pain
- Lower back pain
- Health issues due to a recent surgery or other invasive procedure
Although telehealth offers flexible scheduling, you need to be seen by a healthcare provider right away for urgent issues. Seek care as soon as possible so that you can prevent worsening your symptoms.
How will screenings, preventative interventions, and maintenance of birth control be affected?
Due dates for health maintenance procedures such as mammograms may not be seen as “essential” in-person health services, but it’s important to keep up with annual screenings. Still, waiting a few extra months is unlikely to be harmful. Similarly, contraceptives such as intrauterine devices (IUDs) may have a prescribed “expiration date.” However, there’s a grace period of up to about 6 months, so it may not be detrimental to your health if you have to wait a little longer than usual. Your healthcare provider will be able to provide you with the appropriate recommendations based on personal health factors such as age, pre-existing conditions, and health history.
What about protection of privacy?
Although laying under the covers in the comfort of your own bed isn’t quite on par with a clinic, a virtual appointment is just like any experience that you have with your healthcare provider in person. Protection of your privacy is no different.
Bodily Autonomy?
I would like to preface this with some reassurance: you’re never going to be required to show any part of your body through photos or a video call against your will. There may already be policies put in place by clinics that prohibit sharing images of more private areas of your body. You’ll need to make an appointment to meet in person if a diagnosis cannot be made based on your description.
Health information
Doctor-patient confidentiality still applies. There are federal laws that protect your healthcare information, most notably the Health Insurance Portability and Accountability Act (HIPAA). By law, you will always be provided with a document that lists these policies and a waiver that you must sign before you can even be seen by your healthcare provider. Your health information is also digitally encrypted for your protection.
Personal information
Telehealth appointments offer patients a new sense of discretion when seeking treatment for women’s health and reproductive health services. For many people it may be intimidating or embarrassing to seek treatment from an OB-GYN or healthcare professionals that work in the field of gynecology and sexual health. There are many valid reasons that you may want to keep your consultations and treatments private.
Women’s health is often stigmatized when treatment is sought for any reason other than pregnancy. For example, one’s culture may not be accepting of reproductive health treatment because sexual practices are considered taboo.This discretion also protects transgender men and other members of the LGBTQ+ community from being outed if they choose not to do so themselves. Telehealth allows people to connect with healthcare providers that share the same background as them as well as offering them comfort and non-discriminatory treatment.
What are the implications of telehealth for the future?
There’s really no telling how things will turn out after our lives gain more stability. Everything going on right now is unprecedented and nothing, even healthcare, will ever be the same. Technology is playing an increasingly important role in our lives, as it has been since the last major mass pandemic in 1918, over a century ago. Perhaps in the future, we’ll be offered more of an option between seeing our healthcare providers in person or online rather than being required to do the latter for the sake of our wellbeing. For now, I just hope everyone finds the means to stay safe and healthy.
Featured Image: The Isotope by Craig Pinto
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