Telehealth: the New Home Doctor Visit

“Can you see me?” 

“I am here.”

“Let’s begin your health appointment.”

This is how a conversation might start between a doctor and a family who are not physically together in an office, but separated just by a screen.

Doctors can provide their patients a health portal from a smart device where they can assess health conditions, provide therapy and more. This type of home treatment is rapidly on the uptick. With the outbreak of COVID-19, it became increasingly clear that telehealth could be used instead of the typical face-to-face appointment. 

“We are dealing with a public health issue, especially for people with preexisting conditions,” says Dr. Steven Spalding, vice president of population health and a pediatric rheumatologist at Akron Children’s Hospital. “We want to keep those families and kids in a safe, controlled environment, and it turns out the best place for this is at home.” 

Appointments in a Home Setting

If you are new to telemedicine, you are not alone. This type of health service is not a new tool, but it hasn’t been widely offered. 

Spalding says the national landscape for telehealth has been growing slowly, but steadily over time.

In fact, Akron Children’s Hospital has been extending telehealth options since 2018 with initial offerings for the behavioral health group, according to Spalding. 

He recently has been able to use this service for pediatric rheumatology patients and feels it allows them to learn different aspects about each other.

“The families get to see their doctor in a different setting,” he says. “I get to see them in their home setting. It’s a whole different experience: less formal, more personal and more real.” 

Jennell Vick, executive director of Cleveland Hearing & Speech Center, says the center was offering telehealth appointments for specific adult clients, but has now launched this service for children.

“For a parent, telehealth services are highly individualized,” she says, adding it bridges that barrier between home and an in-office visit and allows parents to use the activities taught in the family session in their daily lives.

“Parents and caregivers are an integral part of any therapy,” she says. “This is a wonderful way (therapists) can incorporate or observe things that are familiar to (patients).” 

Both Vick and Spalding agree: the doctor or therapist can not only connect with patients, but also other members of the family who might not be present at in-office appointments. 

Is Telehealth the Future?

While stay-at-home orders are being lifted for some aspects of healthcare this month, it doesn’t mean telehealth services will go away.

According to medicare.gov, it had temporarily expanded its coverage of telehealth services to respond to the current public health emergency. 

A person interested in telehealth would have to check with their private insurer. Some private insurance companies, depending on individual health plans, already covered these types of services; however, others may not. 

“If (someone) is curious, they should call the doctor’s office,” Spalding says, adding to ask about the technology requirements, billing, co-pay, etc.

These services don’t always have to be on a smart device, either. Many doctors are conducting phone calls to patients.

Spalding says telehealth is providing access to patients who live in rural areas or those with transportation issues.

While this might not work for all healthcare practices or for people who still prefer an in-office visit, it does provide an opportunity to use technology to assess health.

“There are some cases the technology is (still) catching up,” Spalding says. “The doctors can’t lay their hands on patients, so they have to get creative.”

He notes surgeons have adopted this to check in on patients post-surgery and patients and doctors are using available technology like smart watches to provide opportunities to check different vitals.

Patients also can take their vitals with simple techniques like a thermometer to check for a fever or make sure to have a home scale for weight.

Vick says telehealth really eliminates the barriers to access to care and expects it to be part of the future at Cleveland Hearing and Speech Center. 

“Telepractice has been a thrust in the right direction,” she says. “The most important thing, whether in-person or teletherapy, is learning how to apply the techniques and strategies that any therapist or physician has directed.” 

Spalding adds that since we now have a population who has experience with this type of healthcare, “It’s going to be hard to put the toothpaste back in the tube.”