Telemedicine emerges as care option during coronavirus outbreak

Got a worrisome rash? You can still see a doctor if you can't leave home during the coronavirus outbreak.

U.S. public health officials, hospitals and insurance companies are pushing people to try telemedicine for their allergies, earaches and other minor problems and skip the doctor's office or clinic.

It's also a way to check in with a doctor if you think you have symptoms of COVID-19.

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The goal: Prevent the spread of coronavirus, especially to those who are most vulnerable, older people and those with existing health conditions.

Virtual care has long been touted as a way to get help quickly instead of waiting days to see a doctor, yet Americans have been slow to embrace it. There are signs that may be changing because of COVID-19.

Here’s a closer look at how telemedicine works.

What is telemedicine?

Got a smartphone, tablet or computer? That's all you really need to use telemedicine, sometimes called telehealth or virtual visits.

Generally, it just refers to a video visit with a remotely located care provider like a doctor or therapist over a secure connection. The patient uses a website link or an app to connect.

Some telemedicine outlets also offer a version using text messages between a doctor and patient who may not actually speak to or see each other.

Telemedicine often involves diagnosing and treating a new health problem but is also used to keep tabs on an existing, long-term conditions like diabetes. It’s more than calling to get a prescription refill, although doctors can write some prescriptions, like antibiotics, after a telemedicine visit.

Who offers it?

Insurers and hospital systems are frequent sources. In fact, your email inbox may have an offer from one of those providers urging you to try it now because of the coronavirus pandemic.

The federal government last week said it will immediately expand telemedicine access to help people with Medicare, its coverage program for those 65 and over as well as younger patients who qualify because of a disability. And it urged states to expand the service to those enrolled in Medicaid, the government coverage program for people with low incomes.

Medicare coverage of telemedicine had been limited, largely to rural areas where patients had to go to specially-designated sites for their visits. Many Medicare Advantage plans run by insurers also provide access to telemedicine.

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What does it cost?

Prices vary. But many insurance companies and other providers are temporarily waiving fees to push more people to use some virtual care.

Check before your visit with the insurer or employer that provides your coverage. The plan may not cover some specialty care like virtual therapy sessions or it may offer limited coverage.

What if you don't have insurance? You can pay out-of-pocket through some telemedicine providers. MDLive treats mostly through video chats and charges $75 for an urgent care visit. A session with a dermatologist costs $69.

Another company, 98point6, charges a $20 annual fee and then $1 for each visit. The company diagnoses and treats through secure text messaging.

What is telemedicine for?

Sinus infections, bronchitis, the flu, asthma, pink eye or fevers are just a few examples. Telemedicine can handle a lot of care that would normally send patients to a doctor’s office or drugstore clinic.

Dermatologists can examine warts or moles remotely. Therapists also can treat anxiety, depression or stress while allowing patients to remain in a place like their home where they feel more comfortable.

Patients worried about the coronavirus also can get a quick cyber consultation with a doctor. Many telemedicine providers have designed computer programs to ask patients initial questions to help gauge their health or their risk of virus exposure.

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What are its limits?

A virtual physician cannot treat chest pains, broken bones or cuts that need stitches. That doctor also won’t be able to perform a coronavirus test.

In some cases, they also may have to refer patients to another doctor for an in-person visit.

Telemedicine providers often tout their ability to connect patients with help in a matter of minutes. But a surge in coronavirus-fueled demand has slowed response times for some providers.

Doctors also say there are some parts of an in-person visit that telemedicine cannot replicate. A doctor may spot additional health problems simply by noticing a change in a regular patient's behavior or appearance.

"My examination starts when I see the patient walk in the room, the way they talk, the way they walk, just subtle things,” said Dr. Gary LeRoy, president of the American Academy of Family Physicians. “It can’t always be done remotely.”

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Why can patients be so slow to try it?

Researchers have long said that health care behavior is hard to change. In telemedicine’s case, patients may be especially reluctant to try something unfamiliar, especially if it doesn't involve their regular doctor.

Awareness is another problem. People may hear about telemedicine from their employer or insurer and then forget about it when they need help a few months later.

But people frequently become repeat customers after trying telemedicine, said Dr. Jason Tibbels, an executive with telemedicine provider Teladoc Health. And he thinks that the awareness created by the coronavirus will last long after the pandemic fades.

“These are the moments that we were built for,” he said.