Virtual care is exhausting. Here are 3 things doctors should do before every online visit to practice telehealth more efficiently:
1. Get photos of the condition Tell the patient to take a few photos of their condition and send them to you beforehand. Most skin conditions can be immediately diagnosed from a photo.
2. Obtain medical history Ask the patient to provide details about their symptoms and any previously tried & failed treatments ahead of time. This way you can spend the time with the patient reviewing their diagnosis and treatment plan instead of documenting the complaint.
3. Collect a visit fee Have the patient pay for their share of the visit with a credit card before you evaluate the condition. No more chasing patients for uncollected fees.
Obtaining this information prior to a telehealth visit requires substantial legwork by your staff. HealthLens does it automatically.
As the days get shorter and colder, your skin is very susceptible to the changes in the environment and can damage easily. Here are 6 easy skin care tips that should help you and your skin survive this winter.
6. Moisturize More
As the seasons change, your skin care products may need to change as well. Your skin dries out very easily in cold weather. Consider upgrading from a moisturizing lotion to an oil-based ointment. The ointment will help seal in more moisture than a lotion.
5. Stay Hydrated
Just because it’s not 85 degrees out anymore does not mean you should cut back on your water intake. When it’s cold outside, it’s easy to forget to stay hydrated. Dehydration affects your whole body, not just your skin so your whole body will benefit from maintaining adequate hydration.
4. No Super Hot Showers
Nothing feels more soothing than a long hot shower on a cold winter morning. While this may feel great, the prolonged exposure to hot water depletes your skin of essential lipids and oils that maintain your skin’s moisture naturally. In lieu of a long, hot shower, consider a quick, warm one.
Bundling up in your coziest sweats and spending the day on the couch under a blanket is a fantastic way to spend a cold winter day, but don’t forget your exercise. Exercise is not only a great way to stay in shape, but sweating clears your pores and improves blood circulation, which helps deliver essential nutrients to your skin.
2. Don’t Forget Your Sunscreen
Like staying hydrated, using sunscreen is not just a summer sport. Sunscreen is one of the best ways to protect your skin. Most moisturizers already have sunscreen in them so make sure to choose one with a high SPF rating and apply it before you head out in the sun. Furthermore, ski slopes are a hotbed for sunburns. When you’re hitting the slopes this season, make sure to be wearing more protection on your head than just a helmet.
1. Visit a Dermatologist
Nobody has better skin care tips than your skin care specialist. Make sure to visit your dermatologist this winter for the latest recommendations. If you’re too busy to make into their office, try visiting your dermatologist online with HealthLens and create the perfect treatment plan for the winter.
In cities like Los Angeles, there are thousands of doctors that a patient can choose from for an acne evaluation. The patient can read some reviews online and select a doctor in their city that fits the preferences.
When they call the office, the receptionist is able to fit them in at the end of the following day due to a cancellation. Sounds great, right? There is only one thing standing between them and their appointment, traffic.
Rather than endure the misery of idling in rush hour traffic for an hour, wouldn’t it make more sense to take a few photos of their acne with a smartphone and send it to a local dermatologist via HealthLens’ secure telemedicine platform? More and more patients are starting to think so.
So before you book an office appointment for 4 pm across town, consider using HealthLens to have your skin condition evaluated online by a doctor of your choosing. These online visits are covered by most insurances and patients typically get a diagnosis and treatment plan within 2 business days. If the treatment plan includes a prescription, that prescription is sent directly to the patient’s pharmacy.
As a dermatologist, the possibilities of telemedicine were evident early in my career. You did not need a patient to make a diagnosis. You just needed a good picture.
Telemedicine was initially promoted as a benefit to patients. It would increase their access to specialty care and surmount geographic barriers. Unfortunately, the only reimbursed format at the time was live interactive video, which was too impractical for widespread use. Patients also had limited access to the technology. Telemedicine languished.
During this dark time, I was involved with a few unsuccessful start-up telemedicine platforms that focused on direct patient access to specialists. There was a lot learned from the experience but there were no compelling reasons for physicians to adopt the practice.
That changed 2012 when California’s own telehealth law (AB 415) went into effect. Now physicians of all specialties would be beneficiaries of telemedicine. The new law authorized physicians to collect for all forms of electronic interaction. This means you could now be reimbursed for all the free care that you normally give out via the phone or email by using store and forward telemedicine.
The largest benefit, however, is the savings that will occur when physicians no longer have to shoulder the burden of rent, staff, and other expenses when providing care that can be done outside the boundaries of an office. As a result, physicians should explore what aspects of patient care can be responsibly provided online and then try to move patients in that direction. Any progress physicians make in moving portions of their practice online will be protected by the parity law. It requires that online visits be reimbursed at the same full level as an office visit. Telemedicine is now very practical.
Physicians should be wary of many of the telemedicine sites that are out there. Most of the ones you read about in the headlines do not meet the California Medical Association’s (CMA) Principles of Telemedicine. These are the anonymous doctor banks, prescription mills, and sites that use physicians in foreign countries.
Fortunately, there are telemedicine sites that closely adhere to the CMA’s telemedicine standards. Store and forward platforms like HealthLens (Author is a founder), Azova, and SkyMD enable physicians to practice online in a medically sound and ethical manner.
The primary standard is allowing patients to receive online care from their established physician. This enables follow up with that particular physician and a physical location if an office visit is necessary. Another CMA principle is that the patient’s medical insurance should be used to cover the visit. The CMA adherent platforms also provide secure messaging between patient and physician so the visits can be interactive.
Most commercial insurance companies including Blue Cross, Blue Shield, Cigna and United Healthcare cover store and forward telemedicine. Medicare only covers it in Alaska and Hawaii but there is legislation in progress to expand to all 50 states. To get reimbursed for store-and-forward telemedicine visits, just attach the GQ modifier to your CPT code; e.g. 99203 GQ.
In my practice, I see about 60 online patients per month. Acne, eczema and seborrheic keratoses make up the majority of the conditions I diagnose online. Time sensitive conditions like shingles are not uncommon online diagnoses and it is much easier to get patients on antivirals within that 72-hour window of opportunity when they don’t have to wait for an office visit.
I even see new patients on the internet. According to the Medical Board of California, you can evaluate a new patient online and establish a physician-patient relationship as long as the photo(s) submitted by the patient allows the physician to perform a physical examination that is adequate enough to reasonably make a diagnosis. Established patients, who make up the majority of my online visits, can be evaluated and treated without a photograph. This works out well for prescription renewals.
Medical research will also benefit from the shift to online care because of the data that telemedicine provides. In the short time HealthLens has been in operation, we have amassed a large library of clinical images, corresponding diagnoses, treatments and, most importantly, outcomes. The granularity of the data will allow for unprecedented levels of analysis.
Veering from long practiced norms is a troubling process for the medical community. However, the opportunity to eliminate so much of the expense involved in patient care cannot be ignored. Physicians should be leading the charge in shifting patient care online. We will be among the beneficiaries.
This is a guest post from HealthLens co-founder Christopher Schmidt, MD.
Last year, HealthLens say an array of patients using its platform to connect with their provider remotely. Many of the online visits were for skin checks; however, there were a number of other use cases that presented themselves throughout the year. As more patients use HealthLens, we expect to see even more interesting cases from patients all over the world.
Last year a patient traveling through India was able to connect with his dermatologist in San Jose. HealthLens offered a prompt response to his concern about a newly developed rash.
The oldest patient treated on HealthLens was 81 years old and she used her iPad to submit the visit without the assistance of anyone. HealthLens saw a number of Medicare patients use the service even though Medicare does not cover store and forward telemedicine….yet. These Medicare patients often cited the convenience of not having to travel to the doctor’s office as the main reason for using HealthLens.
The youngest patient treated on HealthLens was 10 years old. This girl, with the help of her mother, was able to submit a virtual office visit to her doctor. HealthLens also connected hundreds of college students with the doctor they grew up visiting.
2016 showed steady growth both HealthLens and for the telemedicine market. Many HealthLens patients are continuing to use the platform over and over again. 2017 promises even more growth as more people are warming up to the idea of visiting their doctor online. HealthLens is excited to help facilitate this connectivity with the providers that patients know and trust.
For most parents, the well-being of their child is their chief concern 24 hours a day, 7 days a week. So when their child does fall ill, mothers and fathers will stop at nothing until their child is feeling better. In an age where just about any service can be summoned instantly via a smartphone, moms are demanding a modern solution to the inconvenient nature of a traditional doctor’s visit.
In a recent study conducted by LiveHealth Online, a live-video telemedicine platform started by Anthem Blue Cross and Blue Shield, nearly 3/4ths (71%) of the moms surveyed “reported losing more than two hours from the work/school day due to taking their child for a doctor visit.” This unnecessary strain can result in foregone appointments and added stress at work.
As a corollary, the appeal of telemedicine to moms is increasing dramatically. The study found that “moms are constantly looking for better and easier ways to manage their family’s health, with all agreeing (100%) that having round the clock access to a doctor would be helpful.” Anthem’s Chief Medical Officer Dr. Peter Bowers affirmed this emerging need, stating, “Research shows that busy working moms can find it challenging to see a doctor when they need to address a non-emergency health issue.” Telemedicine appears poised to offer relief.
However, there is a trade-off. Most instant telemedicine services like LiveHealth Online connect patients with a random provider that has never seen the patient before and is unlikely to see them again. The care is quick but fragmented.
Some telemedicine services, like HealthLens, offer a compromise. Patients can send photos and information about their concern to their own family physician, pediatrician, or dermatologist and expect a diagnosis and treatment plan within 48 hours. Most providers typically respond within 4-8 hours so same-day care is uncommon.
Regardless of whether they choose store-and-forward or live-interactive telemedicine, moms will no longer have to sacrifice 2+ hours of their day to have their child evaluated by a doctor.
Being a parent is not an easy job, telemedicine can help.
HealthLens is pleased to welcome to Dr. Kjartan Armann and Dr. Sima Stein to the HealthLens community of doctors. Patients for both doctors will now be able to send “virtual visits” to their respective doctors online via HealthLens’s secure telemedicine platform.
Dr. Armann is a pediatric physician located in Los Gatos, California. For over 30 years, Dr. Armann has been providing pediatric care for all children from infants to teenagers. Regarded highly by his colleagues and parents, Dr. Armann has a track record of healthy patients and warm reviews. Dr. Armann uses HealthLens to evaluate dermatological conditions and refill prescriptions online.
To start an online visit with Dr. Armann, head to KJKID.com and click on “Online Visits.”
Dr. Stein is a distinguished pediatrician with practices in both Mountain View and San Jose. Her practices are dedicated to providing the highest quality medical care to infants, children, and young adults of all nationalities. There are not many other pediatrician offices that can provide services in English, Chinese, Hindu, Russian, Spanish, Ukrainian, and Vietnamese.
Dr. Stein uses HealthLens to evaluate patients who are out of town, at school, or just too busy to come into the office for an evaluation.
To start an online visit with Dr. Stein, head to Doctor-Stein.com and click on “Start an Online Visit.”
Many times patients are curious as to why they have to supply a general appearance photo along with their condition photos when submitting a virtual visit on HealthLens. A general appearance photo is essentially a “selfie” and it serves a couple of important functions during the online evaluation.
Foremost, the general appearance gives the doctor an up-to-date look at the patient’s overall health. If the doctor has never seen the patient before in their practice, this picture provides them with a foundation to compare the patient’s overall skin quality to the skin quality in their condition photos. It is a simple way to gauge how much sun damage the person may have. If it is an existing patient but the doctor has not seen him or her in their practice for a substantial period of time, the general appearance photo allows the doctor see if there have been any dramatic changes to the person’s health or skin quality besides normal aging.
A secondary purpose is that the general appearance photo helps the doctor instantly identify which patient they are evaluating. At a busy practice, there are usually a few patients who share the same name. Likewise, many doctors see multiple siblings from the same family in their practices. This photo eliminates the chance of the doctor getting two patients with the same name mixed up.
The general appearance photo is a vital aspect of your virtual visit on HealthLens. The best way to provide your doctor with a quick snapshot of your overall health is to provide the most recent photo possible. A “selfie” taken while completing the visit works great! So the next time you are submitting a virtual visit on HealthLens to your doctor, keep in mind the comically catchy lyrics of The Chainsmokers’s EDM hit song, “#SELFIE,” which go “But first, let me take a selfie.”
In an age where almost all consumer goods and services can be hailed instantly from the customer’s phone, prompt access to a medical doctor through a smartphone seems to be an appropriate fit for today’s “Uber Economy.” It’s one of the most touted benefits of telemedicine. Patients can connect with a doctor quickly and more conveniently than a traditional office appointment. But like with all new technology, there is a trade-off. In exchange for urgent medical advice, patients are connected with healthcare providers who they have never seen before, and will most likely never see again after the telemedicine visit.
This puts the providers in a tough situation as they feel compelled to take a “worst case scenario” approach to their diagnoses and treatment recommendations. The fear of underdiagnosing a patient outweighs the consequences of prescribing medications that the patient might not need. The most common example of this is the unfettered prescribing of antibiotics by telemedicine doctors. Instead of waiting for confirmation that the patient is not reacting to a virus, these doctors will usually prescribe antibiotics just in case it turns out to be a bacterial infection.
So how can telemedicine companies combat the overprescribing of antibiotics and other prescriptions? The solution is quite simple. Connect patients with doctors who can monitor the patient’s progress over time. At HealthLens, only doctors who are active members of a practice can join. This allows the patients to select a doctor in their area so they can visit their office for additional tests and procedures if necessary. HealthLens also allows the patients to ask the doctor questions after the diagnosis has been made, which improves adherence to treatment plans and, consequently, patient outcomes.
By lengthening the care window from 10 minutes to however long it takes for the patient’s outcome to improve, HealthLens’ telemedicine platform helps doctors make more accurate assessments and recommend more appropriate treatment options.
To find a doctor in your area who uses HealthLens to evaluate their patients online, visit HealthLens.com.
The new school year is right around the corner for most college students. With 100% of their time and energy focused on finding the proper balance of good grades, work, social life, and sleep, their health can easily fall to the bottom of their priority list while at school.
When health concerns do arise for college students, many of them are reluctant to seek medical attention – citing their busy schedules as a common excuse. Even though their campus health clinic is a nearby option, many students prefer to seek treatment from the doctors with whom they have pre-existing relationships. They know that their doctors back home have a much better understanding of their health and lifestyle than a new doctor who won’t have the time to really get to know them.
That’s why Michael, a student at UC Davis, and many of his classmates, use HealthLens to be evaluated by the doctors they know and trust. “A few weeks ago, I went mountain biking and a couple days after the ride I developed a rash on my calves, thighs, and forearms. I assumed it was just a reaction to poison oak, but after a few days the rash kept getting worse and worse. I decided to use HealthLens to send pictures of the rash to my dermatologist in Los Gatos. He confirmed it was a bad poison oak reaction, and recommended a cold compress and prescribed prednisone to a pharmacy in Davis.”
A growing number of millennials like Michael are turning to telemedicine to address their medical concerns. “It’s convenient, fits my budget, and was as simple as sending an email,” said another UC student who used HealthLens to have an ominous mole evaluated by her dermatologist. “Best of all, I knew who would be evaluating and caring for me, my doctor.”
If you are one of the many students who prefers to be evaluated by their own trusted doctor, but doesn’t want to spend Thanksgiving break in their waiting room, try HealthLens and connect with your own doctor.