A laptop with a picture of a doctor online is connected by a winding cord to a cell phone with a patient wearing earbuds.

Telemedicine and MS Revisited

There had been resistance to telehealth visits with medical providers until COVID-19 created the Public Health Emergency (PHE) and forced providers to look at different ways to connect with their patients. Now that this type of service has begun, it looks like telemedicine in some form or shape is here to stay, at least for people covered by the Centers for Medicare & Medicaid Services (CMS).1 If you’re interested in reading more in the official government language, you can access the updated telehealth reimbursement rules and general information online. If the previous patterns hold true, once CMS designates a covered service, the commercial healthcare insurers almost always follow suit. If I could do a backflip, I would, because this is certainly great news.

Using telemedicine for MS

I have been a proponent of distance doctor visits (aka: telehealth) for some time but I am also old enough to remember doctors making house calls. It just made sense to me that if I could talk with my doctor via phone and review my non-urgent symptoms and other medical needs, it could save us both a lot of time. If after the initial call was done, there was still a need to be seen in person, a follow-on appointment could be made.

The benefits of telemedicine

For the patient, this could save a lot of time and resources used to travel back and forth to a specialist office. For the provider, there would also be savings from not having additional staff to handle patients in person, and maintaining physical space in the exam and waiting areas. Connecting through the internet can be a real game-changer, especially for people with MS who may not have a car or able to drive themselves to an appointment.

Preparing for a telehealth visit

I have to acknowledge that preparing for a telehealth visit requires an investment of time on both the patient and provider’s part. 

Secure internet

Providers must arrange for a secure internet or phone system to protect patient confidentiality. They must also read our medical charts in advance of the call so they are refreshed on our condition(s) and what might need to be reviewed.

Confirm insurance coverage

As patients, there are many things we can do to prep for a telemedicine visit, many of which we should already be doing for an in-person appointment. First, don’t assume your telemedicine call will be covered - verify with your own insurance first. A phone call or two can save you from the surprise of an unexpected bill showing up.

Prepare your questions

Whether in-person or via telemedicine, we should prepare a list of items to be discussed so we don’t overlook anything pressing. Do you know how many times you have left an appointment thinking “I should have asked that when I had the chance?” My answer is often! The same goes for telemedicine – make your list of items to discuss and refer to it during your call so you are sure to cover the important points. Also, write down all of the drugs you are prescribed and if you need refills.

Be open to new ways

Multiple sclerosis is a disease with many invisible symptoms, but some of them can be captured by video or photos.  These images can be shared with your provider to illustrate your concern. The doctor will still likely have you do a few other tests that can be observed via your online connection.

Don’t be unsettled or put off if the first time you do a telemedicine visit you encounter problems with connections or sharing information because that seems to be a common occurrence – it does get easier as you and providers gain experience with telemedicine. I can only imagine that providers are also finding this a good way to see many patients, now that they have adopted the technology to make it happen.

I never sensed providers were all that reluctant to try remote office calls, but reimbursement from CMS or private insurers presented an insurmountable obstacle. Now that the obstacle of pay has been removed, I hope we will see the continued adoption of remote visits once this PHE is resolved and I hope we will see even more creative and expanded uses of telemedicine.

Wishing you well,

Laura

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