The Virtual Patient Experience

David Ko, M.D., Family Medicine

Shimaila Zuberi, M.D.. Family Medicine

Prior to the pandemic, you might not have considered a Virtual Visit with your physician. In fact, according to a survey by Sage Growth Partners (SGP) and Black Book Market Research, only 25 percent of respondents had previously tried telehealth prior to the pandemic. Even though the same study reports that 59 percent of respondents are more willing to try telehealth now versus before, almost a quarter still have their concerns. 

That’s why we spoke to Drs. David Ko, M.D., and Shimaila Zuberi, M.D., family medicine physicians on the medical staff at Texas Health Plano and Texas Health Family Care in The Colony, to understand how it works, what conditions can be addressed or treated during Virtual Visits, what conditions would require an office visit, and to get their take on the overall experience. 

 

What kind of initial reaction to telehealth did you see from patients last year? Were people welcoming Virtual Visits with open arms or was there some apprehension about the experience?

“I haven’t met anyone who is really opposed to it. Everyone’s main concern, in the beginning, was really about the difficulty of it — do they have to download something, how do they access it, etc.,” Ko says. “Initially, those concerns were valid, but now it’s very easy and convenient. So I think patients really, really like it.” 

 

How about now, a year later? Is the reception still positive or do you find patients opting for in-person visits more?

“Once you get a couple under your wing, you get used to the flow, and it really doesn’t feel much different than an in-person visit, beyond the obvious fact that you’re not physically there,” Ko says. “Of course, there are still some people who want to be seen in person, whether they’re actively sick or it’s just for a checkup, but I feel like for a certain population, Virtual Visits are so convenient for them that they’re fully embracing it.”

“I find that the frequency of patients opting for virtual visits truly depends on the nature of the visit,” Zuberi adds. “A virtual platform is tremendous for follow ups regarding adjustments in medication, blood sugar readings, depression, rashes, etc. Not only are patients able to access medical care and expertise from the comfort of their own homes, patients out of town for college, vacation, work obligations, etc., can continue to receive medical care from a provider who they are familiar with. Virtual care allows us as physicians to continue to help our patients be the healthiest they can be regardless of geographic location which is truly inspiring and reassuring for both the patient and the provider!”

 

So, you’re seeing a certain population that’s opting for it more than others? 

“I’ve found that those that are elderly, working or in college prefer Virtual Visits the most as they have more restrictions as to when and how they can come into the clinic,” Zuberi says. “For the elderly, they can avoid going through the hassle of leaving the comfort of their home, driving through traffic and waiting in the lobby. Those who are at their jobs throughout the day do not have to take off for a doctor’s visit and spend a few hours getting to and from the clinic. Lastly, college students no longer have to switch health care providers to someone in their college town if they’re unable to come back home for a visit.”

“The convenience factor is such a big positive for a virtual visit. It’s great for people with children who they either don’t have to bring along on the visit or make plans for child care while they’re at the doctor’s office, or people who struggle to take time off work or they’re having to rush out of work at the end of the day in order to make it to the office before they close,” Ko adds. “Personally, I have a wife and two young kids and we did a virtual visit awhile back, which was nice because my wife didn’t have to take the kids along with her like we’ve had to do in the past or make plans for a babysitter to watch them. It’s just incredibly practical.”

 

For anyone who hasn’t had a Virtual Visit before, explain how it works. 

Getting started on a Virtual Visit is quick and convenient, using technology you most likely already have and use in your everyday life. You can use iPhone or Android devices, iPads, tablets, laptops, and computers as long as they have a working camera and microphone. If you’re saying, “but I’m not tech savvy” while reading this, don’t worry — the technology used by Texas Health has been designed so that anyone can use it. But if you are having trouble, you can reach out to your provider’s office for assistance.

Once scheduled for a Virtual Visit, you will receive an email to utilize Texas Health MyChart’s eCheck-In. This is the digital version of the paperwork you might normally fill out in the office when you’re waiting to see your provider.

“As far as paperwork goes, it’s still the same as if you were to come in, except now you’re doing it digitally,” Ko adds. “Consent forms and questionnaires are provided to the patient the day prior via their patient portal, and if you’re a new patient, you still have to fill out new-patient questionnaires and your medical history, which we review during the visit.”

After the eCheck-In process, you will receive an email confirmation or text invitation before your scheduled appointment.  The confirmation email and text invitation will include links to initiate the virtual visit at the scheduled time.

Despite the digital format, Ko adds that the visit isn’t much different than one you’d have in the office. 

“From the standpoint of reviewing your medical history, seeing what medications you’re currently taking, and asking you about what’s going on, the Virtual Visit is no different than if I saw you in-office,” Ko explains. “Obviously there are physical limitations, but we work with what we have available. Typically, I’ll ask the patient if they have a scale, thermometer,  a blood pressure cuff, and a pulse oximeter device and to report those readings to me. Having a blood pressure cuff is really helpful because it can also show us heart rate. The pulse oximeter device, which measures the amount of oxygen in your blood, can be good to know, especially if you’re reporting a cough. That mixed with what I can physically see makes it an informed visit.”

That being said, Ko adds that once he chats with a patient virtually, if he deems an in-person visit necessary or he feels the situation is emergent, he can direct the patient to the local emergency department or set up an office visit for further evaluation.

 

What are some conditions or circumstances that can easily be resolved via telehealth, and what requires an in-person visit? 

“Telehealth visits are a great option for visits that address mental health concerns, COVID-19 exposures, birth control counseling, smoking cessation, obesity management, and other medical needs that do not require a detailed examination of a physical condition,” Zuberi says. 

“We still see a good amount of patients who have skin issues or bladder infections, sinus infections, cough, sore throat — routine stuff,” Ko adds. “If you’re a patient who mainly comes in for follow-ups and medication refills, and you’re not experiencing any issues, you can skip the office visit now and address those needs via a Virtual Visit as well.” 

Patients who require routine blood work before or after seeing their physician still have the option to have a virtual consultation. You can make plans to stop by in the office for a quick blood draw or stop by a preferred testing location that’s conveniently located near you. 

“If a patient is really having difficulty breathing or says they have chest pain, those are things that need to be physically evaluated right then and there in person,” Ko explains. “A prolonged or severe headache can be a tricky symptom to address via Virtual Visit as well, just because a headache can present in a lot of different ways and with a lot of different conditions, so that’s something that is better suited for an in-person visit. Also, we are not currently providing annual wellness exams via telehealth — that is something that you will need to come into the office for.” 

 

Do you think telehealth will be here to stay even after the pandemic is over? 

“With the delta variant causing a lot of concern again, I think Virtual Visits will pick up in popularity again as we head into the cold and flu season,” Zuberi says. “This will especially hold true for our eldery population, immunocompromised patients, new moms, etc. The opportunity to discuss one’s medical concerns with a health care provider without fearing exposure to the virus is truly unique and should be fully utilized.”

“Obviously it’s not 100% equivalent to an in-person visit, just how grabbing takeout isn’t the same experience as dining there in the restaurant, but when it comes down to convenience, if you don’t have to wait for your next day off in order to come see us, that can’t be beaten,” Ko adds. “It’s going to be interesting to see later on down the road what the trend will be in regards to sick visits and if, in the future, in-person visits will trend upward again when you’re feeling ill, but I think for the way it’s going now, it’s going pretty well.”

To learn more about Virtual Visits, FAQs and how to access specific platforms, please visit TexasHealth.org/About-Texas-Health/Virtual-Visits

Finding a physician who can partner with you for your health is essential. We can help find a physician that’s appropriate and convenient for you. Call 1-877-THR-WELL (847-9355) or visit TexasHealth.org/THPG/Doctors today.

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