Telemedicine

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What is Telemedicine?

Telemedicine is the use of electronic information and telecommunication technology to get the health care you need while practicing social distancing. All you need is  a phone or device with the internet to continue your medical care while protecting yourself and your healthcare provider from COVID-19. Speak with your doctor to determine whether telemedicine is appropriate for your health needs.

Why Telemedicine now?

To decrease your contact with healthcare facilities, other patients, and healthcare staff in order to reduce the risk of COVID-19 and keep you and your family healthy

What are the benefits of Telemedicine?

  • Allows you to talk to your doctor live over the phone or video chat  

  • Allows you to send and receive messages from your doctor using chat messaging or email

  • Allows for remote monitoring of patients  

  • Save on travel time/ transportation costs  

  • Reduced wait time for services  

  • Reduced number of visits to clinic

When can you use Telemedicine?

To contact your healthcare provider about the management of your health generally or about management of an existing health condition during the COVID-19 outbreak.  

 

What types of care can you get using telemedicine?

 

  • Screening for COVID-19, testing recommendations, and guidance on isolation or quarantine

  • General health care (i.e. wellness visits, blood pressure control, advice about certain non-emergency illnesses, like common rashes)  

  • Prescriptions for medication  

  • Nutrition counseling

  • Mental health counseling 

How should I prepare for my Telemedicine appointment?

1. Check your internet connection

 

With modern video conferencing software, a video visit should be successful even over a cellular connection.  Most modern systems should only need about 0.6 Mbps of bandwidth to “work” but generally they do better with at least 1.2 Mbps or higher.  

 

Even if you have much higher internet speeds coming into your location, each device that is using that bandwidth adds to the load on the system.  A single device streaming Netflix for example can use 5 Mbps for an HD movie and up to 25Mbps for an Ultra HD Movie.  The more devices using the same network, the more likely it is that the quality of the interaction could be affected.

 

For the best experience, it is worth running a speed test beforehand.  If you are on a phone or tablet, you can search for services to use, such as Bandwidthplace.com to check your speeds.  On a laptop or desktop, you have even more choices, such as Speedtest.net or Speakeasy.net.  If you get at least 1.2 Mbps upload/download speeds, you should be good to go.

2. Make sure you audio and video are working

It can be frustrating if you are about to engage in a visit with Dr. Kimelman online and your video camera doesn’t connect. Sometimes it is simply a matter of giving the software permission to use your camera.  You may see a pop-up box asking for your permission to use video and audio.  Go ahead a give the software permission.  

 

But sometimes, the video just does not connect.  If you have other video software running, like Skype or FaceTime, make sure those are shut down as they may be hijacking your video connection and preventing the telemedicine software from using it.  If that still does not work, sometimes a restart of your computer or re-opening the app will fix the problem and allow you to establish a connection.

 

But the best way to ensure a good quality audio-visual interaction is to test the audio and video beforehand.  Many telemedicine services and software packages have some way for you to test your sound and video before the visit. Doing so may help save you some anxiety and confusion when it comes time to be seen.

3. Find a quiet, private location​​

 

We all lead a busy life.  Sometimes telemedicine visits occur in the passenger seat of a car.  But in order to maintain your medical privacy as best as possible and to allow the medical evaluator hear you well, a private location is recommended.  

 

Find a quiet area, preferably in a room where you can lock the door so others do not interrupt.  Turn off you cell phone ringer.  You will be amazed at how much face-to-face time you can get with a telemedicine doctor when it is just the two of you having a focused conversation and exam.  Compare that to many in-office visits where you often only get a few minutes of time despite with the doctor.

4. Check your lighting

 

This is one of the most important features of a great physical exam.  Checking yourself on video is like checking yourself in the mirror before you go out in public.  Make sure that you are not completely in the dark or draped in shadow during the video visit.  Having a light that is directly in front of you is incredibly useful. Even if that simply means turning towards a table lamp or window.  When you sit with a light source behind you, like a open window during the day, your face becomes completely dark and some important physical exam cues can be easily missed without good lighting.

Grab a flashlight or just the light on your smartphone to help in examining the back of your throat, your eyes, and some rashes.

5. Write down problems and questions ahead of time

 ​​

It is not uncommon during medical visits that patients get caught up in the moment.  There are many things that you want to say but everything seems to get jumbled up and out of order.  Or you completely forget something that you really wanted to talk about.  It happens to all of us.  To help avoid missing important information or forgetting important questions…Write them down!  It is okay to look over your notes during a visit.  Plus it is helpful for the doctor or other healthcare provider for you to have a good timeline and account of your medical issues.

6. Dress appropriately for the visit

 

Just like an in-person visit, a physical exam is needed for many issues.  If there is a pain in the elbow, having a skin tight turtle-neck with a bulky jacket on top of that does not lend itself to a good elbow exam.  Same with rashes.  Dr. Kimelman will want to see what the rash looks like.  Dressing appropriately for the expected exam will improve the ability to get a quality exam and diagnosis.  This will also allow for the visit to continue forward smoothly without delay of trying to work around the situation.

7. Have a trusted assistant if necessary

 

Being part of a telemedicine exam is usually pretty straight-forward.  However, sometimes you need more than two hands.  This is particularly true if you are using your phone or tablet for the visit.  If you are holding the device with one hand, that only leaves the other to perform parts of the physical exam that you are being directed to do.  And while doing that you are trying to follow along with the camera so that Dr. Kimelman can see what is going on. Things can get a bit tricky sometimes.

 

On occasion, it might be useful to have a trusted assistant, such as a family member or friend, be part of the conversation and exam.  A good example of this is an exam of the back.  It can be very difficult to push on your own back, which often takes two hands to do, while holding the camera towards your own back so that the evaluator can guide you through the exam and monitor your responses to it.

 
 
 

Pain Management & Rehabilitation

Alan Kimelman MD

Practice Location

Kimelman Medical Group

4 Florida Street

Vallejo, CA 94590

frontdesk@kimelmanmd.com

Tel: 415-408-3500

Fax: 415-408-3365