Telemedicine: A good fit for cardiovascular care?
Matthew McLaren
PhD in Nutritional Science| Author of 5 Books| Health, Wellness and Marriage
Virtual doctor visits — when you talk to a physician on a video call instead of during an in-person office exam — have been available in certain places for years. But they never really caught on until the pandemic hit earlier this year. Almost overnight, virtual care became an indispensable tool for managing coronavirus infections and other health conditions during the crisis.
In 2019, virtual visits accounted for fewer than 1% of the appointments at Mass General Brigham, a large health care system founded by Harvard-affiliated Brigham and Women's Hospital and Massachusetts General Hospital (MGH). "But during the peak of the coronavirus surge in Boston, 80% of all visits were done virtually," says Dr. Lee Schwamm, director of the Center for TeleHealth at MGH and vice president of virtual care at Mass General Brigham.
Make the most of your telemedicine appointment
Your doctor's office will give you instructions about the software program you need for your computer, tablet, or smartphone. You'll also need a reliable Internet connection. Here are some additional tips:
- Make sure your device is charged or plugged in.
- Set up your device in a quiet, well-lit room.
- Angle the camera so the doctor can see you well. If you're using a smartphone, prop it up so you're not holding it in your hand.
- Have a phone available as a backup in case the video doesn't work.
Otherwise, prepare as you would for an in-person visit:
- Make of list of questions for your doctor.
- Have your medications and any dietary supplements you take in original containers nearby.
- Have pen and paper ready to take notes.
- Your doctor may also have you measure your weight, blood pressure, and blood sugar (if you have devices to do so) prior to the visit so you can share that information.
Telemedicine advantages
From a patient's perspective, virtual visits save a lot of time. You don't need to take time off work or other commitments to drive, park, and sit in a waiting room before your visit. And even though you're not in the same room, you may actually get more direct eye contact with your physician, thanks to the face-to-face nature of video calling.
Another advantage: you may be able to have another person — such as a family member who lives across town or across the country — join the video call. That could be especially helpful if you're facing an upcoming procedure or discussing a serious health concern. Just as with in-person visits, it's nice to have another person listening, asking questions, and taking notes.
For people who have or are at risk for cardiovascular disease, a big part of what doctors do is to review test results and talk about how to better manage the condition, notes Dr. Schwamm. These discussions usually take only about 20 minutes, making them well suited for virtual visits. For this process to work efficiently, health care visits need to be deconstructed and reassembled. For instance, you'd go to a lab near your home to get blood tests prior to the visit and measure your blood pressure at home with an automatic blood pressure cuff (or perhaps at your local pharmacy or senior center, or by a nurse at your independent living facility).
Future directions
Setting up telehealth infrastructure and restructuring how doctors are reimbursed are other crucial aspects of a successful transition to virtual care. But those investments only make financial sense if there's a sufficient amount of virtual care going forward. At MGH, the percentage of virtual visits has declined in recent months as in-person visits have been climbing back toward pre-COVID levels. Dr. Schwamm thinks telehealth visits will likely stabilize at around 20% to 30% of all health care visits.
In the future, remote monitoring of health data using wireless–enabled devices that measure a person's weight, blood pressure, blood sugar, pulse, and heart rhythm could further advance telehealth's promise. "I imagine a world where we are continuously monitoring key health factors and using artificial intelligence to monitor those signals," says Dr. Schwamm. If concerning changes appeared, the system would create an alert. Rather than seeing your doctor at arbitrary intervals, you'd go when monitoring data suggested the need. It would be similar to maintaining your car, Dr. Schwamm explains. "You don't just bring it in every 12 months for a routine check-up; a warning light tells you when something's wrong."
Bible verses for today’s meditation and inspiration: Matthew E. McLaren’
Then you will call on me and come and pray to me, and I will listen to you. Jeremiah 29:12 NIV
Be joyful in hope, patient in affliction, faithful in prayer. Romans 12:12 NIV
And when you pray, do not keep on babbling like pagans, for they think they will be heard because of their many words. Matthew 6:7 NIV
The Lord is near to all who call on him, to all who call on him in truth. Psalm 145:18 NIV
‘Call to me and I will answer you and tell you great and unsearchable things you do not know.’ Jeremiah 33:3 NIV
“For where two or three gather in my name, there am I with them.” Matthew 18:20 NIV
Let us then approach God’s throne of grace with confidence, so that we may receive mercy and find grace to help us in our time of need. Hebrews 4:16 NIV
who is unseen. Then your Father, who sees what is done in secret, will reward you. Matthew 6:6 NIV
Recommended contacts for prayer request and Bible study
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