October 2, 2020

Making (virtual) house calls

With expanded telehealth options, Kaiser Permanente members get convenient access to safe and high-quality care that meets the needs of the moment.

Ari Melmed, MD, serves as medical director of Kaiser Permanente’s Telephone Medicine Center and led development of the "Chat with a Doc" service in Colorado.

During the COVID-19 pandemic, our daily vocabulary has expanded to include plenty of words and phrases we’ve rarely, if ever, used before, such as coronavirus, social distancing, and mask fatigue. But one term stands apart as a particularly welcome addition: telehealth.

Telehealth describes any virtual visit with your physician or care provider. It’s an area of medicine that has expanded exponentially this year and made accessing health care easier than ever.

“There are many ways of interacting with one’s care team or doctor remotely,” said Ari Melmed, MD, medical director of telehealth services for Kaiser Permanente in Colorado, and a 2020 5280 Top Doctor. “We want to make ourselves as available to our members as we can for their medical concerns.”

Kaiser Permanente in Colorado pivoted nearly 90% of its appointments to virtual care during the height of the novel coronavirus pandemic back in March and April and had 20,000 telehealth interactions in the first 6 weeks of the pandemic.

“We’re flexing muscles we’ve had in place for years with our virtual care offerings. We were headed in this direction already and had many new virtual care offerings scheduled for implementation long before COVID-19,” said Dr. Melmed.

We’re flexing muscles we’ve had in place for years with our virtual care offerings.

Wilbur Norman knows firsthand the lifesaving capabilities of virtual care. Three years ago, the Aurora, Colorado, resident and Kaiser Permanente member couldn’t kick his flu-like symptoms. He woke up on a Sunday morning slurring his words. His wife, a registered nurse, was alarmed, but Norman thought she was worrying too much.

They signed in to Kaiser Permanente’s chat feature. The doctor they connected with identified Norman’s symptoms quickly, made connections to the local hospital to ensure immediate access, and told him to go to the emergency room straight away.

“I stayed in the ICU for 3 or 4 days. I had pneumonia. I was septic. I almost died,” says Norman. “Telehealth is the best thing Kaiser Permanente [offers] … It helped save my life.”

Online chat with a clinician is available to members in Colorado and several other regions as one of many telehealth options offered by Kaiser Permanente. Members can complete an e-visit, ask questions via secure email or phone, schedule phone or video visits, or use online physical therapy or remote patient monitoring. Colorado members can also complete an on-demand video visit 24/7 — no appointment required.

Members can also access kp.org 24/7 to schedule visits, view lab results, fill prescriptions, and more. Prescriptions can be delivered by mail to Colorado members with no shipping costs or ordered for same-day or next-day delivery for a small fee.

During telehealth visits, Kaiser Permanente clinicians can securely access your electronic health record and can prescribe medications, order lab tests and imaging, or put in a referral to connect you with other needed care. And all providers are trained specifically in “web-side manner” to make sure you’re receiving the best care possible no matter how you’re reaching out.

“Good communication between providers and patients is a very important piece of our care delivery … and we’re constantly trying to improve that communication because it is so important for our members to feel that they’ve been heard, that they’ve been understood, and that their concerns were addressed,” Dr. Melmed said.

So, how do you choose which virtual avenue is right for your medical inquiry?

“It has to do with patient preference,” Dr. Melmed advises. If you’re at work, for example, chat may be the quickest, most private option. Still, Dr. Melmed says the team does try to encourage patients toward video if possible. “We find that the video interaction is a more data-rich interaction. Being able to actually see a patient, to assess their facial expressions, their range of motion, their posture, their breathing efforts, and so forth can really pass on a huge amount of information,” he said.

Becky Starr, a Kaiser Permanente Medicare Advantage member, wanted the doctor to be able to see her during a recent appointment. She had an irritated, puffy bug bite above her right knee, which she worried was infected. It was a late Friday afternoon. She signed in to her account on KP.org to ease her mind with an on-demand video visit. During the short check-in process, she was prompted to send a photo. She was excited to save herself a visit to the doctor. Within minutes — and despite her self-proclaimed lack of technological know-how — she was face-to-face with a physician.

“He saw the pictures. I put the camera on the floor, and I showed him my leg,” Starr said. The doctor told her she was fine and to let the bite heal on its own. He recommended some over-the-counter medicine to relieve itching. “It took all of 5 minutes — I was thrilled,” said the Denver resident. “I got my answers. I was comfortable in the diagnosis. And I went on my merry way. It was extremely easy and extremely smooth.”

Convenience and quality are among the many benefits of telehealth — especially during a public health crisis that requires limiting our interactions with others. In many cases, you can get answers without having to leave your house. Of course, it’s possible the doctor will recommend coming in for a visit or, in a serious situation, may refer you to urgent care or the emergency room.

“I will always use it,” Norman said, referring to Kaiser Permanente telehealth; and he urges others to do the same. “I believe it’s the best thing out there right now because you can talk directly with a doctor immediately. If you haven’t ever used it, try it out. I’m here now because of it.”


Expert Advice

To get the most out of your telehealth appointment, do the following before signing in:

  • Check your internet connection and make sure your speakers are working.
  • Consider the lighting. When the light is coming from behind you, it can create shadows that make it hard for the doctor to see you clearly. Instead, Dr. Melmed suggests setting yourself up so the light is in front of your face.
  • Think about what answers you’re seeking and choose the telehealth option that makes the most sense. If you want to discuss a rash, for instance, a video visit is probably the best option. If you have a quick question, try chat.
  • If you need or want someone else on the call or video — a spouse or a grandchild, perhaps — let the doctor know. He or she will help get that person connected, too.
  • Remember: The doctors are there to help. They’ll walk you through the process just like they do in person. You don’t need to be tech savvy to use telehealth.