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Due to Covid-19, UNC Health outpatient clinics are “seeing” fewer patients physically. Though most facilities remain open to patients needing an in-person visit, the coronavirus crisis rapidly accelerates the use of telehealth via virtual visits between providers and patients.

Red rotary phone with wheelsProviders are adjusting to new ways of working, as they finetune their work-from-home technology and get trained for video visits in the UNC Health system. Patients, particularly older adults, must quickly learn new processes and technology. Fortunately, insurers now uniformly agree on coverage for telehealth visits, a recent change that will hopefully endure as Covid-19 recedes.

UNC Geriatrics Specialty Clinic’s Assistant Medical Director Meredith Gilliam, MD, MPH, had good news about her first week of transitioning patients from in-clinic to online care. “I had successful visits with 3 out of 3 patients who thought they’d be unable to figure out the process but did figure it out,” says Dr. Gilliam.

Below, Dr. Gilliam describes benefits and challenges in moving to video visits and what patients need to get started.

How are video visits working so far?

Though I miss seeing my patients face-to-face, we are making headway with video visits.

Video visits allow patients to see their provider face-to-face, without physically coming into clinic and risking exposure to germs. Most of our clinic providers are currently doing video visits and others may be coming online soon. This virtual care option is especially helpful for patients at high risk for complications from COVID19, or patients who live far away from clinic.

How do patients set up a virtual visit?

Patients can start a virtual care visit from the safety of their own home or from homes of family members anywhere in the world (while the coronavirus outbreak is ongoing).

Patients must be active on MyChart to start a video visit. MyChart can be activated instantly by email or by text message. When patients call the Geriatrics Clinic to request a video visit our scheduler will give them a specific date and time.

Patients can start the virtual visit from their computer with certain internet browsers and a webcam.

If they have a smart phone or tablet, they can download the MyChart app and start the video visit from the app on their phone.

Some patients may benefit from having a family member or friend help them get started.

What are some challenges that older adults might have with video visits?

Some patients may have difficulty navigating the technology required for video visits right now. Patients who do not have access to technology or a reliable internet or cell phone connection unfortunately cannot participate.

For patients who don’t have video capability, or try the video option but can’t connect, we can also conduct scheduled “phone visits” over the phone.

Patients who have difficulty hearing, or struggle to maintain attention due to a cognitive disorder, may be limited in their ability to interact with their provider. Having a caregiver with the patient may help overcome some of these challenges.

Video visits are NOT appropriate for patients who may be very sick or who need a physical exam to understand what is going on.

How are your patients coping, in general, with the coronavirus crisis?

With so much information being shared across all media, much of it bleak or dire, our patients are very understandably worried. Protocols addressing prevention and testing are changing on a daily basis, which creates confusion. Many older adults are worried about how they should get groceries and medication refills, and when they can see their grandchildren and family members.

Many older adults, however, are also resilient and selfless. I’ve been amazed how many of my patients have written to me worried about my health and exposure more than their own!