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Multiple Sclerosis Centers of Excellence


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Making the Most of Your Multiple Sclerosis Telehealth Visit

Elizabeth Silbermann, MD

Many Veterans now use telehealth for virtual healthcare visits. Telehealth is a powerful tool designed to make your healthcare more convenient and efficient. It can provide improved care access to Veterans living in rural and remote locations, or to those who may have mobility challenges. However, this technology can also present some challenges. This article will review tips and tricks to allow Veterans with MS to make the most of their telehealth visits while maintaining a personal connection with their physicians.

What is telehealth?

In its most basic form, telehealth is a service where patients and providers connect virtually. The VA has been a pioneer in telemedicine and developed telehealth technology back in 2003. Early visits started as clinical video telehealth visits where Veterans and a nurse or medical assistant were set up in one VA and connected virtually to a physician in a different VA. However, as technology has improved, the VA dramatically increased access to home telehealth. Now, Veterans can connect directly to their providers from the comfort of their homes. In addition to medical appointments, Veterans can connect to case management and care coordination virtually.

In 2020, in response to the COVID-19 pandemic, the demand for telehealth increased dramatically; the VA saw a 1,000% growth in virtual visits in the first few months of the pandemic. The VA’s long history in this space allowed them to develop a safe, secure platform for Veterans that works on multiple different devices, including phones, computers, and internet-enabled tablets.

Is telehealth here to stay?

Many Veterans were introduced to video visits as a safety precaution during the COVID-19 pandemic. However, many clinics are beginning to offer telehealth visits as a regular part of Veteran care moving forward. We have done this to provide more equitable care for Veterans who live in rural locations, who have limited mobility, or who simply prefer the flexibility of seeing a physician from the comfort of their home. Virtual care can also be ideal for Veterans who are clinically stable and just have a few questions for their provider.

However, it is unlikely that your care will be 100% virtual. Most providers are asking to see Veterans in-person on a semi-regular basis. This helps providers better assess how patients are doing and more carefully evaluate their MS and other symptoms. In most cases, we will still require that you have routine lab work and imaging which we can review with you at your visit. In addition, any Veteran with new symptoms, concerns for a relapse, or other new medical issue should still be seen in-person. Finally, some Veterans are not comfortable with virtual visits and prefer in-person care. We recommend that all Veterans ask their provider about their own specific case to make sure they are able to develop a long-term care plan that works for their needs.

Tips for a successful telehealth visit:

Set yourself up for success. If you have never used the VA telehealth video system (VA Video Connect), we recommend that you ask your provider to put in a consult so someone can walk you through the system. You may be familiar with making video calls with your loved ones or conducting video visits with a non-VA provider, but every system is slightly different. We have specially trained technicians who can walk you through the details of setting up the video visit. Many Veterans find this extra step makes them more comfortable during their appointment.

Think about your surroundings. Consider where you will conduct your visit. When possible, choose a quiet environment with light directed towards your face. Sitting in front of a window provides great natural lighting. Headphones with a microphone also improves the audio connection. We will often perform a neurological exam over the visit. This means that we will need to see your arms and legs and will guide you through different elements of the exam. This is much easier if you use a phone stand or have another person help assist you during the exam. Finally, consider your privacy! Be mindful of who may be able to hear your personal health information and always strive to be in a private location.

Dress accordingly. Remember that we will perform a physical exam over the video. This may mean that we need to see your eye and face movements and may ask you to move your arms and legs. Please be fully clothed in comfortable attire to make the visit go as smoothly as possible.

Don’t drive and chat! Please make sure you are not driving during your visit. This is distracting for your provider and dangerous to you! If you are in a car, pull off in a safe location before your visit.

Don’t schedule a virtual visit while out of country. Due to licensing issues, your provider needs to know if you are traveling out of state or out of the country. It may be necessary to reschedule your visit if you are unexpectedly in a place where your provider is not licensed to practice medicine.

Frequently Asked Questions:

Can I have a virtual visit without an internet connection? Around 15% of Veterans may not have a home internet connection. In these cases, the VA can often provide Veterans with internet-connected devices for their visit. We encourage all Veterans to reach out to their local VA to learn more about these services.

Are virtual visits secure? Yes, the VA Video Connect (VVC) platform is secure. Your provider will virtually lock the room after the visit begins to make sure no one can enter. In addition, your provider will be in a private space. He or she will always ask your permission before allowing anyone else in the room with them during your visit.

Can someone else join our visit with my permission? Yes, we can typically add a third party to the virtual visit. This can be very helpful if your care partner is located remotely. Let your provider know ahead of the appointment so he or she can make the necessary arrangements.

What if the call fails or I am not able to connect to the visit? Make sure you are near your phone. We will typically give you a call within 5-10 minutes of the visit start time to see if you are still available for the appointment. Depending on the issue, we may proceed with a phone appointment.

Do I have to use the VVC platform? Not all video chatting software is HIPAA compliant. If you are not comfortable using the VVC platform, please tell your provider so you can come up with a suitable alternative for your visit.