If you are looking for the convenience of telehealth you may be wondering how your physical examination is done during your virtual visit.
Preparation for a Telemedicine Consultation
Preparation on part of the patient can be helpful for a successful video visit. First, good lighting is essential. If possible, be in a room with natural outdoor lighting for best image quality. If not, use a good lamp with a white bulb. Next, it can be very helpful to the virtual doctor if you have your vital signs available at the time of the consultation:
- Thermometer, either glass or electronic. If the former, clean with soap alcohol.
- Wrist band or chest band for measuring your pulse.
- Automatic blood pressure cuff for measuring blood pressure.
- Glucometer to measure blood sugar if you are diabetic. Your online doctor will probably want a set of blood sugar readings taken over a certain time period.
- Pulse oximeter, a small device that slips onto a finger, for measuring oxygen saturation. More and more wearable devices (like the Apple Watch starting at Series 6) have the ability to measure your blood oxygen level.
If you have had laboratory testing recently, upload your lab report(s) directly onto your electronic medical record (EMR). An EMR is much like a medical chart used by a doctor’s office or hospital, but online rather than on paper. Your online doctor will put together the information from your chief complaint, your history.
What about the Actual Exam?
Just seeing and talking to a patient via video alone already provides the remote doctor with a lot of valuable information about the patient’s condition. It can e.g. determine
- If the patient is ill-appearing,
- If the patient is in any distress
- If the skin looks pale or well-perfused
- The clarity of speech
- If they are having trouble breathing (e.g. not speaking in full sentences) .
- If the patient is confused
- What their cough sounds like
- What their social/living situation looks like
For a more focused physical exam, the patient can easily aide and assist the doctor through e.g.:
- Palpation or percussion of certain parts of the body
- Ranging painful joints
- Focusing in on any relevant part of the body, e.g. like skin lesions, conjunctiva, the back of the throat
- Aiding with a neurological exam (e.g. finger to nose testing, or having a family member test the skin sensation of certain body parts)
One may be surprised to learn that almost any basic physical exam can be performed remotely—with the help of either the patient or family members.
Listening to the lung or heart (while usually not a high-yield physical exam component) is not yet routinely possible through telehealth. However wearable technology is rapidly advancing, and soon even remote ultrasounds and auscultation will likely be possible.
Yet, despite the advancement of telehealth technology, some chief complaints still require an in-person visit or even an emergent trip to the ER (e.g. acute chest pain, severe abdominal pain or dehydration). In those cases, telehealth may serve as a triage tool to advise patients and guide them to the appropriate place for evaluation and treatment.
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Did you know? QuickMD is offering state-of-the-art HIPAA compliant telemedicine video technology, with crisp video images and highly trained doctors on the other end that can help you diagnose your condition remotely.