Dr. Angela Skrzynski speaks with The Fanatic's Andrew Salciunas about the benefits of telehealth.
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00:00Hello everybody, Andrew Salchunas, 97.5 The Fanatic, and I'm very excited because I get like a free doctor's appointment right now.
00:07It's another doctor on demand with a member of the Virtua Health team, and I'm excited because this is the first time we have a return visitor.
00:15It's Dr. Angela Skarinski. Doc, how are you doing today?
00:17I'm great. Thanks for having me back, Andrew.
00:20Well, thank you for coming back, and today we're going to be talking about telehealth and having a primary physician,
00:25and I probably need to do that right now as you can just hear my voice.
00:29It's not really the best field to work in, radio, when your voice is gone, so hopefully you can help me out by the end of this,
00:35but of course, hopefully you can help out everybody that's watching.
00:37So let me start off by asking this. Most of your patient appointments, they're done via telehealth.
00:42So can you explain how that all works?
00:45Yeah, I would love to. You know, what it really means from the patient perspective is convenience without compromising on the quality of care at all, right?
00:55Because you can now do a visit on your lunch break at work, from home while you're watching the kids,
01:01and you're not having to sort of drag yourself out of the house, which we know can be tough to get mobilized,
01:07especially if you're not feeling well.
01:09And so you have really a lot of increased access to care.
01:13We hope that with our primary care telehealth practice, we're now able to attract those folks who traditionally don't go to the doctor as much,
01:21so that we can catch them, provide them with the preventive care, the counseling, and, you know,
01:26all the health care that they need, and sort of get them back into the system and keep them healthy.
01:31From a clinician perspective, what's really cool is that, you know, you're providing this service to people who maybe wouldn't otherwise seek out care.
01:43And it's a really incredible feeling to know that you're able to reach that mom who's juggling the kids and work,
01:54and, you know, you saved her a 40-minute round trip in the car, or the traveling young businessman who can now do his visit,
02:07you know, on his way to the airport in the back of the car.
02:10So, you know, all of these things, it's really about a capital C, convenience.
02:15So as a clinician, is that what you would say you enjoy the most about the telehealth visits?
02:20It's the ability for you to not only help out with the diagnosis, but also help out in terms of,
02:26hey, this is a busy life that you're living.
02:28I'm going to try to make it easier for you.
02:30I think that's really what is most fulfilling for me as a physician doing telemedicine,
02:34is that I know I'm reaching people where they are.
02:37You know, myself, I am a working mother of three, and I don't want to lug my whole family to the doctor.
02:46And I also love that, you know, it's much easier to set aside 30 minutes for a doctor's visit than 30 minutes to travel there,
02:5630 minutes for the visit, 30 minutes getting back, and, oh, yeah, you know you're going to have to give some time for the waiting room, right?
03:03So this is just so – it's really so much more convenient, and it's really meeting people where they need us.
03:10Now, let me ask you about primary care, whether it's telehealth or coming in person.
03:17What's the importance of finding a, you know, primary care doctor and establishing that sort of relationship with a physician?
03:24You know, it's such an important question because we know that there are so many folks out there who do not have primary care clinicians at their side.
03:32The thing about a primary care clinician is they're really sort of like steering the ship, your healthcare ship.
03:38So when you don't have that person, it can be much harder to know when you're due for some sort of preventive screening.
03:46You're going to typically, you know, find out about health issues later, and you're often going to delay the ones that come up
03:53because you don't really have anyone to just check in with you and bounce ideas off of.
03:58That primary care clinician is so important for just coordinating all of your care.
04:03You know, whether you are a very healthy individual or have a lot of medical complexity, having that person at the helm of the ship for you is just so vital.
04:14And, you know, people have less and less time, and that's a big driver as to why people don't establish with a primary care.
04:24And, again, we hope that primary care telehealth solves for that variable.
04:29So let me ask you about that.
04:30We established it's good to have a primary care clinician.
04:34It's cool to have telehealth at your hand.
04:36So let me ask you, what services are available for patients if you are going via primary care via telehealth?
04:45Yeah.
04:45So this is going to vary depending on where you're seeking care.
04:48In our primary care telehealth practice, you have all of the services available to you that you would in any of our other 25 virtual medical group primary care practices.
04:59And what that means is that we're a digital first practice.
05:02So we're always going to default to a telehealth visit and offer you a telehealth visit anytime that it's appropriate for you.
05:10But when we do need to see you in person, we have that available as well.
05:14We've got two locations in Washington Township and Voorhees Township so that patients can come in.
05:19Well, we need to lay hands.
05:20You know, we need to do their annual physical.
05:22We need to peek in ears.
05:23We need to listen to lungs.
05:25We have that space so that we never need to compromise on the care that we're giving.
05:30We have all the options available to us.
05:32Same thing with testing and, you know, EKGs and labs.
05:37We can do all those same things.
05:39It's really convenience of telemedicine with all the trappings of a traditional primary care practice.
05:45One of the things that's really exciting that we do in our primary care telehealth practice is curbside testing.
05:51So if we see you in telemedicine and you're feeling a little bit under the weather, we don't really feel like we need to lay hands on you.
05:57But, gosh, you know, we should really rule out strep and flu and COVID.
06:01We don't make you come all the way upstairs to have an appointment.
06:06We have we do curbside testing.
06:08So you drive up to the office, meet you at your vehicle and send you on your merry way.
06:13Now, for me to have this telehealth visit with you, what kind of special tools would I need?
06:18Of course, you know, I got a laptop.
06:19I'm talking to you via Zoom right now on the laptop.
06:22Everybody's got a cell phone nowadays, but I'm sure there's more to it.
06:25Right.
06:25I don't know if you need an app.
06:26I don't know what you need specifically to go through these telehealth visits.
06:31The wonderful thing is that you actually don't need anything more than that.
06:35A device that's going to get you on the Internet.
06:38It's as simple as that.
06:39We'll take it from there.
06:41Now, if you've got some tools at your fingertips, it doesn't have to be anything fancy.
06:46But if you've got a thermometer, a weight scale, a blood pressure cuff, you know, those are things that we do like to record at the visits.
06:53If you really want to get high tech, you can actually get Bluetooth enabled devices that are going to send that data over to the physician in real time for them to review.
07:04And there's cool stuff out there now there.
07:07You can do like EKG leads from home and have that sent over to your doc.
07:11You can have an otoscope that takes a picture inside of your ear and sends that over to the clinician.
07:16So there's a lot of wonderful tools that we have available to us now.
07:23But it's a very small proportion of patients who actually need any special tools.
07:27You know, for a diabetic, yes, you should have a glucometer to check your blood sugars.
07:32But it doesn't have to be a fancy one.
07:33It's the same one that you use anyhow for all of your other visits.
07:36So it's really quite flexible and doesn't require a lot on the part of the patient.
07:42So let me ask you, there's a mindset that, all right, I'm feeling under the weather.
07:47I really need to get checked out quickly.
07:48Let me just quickly go to my local urgent care.
07:52So I'll ask you, what is the difference between just getting in the car real quick, going to urgent care and scheduling a primary care telehealth visit?
07:59So, first of all, remember, you don't have to get in the car to go to urgent care because we have urgent care telehealth as well.
08:06So it's really a great point.
08:08You know, when do I go to urgent care?
08:10When do I go to my primary care?
08:12You know, I think the answer is really it's always you always want to default to your primary care clinician.
08:17That's the person that knows you, has an established relationship with you, has records and knows your medical history well and can really tailor your medical plan to your needs.
08:27When it is after hours, a weekend, you can't get in to see your primary.
08:33That's when it's time to go to either urgent care or the ER, depending on what kind of a problem you've got.
08:38Obviously, if it's an emergent issue, you're going to go to the emergency department.
08:41If it's something a little bit less acute, then the urgent care is the place to go.
08:47Now, if you need things like radiology done, if you think you're going to need a splint put on, if you need a laceration repair because you've cut yourself, you need stitches, that's a time to go into the urgent care centers.
09:04But for the vast majority of things that we see in urgent care, upper respiratory infections, eye issues, rashes, you can come in and do this in urgent care telehealth.
09:18Just again, just like the primary care telehealth visits with nothing more than your phone with an Internet connection from the comfort of your own home.
09:26And the difference, of course, between a primary care visit and an urgent care visit is that your urgent care visit isn't scheduled.
09:32You come in when you need us and, you know, most of the time we'll see you right as you come through.
09:40So it's an on-demand service.
09:42So I'll ask you this.
09:43When it comes to telemedicine and then coming in person, obviously the big difference is I'm in the building or I'm at my house.
09:51But what other major differences are there in terms of a regular scheduled visit and a telemedicine visit?
09:56And then what happens if you were talking to me via a telemedicine visit and you go, you know what, we need to see you in person.
10:03So what happens then?
10:05Yeah.
10:06So I think, you know, the major difference is that there are some limitations, right?
10:10We can't lay hands on you.
10:12And so we can't do every single thing that we're able to do in person.
10:15Obviously, the benefit is not only the convenience, but you're reducing your time associated with the visit, your risk associated with the visit.
10:23You're not having to get in a car or schedule transportation.
10:26You're not having to expose yourself to other people's germs or other people to yours if you're not well.
10:33And it can really be a time and cost saving benefit.
10:37But you do you don't you can't you know, somebody can't look in your ears without that special device.
10:41Listen to lungs without that special device, etc.
10:45There are also a couple more considerations that you take into account when you're doing a telehealth visit that are a little bit different than hopping in the car.
10:52Now you're thinking about, can they see me?
10:54What's the technical quality of the visit?
10:56Is my lighting OK?
10:58I got to send them a picture of this rash.
11:00Do I know how to work this thing?
11:03And that's one of the reasons that we really try to streamline the process as much as possible for patients.
11:09And we really do that in two ways.
11:11Number one, we really simplify the technology.
11:13If you have a MyChart account, which is our patient portal account, it's very, very easy to navigate.
11:20And even if you don't, you can get through to us as well.
11:23And the second piece is that we really try to prepare our patients well for these visits.
11:27So they get a lot of appointment reminders and they get preparation tips for how to get the most out of that visit.
11:34Now, what are some of those preparation tips?
11:36Because just today I came into my place of work and I didn't know what the heck the Wi-Fi password was.
11:41So I know that that can become an issue at some point.
11:44So what can I do to make my life easier if I'm having a telehealth visit from my house?
11:49What can I do to make your life easier when we're setting up the appointment and we're going through the appointment?
11:54That is such a great point, right?
11:57Just being able to navigate the technology.
11:59So that's the first step.
12:01Knowing how to get into your MyChart account if you have one and if you're going to access the visit that way.
12:05Knowing where to find the visit link.
12:07Actually, we make that easy, too, because we text it over to you right in advance of the visit.
12:12And then doing a technology test.
12:13Actually coming in a little bit early and checking your audio and checking your speaker.
12:17Making sure everything is working out okay.
12:19Knowing who to call if you do run into a problem.
12:22So when you schedule that telehealth visit, making sure you have the office phone number so that if you're having technology issues that are causing you to run late, you can call and find out what the next best steps are.
12:32You know, who's going to help with technical support for you.
12:36During the visit, we talked about, you know, centering yourself, having that lighting, making sure that you're appropriately dressed to be able to show the clinician whatever it is that you're trying to show.
12:46So if you've got a rash on your leg, then you want to be able to move the camera such that you can show the clinician that rash.
12:54And after the visit, making sure that you know how to access all the after visit information.
12:59So here at Virtua, in my chart, we use an after visit summary, beautiful summary of everything you need to know from that visit and next steps to knowing how to access all of that information, how to book your next appointment, where to get your medications, and where to come back, you know, for your next visits.
13:18And if you have any questions, these are all things that are really important because once you disconnect, you're no longer in the office to ask those questions.
13:25Doc, you're great.
13:28I appreciate it.
13:28Every time I've spoken with you or every time I speak with anybody from the Virtua team, I've learned so much more, whether it's about an illness or whether it's about telehealth.
13:37So I really appreciate it.
13:38But if there's more information that you want to know, if you're watching this, you go, all right, I want to go through Virtua.
13:43I'm going to start telehealth visits.
13:44Or you just want some more information.
13:46Go to go.virtua.org slash primary dash care dash telehealth.
13:52Once again, that's go.virtua.org slash primary dash care dash telehealth.
13:59Thank you so much, Dr. Angela Skorinski.
14:01I really appreciate you taking the time today.
14:03And I hope everybody enjoyed this and learned a little bit more like I did.
14:07Thank you so much.