Virtual Visits

On March 17th, CMS released new guidelines on Telehealth. One important pieces of information in that providers can now use apps like FaceTime, Skype or Facebook messenger video for virtual visits. (Please read full details here and FAQs here). Key points include:


  • Providers should only use “non-public facing” communication software. These include software which allow 1:1 interactions. Some of these software listed on CMS guidance include:
    • Apple FaceTime
    • Facebook Messenger video chat
    • Google Hangouts video
    • Whatsapp video chat
    • Skype
    • Texting applications such as Signal, Jabber, Facebook Messenger, Google Hangouts, Whatsapp, or iMessage.
  • Providers should NOT use “public-facing” communications such as TikTok or Facebook Live.

Before using any of the methods used in this post, please check with your hospital leadership and policies regarding virtual visits. This article is intended to help providers and patients. My intentions are not to get anyone in trouble.

Using Apple FaceTime

This is probably the easiest method for virtual visits, provided the patient has access to an Apple device. Advantages include:

  • Most Apple device owners are familiar to the functionality of FaceTime
  • No additional software needs to be installed
  • Both iMessages and FaceTime have end-to-end encryptions therefore ideal for protecting patient privacy.

If you are considering the use of FaceTime calls, there a few things to consider.

AppleID

If you have an iPhone or iPad, chances are that you are logged in using your AppleID. If you make FaceTime calls with your own device, you will be sharing your personal phone number or AppleID with patients. If you want to avoid this, there is a simple fix to the problem.

Create a New AppleID and use an old iPhone/iPad

If you have an old iPhone or iPad, use these steps to prepare these devices for your virtual visits:

Make FaceTime Calls

Potential Pitfalls

There are some issues with FaceTime calls. First, this excludes patients/providers with Android devices. Second, the necessity for a second device or sharing your own AppleID can be significant barrier.

Using WhatsApp

Over a Billion people worldwide use WhatsApp. This app can be installed on iPhone/iPad as well as Android devices.

Installing WhatsApp

Here is a great guide on installing WhatsApp by WikiHow. Consider sending this link to your patients if you would like them to use WhatsApp for video calls (especially android users)

Using WhatsApp without revealing your personal phone number

If you want to use WhatsApp on your personal device, after installation you will have to activate the app using a validation phone number. If you enter your own cellphone number, this number will be revealed to patients.

However, there is a workaround to prevent that from happening. In order to not display your phone number, you can use GOOGLE VOICE phone number to activate WhatsApp. Here is an excellent guide on how to accomplish this https://www.wikihow.com/Use-WhatsApp-Without-a-Phone-Number

Other Apps

Providers can decide on video app of choice for their office.

Billing and other issues

The American Medical Association (AMA) has created a Telehealth guide with a comprehensive guide on billing.
Link to AMA guide on Telehealth

Changing visit type to VIDEO visit in EPIC

To successfully accomplish video visit (and bill for it), you will need to setup the visit type in EPIC as VIDEO visit.
This can be done by either reaching out to your clinic administrator or you can download and follow the steps outlined here:

Author: Shitanshu Uppal

Assistant Professor Gynecologic Oncology University of Michigan, Ann Arbor

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