29 Sep New technology allows doctor visits from home or the road
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TytoHome lets physician perform exam remotely with smart phone and handheld device
Ever wish you could get your doctor to check your ears or nose or throat without having to drive to their office and sit in a room with potentially sick patients? Ever wish that when you are on the road traveling and feeling a bit off that you could visit with your doctor for a virtual checkup?
We have wished for many times. And that is heightened because of COVID-19.
Well, wish no more. Virtual visits and remote diagnostic exams are now reality. Virtual visits (by phone or video) are not new, but a video visit with remote diagnostics is breakthrough technology. We believe this will keep us out of the doctor’s office when we are sick and be our new travel companion.
First FDA-approved remote diagnostic device in the U.S.
TytoHome is the first FDA-approved comprehensive remote diagnostic device in the United States. Doctors can remotely perform a visual exam of the skin, check temperature, see and hear eyes, ears, nose, throat, pulse, lungs and heart. It’s reminiscent of the Star Trek medical tricorder that Dr. McCoy relied on to examine patients remotely.
TytoHome, developed by the Israeli company TytoCare, is sold worldwide. Combined with your smartphone, the device allows doctors to perform a guided diagnostic exam remotely from your home, work or anywhere. I’m calling this “house calls” for 2020, with the benefit that you can reach a doctor 24/7 from anywhere in the United States and several places abroad. There have been many times in our travels when medical needs arise requiring medical consultation. This allows us to connect with a doctor from a remote destination (certain restrictions apply).
See your personal physician or an on-demand provider
Tyto is growing its network of participating doctors worldwide. I am lucky because my primary care doctor is part of Novant Health, an approved TytoHome vendor. I am told that medical licensing laws require that a doctor be licensed in the state in which you are receiving care. That seems outdated because it means that if I am traveling outside of North Carolina my doctor cannot perform a virtual diagnostic visit because I am receiving care out of state. Silly. I hope that gets fixed soon so we can utilize our personal physician as we travel throughout the country.
I contacted TytoCare to see if there was an option for physician coverage throughout the United States and abroad. A spokesman explained, “Domestically, Live Health Online is an umbrella provider that allows users outside of networks that Tyto is working with to have a virtual visit with a healthcare provider from any location in the U.S., aside from a few regions. For example, if someone purchases TytoHome and does not live in a region that’s covered by a partner health system, they can use Live Health Online.
“As for international travel, while TytoCare does have some international partnerships, the solution is not intended for visits with U.S. providers while abroad,” according to the TytoCare representative.
House calls/travel medicine 2020. Step-by-step of my virtual visit
We arranged a demonstration exam for Wandering Rose Travels readers with Aram Alexanian, MD, a physician at Novant Health Primary Care Gilead Road in North Carolina and executive for clinic provider development.
In preparation for the virtual exam, I downloaded the required app and learned to use the device with video tutorials. In the MyChart app that Novant Health utilizes, patients have the choice of scheduling a Tyto video visit with their personal Novant Health provider or using the on-demand feature to access a doctor 24/7. While the on-demand provider won’t be your personal doctor, he or she does have access to medical record, test results and all medications. I would use the on-demand feature if I have an illness or symptom outside of regular doctor office hours rather than going to an urgent care center. If the patient is under age 17, a pediatrician will perform the exam.
The morning of my virtual physician visit, the benefits became clear … not having to drive to a physical location, waiting for the doctor in the comfort of home, not missing work time, etc. What a benefit this would have been when we had young children with frequent fever, runny nose and sore throats.
The visit began like any video call, with Dr. Alexanian on my phone screen and me on his computer screen. We talked about my general health and concerns as he reviewed my medical history. We then transitioned to the diagnostics phase where Dr. Alexanian guided me through exams of suspicious skin spots, temperature check, listening to my heart and lungs, and examining ears and throat.
Components and capabilities of TytoHome
The master TytoHome handheld device has a high-resolution camera that can focus close enough for a detailed look inside your ear, throat and nose. I was able to see what the doctor was seeing in real time. He took reference images to keep on file for future comparison. A stethoscope attachment allowed the doctor to listen to my heart and lungs and record those sounds if helpful.
My only technical struggle during the virtual visit was getting the camera aimed correctly so that the doctor could see inside my ear. Dr. Alexanian was able to demonstrate the correct technique for me on the video screen and following his directions it then worked easily. If labs or x-rays are required, they can be scheduled same day at a convenient location nearby. If a prescription is needed, the doctor will arrange for that to be filled at the pharmacy of your choosing.
It was a great experience. I feel like I received a thorough exam and all my medical questions were answered. I especially like the feature allowing the physician to save recorded images and sounds for future reference.
After the visit, a barefoot stroll to the kitchen for more coffee
I feared an ear problem, but Dr. Alexanian checked me out and did not see anything of concern. Visit results are recorded in my online medical record with all my other records. When the virtual visit was over, I strolled to the kitchen barefoot to pour myself another cup of coffee.
Dr. Alexanian believes some patients are more relaxed and share more information in their own home environment than they might in a doctor’s office. He describes the in-home virtual visits as humbling, especially with patients he has known for some time. “It’s a privilege being invited into their home and seeing pictures of their children or grandchildren. I now understand that patient more as a person,” Dr. Alexanian said.
Screening sick patients through virtual visits is keeping physician waiting rooms safer and give assurance to travelers. “Often I can diagnose and treat a sick patient virtually and they don’t need to come in at all,” Dr. Alexanian said. “There have been a couple of suspected COVID cases where I had the patient drive to the office and I did an in-person exam in their car wearing full protective equipment.”
Virtual doctor visits skyrocket during COVID-19
I asked how virtual visits (telephone, email, video and TytoHome) were trending during COVID-19. The answer was surprising. Prior to COVID Novant Health recorded 2,000 total virtual visits across its system, according to Dr. Alexanian. In the six months since COVID, Novant Health medical providers have performed 500,000 virtual visits!
Currently, just over half of Novant Health physician visits are in-person, with the balance being virtual. “We advanced 5 years in 48 hours,” Dr. Alexanian said, describing the sudden shift to virtual visits.
TytoHome’s website lists these capabilities:
Ear: Investigating the ear canal for ear symptoms
Lungs: Listening to lung sounds to investigate coughs and congestion symptoms
Heart: Monitoring heart sounds for abnormalities
Throat: Looking down the throat to investigate symptoms in the throat or voice box
Heart rate: Measuring the heart rate
Temperature: Measuring body temperature
Skin: Taking images of the skin to assess bug bites, rashes, and other skin conditions
Abdomen: Listening for abnormal abdominal sounds
What does the future hold for remote medicine?
What does the future hold for virtual visits and remote exams? That may depend on how Medicare and private insurance treat virtual visits in the future. Prior to COVID-19 virtual visits were not covered, or covered at a lower rate. Since COVID-19 virtual visits are covered the same as an in-person visit. I’m hoping the health benefits are proven enough that virtual visit coverage continues. It only makes sense to keep sick people out of the waiting rooms if they can receive comparable care remotely.
If away from home for leisure travel or work, the ability to see a doctor from my hotel room is so much better than running around a new town trying to find an urgent care of doctor’s office. And if I am in North Carolina, the doctor performing the virtual visit will have my complete medical history, another bonus.
The TytoHome kit retails for $299 and is available through Novant Health and Best Buy. Check with your healthcare provider to see if they offer the device. Novant Health serves patients in North and South Carolina and Virginia.