Telehealth – or the ability to have an appointment with a medical provider over the phone of computer – has historically been limited to certain conditions and for certain types of appointments. But in response to COVID-19, telehealth is becoming more widely adopted. Erica Kuhn shares how to get the most out of telehealth on today’s episode.
Erica Kuhn is the Manager of Health Information and Publications at Susan G Komen. Erica has been at Komen for more than 17 years and oversees the About Breast Cancer section on komen.org. She is responsible for developing and editing breast cancer related materials and messages to ensure they are current, safe, accurate, consistent and based upon scientific evidence. She has a Master’s Degree in Public Health from the George Washington University. She currently serves as an ASCO Cancer.net Breast Cancer Advisory Panel Member, a member of the LUNGevity led Consistent Testing Terminology Working Group and a focus group member for the FDA Oncology Center of Excellence Patient Friendly Language Project. She lives in Columbus, Ohio with her husband and two teenage children.
From Susan G Komen, this is Real Pink, a podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room
Telehealth – or the ability to have an appointment with a medical provider over the phone, or computer has historically been limited to certain conditions and for certain types of appointments. But, in response to the social distancing requirements of COVID-19 pandemic, telehealth is becoming more widely adopted following the federal government’s COVID 19 public health emergency declaration this year, restrictions that limited the use of telehealth were lifted making it more widely available for people across the United States and creating more ways for breast cancer patients to connect with their doctors from the safety of their homes. Here today, to discuss why this is a positive and welcome development for many patients and how to get the most out of these telehealth appointments is Erica Kuhn. Erica, welcome to the show.
Thanks so much for having me here today.
I’m really excited to hear your perspective on this and all the details, but let’s get started with you telling us a little bit about yourself and how you got involved in the breast cancer space.
Sure, sure. So my name is Erica Kuhn, and I’m the manager of health information and publications at Susan G Komen. And I’ve been at Komen for more than 17 years now, which is basically most of my career. I feel like I’ve sort of grown up at Komen. So what I do is I oversee the about breast cancer section of our website: Komen.org. So I help to make sure that the information on our website is safe, accurate current, and based on evidence, I have a master’s degree in public health with a concentration in maternal and child health from the George Washington university. And I think I’ve just always been interested in women’s health issues ever since I was a little girl and my grandmother had breast cancer. And at the time I don’t think I quite understood, you know, what was happening to her. I just knew that she was sick and she looked different to me afterwards. So I mean, it wasn’t until I was much older and adult that I really realized what she had been through. So now I have two teenage kids, myself. I have a 13 year old daughter, so I feel it sort of come full circle and, you know, I’ll do everything I can to protect my children and you know, both my son and daughter to make sure that they don’t have to worry about breast cancer.
Fantastic. Well, thank you for the work that you’re doing. I know, you know, that, that part of the common website is just so important to our listeners into so many people. And so thank you for the work you’re doing to keep that information relevant and safe.
Thank you. It’s just a great passion of mine.
Yeah, yeah. That’s great. Well, let’s start broad. Can you give us an overview of how COVID-19 has changed healthcare?
Sure. So before COVID-19, I think few people, except for maybe those with a chronic condition really ever had a telehealth appointment with their doctor or a virtual visit. You know, but the pandemic has certainly changed that it seems almost overnight and forced people to use telemedicine for the first time. You know, many doctor’s offices were closed, you know, to try and help reduce the risk of exposure to COVID for some people, but obviously people still need to see their doctors. So this was a safe and appropriate way for some people to do that. No, now that I think more people are becoming familiar with telehealth they’ll feel more comfortable using it in the future.
Yeah, absolutely. It’s really kind of opened the door and a lot of ways. And that’s been, I think, one of the upsides of this, this whole experience. So what are talking about, what are some of the advantages of telehealth appointments for breast cancer community?
Yeah, so it really helps keep people who are sick out of those doctor’s offices, where they could infect others. And it allows people who are well for those with compromised immune systems, like some people who are on chemotherapy or those living with metastatic breast cancer to stay home and safe so that they’re not exposed to those germs. You know, they’re still able to follow up with their doctor without having to leave the comfort of their home, which is great, you know, and that leads us to another advantage where telemedicine is super convenient. You know, it may save you time and resources. Like you don’t have to pay for transportation perhaps, or you don’t have to worry about getting childcare. So you know, it’s great in that way. And yet it still offers the potential for improved quality of care, you know, possibly allowing more time for questions and dedicated conversation with your doctor. It also lasts people who live in rural communities too, who may not have easy access to care to get that care that they need.
Yeah, I can imagine. I mean, I’ve been in interviewed several people that have to travel very long distances to go and see their doctors about their breast cancer needs. And this might reduce some of those trips, which could be really fantastic for some of them. So that’s, that’s fantastic. So talk about like, what are some of the challenges of telehealth?
Sure. So obviously not having the technology is the big challenge or not having experience using technology or just having unreliable internet service. That’s one of the biggest challenges that that’ll help. You know, also there may be some communications issues, you know, maybe a person is hard of hearing or they don’t speak the same language, which obviously could make talking to your doctor pretty difficult. But I think one of the biggest drawbacks to a tele health visit is that your doctor can’t physically examine you. So you may still need to go in to see your doctor or, you know, get lab work done, or imaging. And then finally telemedicine may not be a really good option for those people who have a low income or limited resources, because again, they may lack the technology or the ability to get that care remotely.
Yeah. That makes sense. And does insurance typically cover telehealth appointments?
Yeah. So at this point it does, did it, COVID-19 the federal government lifted restrictions on its use, making it more widely available. So right now Medicare and some, if not most insurance companies are still paid for telehealth appointments. I think there’s some question as to whether or not this coverage will continue in the future when the pandemic really doesn’t pose a public health threat anymore, but for right now it’s being covered. And of course it’s always best to check with your doctor before going forward with a telehealth appointment, just to make sure you know, that you’re not surprised with the bill afterwards.
Right. Right. So, you know, you’re, you’re an expert here. I’m, I’m a newbie to telehealth, very excited about it. So I guess one of the questions I have is do you think that telehealth is here to stay long-term?
Yeah, so I certainly hope so. And again, I think it will, as long as Medicare and insurance companies continue to cover it, I think it’s really useful for those who want to and are able to use technology to quote unquote, see their doctor. As I said before, I think it’s likely patients will continue to adopt its use even after the pandemic is behind us.
Yeah. I would tend to agree with that. I think that a lot of these new realities in our lives are likely here to stay for the long haul and in many, in many cases that’s a good thing. So so do you have any tips or recommendations for our listeners on how to prepare for their telehealth appointment?
Yes. Great question. Thank you so much. I’ll have lots of tips. So first, you know, again, find out if the visit will be covered by your insurance or if you’ll have to pay out of pocket. Next, do you want to find out how you’re going to access the appointment? Are you going to go through a patient portal? We can get a link through your email or maybe on your a text message. And then they’re going to send you a lot of paperwork beforehand. So you need to make sure that you complete that required paperwork, whether it be consent forms or releases beforehand. Usually that’s required a few days before the visit, and then you’ll want to write down everything you want to discuss with your doctor beforehand, so that you’re prepared. Also you’ll want to take notes during the visit, and then you would like to decide whether or not you’re going to use your phone or your computer.
And once you do decide, then you’re going to want to make sure that your device devices either plugged in or charged. And then you’ll want to test things beforehand, you know, are your speakers working? Does the camera, where are you going to use headphones? Make sure you test all that beforehand. And then you’ll want to make sure that your lighting is good and your chair height is good so that your doctor can see you clearly. You don’t want just the tip of your head showing, cause that’s not really going to be very helpful to your doctors. So you’ll make sure you want to check all that stuff beforehand. And then, you know, if you can find a quiet space and get some privacy beforehand, that’s great. Don’t worry. I know I throw a lot at you, but for those who need a reminder, we created a simple downloadable that you can find on our website, komen.org. So you can refer back to this before your next virtual appointment.
I love a good checklist. That’s fantastic. Thank you for creating that. Absolutely. Okay. So last question and Erica, this has been so helpful. I really appreciate you shedding light on this. I think it’s really important for us to understand telehealth. So the last question, are there any other things that you think our listeners should be aware of?
Yeah. So obviously you talked about it a little bit before just, you know, technology is essential, so you need to make sure you have the capability to have a virtual appointment before you schedule one make sure your internet is working and reliable. So your session isn’t cut off and again, make sure you understand if you’re is, it will be covered by insurance and or what out-of-pocket costs you may be responsible for. So you’re not caught by surprise, you know, keep in mind since your doctor can’t physically examine you. You know, you may need to describe any issues you are experiencing in greater detail than maybe you normally would. If you were in an in-person visit, your doctor also can’t really read your body language. So just keep that in mind that you’ll just have to really describe what you’re going through in a greater detail. And then, you know, I think I probably just add with the use of telemedicine for the most part is really a personal decision and it may not work for everyone and if you’re not comfortable with it, that’s okay. It’s your choice. No, at Coleman, we’re really all about making sure that patients get the high quality care that they need in a way that’s appropriate and right for them.
Yeah. Yeah. That’s great. And you know, one, one thing that’s come up time and again, and in many of my interviews is that patients need to be their own advocate. And I would think that with telemedicine, based on what you’re saying all the more to be your own advocate, you know, your doctor, like you said, the doctor can’t really read your body language. They can’t really maybe pull things out of you the way that they might in, in an in-person appointment. So all the more reason to know what you need to talk about and to be your own advocate within the appointment, would you agree with that?
Absolutely it absolutely. And you know, and another great thing about telehealth appointments is, you know, you have the ability now, if your physician allows it to have a family member join you on that visit, you know, perhaps your daughter lives out of town and they wouldn’t otherwise normally come to your appointments. But now with the use of telehealth, they may be able to sit in with you and ask questions and just be that second pair of ears for you. So that’s, it’s a really great advantage to telehealth then advocacy efforts.
Fantastic. Well, Erica, this has been great, highly informative. I really appreciate you taking the time today. Thank you for joining us on the show.
Pleasure to be here with you. Thank you so much.
Thanks for listening to real pink, a weekly podcast by Susan G Komen for more episodes, visit real pink.com and.org for more on breast cancer. Visit komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam, you can find me on Twitter at @ajwalker or on my blog. AdamJwalker.com.