Reviewed by Charletta Dennis, M.D., CCHP | Medical director of behavioral health at Priority Health with Board Certification in Psychiatry and Forensic Psychiatry
Telehealth visits provide a convenient and cost-effective way to see a doctor but are only advised for certain medical and mental health conditions.
When you have the flu or a bad cold, getting dressed and driving to the doctor’s office to get the medications you need can feel like a major undertaking, not to mention it can put other people at risk of getting sick. And if you live far from your doctor or if you have a busy schedule, access to the care you need can be a challenge. That’s where telehealth and virtual care come in.
The limitations created by the pandemic required healthcare providers to embrace telehealth services in ways they hadn’t before — especially for appointments that didn’t require in-person examinations or services. In fact, in 2021 more than one third of U.S. adults had used telehealth for a medical appointment in the last 12 months.
Being able to conduct a video visit with your doctor is convenient, accessible and cost-effective. However, not all circumstances lend themselves to virtual care. For you to make the best decision for your health, it’s important to understand what virtual care and telehealth are and when they’re appropriate.
What is virtual care? A plain-language definition
Virtual care is defined as remote healthcare services delivered digitally. Virtual care encompasses all kinds of digital tools used to aid in a patient’s care. Examples include:
- Video calls: Telehealth visits allow patients to connect with their providers remotely.
- Online patient portals: These tools simplify the process for patients to access labs, reschedule appointments and submit questions to their doctors.
- Health apps: These enable patients to track health information and get reminders about their care plan or medication instructions.
- Wearables/Remote patient monitoring: Data from wearable devices — for example, a smartwatch with ECG monitoring or continuous glucose monitors — is sent back to the patient’s provider, giving them more accurate information about a patient’s health over time. This improves chronic care management.
- Chatbots: These AI-powered tools can answer basic patient questions or escalate a patient to an operator or a specific hospital department.
- Telestroke: These programs connect ER doctors with remote stroke specialists to provide video consultation on assessments and time-sensitive interventions.
- Hospital at home: This care delivery model combines virtual care tools with in-home clinician visits to allow patients requiring acute-level care to receive care in their homes rather than having to stay in the hospital.
These tools improve the accessibility and convenience of care for patients who may otherwise miss out on important healthcare visits. Patients in rural communities sometimes have to drive more than an hour to access primary care and even further for a specialist. And some patients may not be able to get off work for an in-person visit but can make a virtual visit fit within their schedule. Virtual care tools also make it easier for patients to engage with their provider outside of office hours.
Virtual care vs. telehealth vs. a virtual visit: What’s the difference?
The terms virtual care and telehealth or telemedicine are often used interchangeably by healthcare organizations, and while some health systems define the terms differently, that distinction is not meaningful to patients.
Virtual care
Virtual care is the broad term for remote healthcare services delivered digitally. It encompasses the full range of technologies that enable care to be delivered remotely, including video visits, health apps and patient portals.
Telehealth
Telehealth is a subset of virtual care that refers to the tools used for treatment and diagnosis. Video or phone visits with your doctor, remote patient monitoring and the care modalities that use video visits such as hospital at home or telestroke all fall under the telehealth umbrella.
Virtual visit
A virtual visit or telehealth visit refers to the live interaction with your doctor, whether that occurs over video or the phone. This is the appointment your doctor bills for.
How does a virtual visit work?
Typically, your healthcare provider will share a link or other instructions for joining the call at your scheduled time. The link will send you to a video platform that provides a secure and private connection to your doctor. Providers will use a HIPAA-compliant video platform to ensure your protected health information is secure. Platforms such as Zoom and Microsoft Teams are not HIPAA-compliant by default, so providers will either use a HIPAA-compliant version or a platform designed for patient visits like Doxy.me.
You may have to fill out an e-form with your information and medical history prior to the call.
Before your appointment, it’s important to check that your mic and camera are working. Many platforms include a built-in mic and camera testing function to allow you to address any problems before the call starts. A solid Wi-Fi or 5G connection will improve the quality of the appointment.
During the call, you and the provider will discuss your symptoms and relevant medical history so they can diagnose your condition if needed and provide treatment, medication and other next steps.
Virtual care appointments are more cost-effective than urgent care or ER visits, but for primary care or specialist visits, the copay is often the same whether virtual or in person.
What virtual care can (and can’t) treat
If you’re considering a virtual visit due to an illness or medical concern, it’s important to know what virtual care can treat and what it can’t. Virtual care can be used to address issues such as:
- Acne
- Allergies or rash
- Anxiety, depression, grief, insomnia and substance use
- Minor burns or cuts
- Bug bites and stings
- Cold, cough, flu and fever
- Headaches and sinus issues
- Heartburn, diarrhea, constipation, nausea and vomiting
- Pink eye and eye irritation
- Tooth pain, minor sprains and strains and back pain
- UTIs
For more complex, non-emergency issues it may be possible to conduct a virtual visit with your primary care physician to initiate testing (such as blood work that will then require you to go to a testing site) or to request a referral to a specialist. Telehealth calls can also be used for some follow-up visits if no new testing or in-person exams are required. Make sure to ask your doctor’s office if a video call is an option.
As technology improves, virtual care is expanding. For example, some dermatologists have apps that enable patients to take and share detailed photos of their skin condition. This may allow for doctors to treat a wider range of skin conditions remotely. However, if you’re ever in doubt and in the event of an emergency, it’s always better to seek in-person care.
Virtual care vs. urgent care vs. the ER
Virtual care, urgent care and emergency room visits are all ways to treat acute medical conditions, but where you should go depends on several factors. Here’s a guide to help you decide which option is most appropriate for your situation.
When to do a virtual care appointment
Virtual care visits are best for non-urgent conditions that do not require in-person care or testing.
For example, if you’ve already done a COVID-19 test at home and are looking for medication to relieve minor symptoms, then a virtual care visit makes sense. You’re getting what you need to treat your condition without having to expend energy to leave the house or potentially spread the virus to anyone else.
Essentially, if you already know what’s going on and the severity of the condition is mild and not urgent or emergent, then a virtual care appointment can help you to take care of yourself at home. You can also use these appointments for follow-ups, referrals, medication refills or therapy.
While it’s the most cost-effective option, telehealth visits are often limited to office hours.
When to go to urgent care
Urgent care clinics provide non-emergency, outpatient treatment for acute and chronic illnesses and injuries. These visits cost more than a virtual care appointment, but significantly less than an ER visit. Urgent care is best for situations in which you need to be seen quickly, but the condition does not require complex medical care. If you need in-person treatment or quick testing to diagnose a concern, then urgent care would be the right option.
Conditions that urgent care clinics are capable of treating include:
- Allergies or rashes
- Bites (animal or insect)
- Cold, flu, COVID-19 or other mild respiratory infections
- Ear infections
- Minor fractures and injuries such as sprains and strains
- Sinus pressure and headaches
- Strep throat
- Thrush
- UTIs
- Vomiting
- Simple wound care
It’s important to note that if your condition could become more severe or if the physicians don’t feel they can adequately care for your condition in an urgent care setting, they may refer you to the emergency room.
When to go to the ER
The emergency room is intended for true emergencies. Virtual care and urgent care are intended to provide patients not experiencing an emergency with the quick care they need, preventing them from going to the ER for non-emergent conditions.
If you’re experiencing any of these symptoms, then go to the ER immediately:
- Severe abdominal pain
- Anaphylaxis or other severe allergic reactions
- Uncontrollable bleeding
- Vomiting or coughing up blood
- Difficulty breathing
- Broken bones
- Severe burns
- Sudden or intense chest pain or pressure
- Concussion or head trauma
- Deep cuts, severe injury and serious trauma
- Loss of consciousness
- Suspected heart attack
- Poisoning
- Pregnancy complications
- Seizure
- Stroke
- Thoughts of harming yourself or others
Emergency rooms are open 24/7 and are attached to a hospital where surgery, specialist and ICU care are available. ER visits are the most expensive of the three options, but if you have an emergency medical condition, it’s important to go to the ER immediately for potentially life-saving care.
Virtual mental health and behavioral health visits
Most therapists offer video visits for their patients, and it can be just as effective as in-person sessions. Virtual visits make therapy easier to fit into your schedule, especially if you’re participating in weekly or frequent sessions. However, virtual therapy typically costs the same as in-person therapy sessions.
Mental health conditions that can be treated using virtual mental health visits include:
- Anxiety disorders
- Depression
- Grief
- Trauma
- Stress
- Insomnia
- Couples therapy
- PTSD
- ADHD
- OCD
- Bipolar and mood disorders
- Substance use disorders
What a virtual visit costs with your Priority Health plan
How much a virtual visit costs will depend upon your Priority Health plan. However, all members receive full coverage of virtual urgent care visits when they see a provider through Corewell Health Virtual Urgent Care. This care is available through your Priority Health member account. It is best used for treating minor illnesses and injuries.
Virtual care coverage for visits with an in-network provider will depend upon your plan. To find out which virtual care and telehealth services your plan covers, call 800.942.0954 and select Option #1. If you’re not a member and are interested in comparing plan options, click here.
How to get started with virtual care and Priority Health
There are two ways to schedule a virtual visit. You can either book an appointment through your health plan’s member portal or you can book directly through your provider’s office. Many health plans partner with virtual care service providers to offer quick and direct visits.
Priority Health members can access virtual care in a few ways:
- MDLIVE provides Priority Health members with visits for medical issues and behavioral health support.
- Members can also download the Corewell Health MyChart app for Michigan to access on-demand virtual care with more than 1,000 Corewell Health providers, both primary care physicians and specialists.
- Individual doctors may also offer virtual care services.
To find out which virtual care and telehealth services your plan covers, call 800.942.0954 and select Option #1. For more information about customer service hours, click here. Sign in to your account now to get started with virtual care at Priority Health.