PFNCA’s Dr. Grill Shares Insights about Tele-Health

Dr. Stephen Grill of the Parkinson and Movement Disorder Center of Maryland in Elkridge, Maryland recently shared his insights about Tele-Health. In response to COVID-19, he saw his first patient via Tele-Health on March 25th. Now, he sees about 30 patients a week this way.

“Tele-Health has been very productive, but there is room for improvement,” Grill said. He added that he thinks people may have to be prepared to use Tele-Health visits for some time and urges his patients to make a plan for maximizing them.
Grill’s patients have had success using computers, laptops, smartphone and tablets for Tele-Health visits. He said that sometimes it is helpful to have assistance from a family member.
Grill said there are several things to consider to make the visits most productive:

1.)  Devices – Consider which device you want to use.

  • Computers generally have larger screens so easier for you to see
  • If using a smartphone, it should be connected to WiFi.

2.)  Internet connection – High-speed internet is preferred as this allows a crisp image of you. The better the image and sound quality, the better we can communicate. It also improves our ability to do a visual examination of you. You might consider improving your internet speed. It seems that the internet has become more important to us during the pandemic.

3.)  Set-up – It is important that you set the camera so that we can see you well. 

  • Do not have a bright light or window behind you. 
  • Point camera so we can see you sitting from head to waist. Later we may want to see your legs as well.
  • Plan to be able to point the camera so we can see you walk a bit, preferably down a hallway

4.)  Vital Signs – When we see you in the office, we check your weight, blood pressure and pulse. This is a very important part of your examination. Most people have scales at home. This is a good time to consider purchasing a home blood pressure cuff. They cost about $50 and if you have a medical savings account, it could be used. If you have a blood pressure machine and scale:

  • Weigh yourself some time that day
  • Just before the visit, check the blood pressure and pulse. Keep the machine around because we may ask you to check it again standing. 

“For most people who have gone through a Tele-Health visit, it is a very positive and productive experience,” Grill said. 

Note: Dr. Pritha Ghosh presented a lecture on this topic at the 2020 PFNCA Symposium. The slides to her presentation can be viewed here.

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