In March 1999, physician Jerri Nielsen was stationed at a research facility in Antarctica when she discovered a lump in her breast. For the next seven months, until a plane could safely land in the harsh polar landscape, she treated herself in consultation with an oncologist based in Indiana. The consultations? Those are examples of telehealth in action.

Today, COVID-19 is causing some of the same challenges that Dr. Nielsen faced. We’re physically distancing—in most cases, to avoid exposure to the Coronavirus. But we still need medical care. As a result, the rules around telehealth are rapidly evolving to make it easier for patients to take advantage of virtual doctor visits.

Here’s how telehealth works.

In its simplest form, you set up an appointment and then get on the phone with your doctor to talk.

Indeed, the term telehealth came out of the idea of health care communications delivered by telephone. The concept has been around for a long time, and it has been used primarily in rural areas that lack primary care doctors as well as access to specialists. A 2019 NPR-Robert Wood Johnson-Harvard School of Public Health poll found that about a quarter of Americans have no easy access to providers. And it’s not just remote villages in Alaska; from Mississippi to Nebraska to Native American tribal lands, telehealth can provide a critical lifeline.

“There is synchronous communication, there’s asynchronous communication, there’s telephonic, and then there are patient portals, which are an extension of technology that has been around for quite some time,” said Dr. Joelle Fathi during a recent GO2 for Lung Cancer Lung Cancer Living Room discussion on telehealth.

Synchronous, or real-time, communication, extends beyond just telephone calls to include video conferencing. Video conferencing used to be limited to a few HIPPA-compliant medical platforms (to best protect patient privacy and data). More recently, the Centers for Medicare and Medicaid Services (CMS) has relaxed the requirements to temporarily allow telehealth visits via apps such as FaceTime, Messenger video chat, Hangouts, and Skype.

Asynchronous communication still means that information flows between a patient and their physician—just not in real-time. You could, for example, take your weight in the morning along with your heart rate and blood pressure and send those electronically to your doctor’s office. Once that data arrives, the medical practice workflow system can send your doctor an alert if there’s a problem—and then your doctor can revise your medications or otherwise contact you as needed.

“In oncology, there is symptom management for people who are undergoing current therapy,” said Dr. Fathi. “The data can be sent real-time and monitored real-time and responded to efficiently—rather than patients declining at home trying to manage symptoms and then coming in when they’re sick.” This approach allows doctors to get more timely information and patients to get needed care much faster.

Patient portals are another form of asynchronous communication and a tool for patients and clinicians to share information. Dr. Fathi noted that “increasingly, right now in this time of need, this country has been relying much more heavily on patient portals to provide critical services as our healthcare providers have been on the front lines of delivering direct care.”

One value of a portal is that you can pose a question about symptoms or side effects; a nurse, physician assistant, or even your doctor can go in and respond. It’s also a place where third-party medical provides (think blood draws and other medical tests) can post your blood work results, x-rays, and additional health data.

Will my insurer pay for telehealth visits?

The short answer: It depends.

If you have Medicare, then you are probably covered. The Centers for Medicare and Medicaid Services (CMS) has issued COVID-19 emergency telehealth regulations that allow Medicare patients to use telehealth for a wide range of services that previously required face-to-face visits.

Private insurance companies are also taking steps to ensure access to prevention, testing, and treatment. And many insurers have taken steps to make telehealth more available and to waive cost-sharing fees associated with telehealth visits. There is a helpful list of private insurance plans and their COVID-19 policies. Of course, you should check with your health insurance company to find out from them what they will and won’t cover.

Finally, Joelle Fathi pointed out that telehealth is a vital tool in making sure that all patients have access to the care they need.

“What it boils down to is quality of care,” said Dr. Fathi. “Quality of care is defined in many ways, but the patient really should be at the center of that quality of care. And we have to meet the patient where they are.”