Televisit instructions

Dear Patients

We are now completing televisits for all patients. Please note there are some requirements for proper set up. Sometimes a televisit not appropriate for certain medical conditions and an office visit may be required- We will let you know. Please review the below instructions to see if any apply to you and be prepared. You will get a phone call on the day of your appointment from my office staff to obtain all the below information. Please keep your appointment even if pre-visit labs are not completed as the doctor must still have a tele-visit with you for compliance purposes, in order to receive continued medication refills, and to triage when procedures and certain testing can be done. Click here to see details of how we will conduct televisits for certain patient types

1.  Patient Portal awareness:
We will be sending updates and asking questions of you via portal  
Please also update us with any new pharmacy information
Pre-visit phone calls from medical assistants to ask questions- please have every medication bottle ready with information for us about strength and frequency of dosing. Make sure you have done lab testing- It is safe to get labs done at Labcorp and Quest

2.  Patients with diabetes mellitus  -  We need to connect with your devices:
  • Free Style Libre- Please connect to our clinic with these instructions
  • Dexcom G4, G5, G6-  Please connect to our clinic by following these Clarity instructions to send a patient portal message with the "12 month Clarity Share Code". Or download on your own computer the last 2 weeks of aggregate data and upload to us manually from your device
  • Meters -  We will not be able to download remotely yet.  BUT, if you are on insulin or we have instructed you previously to check on a meter, Be prepared to tell us the recent 1 weeks fasting AM values and then Bedtime values 
  • Medtronic 670g pump- You need to create a Medtronic Carelink account if not already done (only can use Internet Explorer browser), Then press "sign up" or login if you already have account. Once account is created, it will walk you through how to upload pump data by connecting the Bayer Meter to your computer. All you need to do is send us a portal message with your Carelink username and password
  • All insulin pumps-  
    • If you know how to change settings for basal rates and ICR or Correction factors, we can instruct you on what we need. If you are not able/uncomfortable, note that we cannot guide you through those changes at our visit. Instead we will give the change-instructions to our educator and schedule you for a separate visit with our diabetes educator Katie Spence to make those changes with you.
    • Please upload your pump settings and logs to us 4 days prior to an appointment so we may be able to review. If you cannot, please contact your pump manufacturer to obtain the software needed. Best place way to upload is with this link.

3.   Blood pressure readings, heart rate,  height, and weight readings from home devices. 
We need the below recent information from ALL patients especially as below:
a. Those on blood pressure medication
b. Taking testosterone medication 
c. Those with diabetes mellitus
d. HYPERthyroidism 
e. Any patient age more than 45
e. New Patients to the practice 

If not already done, please purchase a device for the below:
a. Blood pressure using and Above-The-Elbow arm cuff from a pharmacy. Check values once per day for the week prior to the visit. Write down the top and bottom numbers. We will ask you for a range on the top and bottom for the previous 1 week.  Also we will want to know the heart rate
b. Weight scale - we want to know a recent weight in pounds. 

4. Records you want to me review:
If we have not received records at least 3 days prior to your visit, then will not be reviewed in the televisit and we will reschedule to another visit to review if you want me to think about it all. Best place way to upload is with this link.
We cannot wait for you to read me the relevant records and I cannot easily review by looking at the televisit screen. We will need time and clear copies in my chart to make informed and accurate decisions

5. Orders for labs and imaging:
Usually we would hand patients current and future lab orders, imaging orders, and special medication orders directly to patient at an office visit. 
Instead,  0-2 business days AFTER the televisit  we will:
a. via secure email send lab and imaging orders and instructions 
b. electronically send lab orders to labcorp and quest lab locations 
c. Set up Prolia and ACTH stim testing orders via portal 

6. Thyroid Nodules:
We will delay FNA thyroid biopsies if possible. For ultrasounds we will plan to schedule in the future or send to imaging centers. We will discuss what is best for each patient during a televisit. 

7. Nuclear procedures
If already scheduled for an in-office nuclear procedure we will keep it, otherwise will we will schedule at a hospital 

Thank you for your understanding,

Medhavi Jogi MD
Fareed Elhaj MD
Diana Desai MD
Cristina Dumitru MD
Dina Winograd MD
Katie Spence CDE