Virtual Visits

When JuanDiego Mata-Ornelas was diagnosed with Hodgkin lymphoma at age 16, he was too young to travel alone from his home in south Texas to MD Anderson in Houston. Instead, his dad drove him to and from appointments.

“The trip was four hours there and four hours back,” says Juan. “I’d miss school and my dad would miss work, but that’s how it had to be.”

After Juan was treated with immunotherapy, the cancer disappeared. Juan, now 19, undergoes blood and imaging tests every four months to check for signs of recurrence. Then he meets with his MD Anderson doctors to discuss the results.

Those meetings began taking place via video in March, when MD Anderson started providing virtual visits to limit the number of people on our campuses during the COVID-19 pandemic.

Fast and efficient appointments

When a nurse called to ask Juan if he wanted a video visit instead of an in-person appointment, he eagerly said yes.

“Even though I knew MD Anderson was being careful to protect patients against COVID-19, I was nervous about making the trip to Houston in the middle of the pandemic,” he says. “Staying home gave me peace of mind.”

The nurse explained how to use the technology and even did a test session to make sure Juan was comfortable using it before his first video appointment.

Juan’s dad joins the appointments and chimes in with questions and comments from his living room couch.

“It’s fast and efficient,” says Juan. “Instead of driving four hours, we log on, talk for 20 minutes and we’re done.”

Community collaboration means better cancer care

Endocrinologist Anita Ying, M.D., treats Juan for thyroid problems related to his cancer. She says virtual visits have many benefits for patient care.  

“Our patients are more able to keep their appointments when they’re not faced with taking off work, navigating Houston traffic, booking hotel rooms or arranging childcare,” Ying notes. “Also, many patients have found it’s easier to stay on schedule with virtual medical appointments, which is appreciated by both patients and health care providers.”

Some of Ying’s patients are intimidated by virtual health care after a lifetime of in-office visits.

“I tell them to think of it as an additional tool they can use to get excellent medical care without making themselves vulnerable to infection during the pandemic,” she says. “Many patients realize after their first video visit that they still feel very connected with their MD Anderson team.”

When out-of-town patients like Juan need in-person procedures such as lab tests or imaging, MD Anderson can contact a patient’s hometown doctor and have the testing done there. The results are sent to MD Anderson.

Ying has noticed a strengthened connection and collaboration with community physicians -- something she believes will last long after the pandemic ends.

“We’re becoming better partners,” she says. “We’re learning to work together for the benefit of our patients.”

Including family and friends in cancer care

Virtual visits also enable patients to include friends and family in their appointments – regardless of where they are located. They may be sitting next to the patient, or thousands of miles away.

“Everyone attends from the comfort and safety of their own home via the computer,” says clinical psychotherapist Carmella Wygant.

This makes it easy for patients to include loved ones who might not have otherwise been able to actively participate in their care. “Patients feel reassured when their family members are present,” says Wygant. “They also feel less pressured to remember precisely what their doctor told them about their condition and treatment.”

Virtual visits enable family support during COVID-19

Brissa Castillo has seen the benefits of joining a virtual visit first-hand. She participated in a video appointment with her mom, Julia, early in the COVID-19 pandemic.

Julia completed treatment for ocular melanoma, a type of eye cancer, two years ago. MD Anderson doctors check her every six months for signs of recurrence.

“I sat with my mom at the computer and helped her talk with her doctor,” says Brissa. “My mom is from Guatemala and is still learning English. She needs me.”

Before the pandemic, Julia’s in-person appointments required some coordination. Her husband would take two days off work to drive his wife from their Dallas-area home to Houston. Brissa, a sophomore at Texas A&M University, would miss classes to come along.

Now, Julia’s appointments and Brissa’s classes are virtual. Everything they need to do can be done from home.

“Virtual visits have made life so much easier for my family,” Brissa says. “They’ve allowed my mom to continue receiving excellent care at home, and my dad and I can participate in her appointments. I’m happy I can be there to support my mom.”

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

To help reduce the spread of the novel coronavirus (COVID-19) and make it easier for patients to see a doctor without leaving home, MD Anderson and many other health care providers are offering virtual visits for many patients.

Existing MD Anderson patients who have a clinic follow-up visit or a consult visit with a new MD Anderson provider may be eligible for a video visit, depending on where they live. Each state has different regulations regarding video visits and the practice of medicine by out-of-state clinicians. Talk to your care team to learn what may be available and best for you.

“Virtual visits offer a convenient way for our cancer patients to continue receiving the outstanding care they have always experienced from their MD Anderson care team, with the added benefit of not having to leave their homes,” says Neema Navai, M.D.

If you’ve never had a virtual visit before, here’s what you should know to get the most out of your virtual visit.

Plan ahead ensure a productive conversation

“Virtual visits offer tremendous convenience since they can be done from anywhere with the click of a button,” says Navai. “But they do require a little bit of planning ahead to ensure you and your provider have a productive visit.”

Whether your appointment is virtual or in person, it can be hard to remember everything you want to discuss with your health care provider.

So, before your appointment, write down your questions, as well as new symptoms and concerns. This will help ensure you don’t forget anything important that you want to discuss during your visit.

Before your virtual visit with your MD Anderson provider, it’s also important to complete the eUpdate process to update your information in MyChart. You can verify your personal details, medications and insurance information up to 7 days before your virtual visit. We recommend doing this 2-3 days before your appointment so these details can be shared with your clinical team in advance. A member of your care team will call you before your appointment to review your list of medications and ensure you’re ready for your video visit.

Download the apps you need in advance

Before your appointment, download the apps you need on the device you plan to use and make sure you can access them correctly.

MD Anderson patients are encouraged to use the MyChart mobile app on a smartphone or tablet for the best video visit experience. You can download the free MyChart mobile app from the App Store or Google Play. You will also need to download the ZOOM Cloud Meetings app to the same device. Newer smartphone and tablets will be able to download the ZOOM Cloud Meetings app; see a list of operating systems that support the ZOOM Cloud Meetings app.

You must use the MyChart mobile app to join a video visit on your smartphone or tablet. You cannot go to our MyChart website from your smartphone or tablet and start your video visit.

While you can use a computer to access your MyChart account at MyChart.mdanderson.org, you may have more technical problems than if you use the MyChart app on a smartphone or tablet. Use our MyChart Video Visit Instructions or call 1-877-632-6789 if you need assistance. You also can watch a video with MyChart Video Visit instructions.

Set the stage for your virtual visit

Just as you’d do for a video call with colleagues, find a quiet, well-lit space for your virtual visit. Be sure to check the background noise and any visuals that may appear around you while you’re on screen.

Test where to direct your gaze on your webcam setup. Look into the camera so your doctor can have a more engaged conversation with you.

Use headphones, if possible

Plan to use headphones or a headset, if you have them. This will make it easier to hear your provider and may improve the sound quality.

If you’re including a household member in your virtual visit or don’t have headphones or a headset, check for background noise and move to a quieter space, if necessary, to eliminate distractions during your virtual visit.

Do a tech check

Before your visit, make sure your device is charged and that you have a strong internet signal or WiFi connection. A higher speed internet connection will help to increase the overall quality of the video and audio during your virtual visit.

It’s also important to confirm that your audio, video and headphones are working at least an hour before your virtual visit. They should work if you’ve recently used your device for other video chats.

“As with any new technology, you may encounter technical issues, but to ensure we can provide a timely and high quality experience, it’s a good idea to test everything before your visit,” says Navai. “You’ll have a better, more focused conversation with your provider if you don’t have to worry about technical difficulties.”

Your virtual visit will last as long as an in-person appointment

Your virtual visit will run a lot like an in-person visit and last about as long. Your provider will ask you questions, covering topics such as new symptoms, side effects and other concerns you may be having, as well as next steps for your treatment or follow-up care.

Use this time to ask questions and share concerns with your provider, just as you would in person.

You can include family members in your virtual visit

Just as you might have brought family members to appointments before visitor restrictions were put into place to prevent the spread of COVID-19, you can include family members in your virtual visit. A family member or loved one can provide a second set of ears, take notes and ask questions you might not think of.

If your family member if participating from your home, have them in the same room as you and make sure they can appear on the screen, too, if possible. If you try to include them from another device in the same home, there may be a distracting echo.

Want to include a loved one in your virtual visit from another location? If you're an MD Anderson patient, you can add them through the ZOOM app by following these instructions. 

Plan to pay the same co-pay that you would for an in-person visit

You will be charged the same co-pay for your virtual visit as you would for an in-person appointment. But you will not be asked to pay during your virtual visit. Instead, the balance will be listed in your eUpdate after your visit. Your insurance company determines the cost of this co-pay. If you have questions about charges, payments and balances, send a message in MyChart or call 1-800-527-2318.

Know what to do if the connection is lost

Sometimes things don’t go exactly as planned. Here’s what to do if you lose your connection during your video visit:

• If you can still see your video, keep the video connection active and don’t close the video window. Your provider may be able to rejoin soon.
• If you lose your connection, restart the video visit following these steps. You may be placed in the virtual waiting room until your provider is able to restart the video visit.
• If the video visit can’t be restarted, your provider will call you to complete the visit or provide more instructions. Your provider will call you at the phone number you listed in your eUpdate, so be sure to keep that phone close by.

Learn more about virtual visits at MD Anderson.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.