Other at home tests

[Southernmiss]

I would think at home versions of these tests will be coming sooner rather than later. There are already minute clinics in chain pharmacies.

So far, my personal intuition about what's wrong with us has been spot on.

At home kits would help confirm that and a 15 minute telehealth visit to get meds would be great.

Even before my daughter was officially diagnosed, I suspected she had a certain autoimmune disease.

40 years ago, I remember my aunt calling the doctor to discuss symptoms and him calling in prescriptions for my cousins when they were sick. Distance diagnosing is not new.

 

[AppleDumpling]

Probably TMI, but there are home test kits for women to check the Ph level of a certain area, that may indicate a bacterial or yeast infection.

 

[tvguy]

Great, although not all do, that's just whatever the doctor wants. It's not always about money. Sister-in-law sat in her car on her lunch break at her work to go over her results for about 15 mins rather than take several hours off work just to do the same thing. My husband fit his in between meetings while he was working from home one day. I don't remember the charge if it was any less although my husband received a 30% discount as he paid in full the charges when the bill came rather than pay in installments.

It's not a one size fits all thing but nor is the adaptation and embracing of it a bad thing. From your comment, this was about your friend so unless you're privy to the rates their doctor charges what your doctor charges is irrelevant.

I had a consult with a specialist in June. $400 if I went in, or $400 for the telemed appointment. When I called to ask why the same price his Business manager said telemed appointments take him just as long, but exist to reduce covid exposure for the Doctor, patient and office staff.

 

[Mackenzie Click-Mickelson]

I had a consult with a specialist in June. $400 if I went in, or $400 for the telemed appointment. When I called to ask why the same price his Business manager said telemed appointments take him just as long, but exist to reduce covid exposure for the Doctor, patient and office staff.

Okay...not sure why you're going over this. Apologies but I'm unsure why.

 

[tvguy]

Okay...not sure why you're going over this. Apologies but I'm unsure why.

Because some assume telemed is cheaper than an office visit.

 

[Mackenzie Click-Mickelson]

Because some assume telemed is cheaper than an office visit.

Gotcha

 

[Pea-n-Me]

Even when critically ill patients are transferred in from other hospitals, tests are often repeated. It may seem wasteful, but when you think that life saving treatments depend on these results, they have to not only be accurate, but verifiable and all that. If they weren’t, things could potentially not go well. Quality can vary place to place, tests may not be exactly what is needed upon transfer, things can change in a day or two, too, etc. Lots of variables.

As for home tests, some of these are very convenient to get an idea of what is going on medically. (Discovered UTI tests when Mom was in hospice care, nurses brought them and told us you can buy them at CVS.) But, largely agreeing with @tvguy, they will likely need to be repeated by your medical team before treatment is begun, for the same reasons as above. Medical personnel have to use quality indicators to prove that these tests are calibrated correctly and lots of bureaucratic things like that, before they are considered reliable (which comes from regulators; some things we used to do at the bedside - like checking stool for blood - now have to be done in a lab, for example, and are then reliably electronically documented).

It’s also important to get results into a medical record no matter where tests are done, and this includes out of network facilities. Not all electronic systems coordinate yet. Heck, even trying to get Health Care Proxy information or tests done at work into my own medical record can be a PIA sometimes. Medical care is unimaginably complex today.

 

[LuvOrlando]

I had a consult with a specialist in June. $400 if I went in, or $400 for the telemed appointment. When I called to ask why the same price his Business manager said telemed appointments take him just as long, but exist to reduce covid exposure for the Doctor, patient and office staff.

Some insurance has a telemed with a RN that does screenings to help triage necessity of visits & they can be free with some plans, we had this in the past although I never used it. When I see my normal Dr's it used to be cheaper in 2020 but is regular copay now, no idea what happens on the back end or OOP. I don't think my new plan has this but if I did I would totally use it with preliminary test results at this point in time to triage if I can wait or not, and how long I should wait - I'm no expert so input would help me.

 

[tvguy]

Some insurance has a telemed with a RN that does screenings to help triage necessity of visits & they can be free with some plans, we had this in the past although I never used it. When I see my normal Dr's it used to be cheaper in 2020 but is regular copay now, no idea what happens on the back end or OOP. I don't think my new plan has this but if I did I would totally use it with preliminary test results at this point in time to triage if I can wait or not, and how long I should wait - I'm no expert so input would help me.

I signed up for that briefly with my insurance. But the RN had no authority other than to try and answer questions. Most of my time was spent explaining my Doctor's reasoning for my treatments. Seemed like a complete waste of my time. Like when she asked if I had considered losing weight to try and take fewer blood pressure medicines. It was something my Doctor had suggested, and I lost 50 pounds over the course of a year and my Doctor had to ADD a blood pressure medicine because my blood pressure went up.

 

[LuvOrlando]

I signed up for that briefly with my insurance. But the RN had no authority other than to try and answer questions. Most of my time was spent explaining my Doctor's reasoning for my treatments. Seemed like a complete waste of my time. Like when she asked if I had considered losing weight to try and take fewer blood pressure medicines. It was something my Doctor had suggested, and I lost 50 pounds over the course of a year and my Doctor had to ADD a blood pressure medicine because my blood pressure went up.

Maybe you are expecting more from the setup than it is intended to be, these aren't usually Dr's. This service is normally acting sort of like the person you talk to when you first get to the ER. The first person you see usually takes your info and categorizes you, as in red alert - get seen ASAP or likely ear infection, no immediate threat, this triage helps filter and prioritize but isn't meant to override a Dr. but has a purpose. My point is, if we all had the ability to do a lot of common sense at home testing that triage would be far more effective and the RN's could better direct patients, it's tough to read someone you don't know so tests would make the process more meaningful.

 

[Pea-n-Me]

Maybe you are expecting more from the setup than it is intended to be, these aren't usually Dr's. This service is normally acting sort of like the person you talk to when you first get to the ER. The first person you see usually takes your info and categorizes you, as in red alert - get seen ASAP or likely ear infection, no immediate threat, this triage helps filter and prioritize but isn't meant to override a Dr. but has a purpose. My point is, if we all had the ability to do a lot of common sense at home testing that triage would be far more effective and the RN's could better direct patients, it's tough to read someone you don't know so tests would make the process more meaningful.

Having worked in an ER for several years with lots of time in the Triage area, I’m not sure at-home testing would make all that much difference, as most would probably still fall into the non-urgent category.

There are three categories in an ER: Emergent (taken in right away: unconscious, limb hanging off, severe respiratory distress, chest pain with ECG changes, arterial bleeding, etc.); Urgent (in ideally within 30 mins, though today it could be much longer given the chaos in hospitals: like a fever, stable wound or shortness of breath for a week); then Non-Urgent: Everyone else.

Most of the at-home tests are measuring things that may have to be evaluated if positive, but are not emergent, or even urgent (maybe with a few exceptions I can think of, like an extremely high blood sugar - had one greater than 650 last week).

Nurse Help Lines are a nice service usually provided by free by certain medical groups. They offer help in deciding what to do, but are not designed to do more than that. Our pediatrician had this type of line and it was invaluable to me. When things were serious, they could get you in right away, too. Or they might tell you what to try at home first before coming in. My doctor now has a nurse available for calls but it’s not really designed in the same way, for advice; it’s more troubleshooting for the doctor. Ours can be hit or miss and has frustrated me on several occasions, especially when my mother was sick, as we didn’t always see eye to eye. Neither takes the place of an office visit.

 

[Mackenzie Click-Mickelson]

Nurse Help Lines are a nice service usually provided by free by certain medical groups

Ours is available for people in my state and the one next to me depending (this part likely more my direct area since the metro is split between the two states), no cost, no need to be a patient and many hospital systems run this.

Actually just used it the other night when I called at 2am needing to know if I could take ibuprofen after taking meds for multiple days with high dosage aspirin (was concerned about taking multiple NSAIDS especially with the warning on the meds). Used it back in 2009 for advice on food poisoning which was very helpful as I ended up falling into the "seek medical care now" category later on in my illness after getting a high enough fever (was very dehydrated needed iv fluids, etc).

They are good for advice but yeah not to actually do a diagnostic job.

 

[LuvOrlando]

I'm not seeing any valid reason why more at home tests could/would be a bad thing. Only negative was veering off into a conversation about what telemedicine is or isn't, seems there are tiers of care. Certainly, going to a Dr is always an available second step to anyone who could use it as a first step and would probably reduce waste. For those where a Dr isn't an easy first step , issues with childcare, finances for too high deductibles, lack of insurance, mobility or employment time off issues, well for a lot of people it would seem this is a better way to go. Dept of health could even monitor complaints for emerging disease by watching frequency of complaints etc. & cast a closer look with things reach a threshold volume, a decent bit of software with good variables could easily do that... not seeing any negatives.

 

[neverlandsky]

The negatives are the loopholes associated with home tests. Such as someone else taking the test and passing it off as your result and/or opting for ways to bypass and dodge a result. Which is why employee drug tests for example are given professionally. This is also why work wouldn’t accept a home + test and it has to be a professional + test to be eligible for benefits coverage such protected excusal from work with illness paid leave.

Relying solely on a home test can sku numbers either way. They can overestimate or underestimate what’s truly happening illness wise. Then there’s positives and false negatives associated with home tests. There’s prescription abuse to consider. Some antibiotics aren’t working too much as before due to being overprescribed. Some people also jump doctors to get the prescription they are seeking.

Home tests are a great starting point to know whether or not to get yourself in-person to a doctor for the official results. Even home tests have that disclosure of to always seek medical care and don’t rely on home test for diagnosis or to self diagnose.