In most of the country, non-essential appointments have been restricted, including many neurologist’s visits. Physicians are turning to telemedicine—connecting via telephone, email, or videoconferencing—to continue to care for their patients.

Before this epidemic, few people participated in or even knew about telehealth, but several studies have shown it to be an effective way to treat many neurologic conditions. Stroke doctors have used telemedicine for years to diagnose and begin emergency treatment for cerebrovascular disease. Parkinson’s disease specialists manage their rural patients’ symptoms through video visits from their offices. Remote visits are a safe and effective way to connect with your neurologist. One silver lining of the current crisis may be that telehealth’s increasing acceptance and insurance coverage means your continuity of care will be even stronger in the future. 

If you’re getting ready for your first virtual visit, consider these important steps.

1. Pick your medium. Before setting up an appointment, talk to your doctor or the office staff to determine what modality—telephone, health portal, non-health portal—you both will use. Telephone is not ideal, but it can be a backup if the video fails. In that case, confirm the exact time for the call and station yourself near the phone at the appointed time. Keep in mind that many doctors may be calling from their home or cell phones and their numbers may show up as blocked or as an 800 number. Be sure to answer anyway if you get a call at the scheduled time.
2. If you use a health portal: Be sure you know how to log into the system on your laptop, desktop computer, tablet, or mobile device whether it’s MyChart or another app. These systems often work better on tablets or mobile devices (“smartphones”) than on computers. It’s a good idea to store your username and password in a safe place so you have it handy for logging on to connect to the visit. Practice logging in to the app at least one business day before the scheduled appointment. If you can’t log in, call the office or a help desk for a software program to guide you through the process. 
3. If you use a non-health app: As with a health app, be sure you know how to log into a non-health app such as FaceTime, WhatsApp, Skype, or Zoom. Some apps are specific to certain mobile devices. For example, FaceTime is available on iPhone but not an Android. Find out which apps are accessible on the mobile device or PC you’re using. Try using the app to connect with family and friends before your visit; they can tell you if you’re pointing the camera in the wrong direction, for example. If you’re uncomfortable using the app for the first time, ask your partner, caregiver, or child or grandchild to walk you through it.
4. Set the stage. Find a quiet space with minimal interruptions close to your router or computer (the closer you are to your wi-fi signal, the better the connection will be). Turn off the TV and any noisy devices, including window heating or cooling units and ceiling fans, if possible. Keep pets out of the way. Cats, especially, love to interrupt visits and jump up to see what’s happening on the screen. If possible, sit in front of a solid-colored wall rather than a patterned or cluttered background or a window. The video connection can pick up every point of light and may need to be uploaded constantly; more complicated or shifting background patterns can slow down or interrupt your connection. 
5. Control the lighting. Your doctor needs to get a good and clear look at you so position any light in front or to the side. If you’re using a phone or tablet instead of a laptop, place it in a stable position or a holder or lean it against something heavy rather than holding it.
6. Don’t go it alone. Having a care partner with you is always a good idea, and it’s especially helpful for telehealth visits since it’s a new situation and can take time to adjust. If it’s a video visit, a care partner can adjust the screen or camera while you focus on sharing your concerns with the doctor. 
7. Allay fears. If you or your loved one has cognitive problems, dementia, hallucinations, or delusions, telehealth visits may be confusing or unsettling. Some patients with delusions may fear they are being recorded or that someone else has been allowed into the home. Telehealth visits are not recorded; they simply allow the health care provider to see the patient only during the visit from a remote location without having to meet at the clinic. 
8. Write down your questions. Prepare a list of your concerns or questions ahead of time and place it in the spot where you will take the call or video visit. Your doctor will have questions, too, so you may not get through your entire list, but identifying two to four main concerns will help ensure that the visit is productive and helpful.
9. Have your medications handy. Either draft a list of all your medications, over-the-counter drugs, vitamins, and supplements, or gather the actual medications and place them where you’ll take the call or video visit. On every visit, you’ll want to confirm with your doctor exactly what, when, and how you are taking everything. 
10. Know the parameters. Before the visit, ask your doctor or the office staff what the doctor will be looking for—and what supplies you may need. Ask how long the visit will be and what the doctor will want to have you do. Depending on why you are seeing the doctor and how—by phone or by video visit—he or she may ask you to check your temperature, weight, or blood pressure if you have the ability and equipment at home to do so. Your doctor also will ask about changes in your symptoms since your last visit. He or she may ask you to stand, walk, or perform certain movements during the visit so that he or she can evaluate whether your symptoms are getting better or worse, which will inform decisions about your treatment. Finally, your doctor will make recommendations or develop a treatment plan.
11. Be prepared with supplies. In addition to a blood pressure cuff, scale, and thermometer, your doctor may want you to have a safety pin, tissue or Q-tip, pen and paper, a cup or glass, and a flashlight available—items that help your neurologist test sensation, measure dexterity or tremor, or better illuminate parts of the body, depending on what condition you have.
12. Ask about follow up. Ask if you should write down your doctor’s recommendations or plan, or if they will be mailed, emailed, or sent to you by a health portal. If you’re writing it down, ask if you can say the instructions back to make sure you have everything right. For example, “Dr. Brown, you said that I should take my seizure medication twice each day, and I should add a second dose of my headache medication.” This allows the doctor to correct any misunderstandings and make sure you are both in agreement.

Dr. Fleisher is the Leslie Nan Burridge Endowed Faculty Scholar in Parkinson’s Disease Research and assistant professor of neurological sciences at Rush University Medical Center in Chicago.