Dr. Bernie on how telemedicine transcends barriers to urologic care


"From a physician standpoint, [telemedicine] allows you to have a greater reach of patients that you can help, that you can educate, that you can help improve their quality of life," says Helen L. Bernie, DO, MPH.

In this video, Helen L. Bernie, DO, MPH, summarizes takeaways from the 2023 American Urological Association (AUA) Quality Improvement (QI) Summit. Bernie is the director of sexual and reproductive medicine at Indiana University and an assistant professor of urology at Indiana University School of Medicine in Indianapolis, Indiana.


You participated in the AUA QI Summit session "How to Effectively Incorporate Telehealth Into Your Practice." Could you summarize some takeaways from this panel?

That's a great question because it was really a wonderful QI summit. I was really thankful and honored to be invited to speak. We had so many wonderful urologists who do all different specialties who came to talk about how they've incorporated telemedicine into their practice. Several of the biggest takeaways were number 1, that we were all using telemedicine, and that we've all been able to use it in our practice, both successfully and efficiently, to really help transcend barriers for our patients, and that the patients love it. They appreciate it. In fact, some of the patients were requesting it—they preferred it over the in-person visits. I think the whole panel, talking about how we incorporated [telemedicine] into our practices, what were our challenges, what were our pitfalls, what were solutions that we came up with, was that everyone agreed that it's so important, because it transcends barriers. From the patient standpoint, all of a sudden, their geography and location are no longer barriers. A patient can see me even if they live 6 hours away in Indiana and they can't take off work. Transportation no longer becomes a limitation for many of those patients who either can't drive, or they need a driver. There's no time off from work or finding childcare in order to make your health a priority and make your doctor's appointment. So I just think that we really hit on the fact that it really allows greater patient access from a location standpoint, as well as access to subspecialty fields that maybe they wouldn't have in their geographic area. Many people are out in rural areas, or even in Indiana here, I have people who drive 6, 7 hours to come see me. And in our state alone, there are only 3 fellowship-trained urologists who do andrology and male infertility. Telemedicine is also cheaper for patients, because there is no missed work, there's no gas mileage, there's no time away to make that appointment. So it also offers them greater variability and scheduling for many of these patients, because you can have visits now early in the morning, or in the afternoon, or maybe even in the evening, depending on how you've set up your practice and how you've incorporated your virtual visits. All of these things were discussed. I think specifically related to my field, like sexual medicine and reproduction, it also helps patients maybe in discussing some of these really sensitive or embarrassing topics, because they're slightly removed by [being] on a phone or video screen rather than in person, where maybe some might feel a little bit more nervous. Also, when you are on a video screen, it allows you to come into that patient's home. You get to see when they're telling you what's going on and how things are troublesome, you're able to see how they are in their home. When you're giving them postoperative care instructions, are they in a setting where they're going to be able to take care of themselves, and are they going to be able to follow those instructions? Do they have a good support network? You really get a lot of insight as well just into the patients from being able to have those visits with them and really having them invite you into the comfort of their home and learning something special about [them]. It really helps bridge that connection and that patient-doctor relationship. I think the biggest take-home is how much it really transcends barriers and how much patients appreciate it. As I mentioned, you get that opportunity for second opinions where maybe previously, they wouldn't have been able to do that. Even from a physician standpoint, it allows you to have a greater reach of patients that you can help, that you can educate, that you can help improve their quality of life. It's less work for your staff to clean rooms; it doesn't take up that space. Oftentimes, I can see patients quicker, even in a 15- or 20-minute virtual visit than having them in the office for the same because there isn't someone having to walk them into the office space, having to check their medications, check their blood pressure. I can see them right away by calling them on the phone and setting up the visit and going from there. I think the biggest take-homes are that number 1, it's very easy and effective to do and number 2, just stressing the importance of telemedicine, not only for the patients but also for the providers and how it offers a greater range of care and allows us to reach patients in a better way.

This transcription was edited for clarity.

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