What Should You Do if Your Medication is Recalled?

Millions of Americans rely on the use of regular prescription medications to treat chronic conditions. Says the National Center for Health Statistics (NCHS), approximately 46 percent of the U.S. population used one or more prescription medications in the past month. If you are among those reliant on medication to help you manage such common conditions as high blood pressure or cholesterol, chronic pain, diabetes, or asthma, know the recommended steps to take if you are notified that your medication has been recalled. The Food and Drug Administration (FDA) recalls medications annually as a patient safety measure. Be prepared with a plan so that your care treatment is not detrimentally interrupted if a recall happens to you.

 

What is a Drug Recall?

A prescription recall is a voluntary action taken by the manufacturer or the FDA at any time to remove a defective drug product from the market.

 

Why are Drugs Recalled?

While it may inadvertently be an inconvenience for patients, drug recalls are the most effective way to ensure safety and minimize the risk of a complication, dangerous side effects—or in the worst case, death—from the use of a specific medication. Drug manufacturers and the FDA work diligently to ensure that before medications are released to the public that they are tested for possible issues. Post-release, the entities continue to monitor the drugs for complications. If anything unforeseen arises that may put patients at risk, the FDA or the manufacturer may decide to issue a recall. Monitored issues range from drug efficacy and dangers to inadequate or misleading packaging, to hazards identified during the manufacturing process that may have contaminated products.

 

What Should You Do if Your Prescription is Recalled?

Most recalls are issued out of an abundance of caution due to minor issues. If a prescription medication that you have been taking is recalled, do not panic. Stop taking the medication immediately, and call your doctor or contact a pharmacist and ask for a recommended replacement.

Read the available materials from the FDA or the manufacturer to understand the reason for the recall. If there was an issue with the efficacy of the product, and you have been experiencing possible related side effects, share that information with your doctor.

Safely discard the recalled medication or return it to your pharmacy. Most drugs should not be flushed down the toilet. Instead, mix it with coffee grounds or kitty litter in a bag and then place it in the trash—carefully out of reach of any children or pets.

Moving forward, if you ever notice anything suspicious with a medication—such as a tampered seal, broken packaging, strange smell or odd appearance, contact your pharmacist before taking the drug, even if you have not been informed of a recall.

 

Recalls of Over-the-Counter Medications

Keep in mind that it is not only prescription medications that may be recalled. Over-the-counter medicines are also closely monitored by the FDA and are subject to recalls. If you own any over-the-counter drugs that are recalled, stop taking them immediately. Return the medication to the store at which you purchased it and ask for a refund. The pharmacist or your doctor can recommend a safe alternative.

If you have any concerns about recalled medications, talk to your doctor, or visit the FDA’s drug recall list.

What is a COVID-19 Serological Antibody Test?

Nova Health, a comprehensive provider of quality urgent care, primary care, physical therapy, and musculoskeletal services in Oregon and Montana, offers COVID-19 serological antibody tests at all clinic locations.

Serological tests for SARS-CoV-2 are intended for those individuals who either have symptoms consistent with COVID-19 and had a negative molecular test, or those that were not tested when ill and now have recovered.  This test determines the presence of antibodies to SARS-CoV-2, the virus that causes COVID-19.

Below is a list of frequently asked questions regarding COVID-19 testing, the COVID-19 serological test in particular, the meaning of positive and negative results, and more.

 

Q. How can healthcare professionals confirm COVID-19 infection?

A. Confirmation of infection with SARS-CoV-2 must be made through a combination of clinical evaluation and other applicable tests.

 
Q. What does a COVID-19 positive serologic test result mean?

A. A positive serologic result indicates that an individual has likely produced an immune response to the SARS-CoV-2 virus.

 
Q. What does a COVID-19 negative serologic test result mean?

A. A negative serologic result suggests that an individual has not developed detectable antibodies at the time of testing. While contingent on a variety of factors, a negative result could be due to testing too early in the course of infection, the absence of exposure to the virus, or the lack of an adequate immune response, which may be due to conditions or treatments that suppress immune function.

 
Q. What should a patient do who tests positive for COVID-19?

A. Decisions about ongoing monitoring, treatment, or return to normal activities for patients being treated for suspected infection with SARS-CoV-2 should be made following guidance from a healthcare provider or public health authorities. Social distancing and disease prevention precautions such as wearing face masks and frequent handwashing still applies.

 
Q. Is COVID-19 serologic testing FDA approved?

A. Serum assays have not been FDA cleared or approved. The FDA released guidance on the diagnostic use of serum assays titled, “Policy for Diagnostic Tests for Coronavirus Disease 2019 during the Public Health Emergency – Immediately in Effect Guidance for Clinical Laboratories, Commercial Manufacturers and Food and Drug Administrative Staff.” The serum assay is an Abbott certified test performed at LabCorp high complexity lab.

The guidance states that the FDA authorizes the use of the serum assay test device:

  • Under an Emergency Use Authorization (EUA) for use by authorized laboratories
  • For the detection of SARS-CoV-2 antibodies (e.g., total, IgG, IgA, and IgM), and not for any other viruses or pathogens
  • For the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for the detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Act, 21 U.S.C. § 360bbb-3(b)(1).

May is Lupus Awareness Month. What is it, and Who is at Risk?

It is the disease that has earned the mysterious nickname of The Disease of 1,000 Faces.

Lupus is an inflammatory disease in which the immune system attacks its tissues and often causes painful joint pain. It impacts 1.5 million Americans and at least five million people around the world. Every May, we recognize Lupus Awareness Month as a time to generate awareness and raise critical funds for life-saving research and support services. What is this currently incurable disease, and who is at risk? Read on to learn more.

 

What is Lupus?

One reason why Lupus Awareness Month is so critical is that many aspects of the disease—including its spectrum of symptom severity—remain a mystery to doctors and researchers. The condition is often challenging to diagnose, painful to live with, and hard to treat. It creates a broad array of symptoms and can appear with little warning.

Lupus is a chronic autoimmune disease. It causes pain and inflammation throughout the body in which the immune system attacks healthy tissues in the:

  • Joints
  • Internal organs, including heart and kidneys
  • Skin

Lupus is a disease of cycles, which means that when it is in remission, a person may exhibit no symptoms. When the condition is active, however, patients experience a flare-up of symptoms.

While no one knows what causes the disease, researchers have found that the condition is genetic. Some experts also believe that Lupus may be triggered in response to specific hormones, particularly estrogen, or to environmental factors.

 

There are four types of Lupus:

  • Systemic Lupus Erythematosus (SLE) – The most common form of Lupus, this version can be mild or severe.
  • Cutaneous Lupus – Limited to the skin, this version can cause rashes and lesions on the face, neck, and scalp. The skin of the inflamed areas can become thick, scaly, or suffer scarring.
  • Drug-Induced Lupus Erythematosus – A lupus-like disease caused by certain prescription drugs. It affects about ten percent of Lupus patients. Some drug categories that may cause this form of Lupus include those used to treat seizures, high blood pressure, as well as thyroid medications, oral contraceptives, antibiotics, and antifungals.
  • Neonatal Lupus – While not a true form of Lupus, this rare condition affects infants of about one percent of women who have Lupus and is caused by antibodies from the mother acting upon the infant while in utero.

 

What are the Symptoms of Lupus?

Lupus is a painful condition with symptoms that can range from mild to severe. Some of the most common symptoms of Lupus include swelling, inflammation, and damage to skin, heart, lungs, blood, kidneys, and skin.

 

Who is at Risk of Developing Lupus?

While anyone can develop Lupus during their lifetime, the disease most commonly affects:

  • Women between the ages of 15 and 44
  • African American, Asian American, Hispanic/Latino, Native American, or Pacific Islander individuals
  • People with a family member who has been diagnosed with Lupus or another autoimmune disease

If you are experiencing symptoms of swelling and pain, and believe that it may be caused by Lupus, talk to your doctor. He or she will diagnose your symptoms and will help you create a treatment plan to help you manage your pain and discomfort.

Asthma and Allergy Awareness Month – Are Your Symptoms from Allergies or COVID-19?

People who suffer from seasonal allergies know all too well the discomfort of running daily errands or trying to focus on work with dry, itchy eyes, a dry cough, and irritating sneeze. These days, as the whole world waits with bated breath for a vaccine or cure for COVID-19, any respiratory symptom can create anxiety. If you’ve found yourself coughing or sneezing and are worried that you may be experiencing something more concerning than seasonal allergies, read our guidance below to familiarize yourself with the critical differences in symptoms.

 

If you believe that you may be suffering from COVID-19, talk to your doctor to determine if you should get tested. If you are experiencing difficulty breathing, seek immediate medical attention.

 

Common Seasonal Allergy Symptoms

Symptoms of seasonal allergies, often caused by pollen, grass, and other outdoor irritants, often include:

  • A runny or stuffy nose
  • Postnasal drip
  • Sneezing
  • Sinus congestion
  • Itchy, watery eyes
  • Itchy sinus, ear canals, and throat
  • Ear congestion
  • Headache
  • Shortness of breath or wheezing
  • Cough
 

Common COVID-19 Symptoms

While the range of symptoms of patients diagnosed with COVID-19 has been somewhat broad, the most common symptoms include:

  • Fever
  • Cough
  • Difficulty breathing
  • Fatigue
  • Appetite loss
  • Diarrhea
  • Nausea or vomiting
  • Lack of smell or taste
 

COVID-19 symptoms commonly appear within five to 14 days after exposure to someone with the virus.

It is important to note that allergy symptoms that most closely resemble those of COVID-19 are less common. These include coughing, wheezing, and shortness of breath. If you do not typically experience such symptoms of your allergies, and particularly if you have been exposed to someone diagnosed as having the virus, you may want to talk to your doctor about whether or not you should receive a COVID-19 test.

 

COVID-19 Testing from Nova Health

Nova Health has been offering COVID-19 testing to patients within our communities since March 12, 2020. We recently expanded our testing capability to include both symptomatic and asymptomatic patients.

Expanded testing will have the most significant impact of decreasing community spread and help flatten the curve of COVID-19 by helping identify the virus before symptoms arise. If you are experiencing symptoms of COVID-19, and believe that you are not experiencing allergies, we highly encourage you to contact one of our clinics to determine if you should be tested for COVID-19. Click here to learn more about our available testing.

If you are experiencing allergy symptoms, we offer telemedicine screening as well as in-car screenings to provide you with the care you need in a safe environment.

Nova Health Offers COVID-19 Serological Antibody Tests

EUGENE, Ore. – April 29, 2020 – Nova Health, a comprehensive provider of quality urgent care, primary care, physical therapy, and musculoskeletal services in Oregon and Montana, is now offering COVID-19 serological antibody tests at all clinic locations.

Serological tests for SARS-CoV-2 are intended for those individuals who either have symptoms consistent with COVID-19 and had a negative molecular test, or those that were not tested when ill and now have recovered.  This test determines the presence of antibodies to SARS-CoV-2, the virus that causes COVID-19.

Part of the excitement of the new testing, is that it will have the potential to be used for patients who were ill this spring and were unable to get a test because of limited capacity.  According to Nova Health Medical Director, Marc Schnapper M.D. Nova Health’s ability to offer the serological antibody testing is part of its ongoing efforts to help our communities have a better understanding of the presence or absence of the disease.

“Nova Health is committed to the well-being of our patients, and all those in our community,” said Schnapper. “Accurate and expedited testing is vital to containing the coronavirus that causes COVID-19. Thanks to this new test we can further meet our goals of evaluating and treating patients.”

A positive serological test indicates that an individual may have produced an immune response to the SARS-CoV-2 virus.  A negative test indicates that an individual has not developed detectable antibodies at the time of testing.  The most common reason a person may have a negative result is when the test is performed early in the illness as it can take up to two weeks to develop an antibody response.

Individuals who have had COVID-19 symptoms and are interested in obtaining this test should visit one of Nova Health’s clinics or use our telemedicine offering to determine if testing is needed. Nova Health has taken substantial measures to segregate patients with respiratory illnesses from other patients to ensure the safety of patients, staff and the community.  Our primary care clinics have been separated from urgent care facilites, and outdoor screening and separate entrances have been established to stop the spread of the COVID-19 virus.

What is Telemedicine and How Can it Keep You Safe During COVID-19?

It feels like COVID-19 is the most significant health risk we are all facing this Spring, which is why it’s easy to forget that millions of Americans are still experiencing minor illnesses and injuries from sprained wrists, to sinus infections, to rashes. With significantly strained healthcare facilities becoming ground zero for the battle against COVID-19, many Americans in need of other minor treatments are fearful of a trip to their local urgent care or doctor’s office.

To provide a safe way for patients with minor injuries and illnesses to interface with their provider, without leaving home or increasing their risk of being exposed to a COVID-19 patient, healthcare providers across the nation are offering telemedicine services. Read on to learn why telemedicine is just as reliable as an in-office provider visit, and how it can help minimize your risk of COVID-19

 

What is Telemedicine?

Telemedicine services are similar to the services our patients receive in our clinics, except, they are provided in patients’ homes via an app or web browser. Using digital technology, patients and healthcare providers can see and speak to one another.

 

For What Types of Health Concerns is Telemedicine a Reliable Option?

You can make a telemedicine appointment for such mild injuries and illnesses as:

  • Allergies
  • Annual wellness visits
  • Anxiety
  • Chronic conditions if you are an established patient on a recurring treatment schedule
  • Cough or cold
  • Depression
  • Diabetes
  • Fever
  • Flu
  • Follow-up consultation to imaging or lab work
  • Migraine or headache
  • Medication refills
  • Pink eye
  • Sinus problems
  • Urinary tract infection

You should see a healthcare provider in-person, or seek emergency care if you are experiencing:

  • An injury that requires hands-on care
  • Abdominal pain
  • Shortness of breath or chest pain

 

Can a Provider Prescribe Medication via Telemedicine?

Yes. During a telemedicine appointment, your provider may prescribe or refill many common medications.

 

Does Health Insurance Cover telemedicine?

Individual insurance plans may not cover telemedicine services. However, insurance coverage is evolving rapidly in response to Federal and State emergency proclamations addressing COVID-19 (coronavirus). Many insurers are adding coverage for telemedicine services. Talk to your insurance provider and ask if your current benefits plan includes coverage for telemedicine.

The Medicare Chronic Care Management Program is a national policy that does not currently restrict patient use of telemedicine. Medicaid reimbursement varies based on state. To determine if you have Medicaid coverage for telemedicine services, call your Medicaid office.

 

Is My Personal Health Information Secure?

Telemedicine appointments are subject to HIPAA compliance, which means your provider must offer you a secure technology service with which to transfer health information and conduct your appointment. Not every video conferencing services, such as FaceTime or Skype meets HIPAA compliance standards, so if you have any questions about security, talk to your provider’s office.

 

What are the Benefits for Me if I Choose Telemedicine?

Patients who seek telemedicine care benefit from:

  • Time efficiency—no need to take time off from work and drive across town to your doctor’s office
  • No travel expenses
  • Total privacy—you conduct your appointment from the privacy of your home
  • Safety from COVID-19 and other contagious viruses during the shelter-in-place mandate and other peak illness seasons

 

Is Telemedicine Technology Easy to Use?

Telemedicine technology is designed to be easy for all patients, regardless of their technical expertise. If you have concerns about being able to successfully use the necessary technology, ask your doctor’s office if it offers a helpful guide for patients.

 

Will Telemedicine Still be Available After COVID-19?

While many healthcare providers have implemented telemedicine to address their immediate need for caring for patients during the COVID-19 pandemic, it is not a new or temporary technology. Healthcare industry experts anticipate that telemedicine will continue to be a common choice for patient care long after we beat COVID-19.

Nova Health is now offering telemedicine services focused on treating new and existing patients for many common ailments. Telemedicine is available 7 days a week from 8 a.m. to 8 p.m. Click here to schedule an appointment.

Nova Health Implements Emergency Action Plan to Ensure Staff and Patient Safety During COVID-19 Pandemic

At Nova Health, our mission is to take care of our patients and each other. We have taken steps to protect our patients and our staff during this difficult time. While the impact of COVID-19 is evolving rapidly, we continue to monitor guidance from the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) and address our patient care and staffing procedures accordingly.

To support national efforts to mitigate virus spread, effective March 18, 2020, we implemented an Emergency Action Plan. Among other steps, we have separated our business locations to designate specific clinics for urgent care treatment only, and other clinics for primary care and therapy services only. Please note the following changes to our clinic services:

  • Established Safe Zones within our clinics to separate exam rooms and waiting areas for patients with upper respiratory concerns
  • Dedicated patient screening protocols to identify at-risk patients based on present symptoms and travel history
  • Treating potential COVID-19 patients outdoors or in the car to protect our patients
  • Offering telemedicine appointments 7 days a week from 8 am – 8 pm from the convenience of your home. Visit NovaHealth.com/Telemedicine to learn more.
  • Following CDC-recommended isolation procedures for at-risk patients
  • Stocked preventive supplies and equipment in all clinics, including waiting room signage and the availability of respiratory masks
  • Elevated training for all clinic staff

In this ever-changing environment, we anticipate regularly updating information about COVID-19 and our processes to keep you safe.

Your health and safety remain our top priority at Nova Health.

What are the Different Types of Face Masks and What Will Protect Me from COVID-19?

What face mask is good for covid?

On April 3, 2020, the U.S. Centers for Disease Control and Prevention issued updated guidance encouraging all individuals to wear a face mask in public when obtaining essential services, such as grocery shopping. This latest evolution in our national efforts to flatten the curve of COVID-19 has left many wondering what the best type of face mask covering to use is, and how to wear one effectively. To help you minimize your risk of COVID-19, read out face mask guidance below, as sourced from the education provided by the CDC.

Why is the CDC Now Encouraging Facial Masks to be Worn in Public?

Initial guidance about COVID-19 contagion mitigation stated that there was no evidence to suggest that wearing a facial mask in public would protect someone who had not yet contracted the illness. Face masks, health officials advised at the time, should only be worn by those who have been exposed to someone with the virus or by individuals who have tested positive.

What we know today, however, is that a significant portion of individuals who have contracted COVID-19 are asymptomatic, meaning they do not initially, or may not ever, exhibit symptoms. Despite these individuals not realizing that they are a carrier of the virus, they can still spread it to others. For this reason, the CDC now recommends that everyone, regardless of whether or not they are exhibiting symptoms or believe they may have contracted the virus, should wear a face mask in public.

What are the Different Types of Face Mask Options, and What Should I Wear?

When out in public or when viewing COVID-19 news coverage, you may commonly see three types of face masks:

  • N95 Respirators – A particulate-filtering facepiece respirator that meets the N95 standard of the U.S. National Institute for Occupational Safety and Health air filtration rating because it filters at least 95% of airborne particles.
  • Surgical Face Masks – A mask intended to be worn by healthcare professionals during surgery to catch the bacteria shed in liquid droplets and aerosols from the wearer’s mouth and nose.
    • Click here for more information about the differences between an N95 respirator and a surgical face mask from the CDC.
  • Homemade Cloth Face Mask Coverings ­– Bandanas, scarves, and cloths that cover the nose and mouth. 

The general public is encouraged to use a homemade face mask at this time. Surgical masks and N95 respirators are in critical demand, and the CDC asks that citizens reserve them for use by healthcare workers and other medical first responders. You can make an effective cloth face covering from household or other common materials. The CDC provides instructions for creating a facemask from t-shirts, coffee filters, bandanas, and other cotton clothes here. All face coverings must be disposed of after each use, or laundered before being worn again.

Note that all homemade cloth face coverings should:

  • Fit securely but not uncomfortably against the face
  • Be secured with ties or ear loops to hold in place
  • Include multiple layers of fabric
  • Allow for unrestricted breathing
  • Be launderable without damaging the material or changing the shape

Cloth face coverings should not be placed on anyone who:

  • Is under age two
  • Has trouble breathing
  • Is unconscious, incapacitated or otherwise unable to remove the mask without assistance

Stay Home. Stay Safe.

Over the next few weeks, as we continue to battle the global fight against COVID-19, stay home and stay safe. Follow social distancing requirements, and minimize unnecessary trips to public places, even if obtaining essential services. Together, we will flatten the curve of COVID-19 and recover as a world from this deadly and devastating illness.

If you think that you are experiencing COVID-19 symptoms or you have had symptoms Nova Health is now offering COVID-19 screening and testing. You can make a telemedicine appointment to get screened or visit any of our clinic locations

Be Careful What You Read – How to Find Trusted Information Online About COVID-19

It is difficult to open any news or information source these days without being inundated with information and opinions about the COVID-19 pandemic. It may feel like every news outlet is solely discussing the virus, that every brand is emailing you updates, and that every person you’ve ever connected with on social media is sharing information about their journey with social distancing.

If you’re feeling overwhelmed, you’re not alone.

While it may feel like COVID-19 information is everywhere, until we flatten the curve of the virus and can resume routine travel, work, and lifestyle behaviors, we cannot safely tune-out the noise. We want to ensure you are following government mandates and fully understand your risks for contagion. It is vital to stay informed about virus spread and local mandates. What is just as crucial is ensuring that you are referencing guidance from trusted entities, and remaining guarded about advice from other sources—including well-meaning friends and family on social media who are unintentionally sharing misinformation and creating unnecessary anxiety.

To ensure you are obtaining news and education information from reputable sources, we have compiled a list of trusted outlets. Bookmark the following websites and reference these experts for any questions or concerns you have regarding COVID-19.

  • The World Health Organization (WHO). WHO is a specialized agency of the United Nations responsible for international public health. They are leading global COVID-19 research and education efforts. Visit the WHO>>
  • Johns Hopkins Coronavirus Resource Center. As of the time of this publishing, the number of identified cases of COVID-19 had exceeded 850,000 globally. With such staggering figures, it is becoming increasingly difficult to fully comprehend the impact of the virus on our communities, our nation, and the world. Johns Hopkins University & Medicine has created a dynamic and interactive COVID-19 global cases map to help illustrate the virus’ impact. The map is updated regularly to ensure it always includes the most accurate, current data. Visit the Johns Hopkins Coronavirus Resource Center>>
  • Your Local Government Website. The battle against COVID-19 is heavily fought at the local level. For social distancing requirements, local business and public facility closures, possible testing opportunities, and restrictions that apply to your hometown visit your local government website. Many administrations have created dedicated COVID-19 resources pages. If you are a Nova Health patient who lives in Western Oregon or Montana, the following sites may offer the local information you need:
  • Your Health Care Provider. If you have any questions or concerns about your risk of contracting COVID-19, or if you are concerned that you have been exposed to the virus or are exhibiting symptoms, talk to your doctor. At Nova Health, you can trust that the COVID-19 information, education, and resources available on our website and social media sites all contain medically verifiable information that you can trust. To help our patients follow safer at home guidelines, we are also offering Telemedicine appointments with all our providers. Visit our COVID-19 resource page>>

Nova Health Offers Telemedicine Services to Provide Safe, Virtual Patient Care During COVID-19 Pandemic

Telemedicine

Nova Health, a comprehensive provider of quality urgent care, primary care, physical therapy, and musculoskeletal services in Oregon and Montana, has announced that it is now offering telemedicine services to new and existing patients. The new virtual provider-patient care service is part of Nova Health’s commitment to safely and effectively care for its patients and the community during the COVID-19 pandemic. Telemedicine allows for the delivery of health care services and clinical information to patients using audio-video conferencing technology in which patients and providers can see and speak to one another via a mobile application or desktop computer. 

According to Nova Health Chief Executive Officer Bill Clendenen, the addition of telemedicine services represents a critical step in Nova Health’s efforts to flatten the curve of COVID-19. 

“We are committed to safely caring for patients who present with symptoms that may indicate a COVID-19 diagnosis,” said Clendenen. “We have made changes to our clinic schedules and service models to minimize exposure of these patients to those seeking routine or non-COVID-19 related care, which remains vital during this pandemic. To further mitigate virus spread and ensure that patients are not delaying routine care or concerns related to minor illnesses or injuries due to worries about exposure to COVID-19, our telemedicine service allows patients to talk to a provider from the comfort and safety of their home.” 

It’s not necessary to speak with your normal provider, so patients can schedule a telemedicine appointment with any Nova Health provider. Telemedicine providers may prescribe and refill many common medications and provide care for many common ailments, such as allergies, bladder or urinary tract infections, bronchitis, cough and colds, diarrhea, fever, migraines/headaches, pink eye, rash, seasonal flu, sinus problems, sore throat, and stomach ache.  

“For now, our community members are safer at home,” said Clendenen. “Our new telemedicine services are allowing us to do our part to keep our patients safe and healthy at home.” 

New and existing Nova Health patients who would like to make a telemedicine appointment should call 541.225.4997 to speak with a member of Nova Health’s scheduling team or visit NovaHealth.com/Telemedicine