Best Practices for Telemedicine Calls
Telemedicine is a useful tool for practices – and especially at this time. Of course, even after the COVID-19 pandemic subsides, the convenience it affords will still help you retain current patients and bring in new ones.
The ways you use telemedicine at your practice – such as follow-up visits, initial evaluations/diagnostics, prescription refills, etc. – may vary from what other practices are using it for. This is actually good because it allows you to stand out from the crowd. On top of that, you can pick up additional ideas when you network with fellow doctors (thereby increasing the value of this service for your practice).
Now, in spite of any variance in how this technology is used, there are a handful of universal best practices for telemedicine visits you need to know.
As you’ll see, these include things like:
- Setting up your space beforehand
- How you present yourself during the call
- The content of the visit itself
Before we dive into what you need to do with telemedicine calls, let’s take a quick moment to see how communication can differ between in-person visits and virtual consultations.
COMMUNICATING: TELEMEDICINE VS. IN-PERSON VISITS
Obviously, there’s a pretty big difference when communicating in these respective ways. The traditional, in-person appointment allows for a greater level of personal communication, while telemedicine has a layer of technology inserted between you and your patient.
What that means is you can bridge the span of miles that separate you from your patient in the physical sense – yet create a new kind of barrier in another sense altogether.
Due to the latter, some doctors are reluctant to embrace this new technology. In these cases, the doctor may believe that communication gaps in virtual healthcare can hinder effectiveness of the visit.
This reluctance may be based more in a refusal to accept change than in reality-based metrics for positive healthcare outcomes. After all, there is a growing body of evidence showing improved patient care outcomes, reduced costs, and higher patient satisfaction with telemedicine.
For those doctors whose reluctance stems from the fact that they are uncomfortable replacing an in-person examination with a virtual call, we have to acknowledge:
Not every healthcare encounter is appropriate for telemedicine.
However, think for a second about how many office visits are from patients who do not require a physical examination. Things like prescription refills, reviewing lab results, and routine follow-ups probably don’t require you and your patient to be in the same room, right?
But let’s get back to the point about the “barrier” that can be created when technology comes between two humans.
Sure, we are talking about two different kinds of patient experiences, yet many staples of basic human communication remain unchanged. And because things like voice tone and eye contact still matter, this is a barrier that you can overcome.
No matter if you are communicating in person or through technology, it’s essential that your patients feel listened to and are comforted. That’s a bigger part of your job than most people realize.
And the fact of the matter is that patient satisfaction is certainly related to the perception of how a doctor communicates.
That is worth noting because your communication now – along with your ability to be there for them during a time of national crisis – will help retain patient loyalty once a sense of normalcy is restored.
So when you offer your telemedicine services (or even if you already do), please keep in mind that the validation and empathy you’d usually provide during office visits should still come through during virtual appointments.
SET UP YOUR SPACE BEFORE THE CALL
For your telemedicine visit with a patient, you should be sitting at a desk or table (not the couch or, worse, bed!).
Your laptop or device’s camera should be in front of you and at eye level. To help with that, you may need to put your laptop, tablet, or phone on a stack of books.
Make sure the desk or table is clear of any objects. Additionally, you should consider installing a screen – like the collapsible ones you can buy that fit onto the back of a chair – in order to block off any distractions.
Wearing headphones protects your patient’s privacy (so their voice is not heard by any family members who are home), and it also makes it easier to hear sounds if a stethoscope is used at the patient’s end.
In many cases, you’ll need two computer/device screens: one for the telemedicine image and another to enter notes into your electronic health records system.
The existing lighting in the room may have to be supplemented with extra fluorescent fixtures that help evenly distribute the light. The color of the walls may impair the quality of the video image. Light blue is a good background color, and again, a screen can assist with a clean video image.
HOW YOU PRESENT YOURSELF DURING THE CALL
Fair or not, how you dress matters. Even if you’re working from home, dress as you would when seeing patients in your office.
Here’s a slight caveat with that:
Be aware that excessively bright or dark colors, pinstripes, checks, or other complex patterns will create distracting patterns on the screen. (If that’s how you’d normally dress in the office, you may need to adjust your wardrobe choices for telemedicine.)
Your virtual bedside manner is another important consideration. If you want to have the best possible rapport with your patients, you need to feel comfortable with your video presence.
Much like hearing your own voice in a recording, this is something not everyone is at ease with. What can help, however, is to rehearse in front of your camera (putting the video in record mode) before you start seeing patients virtually. It may take some rehearsing, but you will see how you come across, can make adjustments, and will become more comfortable with your appearance.
When it’s time, be as punctual for the appointment as you want your patients to be. Fortunately, many telemedicine platforms allow you to set up a notification system (so patients know when you’re ready, and vice versa).
During the call, you should be inviting and put your patients at ease. Remember, they may have the same nervousness about being in front of a camera as you do (or more!).
To help with that, ask questions so your patients open up and nod periodically. This enables patients to know you hear and understand what they’re saying.
As noted earlier, you should maintain eye contact with them. Now, it might seem like the best way to do this is to look at the patient’s image on the screen, but you actually want to look into the camera lens. And if you are going to look away for an extended time – perhaps to write notes or consult the patient’s record – tell your patient what you’re doing.
Finally, you need to be attuned to any visual cues you can gather from the patient during the consultation. And that means you shouldn’t be staring exclusively at the camera lens the whole time.
THE CONTENT OF THE CALL ITSELF
Prior to the appointment, spend at least a little time reading the patient’s complaint and having their chart ready.
When a patient is online, start by confirming their identity, getting a history of the problem, and assessing their appearance. All of this can help you determine if the patient needs an in-person office visit (over a virtual consultation).
Many of your questions are basically the same as those you would ask during an in-person visit and you will need:
- The primary health complaint
- Associated signs and symptoms
- Past medical history
- Family history
- Personal and social history
This is also the time to review medications, allergies, etc.
During the course of the consultation, you may have to direct your patient to perform a self-examination. This might require asking the patient to walk or stand or bend, move a limb in a certain way, and test range of motion or power.
In most cases, this means you will have to rely more on what patients are telling you than in an in-person visit.
Finally, ask the patient for feedback on this visit. One of the most important practices to replicate from the appointment is to determine your patient’s level of comfort with the telemedicine visit.
Doing so will help you improve your services and potentially validate that your patients feel like they’re receiving the same level of care as they would in a traditional, on-premise visit.
USING TELEMEDICINE AT YOUR PRACTICE? MAKE SURE PATIENTS KNOW!
Both now and in the future, telemedicine could be a valuable service for you and your practice.
If you want to receive optimal value, make sure you are promoting it effectively to your patients and potential patients.
Not sure how to do that?
VMD Services has developed some special packages – including one to properly market your telemedicine services – you might be interested in checking out.
Interested in all our services to help you during COVID-19? Check out this page.
Fill your waiting room with the kinds of patients you want to treat.