How to Prepare for your Telemedicine Appointment

Caroline Presley, MD, MPH^✉; Allyson Hughes, PhD^✉; and Jennifer Warnick, PhD^✉; Diabetes SIG

 

The COVID-19 pandemic increased the need for telehealth and flexibility in the way that healthcare providers and patients meet. We have learned many techniques during this time and share these best practices from both the provider and patient perspective in this article.
 

Provider perspective:

• Ensure your patient is speaking to you in a private space free of as many distractions as possible (ie., not while driving, in the middle of a grocery store, etc.). If this is a telemedicine appointment and the patient’s video is off, ask if they would like to turn their video on.
• Reach out to patients with limited technology and/or internet connectivity, offer flexibility in platforms that can be used for video consultation, or non-video options, when possible.
• Provide self-report measures typically given at clinic check-in. This process has had to transition (I.e., PHQ). Consider ways in which your clinic can continue evaluating these areas while also ensuring secure data collection methods.
• Consider ways to make telehealth more accessible. Look for accessible features on your telehealth platform: the ability to include an interpreter on the call with the patient and provider, live captioning, high-contrast display, and automatic transcription.
• From Gerber et al, consider using trauma-informed care strategies: ensuring safety; being transparent and promoting trustworthiness (i.e. allow body language to be visible on screen); working collaboratively towards goals; empowering patients’ choices (i.e. preferences about the extent of the visit); and acknowledging cultural, historical, or gender issues (i.e. consider social determinants of health).
• Groups: Engagement may look different than in person. Many are “zoomed out” from virtual school and/or work. Validate this concern and provide examples of strategies to reduce zoom stress (I.e., turn off self-view, take physical activity breaks). How can you encourage participation in creative ways?
   

Patient or participant perspective:

• Before your appointment, write out any questions that you have for your provider. Do you have any side effects from medications? Need any refills? Do you have questions about your condition(s)?
• Open the telemedicine application before for the appointment to make sure you are comfortable with the platform.
• Make sure you know how early to show up for the appointment. Many ask that you login 15 minutes before the appointment is scheduled to start.
• Test your internet connection to make sure that you will  have uninterrupted connection during your scheduled appointment time. It can be helpful to close other windows/applications on your device.
• Find a quiet place to have your appointment where you will not have interruptions during your appointment. If you have headphones with a microphone, this can protect others in your vicinity from hearing your conversation with your provider. 
• Place your camera at eye level and center your face on the screen. Make sure any windows or bright lights are behind your device, not behind you.
   

Additional resources:

• Fact sheets, toolkits, and translated resources for telehealth can be found at https://telehealthresourcecenter.org/resources/
• Search for updates to telehealth policies by state, payer, or provider type: https://www.cchpca.org/all-telehealth-policies
• Check out this recent article with additional tips for patients or participants in SBM's Healthy Living series: https://www.sbm.org/healthy-living/how-to-get-the-most-out-of-your-telehealth-appointment
• For more information about using trauma-informed care in telehealth:
  • Gerber MR, Elisseou S, Sager ZS, Keith JA. Trauma-Informed Telehealth in the COVID-19 Era and Beyond. Fed Pract. 2020;37(7):302-308
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171569/
• Resource on telehealth for people with disabilities: https://telehealth.hhs.gov/providers/increasing-telehealth-equity-and-access/improving-access-to-telehealth/#telehealth-for-people-with-disabilities