How to Support Patients Remotely (Part 1)
Over the past few years, medicine has shifted from being mostly in-person to being at least partially virtual — a practice called telemedicine or which allows practitioners to evaluate, diagnose and treat patients remotely. Many minor medical issues can be diagnosed over the phone or over a videoconference — particularly if patients have visual symptoms. A trained practitioner can typically determine during a telemedicine appointment if an in-person appointment is necessary by assessing symptoms, listening to the patient describe their experience, and reviewing medical history.
With the future of office visits in limbo, it would appear that telehealth is here to stay. At this point, we can probably expect a degree of telehealth to be present in most medical practices, even if only at specific points of a practitioner-patient relationship, such as check-ins.
Here are some of the benefits of telehealth, best practices to keep information HIPAA-compliant, and some examples of how practitioners are creating hybrid models to best serve their patients. For videos containing more information and advice from our partner practitioners, check out our page.
The Shift to Telehealth
Many insurance plans now include some sort of telemedicine, which means that many practitioner’s offices have also shifted to offering some sort of 24-hour on call service. Some of these services offer video chats, but many are telephone-only. Furthermore, there are many services available now that are not only HIPAA-compliant, but affordable for any situation.
As one might expect, shifting to telehealth can be a struggle for a variety of reasons, and of course, those reasons can be different according to the unique needs of each speciality.
“At first, it was a little awkward,” admits , licensed psychotherapist and brain health expert. Sell has had to shift a significant portion of her therapy practice to a virtual model recently. “But after getting into the groove of things it became a very positive experience.”
There are many benefits of telehealth. Just like any other new process, it gets easier as you get used to it. The best part is getting to learn from those who came before you who can teach you best practices. Here are some things to keep in mind if you’re looking into telemedicine for your practice.
Benefits of Telehealth
The benefits of telemedicine can vary depending on the nature of the appointment but overall, practitioners and patients alike seem to appreciate the convenience factor over anything else.
“While there is no substitute to meeting my patients in person, telehealth has proven to have significant advantages,” says , a reproductive endocrinologist and infertility specialist with . Patel agrees that the flexibility of telemedicine is important and helpful, but for his specialty, there’s another benefit that proves to be critical — “telehealth allows partners to attend more often, as well.”
“It’s much easier to hop on a session during lunch or even before the work day begins. Clients can schedule more frequently as they are not juggling taking several hours off of work for a therapy appointment,” says Sell.
For Sell’s therapy practice, she believes getting a glimpse into her patients’ home life is a fascinating built-in benefit to telehealth. “We get to take a peek into their home life, which is something most therapists don’t get the opportunity to do. This allows us to see valuable information about the inner workings of their lives.”
And as for adapting treatment to the circumstances, she’s making adjustments and has found that it’s not only possible, but sometimes preferable. “I have learned how to use EMDR (a trauma treatment) in session remotely. This has the potential to change so many lives due to accessibility of service.”
EMDR is often used for people who experience PTSD from military service, assault, or other traumatic experiences. In some cases, these patients may have difficulty coming into an office due to physical disability, or they find the treatment is more effective if they’re in the comfort of their own home.
Another benefit of telehealth is fewer obstacles in the way of arriving at an appointment — both literally and figuratively. “Many providers report a lower no-show rate using telemedicine than traditional care because this modality eliminates obstacles that got in the way of patients’ showing up for appointments: travel time and transportation issues no longer get in the way,” says . “Childcare issues are reduced or eliminated, minor illnesses won’t keep them from showing up, and even if they’re running late, they can still get there because ‘there’ is wherever they are.”
King has quite a lot of experience with telehealth. For the past decade, she’s been training and coaching behavioral health providers on best practices including outreach, engagement, specific evidence-based programs, and various treatment modalities — including telemedicine.
Based on her clients’ feedback, King is comfortable saying that telehealth is an excellent way to help people relax, which will likely give them a better practitioner-patient experience overall. “Receiving treatment in their own home or other familiar space can also reduce patient stress and help them be more present for their appointment,” she says.
Furthermore, there are certain specialties that lend themselves easily to telehealth. “Patients with neurologic illness are some of the most immobile,” says Dr. Eric R Anderson, MD, PhD and the Chair of Neurology at . “Some cognitive patients have to rely on caregivers to drive them to appointments — for example, epilepsy patients often cannot drive, patients with movement disorders have difficulty with travel as do patients with ALS, and other neuromuscular conditions. For neurology patients as a whole, there is often a resounding preference for telemedicine visits as it makes care more accessible to them.”
While telehealth may not be practical in every circumstance, the convenience factor is hard to deny. Some people will always prefer in-person appointments, and sometimes, it will be necessary.
Best Practices of Telehealth
Choose a HIPAA Compliant Telehealth Provider to Ensure Privacy
First and foremost, it’s critical that any telehealth provider you choose for virtual appointments meets HIPAA requirements and is completely secure. There are many options available, but our preferred recommendations are DOXY, Vsee, Updox, SimpleVisit, and Zoom for Healthcare (). All of these companies are HIPAA compliant, versatile for anyone’s budget, and have strict security measures to protect data.
How to Support Patients Remotely (Part 2)
Set up a Virtual Patient Portal
If you haven’t already set up a virtual patient portal for your practice, now is a good time. While some will resist it (and they don’t necessarily need to use it if they’re uncomfortable with it), the younger generations will undoubtedly prefer it, and older patients’ children and caretakers will appreciate it because it keeps all their information in one place.
This is also a place where your patients can enter credit card information, fill out forms, view test results, and even book appointments. It’s very convenient, and provides another way to communicate with your patients.
Set up Your Wellevate Dispensary
is a seamless way to keep your patient recommendations organized and accessible. Practitioners are able to prescribe necessary supplements to each individual patient, along with dosage stipulations. Patients can rest assured that they’re purchasing the exact supplements their practitioner wants them to, and that they’re taking them as directed. They can order directly through the website or the mobile app.
Wellevate is an excellent addition to any practice, but is particularly useful for virtual visits and supporting patients remotely. If someone is unable to get to the office for a visit, all the information they need is in their patient portal and their Wellevate app. We specifically created this product because we wanted to make it easy for patients to adhere to prescribed plans.
Be Clear and Concise
Patients who have never used telemedicine may be confused and timid about the new processes. Having explicit instructions to refer back to and a place to turn if they’re confused will be crucial to success.
“Provide clear instructions as part of your appointment confirmation and reminder process,” says King. “Patients need to know when to log in, where, and how. Will you contact them, will they contact you, or will you meet together in a specific online location? Be prepared to have someone in your office provide tech support if needed.”
Have Your Technology Prepared
Technology can be temperamental and frustrating at times. It doesn’t necessarily work when we need it, which can easily annoy patients and practitioners alike — your patients know your schedule is packed and are worried they’re losing their time slot, and you’re worried about your schedule becoming delayed because of technical errors. What you don’t want is the technical issues to be your fault.
“Understand in advance how to operate your technology and get help if you need it before you start seeing patients virtually,” says King. It would be a good idea to do an audio and video test at the beginning of each day (perhaps to another practitioner in your practice) to make sure that everything is in working order.
Most providers are using a laptop or a tablet so that the webcam is built in, should it be necessary. If not, you’ll only need to make sure your microphone is working properly. If you’re using a telephone, this is a bit simpler.
Be Communicative with Patients
King recommends doing your best to be on time for virtual appointments. Of course, things come up or some patients may take longer than you’d expected. For the most part, patients are used to this kind of thing — but the key is communication.
“If you tend to run over, have an office assistant or nurse connect at the scheduled appointment time so your patients aren’t sitting there worrying they’re not in the right place or doing the right thing,” advises King. Then, when you’re ready, you can join to begin the appointment and your colleague can sign off.”
Of course, not everyone is equipped or staffed enough to have a support person. In that case, King recommends having another line of communication ready — perhaps a text or an email — and let your patients know that this is how you will communicate with them in such circumstances. “Set realistic expectations about timing in advance of the first telemedicine appointment to reduce patient frustration,” says King.
Dress and Behave as You Would in Your Office
Whether you’re conducting virtual appointments from home or your office, it’s important to treat the appointment as if you were going to see the patient in person. Dress in the same way you would in the office (whether that’s a white coat or scrubs), and use the same types of communication you would otherwise. The familiarity will help your patients be more at ease.
In order to keep a similar dynamic and tone for his telehealth appointments, holds to his regular dress code. “I’m wearing scrubs with my name on them and my nurse begins every call to introduce me.”
Furthermore, King has some advice in terms of setup — especially at home. “Have a headset to reduce background noise whether using phone or video. If on video, make sure you have good lighting, a professional background (a plain wall works just fine), and a stable camera position — don’t balance your laptop on your knees or hold your phone camera in front of you with your hand. Conduct appointments in a private, professional space (not, for example, your living room couch with kids running around) just as you would in your typical office interaction.”
Hybrid Models
Most practitioners would like to have their patients come into the office at least once per year, but it’s becoming more common for practitioners to do a of in-person and telehealth. Each patient will probably have their own preferences as to how they use a hybrid model, and that’s fine. The important part is that they’re getting the care they need — and that can be a bit tricky, depending on the specialty.
“Plastic surgery is a very visual specialty, so video is the only option,” says Smith. “Whereas a great deal of my exam is performed almost instantly when I meet someone in person, I have to ask specific questions to get the same information via video. For example, I can move my own head around to see how shadows hit a face from different angles in person. On video chat, I have to ask them to show me their face from different angles.”
“The kind of care we can provide changes,” Smith says. However, he can conduct a surprising amount of medicine over a video chat. “We obviously aren’t doing surgery over video chat, but we can help triage patients and determine the severity of an injury. Does a certain cut or burn really require a trip to the emergency room? What kind of treatments can we guide them to perform at home? We also offer pre-procedure planning and post-procedure follow-up at home to minimize office visits.”
Connecting Meaningfully with Patients
Smith feels that while some of the connection is lost, it can be regained through a good conversation. It’s also helpful to take detailed notes during your discussions with patients. Making a note of their spouse’s name, children’s names, and approximate ages can help open conversations up and make patients feel more comfortable. They’ll feel like more than just another patient coming through your metaphorical door, and more like a valued person. Furthermore, this simple action can help establish trust — especially with newer patients.
While the term telehealth implies that it’s healthcare conducted over the phone, the term is broad and can also incorporate video in its meaning. “I prefer video since it allows for more of a ‘connection’ with my patients,” says Patel, particularly because losing that connection was one of his primary concerns about virtual office visits. For in vitro fertilization (IVF) patients, this connection is a significant factor. Fortunately, his concerns were easily dismissed. “I feel it has actually been quite effective. Oftentimes, being able to share one’s fertility story from the comfort of home leads to patients opening up more than they would in a medical office, which, at times, may come across as intimidating to some.”
Of course, some specialties are more difficult than others. can’t weigh her patients — something simple to do in an office that is pretty important for nutritionists, as they often provide weight management counseling. “I have to rely on my client’s best guess of losing or gaining weight. I also can’t give my clients samples or coupons like I used to, though I have sent coupons in the mail.”
Not being able to physically see a patient in the office is frustrating for many practitioners, and Andrews is no different. “I prefer video over phone unless I’ve been working with a client for a while. It’s harder to read body language online, but this forces you to listen more closely.”
Like Sell, Andrews enjoys the sneak peek into her client’s homes, but she also likes being able to give them a sneak peek into her own. “I can run and grab a product out of my pantry to show a client or open my cupboards at any time. They can also show me products they use regularly.”
Another way to stay connected with virtual or remote patients in a meaningful way is to send out a newsletter. The newsletter can update patients of any new developments in the office, introduce new staff members, announce departures, encourage them to reach out with any questions, remind them of important dates and information, and maybe even provide a wellness tip. Having this brief email intrusion will help keep you on their minds, make them feel more comfortable reaching back out to you and your staff, and feel further valued as a patient in your practice.
Alternatively (or together with newsletters), you could use social media to stay connected with patients. If you’re not sure how to do that, Emerson Ecologics has .
Drop Shipping Supplements to Patients
One of the most important ways you can support your patients remotely is to make sure they’re comfortable with their supplements and are sticking to their plans — and Emerson Ecologics can help you with that.
We can drop ship your patients their orders through our virtual dispensary, Wellevate. Patients can also download the . This is the easiest way for them to order their supplements, and it allows you to keep all of their dosage instructions and records together.
How to Support Patients Remotely (Part 3)
Are you interested in learning more about supporting patients remotely? Check out our entire series!
Disclaimer: This article is not intended to be construed as legal advice in any way. Each state has its own set of laws regarding the practice of medicine. It is recommended that you consult with your local attorney and state licensing boards to ensure you are practicing within existing laws, as well as emergency amendments. These experts can provide guidance and interpret the laws correctly for your region and your license/practitioner type.