The COVID-19 pandemic helped thrust telehealth to the forefront of patient care. Front-line physicians may have been most immediately affected by this seismic shift in the art and science of medicine, but medical school faculty and their students weren’t far behind. With the end of the COVID-19 public health emergency, most care is again being delivered in person, yet telemedicine remains a vital mode of care—one that should be part of physician training.
During the telehealth patient encounter, the goal should be to “replicate an in-person clinical encounter as closely as possible, and strategies for incorporating learners into the visit should be the same” as for in-person encounters, according to the authors of the “AMA Telehealth Clinical Education Playbook,” an educator-directed guide focused on embedding educational interactions within a telehealth patient encounter. Download the playbook now.
“This includes clear explanation to the patient of the roles of each team member, learner and preceptor. The experiences should be richer than a simple video call.” Learners should be incorporated into the visit using modified strategies that take advantage of telehealth and minimize barriers to education.
Supporting telehealth is an essential component of the AMA Recovery Plan for America’s Physicians. You took care of the nation. It’s time for the nation to take care of you. It’s time to rebuild. And the AMA is ready.
Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.
The authors identified these essentials to creating a high-quality telehealth encounter.
- Eliminate actions that can distract viewers. These include eating, drinking, being on the phone and looking around.
- Make sure your space is private. Look for a place where you can close the door and be free from external noise.
- Look into the camera. This simulates eye contact. Positioning your view of the patient close to your camera can help.
- Project your voice. In other words, imagine speaking “through” the microphone.
- Sit up straight. Just as you would in person.
- Make sure you have good lighting. Also consider using a background to mimic an exam room.
- Dress professionally. Again, as if you were in clinic.
- “Frame the shot.” Put yourself in the center of the frame.
- If you are doing the encounter by phone, place the phone on a stable surface. Noise from holding it in your hand can be distracting for the listener.
- Create a clinical experience, not just a video call. This includes seamless communication between team members, learners and preceptors.
- Pause before responding to each person’s comment or question. Delays can occur with voice and video transmission, giving participants the impression of being interrupted. This is increasingly important when three or more locations are involved.
- Follow best practices and relevant laws. These include credentialing, licensing and HIPAA.
“Consider providing the patient with opportunities to provide feedback to team members and learners as well,” the authors wrote, adding that this can be done informally at the end of the encounter with questions like, “Do you think our medical student did well today?”
You might also use a more structured feedback format, such as a post-visit survey.
“Similarly, learners should be afforded the same opportunities to share their impressions of the telehealth encounter and thus become incorporated into a collaborative process of ongoing improvement,” the authors added.