“Telehealth is the future.” It’s been a common refrain in health care for years. But the COVID-19 pandemic has suddenly thrust a new reality onto patients and physicians: Telehealth is now.
In a recent “AMA COVID-19 Update” video, a panel of experts discussed how to ensure empathy remains central to the patient-physician relationship on this new frontier.
The AMA and the Centers for Disease Control and Prevention are closely monitoring the COVID-19 pandemic. Learn more at the AMA COVID-19 resource center, consult the AMA’s physician guide to COVID-19 and check out other episodes of the AMA COVID-19 daily video update.
Why telehealth works well for some
“If you really think about empathy at an operational scale—which is making life easier for patients, reducing suffering, reducing time spent waiting—digital tools have enormous potential,” said Adrienne Boissy, MD, chief experience officer at Cleveland Clinic Health System.
Patients with multiple sclerosis, for example, could face huge obstacles in keeping in-person appointments, and virtual visits can help remove those obstacles. They can also promote higher-quality care, since “I get to see the rugs they trip on, the food in their fridge, the family that I've never been able to meet,” Dr. Boissy said.
A recent survey of the health system’s patients found that about nine in 10 would use telehealth again. Clinicians were also surveyed and found to be enthusiastic about the health system’s new digital tools, suggesting virtual visits could help with physician burnout.
“We all desire connection, and I don't think we're bounded by any single platform,” Dr. Boissy said. “And if [they] were hesitant to use them before, they're definitely jumping on board.”
Learn about the key changes made to telehealth guidelines to boost COVID-19 care.
Why it might not work for others
Still, telehealth is not a flawless or uniform experience, said Jen Horonjeff, PhD, founder and CEO of Savvy Cooperative, a patient-owned co-op that enables people to share their experiences with health innovators. She, like many others, had never had a virtual appointment before the pandemic.
“I actually had a reflection of being very sad afterwards because I'm so used to this constant in my life of going to see my care team,” she said. “And while it was smooth and everything went off just perfectly, it was a signal to me that something was wrong. And so I sort of grieved that moment of recognition that the world had changed.”
In addition, not all patients will be comfortable giving others a window into their private lives.
“So we also need to be cognizant for people who are living in different situations that may not have a safe space to talk about whatever it is that they're trying to connect with their clinician about,” Horonjeff said. “They might have disarray behind them that they're embarrassed about.”
Read the AMA Code of Medical Ethics’ guidance on ethical practice in telemedicine.
Patient input is pivotal
Different patients have different needs, Horonjeff said, and it’s important when implementing telehealth projects to seek patients’ insights throughout the process.
“Sometimes, one of the biggest burdens of [being] a patient [is] we throw all this stuff at them, and it was never designed together,” Horonjeff said. “And then we call them noncompliant because they're not using it, but we haven't designed it in such a way that they can seamlessly interact with it.”
The key to good design, Dr. Boissy added, is remembering to emphasize the experience you're trying to deliver. And even then, physicians should expect that even the greatest telehealth system still won’t be a perfect fit for some patients.
“You can't hug people online,” she said. “And so for me, part of my … healer judgment is being able to figure out which tools are the right tools for the right relationship and the right person.”
More help with telehealth
The AMA has developed a Telehealth Implementation Playbook with guidance on identifying needs, forming teams and defining success, as well as designing workflows, partnering with patients and scaling operations. Also check out the AMA’s quick guide to telemedicine in practice.