Telehealth: How to bring warmth to your virtual care visits

Tanya Albert Henry , Contributing News Writer

Study after study has shown that patients and physicians alike have mostly positive things to say about virtual visits during the pandemic.

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But as the U.S. health care system remakes itself into one that includes more virtual visits, how can physicians maintain the empathy and “human touch” that are so crucial to a strong patient-physician relationship?

An insightful AMA webinar examined ways you can maintain those essential elements even when the patient isn’t physically in the same room. It also explores ways virtual visits can enhance experiences and improve outcomes and for patients.

“Being able to see my patient in the context of their own home has been a beautiful thing. I ask them to throw open the refrigerator—show me what you had for lunch. Show me the rug you trip over. Let me meet the dog. …It’s been a powerful communication source for me,” said neurologist Adrienne Boissy, MD, MA.

“For patients, we are saving them time, energy, effort in what are very busy lives. They don’t have to take time away from other things they need to do. Or, for mobility reasons, it’s actually the most empathic thing we can do,” said Dr. Boissy, Cleveland Clinic’s chief experience officer.

The webinar is part of the Telehealth Immersion Program designed to help physicians, practices and health systems implement, optimize, sustain and scale their telehealth efforts. That program is part of the AMA STEPS Forward™ Innovation Academy that lets physicians learn from peers and experts and discover ways to implement time-saving practice innovation strategies.

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There are numerous ways to connect with patients during telehealth visits, Dr. Boissy said. And the strategies are sometimes not much different from the things physicians are doing when patients are sitting across from them in the clinic setting.

Dr. Boissy said patient-centered care—whether that care is in-person or virtual—needs to reflect the preferences and values of patients. That can be achieved by knowing a patient as a human being and keeping the patient safe; making things easy for the patient and engaging the patient as part of the care team.

To help physicians achieve those goals, the Cleveland Clinic offers training that features the REDE model of relationship-centered communication. The acronym stands for “Relationship: Establishment, Development and Engagement,” and the model applies validated communication skills.

Dr. Boissy said nearly 95% of those who have received communication training would recommend it and studies have shown that it boosts empathy, cuts physician burnout and increases patient satisfaction in the inpatient and outpatient settings.

Some of the virtual visit communication tips include:

  • Conveying respect to the patient (“Hello, Mr. Smith”).
  • Introducing the technology for the virtual visit.
  • Collaboratively setting the agenda.
  • Making an empathic statement (“I hear your worry”).
  • Eliciting patient narrative (“Tell me more”).
  • Using reflective listening (“You have said …”).
  • Sharing information with the patient.
  • Collaboratively developing a plan.
  • Confirming a patient’s understanding by asking them to share what they plan to do going forward.
  • Providing appreciative closure (“I’m glad you scheduled this visit”).

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While the virtual platform may have a very different feel from seeing patients in person, there are ways a physician can still convey empathy via telehealth. Some tips Dr. Boissy shared included:

  • Establishing the relationship (“Are you new to virtual care?”).
  • Displaying nonverbal empathy. For example, Dr. Boissy said one physician likes to put her hand over her heart and lean into the camera to let a patient know that she is listening and “all in” on the visit.
  • Acknowledging the situation (“I am sorry you feel ill”).
  • Validating feelings (“That is painful”).
  • Naming emotions (“You must feel ...”).
  • Developing the relationship (“It was good to talk to you Mr. Smith”).

Dr. Boissy said “the opportunities are endless as to how we can continue to humanize what can feel like a less than caring system for the people in it.”