Video consultations – a guide for healthcare managers

Building a framework for Video Consultations


As a manager in healthcare, addressing specific areas can support your co-worker’s efforts towards a secure and sustainable implementation of video consultations. Herein, we discuss three crucial areas to consider.

Organizational structure and digital competencies

Ensuring digital competence among clinicians, therapists, patients, and their relatives is critical for leveraging the benefits of video consultations. This mode of interaction demands distinct competencies compared to physical consultations. Healthcare professionals should possess foundational technical skills to use the video solutions securely and consistently. Furthermore, they must be trained to deliver high-quality video consultations ensuring patient safety. Factors include discerning suitable cases for video consultations and determining the patients’ assistance needs for a successful session.

  • Establish a robust support setup within the organization, such as designated super users or first and second support line guidelines.
  • Involve your team in developing guidelines and protocols.
  • If a specific intervention or patient group is involved, consider creating material to prepare the patients for the video consultation.

The physical environment

  • Dedicate specific rooms for video consultations to ensure privacy for patients. Avoid open office environments that can cause background noise and disturbances within the camera’s field of view. Open offices can disturb the citizen (patient), as well as break the confidentiality of the conversation.
  • If dedicating rooms isn’t feasible, encourage the use of headphones with a microphone. It improves sound quality and prevents unauthorized individuals from overhearing the conversation.
  • Put up an ‘occupied’ sign on the door where the video consultation takes place.
  • Display a sign in the background with the organization’s logo, or use a virtual background featuring it.

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Technical infrastructure

Ensuring the security and integrity of video consultations requires adherence to data protection and telehealth regulations. This compliance extends to all data storage, processing, and transfer activities. Key pieces of legislation affecting these areas can include the European Union’s General Data Protection Regulation (GDPR), or other relevant national and local privacy regulations. These laws set standards for the collection, storage, and processing of personal health information.

When choosing a platform for your video consultations, ensure it can support the expected volume of users and provides robust security features. The platform should use end-to-end encryption, have strong access controls, and comply with relevant data protection laws. Data storage is another significant concern in telehealth. All patient information gathered during the consultation must be stored securely to maintain confidentiality and comply with data protection laws. Familiarize yourself with the regulations relevant to your location and type of healthcare practice. If in doubt, your organization’s Data Protection Officer should be the key contact person.

For the video consultation setup, it’s crucial to have a reliable internet connection, a computer equipped with audio and video capabilities, and suitable data transmission devices. A dual monitor setup can be beneficial, one screen dedicated to the video consultation and the other for accessing the clinical system.

If feasible, provide the room used for video consultations with a dedicated video system. This can enhance sound quality and user experience. If a dedicated video system is not available, headphones, microphones, or a speakerphone can also improve sound quality.

Always have a backup communication plan in place, such as a phone line, in case the video conference communication is interrupted. This ensures continuity of care even in the face of technical difficulties.

In summary, protecting patients’ privacy and securing their health data should be central to your telehealth strategy. By adhering to legal standards and implementing robust technical measures, you can create a safe, effective environment for video consultations.

Suitable for whom?


Video consultations are one of the most prevalent forms of telemedicine.

Video consultations are an increasingly prevalent modality of telemedicine, offering numerous benefits to both patients and healthcare systems. For patients, video consultations can save time, facilitate frequent short contacts, and improve safety through quick follow-ups post-hospitalization. These consultations can minimize or even eliminate readmissions. For healthcare systems, video consultations can reduce transportation requirements and curb the spread of infections like Covid-19.

However, video consultations might not be universally suitable. Patients have different life circumstances, health conditions, and coping mechanisms, and these factors should be taken into account when determining the suitability of video consultations.

As a healthcare manager, your role involves providing clear guidelines, protocols, and decision-making tools to support your co-workers. These resources can help your team ensure the delivery of high-standard healthcare via video consultations.

Protocol for patient groups

In the context of healthcare, inclusion and exclusion criteria are the characteristics that determine if a patient is suitable or unsuitable, respectively, for a specific form of treatment or participation in clinical trials. When applied to video consultations, these criteria help identify the most appropriate patients for this format.

For instance, if a patient presents symptoms that could either indicate a minor infection or a potentially serious condition like appendicitis, the ambiguity and potential risk make a physical consultation the safest choice. Video consultations, while not always an equivalent substitute for face-to-face consultations, can be a convenient and less burdensome alternative for many patients, particularly when non-emergency situations are involved.

Inclusion criteria

Inclusion criteria typically encompass clinical and situational factors indicating that a patient would derive benefits from video consultations. For example, consider a patient, living with a chronic but stable condition that necessitates frequent but non-complex follow-ups. Video consultations offers a convenient supplement to traditional in-person treatment.

Similarly, for individuals who lives in rural areas, video consultations could be the optimal solution for healthcare access, effectively breaking down geographical barriers. Inclusion criteria for video consultations may include:

  • Patients in stable treatment courses or those managing less severe illnesses.
  • Patients with the necessary digital skills, access to the required equipment, and a stable internet connection.

Exclusion criteria

Exclusion criteria aim to identify patients who might not benefit or could potentially be harmed by video consultations.

  • Clinical contra indications e.g. outside normal reference requiring immediate physical evaluation, or patients at risk of suicide.
  • Patients with complex, multi-system medical issues that require thorough in-person evaluation and treatment are not ideal for video consultations.
  • Lack of necessary digital competencies, or the absence of a caregiver who can assist in setting up the required technology.
  • Physical or cognitive conditions, such as severe hearing impairment or attention-deficit disorders, which could inhibit effective communication during a video consultation.

In certain scenarios, video consultations may not be suitable due to the nature of the information being communicated. For example, disclosing a critical diagnosis such as cancer is a delicate process that often needs a personal, empathetic touch that a physical meeting can provide. In such sensitive scenarios, ethical considerations become paramount.

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Questions for reflection


When using video consultations, doubts and dilemmas might arise for the healthcare professionals both before, during and after the consultations. These questions can be a good starting point when implementing video consultations and a tool to facilitate a room for reflection.

Question 1

What might be the ethical challenges when treating and communicating with patients remotely, such as preserving confidentiality and privacy?

Question 2

In what ways might the patient-provider relationship dynamics be altered in the context of video consultations? What are the potential implications for trust, empathy, and patient engagement?

Question 3

What strategies can be implemented to ensure optimal experiences for both patients and healthcare professionals during video consultations?

Question 4

How might the accessibility and availability of video consultations impact the health equity among different patient groups?

Question 5

What is the role of non-verbal communication in video consultations and how can healthcare professionals adapt to its limitations?

Question 6

How might cultural differences and language barriers influence the effectiveness of video consultations, and what strategies can be implemented to overcome these?

Question 7

How might the principles of beneficence and non-maleficence be impacted in video consultations? For example, consider how decision-making about treatment plans might be affected.

Question 8

How can healthcare professionals ensure they are appropriately understanding and addressing patient concerns during video consultations, given the lack of physical examination and potential communication challenges?


These questions can be used individually or as a starting point for discussion in a group session.They are also printable.

Feel free to think of more questions.

Remember, the appropriateness of video consultation should be considered on a case-by-case basis, considering the patient’s medical condition, their personal circumstances, their comfort with technology, and the quality of care that can be delivered remotely. Here are two examples that shows when video consultations can be suitable and where it is not.

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Case: Suitable for Video Consultation

Patient: John, a 65-year-old retired schoolteacher living in a remote rural area, with a history of stable type 2 diabetes managed with oral medications.

Scenario: John needs regular check-ups every 3-6 months to monitor his blood glucose levels, weight, and general well-being. Travelling to the nearest healthcare center is challenging due to the distance and limited transportation.

Why Video Consultation is suitable: John’s condition is stable, and his needs can be met via video consultation. He can share his blood glucose readings and weight measurements electronically. His medication adherence and side effects can be discussed, and his wellbeing and mental health can be assessed. This approach saves him travel time, and mitigates any risk of infections he might acquire in the healthcare setting.

Case: Unsuitable for Video Consultation

Patient: Maria, a 50-year-old woman who presents with new, significant abdominal pain and weight loss.

Scenario: Maria contacts her doctor’s office with these symptoms, which could indicate a serious condition such as gastrointestinal malignancy.

Why Video Consultation is not suitable: Given her symptoms and the potential severity of her condition, Maria needs a physical examination and possibly urgent investigations. A video consultation would not suffice in assessing her properly, determining the urgency of her condition, or ensuring the appropriate next steps in her care are taken immediately.