Improved video consultations
To ensure video consultations are conducted in high quality, there are some simple tips that can prepare you, as the healthcare professional, for a good video consultation.
There are several things that you can do to improve your and the citizen’s (patient’s) experience. These tips will touch upon the physical environment as well as the planning, duration and ending of a video consultation. The information is seen as an add on to existing frame works for good patient communication such as the Calgary-Cambridge Guidelines. Communicating through a digital platform changes some aspects and this module highlight some of these and how to deal with it.
Physical environment and appearance
Make sure there is good lighting in the room so the image is sharp. These are just two among a range of usable tips for a better video consultation experience.
Setting Up Your Consultation Environment:
- Choose a quiet, private space: Avoid open office environments to minimize background distractions.
- Improve audio quality: Use headphones with a microphone to enhance sound quality and maintain privacy.
- Indicate your organization: If you have a dedicated room, use signs indicating your organization and the ongoing consultation.
- Adjust lighting: Ensure the room is well-lit for a clear image, avoiding direct sunlight that may affect video quality.
- Prepare demonstration materials: If showing equipment, keep it within reach and ensure it can be fully seen on camera.
Professional appearance and movement:
- Monitor your appearance: Check your on-screen image regularly to ensure a professional look.
- Limit and exaggerate movements: Sit still and avoid sudden movements. When emphasizing a point, lift your hands into the camera’s view.
- Compensate for reduced body language: Use larger hand gestures and facial expressions as non-verbal cues are less noticeable in video consultations.
- Dress appropriately: Avoid clothing with narrow stripes that can cause screen flicker. Wear a uniform or medical gown if possible.
Source / References
- The British Medical Journal: https://www.bmj.com/content/371/bmj.m3945.full
- https://www.who.int/ WHO guideline Recommendations on digital interventions for health system strengthening
- www.rm.dk Center for Digital Psykiatri Vejledning om videosamtaler
Working from home
Ensure a clean and professional-looking background. If this isn’t possible, use a virtual background featuring your organization’s logo. Assure patients about your access to their health records and ability to arrange in-person consultations if needed. Let others in your home know when you’re in a consultation and cannot be disturbed
Planning the video consultation
Thorough planning for a video consultation can enhance the consultation process and allow for quick adjustments if issues arise. With practice, you will become more comfortable with this method virtual way of interacting with your patient. A test trial may prove helpful for trying out news way or if you need more assurance.
Setting Expectations
- Clearly communicate the potential outcomes of the consultation. Note that some topics may not be adequately addressed via video as they would be in a physical consultation. Ensure the patient understands this to avoid any misalignment in expectations.
- If the patient needs to prepare anything for the consultation, such as measurements or specific equipment, communicate this clearly.
- If your organization provides a leaflet or informational guide about video consultations, ensure the patient has received and reviewed it.
- Collect the patient’s phone number beforehand. This will allow you to continue the consultation via phone call if there are interruptions or technical issues with the video.
- Provide an estimated duration for the video consultation. This ensures the patient can allocate sufficient time.
Technical considerations
- Have the Electronic Health Record (EHR) or other relevant clinical systems open and ready. Ideally, use a two-screen setup, one for viewing the patient and the other for accessing the clinical system.
- Close all unnecessary programs and apps to maximize hardware performance and internet bandwidth.
- Ensure all necessary devices are fully charged or have enough battery life for the duration of the consultation.
- Have the contact details of your technical support team readily available. This will help quickly address technical problems that you may not be able to resolve.
Tips for Effective Communication
- Speak clearly and allow for pauses, as video connections can sometimes lag
- Periodically take short breaks to provide opportunities for the patient, their relatives, or colleagues to ask questions.
- Vary your tone of voice and emphasize important words to make your speech more engaging.
- If multiple participants are involved in the video consultation, establish clear communication rules to prevent interruptions and to ensure everyone has a chance to speak.
- Rehearse the process. Test the video consultation equipment with a team member before using it with a patient.
Remember, the goal is to make video consultations as efficient and comfortable as possible for both you the healthcare provider and the patient. By doing so, we can leverage the benefits of telemedicine while minimizing potential disruptions or misunderstandings
During the consultation
Non-verbal communication like smiling, making eye contact, and using gestures can significantly impact the effectiveness of video consultations. These elements, along with thoughtful questioning and attention to the patient’s environment, contribute to a comprehensive and meaningful virtual medical consultation.
Establishing Trust and Confidentiality
At the start of the consultation, ask the patient how they feel about meeting over a video call. This sets the tone for the consultation and assesses their comfort level. For instance, a patient with anxiety might need additional reassurance. It may also be helpful to remind the patient that you’re alone during the consultation to bolster the sense of privacy.
Ask the right questions
Given that sensory inputs in video consultations are different than in-person visits, it’s crucial to ask the right questions. For example, when consulting with a patient with COPD, ask about how quickly they experience breathlessness during physical activity. This question provides critical information that you might have otherwise assessed during a physical examination.
A window into the life of your citizen (patient)
Video consultations can offer insights into a patient’s home or work environment. Use this opportunity to make functional assessments and inform clinical decisions. For example, ask a patient to show you where they keep their medications, or observe the room for potential fall risks if the patient has a history of falling. Similarly, signs of dampness or hoarding could indicate factors contributing to respiratory or mental health problems.
Body language
Despite the limitations of video calls, pay attention to non-verbal signs and body language. Look at the patient’s eyes – are they avoiding your gaze? Do they look happy or worried? Assess the patient’s body posture, complexion, and overall demeanor.
Eye contact
Cultivate a sense of connection by looking directly into the camera, which simulates eye contact. Explain to the patient that when you look down, you are observing them on your screen, not losing focus. A correct placement of the webcamera can help with this issue. If that is not possible, it might be helpful to explain, that when you look down, you are observing them on your screen, not losing focus.
Practical tips for the Video consultation
Welcoming the Patient
As soon as both parties have logged into the video consultation, ensure you warmly welcome the patient and introduce yourself, as you would do in a face-to-face consultation.
Patient Identification
Before proceeding, confirm the patient’s identity using their name and social security number. This step is crucial for maintaining confidentiality and ensuring the correct patient records are being accessed.
Setting the Agenda
To maintain clarity and structure during the consultation, it is beneficial to align expectations and establish a shared agenda with the patient at the start of the meeting.
Managing Consultation Time
Inform the patient about the consultations duration, and remind them that they can request a break at any time. Be mindful of the patient’s comfort and offer breaks when necessary, such as offering them time to get a glass of water.
Providing Summaries
Regularly check on the patient’s understanding by providing concise summaries of the information discussed. Ensure they are comprehending the key points, and encourage questions for clarification.
Ending the consultation
The successful completion of a video consultation requires careful attention to ensure that the patient’s needs have been adequately addressed and that the next steps are clear for both parties. Here are four essential steps to ensure a smooth and effective conclusion to your video consultation.
Making sure the citizen’s needs have been met
Throughout the video consultation, the patient may have specific topics or questions they wish to address. Always make sure to inquire if the patient has any lingering questions or concerns that need to be discussed.
Agree on the next steps
Before ending the conversation, it is a good idea to agree on the next steps of the treatment with the patient. Any agreements or changes in treatment discussed during the video consultation should be properly documented in the health records, akin to a physical consultation.
Ask about the experience of using video call
Towards the end of the video consultation, take the opportunity to ask the patient about their experience with the virtual consultation process. Assess their comfort level with the technology used and the overall experience. This feedback can provide valuable insights for making necessary adjustments in future consultations.
Set a date for a new appointment
If the video consultation is part of a regular check-up or treatment schedule, it’s convenient to agree upon a date and time for the next appointment during this consultation.
Ending on a good note
Concluding a video consultation can often feel abrupt, lacking the opportunity for casual small talk usually present in physical encounters. Therefore, it’s vital to deliberately create space for the conversation to wind down. Clearly communicate to the patient when the video consultation is coming to an end.
A recommended practice is to instruct the patient to disconnect first. This ensures that the patient is not left wondering if the consultation ended due to a technical glitch and that they feel in control of the consultation’s conclusion.
Documentation while Fresh
Promptly document and journalize the consultation while the discussion is still fresh in your memory. In some instances, note-taking during the consultation may not be feasible due to the need for maintaining eye contact, preventing keyboard noise, etc. Therefore, immediate post-consultation documentation becomes even more critical.
