Caring differently: optimizing health through telehealth

---

Covid-19 has led to a boom in telehealth visits, and fortunately, it seems they are here to stay! This is great news as emerging research shows excellent outcomes with good patient satisfaction from telehealth visits. Our goal is to make this experience even better, as most of us never learned how to “see” a patient on video during our

training. We’re going to cover some telehealth tips that will help make you successful and keep your patient engaged.

Tools: Basics of a Virtual Visit 

Do Not Disturb Sign

Positive communication skills will support your medical evaluation and ALSO signal to the patient that you are truly interested and concerned about their health and well-being. Some of these skills aren’t any different than in the face-to-face office visit, but some skills will require new tips and techniques to overcome the barrier of distance care. In this video, we will share some strategies to improve your relationship centered communication skills when delivering care remotely.

Tool: PEP

For some communicators, showing empathy is natural. Others of us will struggle more and need to be more intentional. A mnemonic can help remind us of phrases and sentences we can try to incorporate into our patient interactions. One easy tool to help practice empathetic communication is the NURSE mnemonic.

Resource: https://www.vitaltalk.org/guides/responding-to-emotion-respecting/

Tool: Empathy Mnemonic: NURSE

Many components of a telehealth visit are similar to an office visit. One crucial piece of a visit that is different on a video screen is the gathering of objective data including vital signs and the physical examination. This video will give you ideas about all of the information you CAN gather during a telehealth visit.

Tool: Completing the Objective Portion of a Virtual Visit

While every virtual visit should have some vital signs obtained and all will have observation, palpation and auscultation will not be necessary in all visits. When it is necessary, you can help your patients help you get more information for assessment if you incorporate some of these tips!

Tool:  Completing the Objective Portion of a Virtual Visit

This video will give you some tips and a suggested structure for visits with geriatric and mental health visits.  We’ll focus the 4Ms to improve your telehealth visits: What Matters, Medication, Mentation, and Mobility.

Resource: http://www.ihi.org/communities/blogs/what-to-say-during-telehealth-visits-with-older-adults

Tool: Tips for Virtual Care: 4Ms

If you have more time with your chronically ill or geriatric patient, you may want to use this tool to help you with a comprehensive video assessment of your patient’s status. This INHOMESSS checklist was developed to guide home visit content, let’s try using it for our VIRTUAL home telehealth visit!

Resource: https://www.aafp.org/afp/1999/1001/p1481.html#sec-3

Tool: Tips for Virtual Care: INHOMESSS

The mnemonics discussed previously the 4Ms and INHOMESSS can also be used for pediatric patients. Just like in an office visit, a lot of the objective information you get in a virtual visit will be by observing communication, language, behavior, interactions, and activity.

Resource: American Telemedicine Association Practice Guidelines for Telemental Health

with Children and Adolescents. Telemedicine and E-Health, 23(10), 779–804.

The goal of this video is to help you incorporate some motivational interviewing techniques and tools into your telehealth patient visits. The OARS communication technique can help you with successful communication.

Resource: https://www.mcgill.ca/familymed/files/familymed/motivational_counseling.pdf

Tool: OARS Communication Technique

In addition to incorporating OARS into your communication skills, which you learned in a previous video, follow the RULE of Motivational Interviewing to increase your patient’s engagement.

Resource: Haque, Shariq F., and Allen D'Souza. Motivational interviewing: The RULES, PACE, and OARS."Current Psychiatry, vol. 18, no. 1, 2019, p. 27+. Gale OneFile: Health and Medicine.

Tool: RULE of Motivational Interviewing

For your patients letting them know telehealth visits are available.

Tips for your patients to help them have the best telehealth visit possible.