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Top Tips for Mastering Telemedicine Consultations

Blog: Top Tips for Mastering Telemedicine Consultations

Our guide to making sure your patients get the best online care

Providing telemedicine consultations, and how best to carry them out, came into sharp focus with the Covid pandemic.

Although the idea of providing health care at a distance, instead of face to face, seemed to fit perfectly with lockdown restrictions the take up was never as high as expected.

Technological barriers to the take-up of video existed pre-Covid but the pandemic caused providers to accelerate development to the extent that now it almost seems unthinkable that video consultations could not take place just a couple of years ago.

Telemedicine appointments allow patients to communicate with healthcare professionals in real-time using tried and tested video conferencing technology.

Making video a key part of healthcare tech

Many GPs are undoubtedly put off holding video consultations for want of some basic guidance so we’ve compiled a series of tips which aim to help provide effective and compassionate care during video/online consultations while maintaining professionalism and privacy.

Being prepared builds confidence

  • The internet connection must be reliable and, preferably, you need a back-up plan if connectivity issues do occur
  • Check that your computer has a high-quality camera and microphone for clear audio and video
  • Be familiar with the video conferencing platform you will be using. If necessary, colleagues can trial a dummy consultation or two as a way of ironing out any unforeseen problems.
  • A little preparation will go a long way in building confidence that you can cope with any glitches or change approach, if necessary

Blog: Top Tips for Mastering Telemedicine Consultations

Create a suitable environment

  • Make sure that the place you will be using is quiet and well-lit
  • Minimise distractions and background noise, if possible
  • Ensure that the background is free of personal items, so it looks as professional as possible

Use the personal touch

  • Most patients will appreciate a personal touch, so begin the consultation by putting them at ease with a warm greeting and introduction to yourself
  • Making eye contact is a good way to help establish a rapport. Looking at the camera, rather than the screen, will be necessary for this
  • Using the patient’s name frequently will help personalise the experience
  • Be prepared to offer assistance to less tech-savvy patients and have a troubleshooting plan if issues arise, which may involve using a phone call for the consultation instead

Privacy and security

  • The connection needs to be secure, as specified by the NHS
  • Confirm the patient’s identity and date of birth
  • Remind the patient to ensure their own privacy during the consultation
  • Video sessions must not be recorded but notes should be taken

Communicate clearly

  • Speak clearly and at a moderate pace
  • Avoid using medical jargon when explaining diagnoses and treatment plans
  • Offer opportunities for patients to ask questions

Active listening

  • Do pay attention to the patient’s concerns and questions
  • Verbal cues such as ‘I understand’ or ‘I see’ as well as nods will show empathy and engagement

Visual Examination

  • Train to effectively conduct visual assessing by video
  • Patients should be asked to show specific body parts, if necessary, as long as they are comfortable with doing this online

Watch the clock

  • Do your best to keep your telemedicine consultations on schedule. This respects your time and the patient’s
  • Set clear time limits for the consultation and allow time for questions

Blog: Top Tips for Mastering Telemedicine Consultations

Patient Education

  • Screen sharing can be useful to display relevant images or diagrams
  • Summarise key points and treatment recommendations in writing for the patient to refer to later

Following up

  • Discuss any follow-up plans and schedule a home visit, if necessary
  • Send any prescriptions electronically to the patient’s pharmacy
  • Update the patient’s electronic health record (EHR) promptly

Why get on the learning curve?

During a video consultation, clinicians can assess and diagnose patients’ conditions remotely while discussing their symptoms, medical history and concerns within certain constraints.

Healthcare professionals who are confident with their findings during an online consultation can prescribe medications, and also make referrals for in-person tests, treatments or specialist consultations.

In some cases, healthcare providers may provide patients with chronic conditions remote monitoring devices, such as blood pressure monitors and glucose metres, that transmit data. This enables adjusted of treatment based  on the information being submitted.

Online consultation growth is continuing

Although the percentage of consultations remains low there is evidence that it’s becoming an important complement to telephone and face-to-face appointments. 

In August 2023 nearly 598,000 video/online appointments were carried out – up by 444,000 on August 2022 – indicating that telemedicine is not going away.

So, although representing only 2.11% of the 28m appointments carried out in general practice in August 2023, the numbers seem to be growing. In contrast, the number of telephone appointments saw a slight decline. 

There were 250k video consultations delivered in Wales, from the inauguration of the service up until September 2021.

An evaluation recorded particularly high ratings of patient and clinician satisfaction with a 92.4% rating for ‘quality’ (Excellent, Very Good or Good) for patients and a 71.9% rating for clinicians.

This research also showed that patients expressed enthusiasm for factors such as saving on travel and parking time and costs (92%), avoiding the need to take time off work/school (81%) and enjoying improved convenience and access to care.

Nearly everyone said they would use the service again…

Meanwhile clinicians in Wales, although indicating lower levels of satisfaction, did highlight benefits such as the ‘more efficient use of their clinical time/space’ (75%), ‘increased access to care’ (72%), ‘reduced waiting times’ (69%) and ‘reduced Did Not Attend rates’ (61%).

In Scotland the number of video consultations has grown from 40k video a month in 2022  to 20k a week

Users surveyed estimated that such appointments save an average travel distance of 36 miles each time.

When asked if they would use the service again 97% of respondents expressed a positive rating while 92% found the system easy to use.  

Technology can support patients in their homes

A good example of where technology is supporting urban patients is in the London borough of Newham

Technology is being used to support people in managing their condition, maintaining health and wellbeing, and enabling them to be able to continue to live independently for longer. 

Careful managing of long-term conditions, including high blood pressure, heart and breathing problems, is essential to prevent illness and keep hospital visits and admissions to a minimum.

In Newham, patients’ readings go to a centre where they are automatically logged and checked, so that they can be contacted or visited if there is any concerns arise.

Patients are reviewed monthly over the phone and an ongoing evaluation process is in place.

For most clinicians, their experience with telemedicine will be more similar to that in Wales and Scotland, through online services offered by healthcare service providers including Silicon Practice, NHS Attend Anywhere and AccuRx.

Whichever system your practice uses, there are advantages with being familiar with how it works. 

Conclusion – is telemedicine at the ready?

While the take-up of telemedicine, in particular video consultations, has been slower than anticipated, it still remains an area with huge potential.

The number of video/online consultations is increasing, making it an increasingly important means of delivering consultations. This shouldn’t be underestimated as it acts as a complement to other forms of appointment rather than replacing them. 

Those who gain skills in using video consultations now may gain an advantage in the unfortunate event of another global outbreak that restricts movement of clinicians and patients.

Our video consultation system allows the clinician to schedule appointments or start them immediately, perhaps while already speaking to a patient on the telephone.

Once patients book an appointment, they will receive a message that includes a clickable link to access the session.

Blog: Top Tips for Mastering Telemedicine Consultations

Clicking the link at the start of the appointment time takes the patient to a virtual waiting room, where clinicians can send messages if there are any delays.

Patients can join the consultation when the clinician is prepared.

During the appointment, the clinician retains control, with the option to conclude it when finished or enter ‘Privacy’ mode, which deactivates both video and audio while keeping the session open, ready to begin again.

Notes can be made during the appointment and can be transferred to the clinical system after the session. Please note that, for legal reasons, video consultations cannot be recorded at this time.

For training videos please see our YouTube channel

Find out more about Silicon Practice and our products here

Blog: Top Tips for Mastering Telemedicine Consultations

Written by Bruno Clements

Can video ease pressure on primary care?

Can video ease pressure on primary care?

While video consultation provision was accelerated by the Covid Pandemic it’s fair to say that take up has not been as widespread as expected by those championing online expansion.

In this blog we look at whether video consultations can become an essential part of the primary care toolkit or will be relegated to niche healthcare roles.

Blog hero image: Can video ease pressure on primary care?

The UK primary healthcare industry faces numerous challenges, including increasing patient demand, limited resources and the need for improved access to healthcare services. These challenges have highlighted the urgency for innovative solutions that can optimise healthcare delivery while maintaining quality care.

Video consultations development was fast-tracked as it was seen as one of the ways to interact with patients while minimising physical contact during the pandemic.

What was being seen as an optional extra became a key part of online services offered by Silicon Practice and others.

However, while video seems to have found a place in urgent care settings its takeup has slipped back in general practice.

Clinicians in control

Silicon Practice provides a secure and user-friendly platform for video consultations. With robust privacy measures in place, patients and healthcare professionals can connect virtually, ensuring confidentiality and maintaining the trust between providers and patients.

From the very start, video consultation sessions were developed by Silicon Practice to keep the clinician in full control.

Sessions can be scheduled online, with notifications sent to patients online or by SMS, or happen on demand – directly in response to a patient message received through our advanced dashboard or when the clinician is on a telephone call to a patient.

Patients are messaged to remind them of a forthcoming video appointment and if the clinician is running late they can notify the patient in the online ‘waiting room’ without having to begin the consultation.

The Silicon Practice dashboard itself can be tailored to each practice’s requirements. Staff work hard to make sure customers are satisfied with how their site works at its launch and practices have the flexibility to alter their site and dashboard’s functionality as needs change.

Can phone calls do the heavy lifting?

It’s fair to say that takeup of video consultations has not been as great as politicians and the public might have expected.

While fewer than 1% of UK general practice consultations occur by video that still means that around a million video consultations could be being provided each year (based on 300m general practice patient consultations annually).

Although the perception can be that video consultations are being offered as a replacement for face-to-face consultations they can, in fact, be a useful way of seeing patient reaction or a way of picking up on their behaviour which might speed up the decision on which course of action to take next.

It has also been reported that patients with mental health issues have been able to have a video consultation when they would have been anxious about leaving home.

It may be that easy phone communication acts as an unintended barrier to greater video consultation uptake.

Clinicians have reported that phone conversations provide much of the information they need on which to base a medical decision – even if that often means scheduling a face-to-face consultation.

And talking a patient through a self examination as part of a video call means a lot of detailed instructions and being able to examine the patient personally is usually considered easier, quicker and more likely to result in an accurate assessment by clinicians.

Urgent care medics lead the way

There may be lessons to be learned from the fact that a focus group study earlier this year found that urgent care GPs were keener about the technology, using video it more frequently than ‘in-hours’ GPs.

Urgent care GPs found that their anxieties about using video were overcome by training and, once they were confident, the technology had a range of benefits. These included during the initial assessment, allowing better rapport and trust between clinician and patient.

Video was found to have value in a wide range of conditions, including in identifying safeguarding issues, and was also useful for bringing others into the consultation and helped maximise resources.

‘In-hours’ GPs identified a range of problems, and generally being less confident treating patients without seeing them face-to-face compared with those in urgent care.

Where video proves most effective is in supporting decision making, for example being able to see how distressed a patient is which may not be as apparent from a phone conversation.

One in-hours female GP told the study: ‘I find some people can sound really awful on the phone, but when you look at them on the video you can see instantly … they’re actually all right and vice versa.’ 

Beware of two-tier system

While rural areas would seem to be ideal places for video consultations, potentially saving on long journeys for the patient or clinician, there are concerns that this could lead to a two-tier system.

Poorer families may not have the access to broadband which the more affluent may take for granted and GPs also reported those with larger homes had wi-fi blackspots.

The focus group study also found a wide split in use across the age ranges – some elderly patients, used to speaking to relatives online, were adept while others struggled to use video.

However, poor takeup by some GPs and barriers in day-to-day use doesn’t mean that the potential of video consultations has vanished. It may be a case that we are still only just starting to explore the potential of video.

Blog image: Can video ease pressure on primary care?

Functionality has been increased by Silicon Practice to allow group calls, which could prove invaluable for clinicians needing to have a translator involved in a consultation, a trusted third party or to bring in another clinician for advice.

Video has been used to link with nursing home staff to discuss patients, to at least partially replace visits and for statutory functions such as issuing death certificates, and this could be an area where the technology increasingly comes into its own.

Conclusion: Video’s flexible future

There are many reasons why video consultation uptake continues to be slow.

However, it is still a relatively new technology. A certain amount of resistance from patients and clinicians is inevitable but additional training would seem to be one way of making better use of the equipment which so many people now have at their fingertips.

If those barriers can be overcome, and demand for video in primary care expands, you can be certain that Silicon Practice will be ready.

Contact us to find out more about Foundation with, or without, video functionality. Follow us on socials.

Silicon Practice logo: Blog Can video ease pressure on primary care

Written by Bruno Clements