Telemedicine/Telepharmacy: Tips for Connecting With Patients
Telehealth (includes telemedicine and
telepharmacy) is commonly used, especially with rural or underserved patients,
or during the COVID-19 pandemic. Examples
of telehealth methods are e-visits (e.g., video calls), telephone calls, text
messaging, and emails.1 Use these tips as you practice
telehealth.
Plan Ahead
- Ensure
patients have home monitoring tools (e.g., blood pressure cuff, peak flow meter,
glucometer).
- Do
a test e-visit to trouble shoot any technology issues.3 Build time into your schedule for
technology issues, especially at first. Visits
may take a little bit longer until everyone gets used to the process.5
- Ask
patients to plan to use a quiet location without distractions for visits (e.g.,
not while driving).5
- It
may be helpful for some patients to have someone with them during e-visits,
especially if they may have difficulty understanding or remembering things
discussed during the visit.
- If
using your personal phone, dial *67 before the phone number to block your
number from caller ID.
Be Efficient
- Involve
team members. For example, medical
assistants, nurses, or pharmacy techs can help with things like coordinating
appointments, triaging visit types, documenting patient weights or home blood
pressure or glucose readings, reviewing med lists, trouble shooting technology
issues, etc.
- Use
tools or checklists to make sure you have covered everything. For example, a guide for virtual med histories
and discharge education can be found at https://www.ismp-canada.org/download/safetyBulletins/2020/ISMPCSB2020-i2-VirtualBPMHDischargeEducation.pdf.
Provide Good “Webside” Manner3,5
- Keep
the camera at eye level and look directly at the camera for direct eye contact.
- Movements
are magnified on camera. Sit still,
avoid distractions, and focus on the visit.
- Make
sure patients can see you. Lighting
should come from in front of you, NOT from behind.
- Limit
background noise and distractions (e.g., work in a private area, close the
door).
- With
phone encounters, let patients “hear” your smile. Request detailed verbal information if you
can’t see the patient (e.g., “tell me the steps you take to use the purple
inhaler”). Feel comfortable with silence
while the patient absorbs information, or while you document or gather your
thoughts.
Document Visits and Limit Errors
- Follow
policies and procedures to document telehealth visits. These may include things like:4
- the
method of communication. (Note that
reimbursement may vary with visit type.)
- where
you are and where the patient is during the visit (e.g., home, office, other).
- start
and stop times for each visit.
- Use
the teach-back method and document patient understanding of the “take home
message” from the visit (e.g., instructions for new med, when to check blood
sugars, what to do if not improving).5 Can also send an after-visit summary
to the patient.
- When
calling in verbal Rxs, spell all names (prescriber, patient, med). When receiving verbal Rxs, read back the
order for verification. Speak clearly
and loudly if needed, especially if wearing a mask.
Protect Patient Privacy During Telehealth Visits
- Start
telehealth visits by confirming the patient’s identity and obtaining consent.6
- Avoid
doing e-visits in rooms with windows positioned to view your monitor (or cover
windows).6
- Put
a sign on the door for privacy to prevent others from entering the room during
an e-visit.6
- In
the U.S., healthcare providers will not be penalized for HIPAA violations that
occur in the good faith provision of telehealth during the COVID-19 nationwide
public health emergency.2
Project Leader in preparation of this clinical
resource (360514): Beth Bryant, Pharm.D., BCPS, Assistant Editor
References
- Toh N, Pawlovich J, Grzybowski S. Telehealth and patient-doctor relationships in rural and remote communities. Can Fam Physician 2016;62:961-3.
- U.S. Department of Health and Human Services. Office for Civil Rights. FAQs on telehealth and HIPAA during the COVID-19 nationwide public health emergency. https://www.hhs.gov/sites/default/files/telehealth-faqs-508.pdf. (Accessed April 20, 2020).
- eVisit. 5 easy steps to get the best webside manner. https://blog.evisit.com/5-easy-steps-to-get-the-best-webside-manner. (Accessed April 20, 2020).
- American Medical Association. Telehealth implementation playbook. 2020. https://www.ama-assn.org/system/files/2020-04/ama-telehealth-playbook.pdf. (Accessed April 20, 2020).
- Connelly A. A health professional’s guide to optimizing telehealth communication. March 2020. https://covid.pharmacy.ufl.edu/2020/03/25/optimizing-telehealth-communication/. (Accessed April 21, 2020).
- Ontario Health. Adopting and integrating virtual visits into care: draft clinical guidance for health care providers in Ontario. March 12, 2020. https://quorum.hqontario.ca/Portals/0/Users/170/54/10154/Draft%20Clinical%20Guidance_Adopting%20and%20integrating%20virtual%20visits%20into%20care_V1.pdf?ver=2020-03-13-091936-370. (Accessed April 21, 2020).
Cite this document as follows: Clinical Resource, Telemedicine/Telepharmacy: Tips for Connecting With Patients. Pharmacist’s Letter/Prescriber’s Letter. May 2020.