- Are you comfortable with the technology?
- Is the patient safe to be seen virtually or do they need an in-person assessment?
- What type of virtual visit is most appropriate?
- Adapting your usual communication skills
- Important requirements & processes to be aware of
ARE YOU COMFORTABLE WITH THE TECHNOLOGY?
- You will be oriented to the use of Ontario Telemedicine Network (OTN) or Zoom but make sure you are comfortable before proceeding with the consultation.
- Some virtual platforms (such as Zoom) have both secure and non-secure account versions. This should be clarified with your institution/attending physician before you start virtual care. Further resources are available in the references section
IS THE PATIENT SAFE TO BE SEEN VIRTUALLY OR DO THEY NEED AN IN-PERSON ASSESSMENT?
- If an in-person visit is needed, what is the urgency, and how can that be organized?
- Are there barriers that might negatively impact a virtual visit?
- Examples include language barriers, cognitive, visual, or auditory impairment, technological barriers, internet connectivity limitations
- Can they be addressed (e.g. use of interpreter, family member, etc.)?
WHAT TYPE OF VIRTUAL VISIT IS MOST APPROPRIATE?
When would a video format be preferred?
- Certain types of visits require visual inspection (e.g. Dermatology)
When would a phone visit be appropriate?
- Phone visits are easier to organize
- Patients may have technical limitations in conducting video visits (including lack of internet access) but be more comfortable with phone
ADAPTING YOUR USUAL COMMUNICATION SKILLS
For VIDEO visits:
- Observing patients and eye contact are both important. Try to balance looking at the patient (to observe them) and looking at the camera (to maintain eye contact with your patient).
- When your patient speaks you can observe them on screen;
- When you speak, look at the camera; and
- when looking away, explain what you are doing (e.g., “I just need to look at your chart”)
- Non-verbal cues can be missed with video visits as well due to the lack of eye contact at baseline. Be attuned to such cues in this setting as well
- For video calls, try not to move your hands too much as it can distract patients.
For PHONE visits:
- With telephone consultations, you lose all the non-verbal cues you would normally use with patients. Try to be attuned to changes in tone of voice and other “paraverbal” communication like intonation, volume, speed or tone of speech (or changes in these factors)
IMPORTANT REQUIREMENTS & PROCESSES TO BE AWARE OF
- Back up plans if telephone or video appointment system fails
- Patient confidentiality requirements at your hospital
- Documentation and prescribing requirements for virtual visits at your hospital
- Professional behaviour and etiquette for videoconferencing
- Patient safety procedures (what to do in case of need for urgent/emergent care)
- Hospital-specific requirements for documenting virtual care should be reviewed with your attending prior to conducting the visit