 and a family medicine physician in Middleton, Massachusetts. 

Mark Allara, MD

Due to COVID-19, many physicians are trying telehealth for the first time.

For those unaccustomed to telehealth visits, establishing your virtual bedside manner or “webside manner” can be a challenge. I remember confronting this issue on my first telehealth visit in 2016 when I treated one of my long-time patients facing a gout flare-up while on a business trip. Although it was a successful visit, I have learned a lot since then about delivering effective and efficient care online.

Here are my top five telehealth tips to cultivating a pleasing webside manner, improving patient satisfaction and increasing loyalty:

Remember that most patients are unfamiliar with telehealth and could benefit from some upfront explanation, both operationally and financially. Take a few minutes to explain the technology, such as mute control, and ask if they can see and hear well. Share tips to maximize their benefit, including reminding them to be as descriptive as possible since you will not be able to perform a hands-on examination.

Also, it is important to educate patients that services delivered using telehealth are likely covered by their insurance, including Medicare. As of mid-November, the Centers for Medicare and Medicaid Services were reimbursing telehealth services 

 as in-person visits due to the COVID-19 pandemic. While 

 to pre-COVID-19 reimbursement policies, so be sure to check the health plan beforehand and notify the patient if services are not covered. Also be sure to let patients know what services your practice is offering and treating through telehealth.

Finally, if you’ve chosen a HIPAA-compliant telehealth solution, remind your patients that the visit is over a secure connection, and the visit—just like an in-office visit—will remain confidential.

Classifying 'Independent Contractors' in Your Medical Practice

Consider the visual aspects needed for a successful appointment and pleasing webside manner. For example, your office should be well-lit and organized to indicate professionalism. Likewise, physicians should dress professionally in their familiar white coat to relax the patient and establish trust.

Eliminating distractions and noise is also important so the patient can concentrate on their condition and their concerns. It’s okay to politely ask patients to brighten their room, turn down a loud television or remove a pet from their area if it is interfering with the exam.

Eye contact is crucial, but tricky to achieve online. Adjust your web camera so the patient’s video window is positioned to give the appearance of a face-to-face conversation while enabling you to also review their chart on your screen. To support eye contact, electronic health record (EHR) data should be integrated with the telehealth technology so you can easily refer to information without searching. Likewise, a screen-sharing capability can share exhibits, such as x-rays, labs or other information to help the patient understand their condition better and improve the overall experience.

Asking the patient more questions will likely be necessary since physical exams are more challenging. As such, don’t be afraid to creatively collaborate with patients to learn more from your visual physical exam, such as asking them to adjust their camera or perform movements or exercises that can help narrow your diagnosis. Working together you can get more out of a physical exam than you might expect. For example, on my first telehealth encounter, I asked my patient to remove his shoe and show me his gout-inflamed foot.

To further demonstrate empathy, be careful to allow the patient to finish expressing their thoughts to avoid talking over them. Non-verbal communication, such as smiling and nodding regularly can further reassure patients that you are attentive and listening to their concerns.

In addition, you can strengthen your webside manner by repeating or paraphrasing patient concerns, questions and priorities to forge mutual understanding. Beginning the appointment on time also shows the patient that their health concerns are important.

Wellness services may pose compliance risk

The success of the telehealth session can be improved if the whole process is familiar and easy for the patient and any support staff.

Accessing the telehealth platform should be as simple as possible, avoiding unnecessary downloads or logins. Likewise, the platform should integrate all of the pre-visit steps for a seamless experience that mirrors familiar in-office workflows; for instance, reminding the patient of their upcoming appointment through email, text messaging or postal mail, depending on their preference.

Same as an in-office visit, the telehealth appointment should include check-in steps and a “waiting room” before the session starts. Continue to update the patient that their appointment will begin soon to show that you didn’t forget about them. The telehealth experience should also include preliminary steps with clinical support staff, if necessary. The more familiar and seamless the flow, the more successful for all involved. Combining all aspects of the virtual visit in a single telehealth platform makes it easier for the practice to manage, as well.

Initially, virtual visits may seem strange for both physicians and patients alike, but by focusing on optimizing the patient’s experience and cultivating a positive webside manner, physicians and practices can improve patient loyalty by affording them a new and unique way to access care and manage their health.

and a family medicine physician in Middleton, Massachusetts.

Articles

5 tips for improving virtual bedside manner.