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Research has demonstrated the therapeutic effect of the doctor-patient relationship in enhancing patient satisfaction, improving health outcomes and reducing potential conflicts.

  • More complaints against doctors are related to poor communication than clinical competency.
  • Good interpersonal skills are important for building rapport and trust. Effective communication enables physicians to better understand patients’ values and beliefs. This is especially important where there are cultural, language or social differences.
  • therapeutic alliance involves the patient in all aspects of their healthcare decision-making.
  • Interactions between healthcare seekers and providers depend upon exchanges of information. Technologies can enhance care by optimising communication.
  •  

The COVID-19 pandemic has accelerated the use of technology in healthcare

This reflects the cultural shift in society with virtual meetings now commonplace both professionally and socially.

Increased use of new technologies can be unsettling as we fear losing the personal touch.

Used appropriately, technology can enhance patient-provider relationships. Well-designed and integrated systems allow the focus to remain on effective communication and compassionate care, rather than the technology being used.         

When are video consultations appropriate?

Video-consultations have been shown to be safe and effective for selected patients and situations. Communication has been found to be similar to face-to-face where there are no issues with technical connections.

They appear to work better where there is already an established doctor-patient relationship.

 

 

Can consultation be carried out safely and effectively by video?

Video consultation may be appropriate

 

In-person consultation may be required

Chronic, stable conditions (especially with established doctor-patient relationship)

 

Serious or high-risk conditions

     

Increased demand where in-clinic or home appointments unavailable

 

New patients with exceptions for urgent consultations when clinic appointment unavailable

     

Routine follow-up

 

Patient unable to use required technology and no appropriate support available

     

Ability to easily show physical or visual symptoms via video

 

Physical or internal examination required

     

Triage where telephone call insufficient

 

Unable to prescribe securely, especially for controlled medications

     

Ability to use and report on home monitoring devices e.g., BP, blood sugar.

 

Breaking bad new to patients and carers

     

Patient or physician required to quarantine or self-isolate due to COVID-19 restrictions

 

Patient does not consent to video consultation.

Challenges of using virtual consultations

The use of body language, social cues and non-verbal communication is limited.

Inability to do physical examination or give physical reassurance.

Potential for distractions, especially when speaking from home.

Poor internet connection causing lags or breaks in video or audio

Integration of video consultations into clinic workflow and patient management systems


How can we improve virtual consultations? 

  • Ensure that video consultation is appropriate and safe
  • Test audio and video connection prior to consultation
  • Obtain informed consent for video consultation (both digitally and at start of call)
  • Have medical records to hand wherever possible
  • Use pre-consultation questionnaire where required
  • Consider use of headphones to improve concentration and sound quality
  • Use a neutral background and good lighting
  • Ensure privacy and minimise interruptions
  • Ask for phone number in case of technical problems
  • Introduce yourself, greet patient and check their identity if not already known to you
  • Acknowledge carers or relatives and introduce any other staff on the call
  • Demonstrate that you are listening to the patient:
    • Eye contact – Look directly into your webcam rather than at the screen
    • Appropriate facial expressions or nod head when listening
    • Tell the patient if you need to look away to check or record notes
    • Relay back what you have heard from patient to confirm correct understanding
  • Ask open-ended questions
  • Ensure confidentiality as for in-clinic consultations
  • Summarise call, check patient has understood discussion and ask if they have any questions
  • Inform of addition sources of information and how to contact for any queries
  • Say goodbye before ending the call

Smooth, efficient workflows and be achieved when video consultations and secure direct messaging technologies are embedded into patient management systems.

Medoment is a new healthcare engagement portal. It seamlessly integrates all aspects of communication, including scheduling for either in-clinic or video consultations, a virtual waiting room and many other features.

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