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April 22, 2015 News No Comments

Leveraging Video for Positive Outcomes via Telehealth
Replicating the Primary Care Provider Experience for Acute Unscheduled Care
By Alan Roga, MD


You’ve struggled through a long Friday at work, feeling run down but knowing you needed to push through. Once at home, you feel even worse: You’re burning up, your head is pounding and you feel like you just ran a marathon … without the benefit of training. There’s no way you’re up to driving six miles to the urgent care clinic or waiting for an undetermined length of time in your local hospital’s ER. Tomorrow is Saturday, so even if your primary care doctor could see you Monday, you’re miserable now. Luckily, you have a telehealth provider standing by for exactly this reason. This provider gives the option of a phone call or video appointment. Which would you choose?

Video conferencing has quickly become a preferred means of communication for both business and leisure. According to a global survey of corporate leaders, 76 percent of respondents currently use video solutions in the workplace, with 56 percent participating in at least one video call per week. Despite widespread acceptance in the business realm, video conference utilization varies greatly among telehealth providers. Some embrace video utilization, leveraging it in both Web and mobile applications, while others conduct most patient appointments via phone.

Leveraging video to treat patients via telehealth not only promotes a better patient experience, but also helps promote the best possible outcome. This fact is validated by the Federation of State Medical Boards, which developed the Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine. Per FSMB, fostering a physician-patient relationship is paramount, and video is a critical tool to help achieve this relationship. Video appointments foster the connection formed through face-to-face interactions. The ideal doctor-patient relationship, whether it encompasses a single care episode or 100, is centered on a feeling of trust, communication, and above all, connection.

In addition, video enables the physician to observe the patient’s actions, mannerisms, and expressions. This skill is a core attribute of a seasoned physician and critically important because it draws upon a physician’s knowledge, experience, and instincts. The same way a detective can read a suspect or a teacher can intuit the best way to instruct a child, doctors have perceptions seasoned by their knowledge and experience.

Lastly, video appointments provide a more conducive environment for certain telehealth best practices. By leveraging technology, these best practices facilitate doctor-patient communication, comprehensive data gathering, and an accurate diagnosis:

1) Replication of the physician office visit
From spending a moment in the virtual waiting room to receiving discharge instructions and prescriptions, doctor’s appointments have a cadence familiar to patients that should be replicated in telehealth. This cadence facilitates the proper pace for physicians to view the patient, collect data, and ask and answer questions. It allows sufficient time for clinical documentation. Toward the end of the appointment, the doctor can confirm pharmacy information and give instructions about next steps and a work release form for the patient. Conducting the appointment in a face-to-face video environment also helps replicate the tried-and-true office visit. Together, the face-to-face video environment along with a structure that follows a typical appointment can help ensure the physician and patient both obtain all the necessary information to promote the best outcome.

2) An identical experience regardless of technology or location
Telehealth enables anywhere, anytime access – an advantage for the business traveler in an airport lounge or vacationing parents with a sick toddler in their hotel room. Ideally, the patient should have the same experience whether it’s via phone or laptop. As mentioned previously, this appointment should replicate a traditional office visit as closely as possible. The mobile app, therefore, will ideally offer the same experience – from video visit to discharge paperwork – a doctor and patient would have via computer.

3) A strong doctor-patient connection along with comprehensive documentation
Today’s patients are accustomed to talking while clinicians type data into an EHR. While technology such as EHRs serves an important role, it can hinder the doctor-patient connection. In a telehealth appointment, technology must help foster an intimate connection between the doctor and patient. Tools to facilitate faster, easier documentation can enable the physician to gather extensive data, from the patient’s chronic conditions to the number and ages of the individual’s children – all while maintaining eye contact, picking up non-verbal cues, and maintaining the conversational flow. In short, technology should make patients feel like they are in the room with the physician having an intimate discussion – but not at the expense of comprehensive documentation. Ultimately, this type of telehealth encounter not only results in improved patient satisfaction, but also reduced referral rates when physicians are able to more accurately treat patients through improved technology and documentation capabilities.

In addition to these three items, telehealth providers should keep other best practices in mind. For example, physicians should not only ensure the best possible outcomes for patients, but also identify any non-acute follow-up items such as referrals or chronic condition management. Additionally, it’s important to establish a team-based approach to care by composing a dedicated team of physicians who know each other. They can then provide more cohesive, consistent care and further reduce any sense of anonymity or feeling of transience a patient may experience.

According to the Association of American Medical Colleges, the physician population will only increase by 7 percent in the next 10 years, which will likely create more strain on emergency departments and primary care providers. As telehealth emerges as a viable, cost-effective solution for unscheduled acute care, providers must integrate video and make it a priority for all patient care episodes. Through video, telehealth providers can achieve the best practices necessary to ensure positive outcomes, excellent patient experiences, and strong physician-patient connections.

Alan Roga, MD is a board certified emergency medicine physician, founder and chief executive officer of StatDoctors in Scottsdale, AZ.


JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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