7 Ways CMOs Can Improve Telehealth Sessions

There are seven tips for CMOs to help clinicians communicate well during telehealth visits, according to the CMO of RWJBarnabas Health.

Telehealth visits increased exponentially during the coronavirus pandemic and remain well above pre-pandemic levels.

According to a study, the rate of telehealth visits among commercially insured U.S. adults increased from 0.3% of all healthcare encounters in March 2019 to 23.6% of encounters in June 2020.

A recent journal article, which was published by the Journal of the American Medical Association, gives four tips to help clinicians communicate well during telehealth visits, and Andy Anderson, MD, MBA, executive vice president and chief medical and quality officer at RWJBarnabas Health, provides three more.

1. Wait a second or two

According to the journal article, an experiment found that the time between one person speaking and another person speaking in a conversation increased from 135 milliseconds during in-person conversations to 487 milliseconds during video-based conversations.

"These findings suggest that during video telehealth encounters, clinicians should allow patients a second or two longer to respond to their questions than may feel natural," the journal article says.

It is often a good practice to give patients more time to respond to questions during telehealth visits, according to Anderson.

"If a patient seems hesitant or seems to need more time, that time should be given to the patient," Anderson says. "The clinician should go at a pace that the patient is comfortable with and give them time to respond to questions."

2. Start a telehealth visit with small talk

A clinician should ease into a telehealth visit with small talk, according to the journal article.

One study found that "friendly conversation" including small talk established a positive connection between pediatric cancer patients and oncologists.

"This argues for the utility of beginning a telehealth session with a small talk prompt, such as, 'How has your day been so far?'" the journal article says.

Starting a telehealth visit with small talk is helpful, just as it is in an in-person encounter, according to Anderson.

"Having a personal connection and having the patient start with talking about something that is easy to talk about warms them up," Anderson says. "It makes the telehealth visit feel more like a normal, in-person conversation."

3. Project a professional image

Selecting an appropriate virtual background such as an image of a doctor's office can help build credibility for a clinician during a telehealth visit, according to the journal article.

One online education study evaluated how students reacted to the virtual backgrounds of their instructors. The study found that personal virtual backgrounds were linked to a perception among male students that the instructor was less caring and trustworthy.

"Institutional or professional virtual backgrounds may help establish credibility," the journal article says.

Whether a clinician's background is virtual or real during a telehealth visit, it should be professional, according to Anderson.

"It can be an office or an examination room," Anderson says. "For example, the clinician should not be sitting in their living room with a television. As long as the background is professional, whether it is a real background or a virtual background with the name of the health system, either is OK."

4. Try to establish eye contact

Particularly for first-time telehealth patients, clinicians should look directly into the camera, and explain why they may have to divert their gaze for taking notes or completing other necessary tasks, according to the journal article.

Anderson also emphasized the importance of looking into the camera for clinicians who conduct telehealth visits.

"Ideally, you want to have good eye contact," Anderson says. "If you have to look away, you can tell the patient that you are going to write something down or look at the computer."

Other best practices

There are three other best practices for clinicians to optimize communication during telehealth visits, according to Anderson.

The telehealth visit should be treated just as an in-person visit would be treated in terms of some of the basics such as allowing the patient to talk and tell their story. Other basics include listening intently to the patient and giving the patient time to ask questions.

In terms of appearance and dress code, the clinician should dress professionally. Professional attire can boost the clinician's credibility.

Lastly, a clinician should ensure the patient is comfortable with the virtual visit technology in terms of how to use the camera, how to speak, and hearing the clinician. Cross-checking the technology is an important part of the visit to make sure it is working well for the patient.