Speaker 1: Telehealth, or telemedicine, lets you provide medical care to patients without an in-person visit. That can mean live interactions, including video calls, audio-only calls, or live secure messaging. It can also mean less immediate interactions, for example, email, sharing images or lab results, or remote monitoring of vital signs. Since telemedicine is an evolving field, some challenges still remain, like disparities in patient access, lack of ability to complete a comprehensive physical exam, and difficulties making an emotional connection or interpreting a patient's body language. However, the many benefits of telemedicine far outweigh any limitations. Thanks to its potential to improve health care access to underserved populations, its cost-effectiveness, and its potential for enhanced social support for patients. Because telemedicine is such a new kind of patient care, it requires specific communication and technical skills, different clinical skills than in-person assessments, and unique patient safety, legal, and privacy considerations. Now let's explore how a telemedicine visit with a patient might unfold. Before any telemedicine encounter, make sure your patient is prepared. The right equipment, communication skills, and any necessary medical information. This preparation can be completed by office staff during scheduling of the visit. Societal factors, such as language barriers, health literacy, and access to technology can make telemedicine difficult to access for marginalized individuals. By properly preparing your patient before a virtual visit, you can help make sure you are providing equitable care to all patients. As a physician, you also need to be prepared with the right equipment, the right software, and the right environment. Make sure your location has a professional-looking background, adequate light, and you are framed with head and shoulders centered on the camera. At the start of the visit, introduce yourself and your supervising physician, if applicable. Confirm the patient's identity with their name and date of birth. Inquire if anyone else is with them and where they are located. If necessary, ask the patient to adjust the camera and audio for clear communications. Next, get the patient's consent for the visit and confirm they are in a private place. Then explain the purpose of the visit and what you hope to accomplish. Be prepared to address any technical issues that might arise during the visit. If the patient does not log on at the designated time, call them and make sure they have the right information to connect with the visit. If there are issues with picture, sound, or the internet connection, try converting to a telephone visit rather than rescheduling. If the patient is not in a private area, ask them to relocate. If this isn't possible, recommend rescheduling the visit to ensure the patient's privacy. For the most effective communication with your patient, keep these tips top of mind. Slow down and enunciate clearly. Look at the camera, not the screen, to maintain eye contact. Talk with the patient at regular intervals to make sure you are being understood. Start the exam with a visual assessment of the patient. Consider vital signs if the patient has the appropriate equipment. A more focused physical exam will depend upon the purpose of the visit and specific patient concerns. If an in-person physical exam is necessary, recommend an appropriate follow-up depending on the urgency of the situation. If the patient experiences an acute emergency while on the visit, activate the emergency response system and direct them to the patient's location. After the visit, review the agreed-upon plan of care and next steps with the patient. Be clear about whether the next visit will be virtual or in-person. Provide the patient with contact information for any follow-up questions they might have. Documentation of the visit is similar to an in-person visit, with the following additions. Include the total duration of the visit. Document patient consent. Specify if vital signs were provided by the patient and what equipment was used. Describe how the physical exam was obtained. Finally, include both the provider location and patient location. Keep in mind that generally, a health care provider needs a license to practice in the state where the patient is physically located. With practice, your telemedicine skills will improve and virtual patient visits will become more familiar and productive. In this way, you'll help advance patients' access to evaluation, diagnosis and treatment and play a valuable role in creating better patient engagement, outcomes and overall satisfaction.