Cultivating trust and building relationships during a telehealth visit
Trust is an essential part of an effective patient-provider relationship. A health care relationship with a strong trust foundation improves communication, patient engagement in self-management, and health care outcomes. Below are strategies to help you build trust in a virtual setting via video and phone to optimize your telehealth visits, whether it is for a one-time visit or ongoing care.
Before the visit
Appearances Matter. First impressions matter; patients are more likely to trust a health care provider who is dressed professionally.
Portray a Professional Environment. The space where you conduct the visit should appear professional, clean, and free of distractions. Position yourself approximately an arm’s length away and in the center of the screen.
Pre-Test Technology. Test your technology to make sure it is working well. Troubleshooting telehealth technology provides some strategies to prevent or solve technology issues. Make sure your computer or device is on a stable surface, test the camera and microphone, and adjust lighting or volume as needed.
Eliminate Disruptions. Reduce background noise or other distraction and turn off alerts, ringers, or alarms.
Minimize Wait Time. Delays in initiating a telehealth session can create anxiety. Notify the patient if the provider is running late.
Provide Digital Support. Before the appointment, have a staff member walk the patient through the technology platform and answer questions. It may be useful to send patients an information packet describing telehealth and answers to frequently asked questions. Encourage patients to review troubleshooting telehealth technology before the visit.
During the first visit
Introductions. At the start of the visit, it is important to help make the patient comfortable. Planning your telehealth workflow includes information to facilitate a successful visit. Additional strategies to build a relationship with the patient through a telehealth visit include:
- Explain how the technology operates
- Answer questions about the process
- Reassure the patient that you are experienced in delivering care using telehealth
- Explain that the session will not be recorded and all information will be kept private and secure
Casual Conversation. Take a couple of minutes to informally talk with the patient to help the patient relax and become more at ease communicating through the online platform or phone.
Acknowledge the Patient’s Concerns. Ask the patient if they have questions or concerns. Reassure the patient that the care you are providing is the same high-quality care you would provide in an in-person office visit.
During the first visit and ongoing care
I See You. During the telehealth visit it is important to focus on the patient so they know you are listening. Conducting a telehealth visit provides useful tips for engaging patients during a telehealth visit. Patients feel more comfortable when a health care provider is fully focused and attentive.
Aware of Body Language. Patients are more comfortable with a provider who appears open and calm rather than tense or closed off. Avoid crossing your arms or positioning your body away from the camera.
Take Time to Listen. Patients establish more trusting relationships with providers who engage them in a discussion. Ask open-ended questions and repeat key phrases or symptoms to confirm the information they are sharing. Use techniques like motivational interviewing and the teach-back method to improve engagement and communication.
Express Empathy. Patients prefer providers that are compassionate and understanding. Use verbal and visual cues such as affirmative comments and nodding to show that you understand.
Planning your workflow offers additional recommendations to establish a productive telehealth visit.
Provide appropriate accommodations
Time for a Translator (when applicable). For patients with limited English proficiency (LEP), translation services are essential. Open the telehealth session a few minutes early to allow the patient and translator time to discuss the reason for the visit. This will help the patient feel more comfortable. Additional tips and guidance on providing telehealth to patients with LEP are available at Telehealth for Patients with Limited English Proficiency.
Accessibility for all Patients. In advance of the appointment, identify any specific needs or accommodations the patient might require. Tools and tips for patients with disabilities are available at Telehealth for People with Disabilities. Patients will be more relaxed when they know that the telehealth session will be adapted to accommodate their individual needs.
Cultural Competency. While not unique to in-person care, understanding and respecting cultural differences is a critical component in establishing a trusting relationship. Cultural competence considers an individual’s standards, practices, and attitudes, resulting in improved quality of care. Tools and resources are available to help providers deliver telehealth care that is respectful of individual cultures, backgrounds, and preferences for LGBTQ+ patients, American Indian and Alaskan Native communities, older adults, and tools to assist parents of children with special health care needs. Guidance on providing telehealth for patients from underserved communities provides insights to improve health equity.
After the visit
Time to Reflect. After each visit, take time to consider what you could change or do to improve your engagement with the patient. Questions to ask:
- What went well or did not go well?
- Were there specific challenges? How can you prevent or minimize them?
- Is this patient a good candidate for telehealth? What are the risks vs. benefits of having the patient come in for an in-person visit?
- Conduct a Telehealth Physical Exam
- Getting Patients Set Up with Telehealth Technology
- Telehealth Etiquette Video Series — from the Southeast Telehealth Resource Center
- Building Trust with Patients via Telehealth — from the South Central Telehealth Resource Center
Virtual Care Room Design Toolkit — from the California Telehealth Resource Center
Resources to share with patients
- What Do You Need to Use Telehealth (video) — Department of Health and Human Services
- What to Expect from a Telehealth Visit (video) — Pacific Basin Telehealth Resource Center
- The Basics of Telehealth (PDF) — from Health Resources and Services Administration
- Preparing for a Virtual Visit