Preparing patients for telehealth
The transition to telehealth is an adjustment for patients as well as health care providers. By preparing your patients for this new experience, you help ensure their comfort and maintain quality care.
Announcing the availability of telehealth
Once you’re ready to let your patients know that you offer telehealth, you’ll want to communicate this in multiple ways. Promoting your telehealth services helps you increase visibility and it’s an opportunity to remind them to not put off routine appointments.
You may consider:
- Updating your website
- Sending an email to patients
- Mailing a letter or postcard
- Sharing information via social media
- Announcing services in local newspapers and radio
- Placing brochures or handouts in your waiting room
- Publicizing to local community groups
For details on creating a marketing plan:
- Marketing Telehealth — from the Northwest Regional Telehealth Resource Center
- Marketing Considerations for Telehealth Programs — from the Rural Health Information Hub
Introducing patients to telehealth
Patients are likely to have questions about what to expect from a telehealth appointment. Here are some key topics to help them feel at ease.
- Types of care you offer through telehealth, including when it’s a good fit for telehealth and when an in-person appointment may be needed
- Options you provide (video, phone, text, email, mobile health, remote monitoring)
- Ways a telehealth appointment may resemble or differ from an in-person appointment
- Ways you will protect their privacy and personal information, including where to find the electronic Notice of Privacy Practices
- The cost for a telehealth appointment
- That the patient can end a session or seek in-person care at any time
Benefits of telehealth
- Reduces everyone’s exposure to COVID-19
- No need to commute, travel in bad weather, take as much time off of work, or arrange child care
- Often able to see a provider more quickly, sometimes same-day
- Ability to address health issues without leaving your home
- Easier to access specialists who live elsewhere
Telehealth isn’t a perfect fit for every patient or medical condition. Make sure you also discuss any disadvantages or risks with your patients.
- When you offer telehealth appointments
- How to make an appointment
- What technology your patient needs
- How you can help them set up their technology
- Who else will be present at the appointment other than the patient (interpreter, caregiver, clinical or technical assistant)
For examples of common logistical questions and answers, see:
- How Patients Can Engage Telehealth (PDF) — from the National Consortium of Telehealth Resource Centers
- Telehealth Information for Patients — from the Pacific Basin Telehealth Resource Center
Obtaining informed consent
Once your patient has decided to use telehealth for an appointment, you may opt or be required to get their official informed consent. Make sure to have your medical/intake forms reviewed by your legal team. Obtaining informed consent with your patient is typically done before the first appointment.
While specific informed consent laws vary by state, these common sense actions are always a good idea:
- When you meet with a patient, explain what they can expect from the telehealth visit and what their rights are
- Check in with the patient about their responsibilities during a telehealth visit — for example, the patient needs to consider privacy on their end
- If there’s anyone observing the visit, tell the patient and get their consent at the start
For more about informed consent, see:
- Informed Consent – from the National Telehealth Policy Resource Center
- How to obtain informed consent for telehealth — from the Agency for Healthcare Research and Quality
- Easy-to-Understand Telehealth Consent Form — from the Agency for Healthcare Research and Quality
Getting patients set up with new technology
Every patient has different skills and comfort levels with technology. They may also have other challenges due to older computers, out-of-date software, and low-bandwidth.
Provide written instructions that go through the entire process, step-by-step. When possible, have a telehealth coordinator, nurse, community health care worker, or administrative staff walk patients through the setup process before their first appointment. This can help reduce time troubleshooting during the actual appointment.
What you need to review with each patient will vary depending on their situation.
Find out about the patient’s available technology
Will your patient:
- Have a computer, tablet, or mobile device with camera and microphone that will work with your telehealth platform?
- Have an internet connection with enough bandwidth if the appointment will use video?
- Be able to do the appointment from somewhere with secure internet (home, work, another location)? If they will be using public wifi, discuss if your telehealth platform will suffice for security and if not, what alternatives they have.
- If your telehealth platform requires it, does your patient have an email account? If not, do they need help setting one up?
One of the biggest barriers that prevent patients from doing telehealth is a lack of access to internet service with enough bandwidth for video.
- They may qualify for federal support through the Lifeline program
- Many fast food restaurants have free wifi that reaches the parking lot
- Most public libraries provide access to high-speed internet (and often private rooms)
Walk your patient through the setup process
Provide the following to your patients as written step-by-step instructions or through direct support.
- How to install necessary telehealth software (if needed for your telehealth platform)
- How to update their browser application and make sure any necessary plugins aren’t being blocked (if needed for your telehealth platform)
- How to open the telehealth platform
- How to check that the camera and audio is working (the first time you open it, it may prompt you to enable the web camera and audio)
- Give a tour of only the features your patient will need for their appointment so you don’t overwhelm them with too many things at once
- How to find the telehealth app again or setup a shortcut/bookmark
- Explain how you will share the actual appointment invitation or show what it will look like
Tip: If possible, have someone from your team simulate a brief practice appointment so your patient can walk through each step from beginning to end.
Provide patients with troubleshooting information
Patients will feel more at ease if they know what to do if something goes wrong. Here are common troubleshooting tips to share with your patients.
- Restart the computer or device
- Check that the internet connection is working and is strong enough to work with your telehealth platform
- Close all other applications
- Update their browser (if the telehealth platform is web-based)
- Give contact information for who can provide help if needed
Tip: Most telehealth platforms look different on PC/Mac or desktop/mobile. If yours does, make sure to create separate instructions for each.
Keep patients informed about changes
If your telehealth platform gets updated, make sure you inform your existing patients of the change and any actions they need to take to be ready for their appointment.
Helping patients prepare for their appointment
Patients who are new to telehealth may need extra guidance about what to expect and how to prepare. Consider discussing these topics before their first appointment — either verbally or in writing.
Basic expectations and instructions
- That your patient should treat the telehealth appointment the same way they would an in-person appointment (dress appropriately, focus on the appointment, etc.)
- Who needs to be available during the appointment — if the appointment is for a minor, make sure to mention the minor needs to be present and if the parent should or should not also be present
- How your patient will connect for the appointment — that they’ll receive a phone call, an email with a link, or text message reminder
- That your patient shouldn’t hesitate to ask you questions
- What your patient should do if they can’t make the appointment, have trouble connecting, or get disconnected during the appointment
If an appointment will address sensitive topics, consider discussing the following with your patient:
- Why and when having privacy is important
- Will your patient be able to find a private place for the appointment? If not, provide tips on finding a private location in their home, car, or friend’s house
- How to use other communication options like email, text, or your telehealth platform’s chat feature — especially if there might be issues with personal safety
- If the patient will have an interpreter or caregiver present, discuss what they feel comfortable permitting the other person to hear. Determine if they need to fill out a release of information.
It’s helpful to provide guidance to your patient on how to get set up for their appointment.
- Choose a spot with plenty of light — avoid sitting with back towards a window since this will make it harder to see your patient’s face
- Make sure the camera is steady, at eye-level, and will show their head and shoulders in view
- Wear loose clothing if you’ll need your patient to show you something on their skin or a specific part of their body
- Find a quiet place or reduce background noise and other distractions
- Get their computer or device ready by closing other applications so they don’t slow down the internet connection or get distracted
- For video appointments, connect 15 minutes early to allow time for last-minute troubleshooting
- Describe what to expect if they connect early (virtual waiting room, hold music)
Template for a patient handout: Patient Instructions for a Successful Telehealth Visit (PDF) — from Caravan Health.
Medical information needed
Depending on the nature of the appointment, here are some things you may want to request that the patient prepare beforehand.
- List of their current medications or gather the actual bottles
- Medical history
- Symptoms, questions, concerns they want to discuss
- Pharmacy contact information
- Measurements like weight and temperature
- Flashlight or smartphone light if needed for looking in the patient’s throat
Creating an emergency plan
With telehealth, you’re seeing patients outside of the safety and control of your office. An emergency situation may arise from a wide range of causes, including a mental health crisis, stroke/heart attack, overdose, etc. Planning can go a long way to prepare you for an emergency situation and set expectations with your patients.
Answer the following questions with your patient before or during their first appointment.
- What is the full address for the location your patient plans to do their telehealth appointment from? You will need to confirm at the beginning of each appointment that they are in this location and if not, get the address of their current location.
- What are the direct, 10-digit emergency contact numbers for that location? 911 only works if you are in the same location as the person needing help and calls cannot usually be forward to the correct location. The best way to find this information is to use a search engine to find local numbers for emergency services like the police, fire department, mobile crisis unit, crisis hotline, nearest urgent care or emergency room.
- What is the contact information for other health care providers who may need to be contacted in an emergency?
- Who is their emergency contact? A family member, friend, neighbor — someone nearby who can offer support in the event of a crisis.
- Get the patient’s authorization to release information to their emergency contact if needed.
- What is the plan if you get disconnected during an emergency? Who will call whom and at what number?
- Under what conditions will you consider activating an emergency plan?
- What actions will you take in the event of an emergency? For example, situations when you would call on an emergency contact to assist in evaluating the patient’s safety, transport the patient, or have someone call 911 from the patient’s current location.
- What will you do if they miss an appointment and you think they might be in a crisis?