Telemedicine is one of the advances that can have a significant impact on American healthcare. Our medical transcription company recently reported on how telemedicine plays a critical role in helping victims of natural disasters to obtain access to the healthcare services they badly need. Market research reports indicate that factors such as an aging population, the rising incidence of chronic diseases and the need to curb escalating health care costs are driving the growth of telemedicine sector. Many elements go to determine the success of telemedicine and one of the most important, according to industry experts, is the clinician’s communication skills when managing patient encounters on this platform or “webside manner”.
Wiktionary defines webside manner as the way in which a healthcare professional interacts with patients remotely in telehealth or telemedicine. Unlike the traditional face-to-face where the physician is in direct contact with the patient, telemedicine requires effective communication and interaction in digital mode. Therefore, much of the success of the virtual care model depends on the physician’s ability to relate with a patient online and convey the desire to help. The debate has veered away from “bedside manner” to “webside manner”.
Forbes reports that the matter of improving webside manner was recently discussed at a session on telemedicine during the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting. The ACAAI position paper discusses the need for allergists and other practicing physicians to deliver quality care for patients remotely as technology transforms the traditional doctor-patient relationship. This brings us to the question – what are the skills that define good webside manner?
Communicating via telepresence is vastly different from communicating in person. The most important need is for all people involved to become more digitally competent. A 2014 article in CURVE, the Institutional Repository for Coventry University, U.K., suggests that staff providing telehealth services need to have the following basic skills sets:
- Basic Information Technology (IT): This includes digital literacy (including how to use mobile phones) and awareness of user benefits of IT.
- Personal Information: Clinicians should be aware about the importance of privacy and confidentiality (including the risk of breaches to the same and how these risks can be addressed), protocols that define how information sharing can take place and procedures for obtaining informed consent.
- Telehealth Technologies/Equipment: knowledge about the types of technologies available, and how they can be obtained
- Assessment/Self Assessment: Recognizing the place of telehealth within the range of services within which assessment / self-assessment can take place, and undertaking or supporting assessment.
- Installation, Removal and Disposal of Telehealth Equipment: This includes knowledge of basic safety procedures, links to power sources and Broadband networks and fault finding and testing, removal and disposal of equipment.
- Telehealth Services: Role and purpose of services in relation to health and well-being, fit with home care and ‘hospital at home’, and how calls are made and handled.
Along with these ‘basics’, physicians will need a range of more specific skills to become experts in virtual care, that is, they must develop a good webside manner.
The University of Arizona is one of the first schools in the U.S. to incorporate telemedicine instruction into its medical school curricula. Forbes reports experimental psychologist Elizabeth Krupinski, associate director of evaluation for the telemedicine program at the U of A as saying that physicians need to think about managing the technology bit, what they are wearing, and most important, monitor their behavior. Some physicians may be great in person, but are camera shy. Telemedicine students are often instructed to disable their video chat’s picture-in-picture feature and look like they are making direct eye contract with the patient by looking directly into their system’s webcam. Physicians also need to control mannerisms like slouching, fidgeting, or gesticulating, which can be distracting or off-putting on a webcam, says Krupinski.
At its 2016 Annual Meeting, the American Medical Association (AMA) adopted policy to help medical students and residents become more familiar with using telehealth in clinical practice. The policy recommends that accrediting bodies for undergraduate and graduate medical education include programming which supports core competencies for telehealth. It also reaffirms existing AMA policy, which supports reducing barriers to incorporating the appropriate use of telehealth into the education of physicians.
Telemedicine includes multiple medical subspecialties, such as telepediatrics, teleradiology, telepsychiatry, teleneurology, and telecardiology, though there are still barriers in delivering these services to the people that need them most. Further, studies have found that cooperation was often missing from physician-patient interactions. Wired.com reported that a study published in JAMA Internal Medicine last year found a huge range in quality of care and webside manner. The researchers also found that in telemedicine, clinicians did not refer their first-time patients to specialists in their area as frequently as they would in an emergency room (ER).
Developing empathetic and compassionate rapport with patients is an important part of the healing process in face-to-face visits. In telemedicine encounters, easy-to-use video technology can help physicians project good webside manners. As conscientious providers of virtual care look to improve, HIPAA-compliant medical transcription companies can help them maintain relevant patient-related electronic communications related to telemedicine encounters in the medical record along with relevant patient-physician e-mail, prescriptions, laboratory and test results, evaluations and consultations, records of past care and instructions.