How Can Hospitals and Doctors Make the Best Use of Online Consultations
There’s no secret to the fact that online consultations have been on the rise across multiple specialties in India. Whether for themselves or for loved ones living far away, factors like timely access to care, manageable financial costs, and ease of use have helped patients and doctors alike with adopting this method for care.
Certainly, the delivery of care in digital environments comes with its own set of challenges. Time needs to be managed efficiently, records need to be kept well-organised, and most importantly, patients need to be put at ease over phone or video calls and (sometimes) faulty internet connections.
“We’ve had so much information lost over dropped calls, it’s almost comedic” says Dr. Rachna, a Delhi-based GP. “And pandemic fatigue is making patients push back against Zoom calls. But we still advise teleconsultations as the first line of defence, given the obvious risk-mitigation they come with.”
However, a few key measures by hospitals and doctors – before, during, and after the online consultation – can help increase the quality of care and the ease of use.
Before the Call
1. Administrative Outreach
The best time to establish a rapport with patients might be before the call actually begins.
Administrative staff should be trained to reach out to patients prior to their online consultations and outline clear steps for how patients need to prepare. “We have found that the outreach helps with building patient trust and makes the delivery of the care easier.
Our medical assistants connect with every single patient before their appointments to help answer any questions they may have about a teleconsultation. We record every detail in our EMR software, including any symptoms they mention” says Dr. Rachna.
2. Ensure Patient Consent
According to The Telemedicine Practice Guidelines released by the Board of Governors at the Medical Council of India, “Patient consent is necessary for any telemedicine consultation.”
Something as simple as a text message on WhatsApp, a one-line email, or even a recorded message agreeing to the teleconsultation suffices as consent. And it must be recorded.
3. Ensure Privacy and No Distractions
“Ensuring privacy is especially important for doctors who are seeing patients from their private offices or clinics” says Dr. Rachna. “We have to make sure there are no family members or household staff around when we’re taking calls.
Ensuring there’s no unnecessary footfall, phone calls, or disturbances during the online consultation helps keep the focus on the patient and puts them at ease.”
During the Call
1. Set Clear Expectations
Oftentimes, some distractions can’t be avoided, for instance an urgent call you might be expecting. At other times, you may need to look away from the camera to take notes and write out prescriptions. Or you may need to share your screen with the patient, if they log in through an app.
Let your patients know exactly what they can expect at every stage of the call.
We also recommend allowing yourself 5-10 minutes between calls to take care of tasks like sending prescriptions or resolving tech issues.
2. Ask for a Backup Contact Option
Since the best technology can sometimes fail, ask for a backup contact option right away. “Even better, ask your administrative staff to capture this information and share it with you ahead of the call” advises Dr. Rachna. “You’ll save a lot of time if the connection is suddenly poor.”
3. Speak Clearly & Directly
We’ve already touched on the issue of faulty Internet connections above, which highlights how important it is to speak in a direct, clear voice with patients. According to Dr. Rachna, “Little details such as introducing yourself, asking patients how they are, pausing to let the information sink in, and speaking in a normal tone of voice help with keeping an online consultation moving smoothly.”
Ending the Consultation and After
1. Recap the Diagnosis & Next Steps
Before you end the call, take a few minutes to recap the diagnosis, any medication prescribed, and any next steps that your patients may need to take.
“We have work processes, where if a patient needs a lab test, our admin staff takes over the call once I’m done and helps them get connected to a lab near them” says Dr. Rachna. “We really have to step into our patients’ shoes and bring thoughtful consideration to what they need and expect from a medical visit; and then do our best to fulfil those expectations during an online consultation.”
2. Have a Closing Statement Ready
To avoid ambiguity, a statement as simple as “All right, Mrs. Pereira, I’m going to end the call now. I hope you feel better soon. Please contact me if you have any questions” can be quite effective and help you end the call on a positive note.
3. Send a Copy of the Prescription & Diagnosis
Set a time window within which to share the written prescription and diagnosis with your patients. “We’ve had patients come up to us and say that their doctors forgot to send out written prescriptions” Dr. Rachna points out. “And later, they weren’t able to speak to their doctor or the doctor’s office to get a clear picture of the aftercare needed. I’ve made it a point to send written prescriptions within ten minutes of each call.
In a new and technology enabled scenario, ensuring a positive patient experience will require some rethinking and redoing of our standard practises. We’re all learning how to operate in a new paradigm, but the important thing is that we stay open to adapting.”