Getting started
Telemedicine basics
Overview
This page will guide you through a high level checklist of what clinics and patients/families need to get started with telehealth visits. In many cases telehealth can be beneficial to either augment or replace traditional visits but there may also be situations where there are risks. The visit guide page provides detailed templates for common pediatric visits, adapted for telehealth.
Telehealth Benefits
- Convenience and access to patient care
- Increased engagement through maintenance of appointments
- Ability to assess the home environment for more contextual care
- Decreased travel stress for patients
- Cost savings (transportation and time off from work)
Telehealth Risks
- Insufficient information transmission (ie poor resolution) to allow appropriate medical decision making
- Inability to conduct all types of evaluations over a virtual visit
- Need to follow up with an in-person evaluation may arise post telehealth visit
- Delays in medical evaluation or treatment due to deficiencies of the technology being used
- Limited privacy: patient may not be in a private location at time of visit
- Treatment options may be limited
Informed Consent
Per most states law, providers must receive oral or written consent prior to telehealth visit after explaining risks and benefits
Telehealth terminology
Audio + Video: Usually what is considered telehealth
Audio only: Also considerd telehealth but depending on your state and visit type may not be reimbursed at the same level.
Synchronous: "Live video-conferencing"
Asynchronous: "Store-and-forward video-conferencing"
Patient setup
Device
Phone or computer with camera and microphone
Internet
Need a high speed connection
App
Some telehealth services require an app download
Space
Ask patients/family if they have a private space to talk before starting the visit
Additional considerations
Webside Manner
● Make sure you are in a well-lit room and positioned in front of the camera. Adjust your position before the encounter on screen and use a video system that includes an image of how you appear.
● Make eye contact with the camera and not the screen. Sit a bit farther away from the camera to give the patient the impression of direct eye contact.
● Be in a quiet/private place during visit to maintain patient privacy
● Avoid looking away from the camera. Verify any movements/actions you do.
● If possible, make your ID visible on camera
● Gesture more frequently and speak slowly. Be 25% more vocal during visit
● Be sure to give ample time for a patient to hear your question or statements
More tips on good webside manner at
Additional References
American Academy of Pediatrics (AAP) Telehealth getting started:
American Medical Association (AMA) telehealth modules:
https://edhub.ama-assn.org/steps-forward/module/2702689
American Telemedicine Association (ATA):