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    Prepare providers for telemedicine: 3 critical training areas


    In the development of any telemedicine training protocols and curriculum, it’s critical to begin with the question: Which patient is appropriate for virtual care?

    In the past 10 years, the telemedicine industry has expanded rapidly to meet consumer demand for convenient healthcare. In 2016, a survey by the American Telemedicine Association found that 22% of respondents had already begun using video conferencing to speak with a healthcare provider.

    This rise in utilization also reflects growing availability of virtual care options, with more health systems making telemedicine available, and more insurance plans covering virtual visits. In an effort to control rising health management costs, major employers are expected to increase their telemedicine options and coverage for employees, further expanding the demand for clinicians prepared to offer virtual care.

    The need for telemedicine training

    Practical training in virtual care has not been widely incorporated into medical, nursing, or continuing education curricula, which leads to confusion and uncertainty among providers. Operating in a new care medium, healthcare providers are feeling pressure to provide quality care while simultaneously considering patient expectations regarding outcomes and patient satisfaction metrics.

    Last year, the AMA Immediate Past President called attention to the lack of telemedicine training, “The vast majority of medical students are not being taught how to use technologies such as telemedicine or electronic health records during medical school and residency,” he stated. “As innovation in care delivery and technology continue to transform healthcare, we must ensure that our current and future physicians have the tools and resources they need to provide the best possible care for their patients."

    The AMA enacted a new policy in 2016 to encourage schools to address the gaps in training related to telemedicine.

    To ensure providers are prepared for telemedicine practice, healthcare leaders must provide training in the following areas:

    1. Virtual data capture

    Offering virtual care is not as simple as conducting a traditional office visit over the phone or webcam. In a clinic setting, providers have specific tools at-hand to assess patients including physical exam data, point-of-care testing, or full access to existing medical records.

    It may feel unfamiliar to providers to see patients without having all these data to consider in their clinical decision making. Operating in the virtual space requires different methods of gathering data and understanding how the available information should be weighted in reaching a diagnosis. Providers should feel no hesitation, and should face no penalty, for concluding that a patient should be seen in-person if adequate diagnostic data cannot be obtained virtually.

    In developing a virtual care training program, it’s critical to break down the elements of an in-person visit to understand what data are available to the provider in a traditional clinic and evaluate—piece by piece—when and if that same information could reasonably be gathered in a virtual visit.

    When a patient reports their medical history in the clinic, body language is an important data point for a provider to evaluate. When interacting via webcam, while some body language and non-verbal communication occurs, this may be limited by webcam resolution or lighting.

    Consequently, there is more reliance on verbal communication in virtual visits, as providers and patients interact and seek to understand each other.

    Next: Training areas #2 and #3


    Erin Aas, MSN, ARNP
    Erin Aas, MSN, ARNP, is a nurse practitioner and clinical lead for Carena Medical Providers and Carena Inc., a telemedicine solution ...


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