Prepare providers for telemedicine: 3 critical training areas
2. Patient safety
In utilizing new technology, the primary commitment has to be to patient safety, not treating as many patients as possible. It’s critical to review existing clinical practice guidelines as well as primary source data, and apply these to the context of telemedicine.
This helps clinicians determine which patients, symptoms, and conditions are appropriate for virtual care, and when to refer patients to be evaluated in-person. Of course, each patient is unique and has to be considered individually, but providers can never accept putting a patient at risk by assuming they have enough data to make a diagnosis if that’s not actually the case.
It is important for clinicians to understand that telemedicine is not appropriate for every patient or in all situations. Telemedicine should not be a substitute for an ongoing relationship with a primary care provider, but an extension of a care continuum.
3. Patient education
Patient education is key as well. Maybe they have never accessed virtual care before and may not understand when it is appropriate. This can lead to understandable frustration when a visit ends up with a recommendation for further in-person care or doesn’t result in a prescription that the patient had hoped for.
Providers should explain to patients that their self-reporting is the primary source of information that will be used when formulating an assessment and recommendation. The provider might illustrate this point by explaining that when the patient is in clinic and their provider uses a stethoscope to listen to their chest, this provider is collecting important data that help them make a diagnosis. In a virtual visit, though the provider can gather considerable information, he or she typically can’t use a stethoscope to listen to the patient’s heart or lungs, so the provider might not be able to safely determine the cause of the patient’s cough or other symptoms. Giving concrete examples like this helps patients understand and adjust their expectations appropriately.
Patient populations have different expectations. In telemedicine, many patients have self-diagnosed or may believe that antibiotics or a specific medication is necessary for their symptoms.
Though this is not unique to telemedicine, the convenience of a virtual visit is particularly appealing to individuals who hold such beliefs. Clinicians offering virtual care often hear, “I have this infection,” or “I need that antibiotic.” It is the provider’s job to be sure patients are receiving the safest and most appropriate treatments, which sometimes means telling them no.
Providers should be trained on strategies for these difficult conversations, on ways to explain their rationale, and how to discuss symptom management and follow-up precautions in a fashion that allows patients to feel that their concerns were heard, even if they didn’t walk away with an antibiotic prescription.
Appropriate training in telemedicine can improve provider understanding of the patients and situations that are most appropriate for virtual care, and on the nuances of this unique care modality.
Patients who have a safe and welcoming telemedicine experience are more likely to access it appropriately in the future as part of their comprehensive healthcare continuum, rather than seeing it as a replacement for in-person care.
Erin Aas, MSN, ARNP, is a nurse practitioner and clinical lead for Carena Medical Providers and Carena Inc., a telemedicine solution provider. He cocreated and facilitates their virtual care training platform. He was previously a National Health Service Corps Scholar and worked in primary care and community health.