Recommendations For Optimizing Televisits

Mary Costello has spent over thirty years in the healthcare and clinical research fields, working in commercial leadership roles with lar...

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Like many of you, the past months for me have been learning about how to transfer what was my everyday normal life into online mediums.  Some have worked well, while others have fallen short. For instance, I liked virtual workout classes better than I would have expected. However,  a zoom or facetime call with my 86 year old father ends up feeling more sad than satisfying.  However, only this week did I finally experience my first health televisit, with my physician who wanted to discuss a medication change.  

Given that I have spent the last ten months working with sites interested and eager to introduce digital options into their clinical research realm, I felt this was an opportunity for me to observe how the process works in healthcare.

First of all – what worked?  

I was given instructions verbally over the phone by the nurse about three weeks prior on what to do, none of which I wrote down. But, I did remember the basic expectations! “Check that my registration with the on-line portal was up to date, download the app for the televisit and be ready ten to fifteen minutes prior to the appointment.”  

I was prompted the week before to confirm my visit via text. I did receive an email with a link to download the app, and I remembered my apple password without having to retrieve it, and my doctor called me exactly at the time of my appointment.  It was actually great! I know her, seeing her and having her undivided attention for twenty minutes with no waiting ahead of time or hassles of parking etc. went well!  If I had rated my satisfaction with the visit itself, I would have given it a ten, as I did not feel as though the level of care or attention was any way less than an in person visit would have been and the hassle factor was significantly lower.

What didn’t go as well? And, what were my takeaways when incorporating into research?  

I am not sure that the scheduling system / text reminder system was synchronized with the televisit.  I got a prompt on Sunday night reminding me about safe visit procedures on masking and ensuring I was COVID symptom free before coming to the office.  That was the first red flag.  Since I had also gotten the email asking me to download the app, I figured it was just what it turned out to be – two separate systems for communication, operating independently.  

On Monday morning, I saw a missed call from the doctor’s office.  When I returned it, the message said that due to inclement weather, the office was closed that day.  Austin had had its first snowstorm in about ten + years the night before.  There was no way to leave a message and if I chose to call their on call service for a non-emergency, the standard message warned me that I could incur a charge.  At this point, I am wondering whether my physician, since her office was closed, would expect me to reschedule and would take the day off.  

How did it go?

She called right at the appointed time which had always stayed as a possibility for me.  The other communication ended up being distracting rather than downright annoying as we are still under Stage Five restrictions here.

However, it did underscore for me that sites need to think about how they communicate and how they create automated reminders and confirmations.  Before implementing tech for a televisit, walk through how all your patient communications will go.  As it was my first televisit, it would have been quite helpful for the office to have a standard. In fact, it could look a bit like this.

“How to prepare for your first televisit. Here is the link, here are the steps, here is a screenshot, etc.:

In essence, over communicate!

If you can’t modify your reminder systems, then point out that a patient may receive a reminder making it seem as though they have an in person appointment, and advise them to ignore that message.

As we migrate to the new world order, we must remember that flexibility is here to stay and our goal should be to enhance that experience at every level!