August 3, 2018

Improve Your Webside Manner: Tips on Virtual Visits

How to connect with patients through the screen

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By Rachel Taliercio, DO, Nikhyl Jhangiani, MBA, MPH, and Mary Beth Modic, DNP, APRN-CNS

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Cleveland Clinic launched its distance health initiatives in 2013, and some patients and providers were initially reluctant to adopt the virtual visit technology. That reluctance has changed; in 2018, we’ve seen over 3,600 virtual visits per month on average. Let’s address common myths we have encountered regarding virtual visits:

The generation gap myth

The perceived generation gap is closing. Older generations are increasingly embracing digital technology, with nearly 70 percent of baby boomers and four in 10 adults age 65 and older owning smartphones.

The diagnostic accuracy myth

Many assume a virtual visit compromises diagnostic accuracy because of the inability to do a physical exam. However, specialty virtual visits are only offered as follow-up appointments; in-person initial appointments allow for a comprehensive physical exam. Urgent care virtual visits are limited to concerns that can be addressed without an exam. We also found that visiting from home can enhance patient comfort, leading to greater openness with the clinician.

The out-of-pocket myth

The myth that patients will be reluctant to embrace an out-of-pocket expense is pervasive, but virtual visits can save patients money, particularly when accounting for expenses such as copay, parking, food, gas and missed time from work.

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The patient satisfaction myth

Patient satisfaction does not, in fact, decrease. Over 90 percent of patients are satisfied with their visits in our current program, Express Care Online. Forty-five percent report an improved relationship with their clinician, and another 53 percent report no impact on the relationship.

Tips for displaying empathy virtually

Whether the visit is in person or virtual, empathy is a vital part of the encounter and requires the same communication skills. The ability to express empathy through carefully chosen words and nonverbal communication is a key to successful connection with patients.

Instead of “what’s your complaint today?” or “how can I help you?” a simple acknowledgement that they have invited you into their home by using this technology can speak volumes about your willingness to understand the patient’s internal state. “Thank you for inviting me in your home today,” is an easy start.

It’s also important to acknowledge verbally that you are listening in a virtual visit. It may be more obvious in person, so phrases like “I hear concern in your voice. Tell me more about this,” after a patient describes a problem can signal that you are fully engaged.

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If the patient seems apprehensive of the virtual medium, acknowledge the newness of the situation with phrases like “I realize this visit style is new, thank you for giving it a try,” or “I’m glad you thought of this as a way to connect with us about your health concerns.” Always acknowledge that you may be typing during the visit so that patients know you’re fully engaged: “I want to make sure I capture your story accurately, so I’ll be typing as we talk.”

These busted myths and communication tips should help enhance webside manner and provide a better patient experience in virtual visits.

Dr. Taliercio is staff in the departments of Pulmonary Medicine and Critical Care Medicine. Nikhil Jhangiani is Program Manager for Distance Health. Dr. Modic is a clinical nurse specialist.

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