While there were certainly many clinicians performing telemedicine before COVID-19 struck in early 2020, the pandemic foisted telehealth on countless numbers of additional physicians and nurses, forcing them to get up to speed and feel comfortable with the technology.

But many caregivers still struggle with the different paradigm for delivering healthcare. Some are uncomfortable with the video medium; some are just not familiar with the technologies in use; some are not certain how to incorporate virtual care into the day-to-day operations of their practice.

Healthcare IT News interviewed Dr. Richard Tytus, associate clinical professor at McMaster University and cofounder and medical director of Banty, a vendor of a HIPAA-compliant video platform used for telemedicine. He offered advice on how to get clinicians more comfortable with virtual care, how pilot projects can help and what they should look like, and the importance of smart telemedicine scheduling.

Q. Your first suggestion for physicians needing to get more comfortable with telemedicine is to build familiarity over time. Please elaborate.

A. As a longstanding advocate of telemedicine, it's easy for me to speak openly about the benefits of it and passionately encourage my fellow doctors to start offering their patients virtual visits. However, I also realize there is a faction of doctors who love the idea of telemedicine but are hesitant about implementing a solution at their clinic.

A lot of the time, I feel this hesitation is a result of some doctors feeling intimidated by the technology. This could be the result of a doctor who has very little video call experience, or a doctor assuming there will be a lot of logistical hurdles attached to getting a telemedicine solution up and running for patients.

The best advice I could give here is to find a telemedicine solution out there that meets the clinic's needs. This could include – but is not limited to – ease of use for clinical staff, excellent online privacy standards, as well as features that are straightforward and simple to understand.

Once that solution has been chosen, doctors and clinical staff alike should test drive it internally for an agreed upon period of time, before inviting patients to use it. This will allow everyone to learn the ins and outs of the telemedicine solution the clinic will be using. Such a process will allow people to make mistakes, learn from them and continually get more familiar with the technology.

Having this educational process at the outset is important. Not only will it help get the clinic staff on the same page, but it also will make those initial virtual visits with patients feel much more positive and seamless.

Q. You advise that healthcare provider organizations should have a pilot project with patients. What should this look like, and how will it help with comfort?

A. There is not a hard-and-fast rule regarding how a pilot project should look for a medical clinic aiming to roll out telemedicine services. In reality, a lot of how one is set up has much to do with what a clinic feels it needs to successfully have online doctor appointments for years to come.

That said, one way to approach a pilot project is for a clinic to identify a group of patients it believes would be interested in testing out its telemedicine services. Ideally, these are individuals who have a pleasant, longstanding relationship with the clinic and a relatively strong understanding of technology.

Clinics would ask these patients to book an online appointment and go through the process. Along the way, these individuals would be tasked with noting what they liked or disliked about the online appointment structure, as well as the overall experience – for example, logging in for an appointment, navigating the solution, physician performance, etc. This feedback then should be forwarded to the clinic so that it can tighten any screws it needs to.

Throughout this process, it's important for the clinical team to remind these test patients that there could be stumbles along the way. As such, their assistance will help lessen the chance of similar problems happening during future appointments.

In terms of how long this type of pilot project should last, I'd recommend only keeping it active until the clinic feels comfortable and confident about introducing virtual visits to all patients.

Q. Be smart about telemedicine scheduling, you say to physicians and their teams. Please explain exactly what you mean here.

A. Whether patient appointments are in-person or virtual, a medical clinic should always do its best to create a schedule that is manageable for the doctor. Essentially, do not overbook, and leave wiggle room – where possible – in the event certain appointments start late or run long.

However, for medical clinics that are just starting to find their footing with telemedicine, even more care should be taken with the schedule.

Clinics need to appreciate that some patients will have technical difficulties getting into, or through, their virtual visit. This could include internet connectivity issues, or not knowing how to properly adjust one's audio or video settings on their computer, tablet or smartphone. These instances, to name just a couple, can cause delays.

Doctors, meanwhile, may also have trouble initially adapting to online appointments. They are so used to running from one exam room to another that veering from such a routine to meet a patient online could lead to challenges.

To see that the doctor has an easy time adjusting to offering both in-person and virtual appointments, keep them in separate spots on the schedule. For example, a clinic can inform patients that online appointments will only be scheduled on Tuesday and Thursday afternoons from 1-4 p.m.

Putting this measure in place will allow the doctor to know exactly when they need to see patients online, versus having to run from an exam room to a computer, to another exam room, and back to a computer again.

Once the clinic has become more comfortable in how it conducts telemedicine appointments, the scheduling routine can be adjusted to best meet physician preferences and patient needs.

The goal at the beginning, though, should be to keep the schedule as uncomplicated and stress-free as possible for everyone involved.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.