Create a safe and professional environment
Find somewhere private and free from distractions. Video consultations should always be conducted from a physical space that guarantees patient confidentiality.
Create the feeling of a clinical setting during the video consultation. Having a neutral background that doesn’t show any personal items or picture frames feels more professional. This also creates fewer distractions for patients during consultations.
Be in a room with a good light source that faces you. This can be from a window or a desk lamp. Also, make sure patients can clearly see your face. If the light source is coming from behind you or from the side it can affect video quality.
Set up and test your equipment
Make sure your internet connection is stable. If you can, connect your computer to the internet by cable connection. These are often more stable than wireless internet connections.
Before your first consultation, test your camera and microphone to make sure they work properly. Consider doing a test video consultation with a friend or colleague. Headsets with a microphone give the best sound quality for patients.
Position your camera close to eye level. This angle makes your face clearly visible and ensures patients can see your facial expressions and other non-verbal cues.
Conducting the consultation
Stay present and maintain eye contact
With digital healthcare, it’s even more important to be present and to keep eye contact with patients during consultations. Many patients have never had a video consultation, so it’s important to make them feel comfortable and safe.
If you must break eye contact for a longer period of time, clearly tell the patient what you are doing and why. This can happen when writing medical notes or when checking something on another screen. It could also happen if you temporarily turn off your camera or microphone for some reason. Informing the patient about what you are doing ensures they still feel listened to, even if you need to complete another task.
Speak clearly and set clear expectations of what is (and is not) possible with video consultations.
Examining the patient and working together
In a video consultation, the initial examination of a patient can quickly highlight conditions that need urgent medical attention, such as abnormal breathing or signs of physical trauma. After this initial examination, a more detailed examination of the patient can be conducted as needed.
Patient participation is an important tool in video consultations. As a healthcare professional, you need to work together with the patient more than you would do in a conventional in-person consultation.
Some examples of clinician-patient collaboration during a video consultation
Asking the patient to fetch their thermometer and to take their temperature.
Asking the patient to point their smartphone camera towards the back of their throat so that you can examine them. The patient should turn on the torch function on their smartphone to give better lighting. This can be a bit tricky for the patient to do, but you can be a guide by saying things like: “Could you move the camera closer to your mouth” or “Please move your phone a little to the right”.
In video consultations with children, asking the legal guardian to point the camera at their child while you talk to them. Observing the child while interacting or playing can be very helpful in determining the child’s current health status.
For examinations of orthopaedic symptoms, asking the patient to rest their smartphone against something so that you can examine different movements. Seeing the patient's whole body in the frame of the video is helpful here.
When writing medical notes, make a clear distinction between actual findings that you as a clinician have made and what the patient has reported. For example: “patient reports a pulse measurement of 70 beats per min”.