How healthcare providers are the key to building patient trust in telehealth care

• Patient trust in telehealth is largely reliant on physician support and doctor-patient relationships.
• Improving the overall patient experience of telehealth appointments builds confidence in the technology.
• Training physicians on technology is an essential part of medical education.

Doctors and healthcare systems are playing an important role in boosting patient confidence in telehealth, which has become integral to ambulatory care during the COVID-19 pandemic.

"The pandemic really pushed telehealth to the forefront of patient care," Dr. Michele Mitchell, regional medical director and family medicine physician at Oak Street Health, said. The center provides primary and preventive care to Medicare recipients in 19 states. "It's our responsibility to make sure that we are giving patients all the tools and support to be successful when they're using it."

To create trust in this new virtual model, providers have worked to improve patient access to care. They use varying levels of technology, offer ongoing technical support, and work to improve the overall patient experience of a telehealth appointment. Because this model is so pervasive, medical trainees are learning how to best engage patients in the technology.

Recognizing patient level of technical access and ability builds confidence

At the beginning of the pandemic, physicians at one of Oak Street Health's Detroit locations conducted phone visits with patients, as the tools were easy to use and provided more accessibility. Weeks later, the healthcare organization surveyed patients to learn more about the reality of their video capabilities.

Once these individuals were identified, medical assistants helped address patients' technical issues with video conferencing before their actual appointments. And providers are always ready to convert a telehealth video appointment to a phone call, especially if Wi-Fi access is a problem. "We don't want to compromise the time we have with the patient," Mitchell said.

Laura Semlies, vice president of the digital patient experience at Northwell Health in New York state, says the rapid adoption of telehealth during the pandemic required flexibility. "In the early days, in a lot of ways, our providers became tech support, distracting them from clinical care. It was critical that we flip the paradigm immediately."

In response, Northwell Health invested in demystifying technology - so even patients with limited proficiency could easily navigate a virtual visit. This included communications to prepare patients for a successful telehealth appointment, pre-visit technical checks of audio, video, and bandwidth capabilities, and proactive, personalized support for those who needed it.

Improving the overall patient experience creates trust in technology

In addition to ensuring access to appointments, healthcare systems can use technology to improve the overall patient experience to build trust, Semlies said. For example, this includes rooting virtual visits in traditional practice operations, such as language translation, pre-visit testing, and post-visit follow-up coordination.

According to Semlies, including caretakers and other members of the healthcare team in telehealth appointments can streamline care and help patients feel supported. This includes ensuring that patients are seamlessly transitioned to administrative staff at the end of the telehealth visit to schedule any needed follow-up appointments.

Healthcare providers are adding some at-home services to telehealth care to improve the patient experience. For example, Northwell Health uses LabFly, an app that allows patients and their caregivers to schedule blood work with a phlebotomist who visits them at home. Other services, including electrocardiograms, glucose and blood pressure monitoring, and ultrasounds, are also moving to the home.

Learning to build patient trust in technology starts during medical training

Building trust with patients and hands-on experience with telehealth technology are addressed during medical training, which helps to prepare tomorrow's physicians for the rapidly changing model of care, Dr. Michael Kanter, chair and professor of Clinical Science at Kaiser Permanente Bernard J. Tyson School of Medicine, said.

Through clinical rotations with their preceptors, students are learning how their patients can best engage with telehealth. And they're also finding the best times to use it. "We've found some patients just won't use the technology because they feel like they can't connect with their doctor well virtually," Kanter said.

"The challenge is the landscape is changing dramatically, both as the technology evolves and as our understanding of what the technology can and cannot do," he said.

"Having students learn how to evaluate the strengths and weaknesses of new technologies based on available evidence, just as they would a new medication or treatment, is critical."