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The Experience of Providers and Patients in Navigating Telehealth Visits

Telehealth visits using video communication technology have become commonplace during the COVID-19 pandemic. Using a smartphone, tablet, or computer, a provider can make real-time video and audio assessment of a patient when the patient and provider are in separate locations. However, the technology that enables video visits may also result in unintended consequences for the patient-provider interaction. During a video visit, both technical and interpersonal aspects make communication between provider and patient different than communication during an in-person visit. Provider-patient communication during video visits may be less patient-centered than communication in face-to-face encounters.

In an HSR&D funded study, we interviewed patients and providers to evaluate communication during video visits and designed intervention materials to improve communication. We evaluated the perspectives of both patients and providers during video visits compared with in-person visits. Patients identified several challenges and concerns about video visits compared with in-person visits, including: the perception that providers paid less attention to them; more difficulty finding opportunities to speak up to ask questions or express concerns; and feeling rushed by the provider. Providers reported that the technology associated with telehealth visits changed how they develop therapeutic relationships with patients and how they provided patient education.

With the growing use of video telehealth, providers are increasingly aware of how technology influences communication during a patient visit. One drawback of telehealth visits is that the positioning of the camera can leave patients feeling a lack of eye contact or lack of engagement in the visit, especially when the provider gazes at multiple monitors. In addition, telehealth visits limit the opportunity for the human sensing allowed by an in-person visit (touch and smell), and vision is limited to a two-dimensional viewpoint.

Recognizing how the video visit setting influences provider-patient communication helps suggest remedies to minimize and overcome these challenges. Early in the pandemic, we created an infographic to help patients prepare for telehealth visits (available at https://hsg.people.uic.edu/getreadyvv.html). We also produced an infographic that helps providers conduct more patient-centered video visits. We then used the infographic to produce a brochure for providers that highlights five habits providers may use to navigate successive and successful steps in the medical interview. (https://hsg.people.uic.edu/mtmgraphic.html)

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