Greet your patient

When both the practitioner and patient are logged into the video conference, welcome the patient and introduce yourself. Start by making sure that it is the right patient (check name and social security number), in the same way as when having a physical meeting. Ask the patient if the sound and video quality is okay.

Ask the patient how it feels meeting through the screen right now. This will allow you to make sure the patient is ready for the consultation.

Make sure you are not disturbed

Keep in mind that the video consultation is ”private”. It must take place somewhere suitable for the purpose. Avoid disturbances and unauthorized persons listening in on the conversation. Tell the patient that you are alone in the room—the patient can’t see that on the screen. Also ask if the patient is sitting in a suitable place.

Keep track of time—maybe offer breaks

Inform the patient about the expected durability of the video consultation to be, to make sure the patient has allocated enough time for the consultation.

Tell the patient that he or she can always ask for a break during the consultation. You can ask if the patient needs a break or a glass of water if you have a feeling, that there is a need for this.

Use other senses and ask questions

During video consultations you can’t use the same senses as during physical meetings. Normally you would gain a lot of insights by observing the patient’s behavior or the environment in the patient's home for example. This is not possible during video consultations. It is, therefore, extremely important to pose the right questions that will provide you with the knowledge about your patient in another way.  In case of a patient with COPD, you could for example ask, how fast they get out of breath, when being active.

Look for non-verbal signs and body language

It may be harder to read the patient’s signals through video. Therefore, look for non-verbal signs and try to read the body language. 

How are the patient’s eyes: is the patient avoiding your gaze? Happy or worried? How is the body posture? Is the patient pale, ruddy etc.

Video conversations and eye contact

Be aware on how to make eye contact over video. Give the patient the experience of eye contact by looking directly into the camera. It may take some practice to look into the camera and observe the patient simultaneously.

Tell the patient that, ”when we are having eye contact like this, I am looking into the camera. When you see me looking down it is not because I am unfocused, but I am looking at you on my screen.”

Agree on the next steps

Before ending the conversation, it is a good idea to agree on the next steps of the treatment. Agreements on treatment methods or changes in treatment made during a video consultations are documented in the health care records in the same way that you would do in connection with a physical consultation.

  

Speak clearly and remember breaks in your flow of speech

Speak slowly and clearly since the video connection can cause a small delay. Make short breaks. With breaks you also give the patient, relatives or colleagues the opportunity to ask questions. It is an advantage if you vary your tone of voice and emphasize essential words.

If there are more participants in the video conversation, it is important that you do not interrupt each other. Agree on some communication rules, for example, on how to make yourself heard during the consultation.

Sit still and keep your hands height in demonstrations

Avoid sudden movements since they may cause ”image noise”. Also make sure you have documents and equipment you wish to demonstrate right at hand before the consultation begins. This will minimize your need for moving during the consultation.

Also avoid clothes with narrow stripes. This makes the screen flicker.

If you gesticulate with your hands to emphasize a point, lift them and make sure they can be seen on the screen.

How is your appearance on the screen?

If you are demonstrating use of equipment, make sure to keep the equipment within the camera’s angle (check what is shown to your conversational partner via the small picture of yourself called Self view). Also remember that the image that is shown to the patient is reversed. Ask the patient to repeat your instructions to make sure that they are understood correctly.

Inform your patient if you take notes during the conservation

Explain what you are doing along the way. If you want to take notes during the conversation, it is a good idea to tell the patient what is going on. Otherwise you may seem unfocused or like you are doing something irrelevant to the consultation.

Be aware that key sounds from your keyboard can be heard by your conversational partner, and may be disturbing.

Share your screen display with the patient

You may share your screen display with your conversational partner.  Remember to document while the patient is included. Also when you, for example, agree on new exercises, on adjusting medicine etc.

Ask if the experience with using video was all right

By the end of the video consultation, ask how the patient experienced having a consultation using the computer, and how he or she experienced the contact. This will also allow you to make adjustments.