How to Prepare Families for a Telehealth Visit

Telehealth is an important mode of health care service delivery but requires clinicians to consider a few important factors when preparing families/caregivers for an appointment. This tip sheet includes steps for clinicians and the care team to implement in order to ensure their families/caregivers are well informed before, during and after a telehealth visit.

Step 1: Determine appropriateness of the telehealth visit

In partnership with the family/caregiver, and in alignment with AAP policy, determine appropriateness of the telehealth visit.

• A few examples of situations where clinicians may recommend a telehealth visit: mild illness, management of chronic issue without exacerbation, patient preference, follow-up appointments, medication checks.
• A few examples of situations where clinicians may recommend in person visits: moderate-severe illness, certain new patient evaluations, need for imaging/labwork, patient preference, lack of access to adequate technology, immunizations, well-child visits.

For more information, review the AAP Guidance on the Necessary Use of Telehealth During the COVID-19 Pandemic.

Step 2: Prepare yourself for the telehealth visit

• Use a HIPAA compliant workspace and technology platform whether at home or at the office.
• Accommodate yourself for a telehealth visit the same way you would for an in person visit.
• Review pertinent information about the patient and be sure you have all the resources you need to document the encounter.
• Make sure you are on a private network and in a private setting where the patient’s privacy and conversations can be protected. Recommend placing a sign on a closed office door to minimize interruptions during the visit.
• Check that your microphone and camera are working.
• Consider use of a virtual background for less distraction to families and patients.
• Ensure that you have access to a technology support line number in case of any technology issues.
• Consider including other providers in the visit if this is appropriate to address primary concerns. Inform the family/caregiver and patient of all providers who may be present during the appointment.
• Send any questionnaires to the family/caregiver to fill out prior to visit.

Step 3: Prepare the family/caregiver for telehealth visit

• Create a tips resource describing the technology needed for the telehealth visit. Share this information with the family/caregiver as well as broadly (through practice websites, portal message links, social media links, etc.).
  
  • Inform family how they can access your platform (email, portal login, text message).
  • Allow a test run of logging into the platform prior to the visit (offer tech support number).
  • Provide family/caregiver information on the HIPAA requirements of your platform. Reassure family about privacy and confidentiality.
• Ask the family/caregiver if any accommodations are needed for language and/or disability.
• Review expectations and flow of visit with the family/caregiver.
  • Child/youth needs to be awake and available during the entire visit (unless it is a consult visit that can be done without the patient).
  • Consider messaging the clinic prior to visit with any videos or pictures of concern if the child/youth is unlikely to cooperate in a telehealth visit.
  • Review which practice/clinician staff (i.e. nurse or physician) will start the visit and how many providers will participate in the visit.
  • Consider scheduling the visit when home nursing or therapy is present to provide additional information and/or assistance with a telehealth physical exam.
  • Prepare list of celebrations/accomplishments and concerns.
    • Provide families with the Preparing for a Successful Telehealth Visit Planning Worksheet.
• Conduct a “Tech Check” prior to the appointment and offer a help line/clinic line for families/caregivers to call the day of the appointment in case there are any issues
  • Ask families if they have access to a tele-ready device (device with a camera and microphone). If they do not, provide them with the No Device Barrier Buster to help them determine how to access a tele-ready device. Offer an in person visit, if needed.
  • Ask families if they have access to internet services and provide them this No Signal Barrier Buster to help them problem solve. Offer an in person visit, if needed.
  • Request accommodations/interpreter, if needed.
  • Check that camera and microphone are working on the phone/computer/device.
• Prepare space/time for visit
  • Ask the family/caregiver to identify as quiet/private of a space as possible where they are comfortable discussing personal health information and any sensitive issues that need to be addressed. For tips on how to find a quiet space, provide families with the Finding a Quiet Place Barrier Buster to help them solve the problem.
    • Consider a space where the child has the option of playing when they do not need to be on camera.
  • Inform families/caregivers that they should not drive while participating in the visit.
    • Inform families/caregivers to let the clinic know if they are traveling out of state as visit may need to be delayed due to licensure reasons.

For more information, review the HealthyChildren articles Telehealth 101: Get Plugged in to Your Child’s Health and Telehealth Visits for Children Who Need Hearing or Vision Help
 

Step 4: Follow-up planning

• Develop plan of care with families/caregivers for next steps
  • Discuss if you will need or will provide referrals, prescriptions or orders for supplies, therapies or medical care.
  • Clarify who is responsible for key parts of care plan, communication and care coordination.
• Ensure the family/caregiver has access to note/instructions on the electronic medical record portal.
• Discuss timing of next appointment and whether telehealth or an in person appointment is needed.

Additional Resources:

• PediaLink Course: Providing Telehealth and Distant Care Services in Pediatrics
• Minimizing Telehealth Technology Barriers in Rural and Underserved Communities
• Ensuring Equitable Access to Telehealth
• Autism Speaks: Telehealth Tool Kit for Families and Providers
• Family Voices: Telehealth Social Story for CYSHCN

This resource is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) as part of an award totaling $6,000,000 with no percentage financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the US Government.