Page 25 - Telemedicine - Essentials of Virtual Care Delivery Part One

SVMIC Telemedicine: Essentials of Virtual Care Delivery

Setting Up the Telemedicine Workspace

Set the stage for professionalism:

• Choose an appropriate background to avoid distractions.

• Center yourself in the video screen, preferably with your

head, chest and shoulders visible.

• Ensure you are not too close or too far from the camera.

Eye contact and visualization of your facial expressions

and hand gestures are important.

• Avoid setting up near a door as this gives the patient a

better sense of privacy and comfort.

• Use the patient’s name and take a moment to break the

ice with a question such as “How have you been doing?”
or other general question before diving into the problem-

focused visit.

• Ask open-ended questions.

• Acknowledge that this is different from a standardized
physical exam and ask permission to engage the patient’s

participation in the physical exam.

Physical Exam

The traditional SOAP note is a good framework for the
telemedicine encounter. However, some feel the subjective

component will increase and the objective component, generally
derived from the physical exam, may shift from the hands-on

evaluation by the physician/provider to patient observation
and participation in the exam. The patient will become the

liaison or the “hands-on” for the clinician. Telemedicine will
likely strengthen the power of observation by both physicians

and patients. Many physicians assert that 80 to 90 percent of

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