Telehealth is here to stay – in practice and in medical education
The explosion of telehealth during the COVID-19 pandemic has pushed back the timeline for telehealth education for medical schools and residency programs. But the relative lack of training in the use of this new modality of care has not only been a challenge for doctors in training. Preceptors also suffer from a lack of preparation to make the transition from in-person visits to online consultations.
“While it may be tempting to yearn for a ‘return to normal’ in the delivery of patient care and education, the reality is that, like telehealth, telepreception is the new normal,” wrote the authors of the “AMA Telehealth Clinical Education Playbook”. a new guide for educators focused on integrating educational interactions into a telehealth patient encounter. Download the playbook now.
The playbook considers the many different stages of telehealth implementation. Some educators, for example, might need to focus on telehealth skills, such as having a camera, voice modulation, patient focus, or communicating with surrogates.
“It’s fundamentally different from focusing on delivering quality patient care in telehealth settings,” wrote the authors, who were all from member schools of the AMA Accelerating Change in Medical Education Consortium. “Each of these goals is equally valid and important to pursue, but not all need to be pursued simultaneously or in any particular order due to the unique needs and resources of each clinical healthcare education setting.”
The playbook tips are divided into these three main sections.
This includes an orientation on the history of telehealth, the basics of telehealth practice – including billing and documentation – barriers and challenges to telehealth success during the COVID-19 pandemic, and a glossary of common terms.
“Telehealth education does not begin and end with the clinical encounter with telehealth patients,” the manual states. “There are key considerations and planning decisions required before the encounter and, in many cases, after the encounter that can greatly extend the quality and power of the learning experience.”
The authors then outlined four key steps to prepare your clinic or facility to facilitate the integration of telehealth into its existing educational and clinical infrastructure.
Use the four quadrants of telehealth training to identify your needs. Concretely: Optimize logistics, build skills, facilitate learning and innovate. This section includes a checklist.
Get to know the three phases of the telehealth encounter. It’s not just about what happens on screen. Telehealth encounters often include a pre-encounter phase and a post-encounter phase.
Evaluate how you may need to adapt encounters. “Review operational and educational similarities and differences so that the learner can use a familiar paradigm (face-to-face encounter) to better understand and prepare for the telehealth encounter,” the authors wrote. “Highlight aspects of a patient encounter that are important for both telehealth and in-person encounters,” such as the patient room.
Review your goals and skills. This helps to “identify enduring and transferable content, thereby fostering ‘intentionality’ in designing a successful educational encounter,” they noted. “The question of whether and to what extent goals are achieved becomes a critical part of the subsequent assessment of success.”
The third part of the playbook delves into the requirements of the telehealth encounter and the educational encounter, as well as how to assess success.
The AMA Telehealth Clinical Training Manual builds on the success of the AMA Telehealth Implementation Manual. The AMA also created the Telehealth Quick Guide with tips and tools for getting started, evaluating and selecting providers, as well as workflow and patient care.
The AMA also helps guide physicians, practices, and healthcare systems in optimizing and sustaining telehealth in their organizations through the AMA Telehealth Immersion Program. The program is part of the AMA STEPS Forward™ Innovation Academy, which enables physicians to learn from peers and experts and discover ways to implement practice innovation strategies that earn time.