Teaching clinicians how to conduct online consultations

An article about recent funding for the good folks at Breakthrough reminded me of the importance of the teaching that we give to clinicians at our customer sites. Breakthrough allows mental health professionals to conduct consultations through video securely. The press included customary commentary and hand wringing:

But some doctors have expressed concern that telemedicine is perilous and will increase the rate of misdiagnosis. The most conservative among them fear that telemedics will fail to notice telltale symptoms […] In the case of telepsychiatry, it seems even more likely that a therapist might miss the subtle signs of depression.

The doctors quoted are demonstrating why they need teaching. Sure, seeing someone in person in the clinic gives you some better visual cues about the person’s mental health than what you can see during a video call. The way they walk in, seeing their whole body up close, and other visual data are certainly more available when a person is sitting in your office.

But all these pale in comparison to the additional data from seeing a patient in their home. Can you imagine how much better informed a mental health professional would be if they could see the patient in their bedroom? They can see whether the patient with depression had a clean bedroom, whether they had bothered getting out of bed, what clothes they are wearing, and so on. These observations are far more significant than the ones from an artificial visit to a clinic.

We train doctors to fill in the gaps from medical schools.

We start by explaining what has already been done. For example, if you ask most clinicians whether or not they should consult using Skype, they will give many well-articulated and completely incorrect reasons why this cannot be done. The article about Breakthrough included examples of faulty reasoning. But if we tell them that clinicians are already using PKB for Skype consultations, they pause… and then are inspired to try and get this pushed through their local IT governance.

We then walk the clinicians through the different options, and how to engage with patients in these. Some times a pre-clinic survey questionnaire is appropriate, other times secure messages work better, other times still a schedule video call is necessary. Patients are quite good at choosing between these options, as long as you set their expectations. For example, sending a message at 3 am does not mean getting a reply at 3:10 am, it means that the patient is safe in the knowledge that the message is going to the right person, and that they will receive a response within one working day (or whatever speed the clinical team offered). And of course, powering all of this is a complete medical record, with data for the patient from across all clinical teams, ensuring safe and fast care for the patient.

It is a delight to see the clinicians after they have received this training. Most had really wanted to engage their patients in more innovative and convenient ways, but simply did not know how. With their new skills, they enjoy the improved service that they are giving to their patients.

All of this training is delivered to clinicians by our own clinicians. If you want to join our training team, teaching clinicians all over the world how to work with patients online, we would love to hear from you.

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