Becker's Hospital Review

56 CIO / HEALTH IT How physicians can show empathy over virtual visits By Jackie Drees A s physicians maneuver the transition to virtual care during the COVID-19 pandemic, they can still exhibit em- pathy toward their patients by adopting ver- bal and nonverbal habits. Empathy can help physicians enhance com- munication and build trust with their pa- tients, according to a study published in the Journal of the Society of General Internal Med- icine. is in turn benefits the treatment pro- cess and can help decrease patient anxiety. Expressing empathy through virtual visits is especially important during the COVID-19 pandemic because virtual care is the safest way to help prevent patients and clinicians from contracting the novel coronavirus, according to Cleveland Clinic's COVID-19 Digital Health Playbook. Physicians can express empathy both non- verbally and verbally over virtual visits. Non- verbal displays of empathy include main- taining direct eye contact with the patient by looking into the camera to show interest in what the patient is saying and in their care. Some other nonverbal tips to show empathy are exaggerating motions like head nods so the patient knows the physician is listening. "Develop a 'video presence' that includes staying visually attentive, exaggerating facial expressions at times and ensuring the patient has a clear view of your face and body lan- guage," Cleveland Clinic's playbook stated. Statements such as "I'm here for you" and "let's work together to figure out what's going on" can also help physicians increase their show of empathy. Further, verbally acknowl- edging and validating the patient's feelings or experience can help the patient feel more understood and strengthen their care experi- ence, according to Cleveland Clinic. Philadelphia-based Jefferson Health physi- cian Aditi Joshi, MD, practiced empathy to enhance her virtual visit experience when providing care to COVID-19 patients ac- cording to the Philadelphia Inquirer. Dr. Joshi, who had been diagnosed with COVID-19, said contracting the virus helped her better understand her patients. n Telehealth during the COVID-19 pandemic: What's different & what has stayed the same for clinicians By Jackie Drees F rom relaxed federal regulations to expanded in- surance coverage, the COVID-19 pandemic has driven several changes for clinicians providing telehealth services. Here are five differences about telehealth visits for clini- cians: 1. Licensing regulations. President Donald Trump on March 13 declared a national emergency over the COVID-19 pandemic, which allowed HHS to waive federal licensing regulations to permit out-of-state physicians to treat patients via telehealth. 2. Medicare reimbursement. CMS extended Medicare coverage for telehealth services during the coronavirus public health emergency, allowing physicians to be reim- bursed at the same rate as in-person visits for more than 85 additional services delivered via telehealth. These services include common office visits, mental health counseling and preventive healthcare screenings. 3. Payer coverage. Insurance companies including Aetna, Cigna and UnitedHealthcare all expanded coverage for telehealth visits, allowing providers to be reimbursed for various services during the pandemic. 4. New telehealth platforms. President Trump relaxed HI- PAA penalties in March, which allowed providers to start using platforms such as Apple FaceTime, Zoom and Skype to perform telehealth visits with patients. 5. More patients getting care virtually. Some hospitals and health systems have transitioned thousands of pro- viders to its telehealth platforms to care for non-COVID-19 and COVID-19 patients. NYU Langone Health added 1,300 physicians and other care providers to its telemedicine platform in late March, and a Merritt Hawkins report found that 48 percent of physicians are treating patients through telehealth, up from 18 percent in 2018. Here are three things about telehealth visits that have stayed the same for clinicians: 1. Clinical documentation. For clinicians at Cleveland Clinic, schedules and clinical documentation for virtual vis- its can still be found in the health system's Epic EHR system. 2. Building relationships with patients. Even though cli- nicians are connecting more with patients via telehealth technology, they can still practice empathy through ver- bal and nonverbal actions. These can include maintaining direct eye contact with the patient and saying statements such as "I'm here for you." 3. Internet access, or lack thereof. Some clinicians are still struggling with virtually connecting with patients locat- ed in regions that lack broadband internet. Almost 35 mil- lion Americans do not have internet access, which restricts them from joining video chats with healthcare providers. Earlier in April, lawmakers proposed a bill that would al- locate $2 billion to expand internet connectivity at public and nonprofit healthcare facilities. n

• Cover