During the COVID-19 pandemic, many patients and healthcare providers had little choice outside of telehealth options to manage care. In 2020 alone, telehealth services for Medicare beneficiaries saw a 63% increase since 2019.
While this practice was meant to be a temporary solution, it has become a relatively new norm favored by many patients. Despite these visits naturally declining going into 2022 as more in-person options were available, telehealth remained in use for 30% of adult patients—only a 7% drop from 2021.
Telehealth isn’t only helpful for patients as NPs have seen benefits as well. With reduced wait times for patients and expanded work hours from multiple locations, NPs can gain more flexibility and control over their schedules.
Although there are a number of benefits to be had from telehealth services, there are also challenges to face as well. For NPs looking to offer regular telehealth appointments, here are just a few challenges to watch out for and manage.
Hands-Off Diagnoses
One of the main arguments against telehealth services is the presence of physical cues that NPs can better observe during in-person appointments. This is especially the case since some conditions may require a hands-on assessment to be identified—such as heart murmurs or other forms of internal pain.
During telehealth appointments, patients must also be able to articulate their physical symptoms. However, they may describe symptoms inaccurately or fail to identify other symptoms that a healthcare professional would notice when in person. With these risks in place, NPs will have to prioritize extra solutions to ensure remote diagnoses are performed accurately.
Tools for Remote Diagnoses
Thankfully, there are tools NPs can implement to ensure accurate diagnoses. They can recommend patients to wear smartwatches and fitness trackers that provide data on heart rate, oxygen saturation, and activity levels in real-time. Home kits can also provide features such as blood pressure cuffs and oximeters that allow patients to share vital information during telehealth appointments.
Virtual Mental Health
While mental health services don’t need the hands-on assessments that physical conditions benefit from, these services can still bring their own challenges to telehealth appointments. Mental health assessments completed in person allow NPs to pick up on physical cues that could be signs of the patient’s current condition. With variations in camera angles and camera quality, these cues can go unnoticed during a telehealth appointment.
Suggestions and Strategies
NPs can encourage their patients to position the camera to include most of their body to allow for observation of movements. These settings also work best with open-ended questions about how patients with follow-up questions that show active listening and build rapport—an essential for building trust with patients when providing mental health care. Some helpful questions would be:
- How are you managing your daily routines?
- What emotions do you experience the most often?
- It sounds like you’re feeling anxious about your situation. Is that correct?
Managing the Virtual Emergency
Telehealth appointments are helpful for routine checkups and assessments, but in an emergency, NPs must quickly act to understand the severity of the patient’s state while having a pre-designed plan of action to follow.
NPs can start by asking questions about the patient’s safety or if they are experiencing specific symptoms that would require immediate attention.
Emergency responses in these situations may be delayed, so NPs must prioritize clarifying the patient’s location in the case that emergency responders need to be called. NPs can ensure this information is ready by requiring documentation before the appointment that details the patient’s location as well as any emergency contacts. It’s also helpful for NPs to have a list of nearby emergency resources that are near the patient’s location.
The Future of Telehealth
Telehealth has transformed the healthcare landscape, offering both patients and nurse practitioners flexibility that was previously limited. By embracing innovations and preparing for potential challenges, NPs can continue to provide high-quality care remotely while maximizing the benefits of telehealth for both them and their patients.
