How to Deliver a Successful Telemedicine Session

Abigail Sabido
April 13, 2020

Technology allows for more accessible and convenient healthcare delivery through telemedicine. Thanks to videoconferencing, office consultations may now be done at home. However, practitioners should create an environment where patients can feel accommodated and cared for despite the remote setup. It’s also essential in telemedicine that patients see that their doctors have a professional and well-thought-out organization.

Get the Right Platform and Tech

Videoconferencing is a tool that relies on secure applications and devices, internet connectivity, and adequate preparation. Securing PHI is a top priority, but it doesn’t have to detract from good audio and video quality. This requires investing in devices with high-quality systems or peripherals for smoother communication. So when selecting a telemedicine system, consider its reliability, usability, security compliance, and cost-effectiveness

The Federal Communications Commission (FCC) has laid out minimum bandwidth recommendations depending on the type of practice. A single physician practice requires a minimum of 4 Mbps upload and download speed, while a 2-4 physician practice needs at least 10 Mbps. These are minimum necessary speeds but any additional is extremely helpful to reduce instances of lag, buffering, or stutters. Bandwidth requirements vary depending on the number of users, frequency of real-time transactions, and location.

While a laptop or tablet’s internal camera is enough to facilitate telemedicine, practitioners may opt for an upgrade to the latest video and audio technologies. Key players like Polycom’s RealPresence Group Series offer heavy-duty, facial recognition-capable cameras and noise-block audio systems starting at $2,999. Cisco’s Webex DX series can be a cheaper alternative but is only ideal for individual meetings and not for board room conferences. For practices that require frequent collaboration with multiple physicians, Avaya’s XT5000 Room System could be the perfect tool but the price ranges from $8000-$10,000 and has a complicated setup.

Other notable names like Lifesize, Logitech, and GoToMeeting offer bundles of affordable quality equipment but with limited collaborative functions and board room options. Lifesize’s 4K Icon series comes with an Opus-powered audio system and simple touch controls. Logitech’s MeetUp series costs around $899 to $1079 for its auto-framing RightSense technology and 4K resolution and 5x zooming capabilities. A cheaper alternative like the Logitech C930e 1080p full HD camera and 2 omnidirectional microphones is priced at $200. Genius WideCam F100 has a comparable 1080p HD camera and a built-in stereo mic at only $50.

Make a Good Impression

People working from home can enjoy the pleasure of taking a break from old mundane worries like fashion and hairstyle. However, appearance makes a big impact in telemedicine. While it’s best to avoid appearing overdressed, dressing down might not work either. Cool and neutral-colored tops go well with any setting and lighting, while bright colors and excessive prints usually appear jarring on camera.

Doing telemedicine visits at home can be tricky. If a home office or spare room isn’t available, the space must be private enough to limit distractions and reduce noise. It should also have a neat and simple background. Doctors may opt to mimic their office by curating props like stethoscopes, books, charts, and plants to look more professional. Virtual backgrounds like in Zoom and some cameras make good alternatives but will require a plain background wall with a solid color. The next consideration is lighting where natural light is highly recommended. When using lamps, muted or natural colored LED bulbs work best to achieve a more natural-looking indoor light source.

Camera positioning is just as important. Think about that news reporter who recently made headlines after appearing on TV without his pants. This is a good lesson in proper camera framing. Cameras must be at eye-level to get a flattering angle, reinforce eye contact, and hide clutter or eye-sores. When talking, the eyes should be on the camera and not on the screen. Good posture must be maintained, as slouching could mean a lack of motivation while sitting straight indicates focus and attentiveness.

Doctors should also pay attention to gestures. They come naturally when people speak but should be controlled in videoconferencing. The patient’s field of vision is limited to the camera. Hands and other bodily gestures may go unseen and can be distracting or misleading. The same goes when multitasking. Whether it be taking down notes or typing details on the computer, the patients have to know what their doctor is doing.

Be a Good Host

Even with an advanced mode of communication, certain issues may still arise causing miscommunications or the cancellation of sessions altogether. For instance, some patients may not be aware of the 2-3 second delay that occurs in some cases. It could be misinterpreted as being distracted. Doctors may also not be up for the challenge of guiding patients through troubleshooting common problems.

Video calls are prone to technical glitches like audio lagging and videos freezing. These disrupt engagements and can consume time to troubleshoot. Typically, these happen for several reasons: (1) slow internet connection or (2) improper equipment connection.

The following steps are the basic troubleshooting steps for audio lags, choppy lines, and voice echoes:

  1. Check the internet connection. The practitioner and patient are advised to check their internet speed. If slow or intermittent, closing other bandwidth-consuming applications can help. Otherwise, the internet modem should be refreshed by a quick restart.
  2. Check the peripherals’ connections. If it isn’t a bandwidth issue, the next thing to check is the hardware. Both parties should see if their microphones, speakers, or headsets are securely connected to the proper ports or are configured correctly.
  3. Create a new session. If changing the peripherals doesn’t work, closing the application might show some improvement. For calls done on websites, start a new session after refreshing the page.

A microphone being boosted often causes echoes. This is exacerbated if headsets or earphones are unavailable. This may require disabling microphone enhancements like “surround,” “equalizers,” and “mic boost” that are found in the audio/video setting of the device or the software. When encountering camera freeze, try turning off the camera for a few seconds. The audio will remain functional in most cases so both parties can still communicate. If the problem persists, doing the same steps mentioned above on the camera can remedy the mishap.

As hosts, physicians are responsible for giving patients a quick orientation on how video conferencing works. This is best done by a staff member prior to the scheduled appointment, so expectations are set and complex technical concerns can be addressed.

The technicalities of telemedicine leave many doctors and patients reluctant to switch to the remote setup. Sometimes, unmet expectations result in cancellations. That’s why running audio and video tests and configurations before the actual session for overall appeal and proactive adjustments.


Abigail is a senior writer in Xilium. Before joining the company, she worked as a content creator for online startups and has written about current events, health, lifestyle, and entertainment for US-based online news portals and lifestyle blog sites.