Optimizing Telehealth Delivery for Dietitians�����������������������

KRISTA FEDORCHAK

MS, RDN, CDN GUEST AUTHOR

Does your client visit begin with the click of a mouse instead of the calling of a name? Is your practice looking to open its virtual doors? If so, you are a part of a growing group of dietitians who are taking advantage of the emerging delivery method of telemedicine, or telehealth�

Telehealth increases access to care for many people, and nutrition counseling is well suited for the virtual world in many ways� Yet, technology presents its own set of challenges� Do not let the limitations of technology detract from the high-quality care you provide� Consider the following to create a counseling space that is welcoming for the client and retains the character of an in-person session in a way that fosters genuine connections�

VISUAL AND AUDIO:

What you see is what you get & “Can you hear me now?”

Setting up a pleasing visual experience is all about minimizing distractions so you and your client can focus on the conversation� Optimize your environment by considering your:

y Background. Set up a plain background or one with minimal distractions� Ensure everything within view is appropriate for the patient to see (such as decorations or personal items)� If possible, keep the background the same over time to help create a sense of familiarity and comfort for your returning clients� y Clothing. Choose visible clothing that is professional and contrasts with your background�

Don’t be a floating head! y Light source placement. Place the light source behind the camera and toward your face to help eliminate shadows that may hide facial features� y A clear audio connection. This is imperative for a productive visit�

Use headphones with a built-in microphone to quiet background

noise and avoid audio feedback and echoes� Be sure to set your computer settings appropriately to recognize the desired input and output source�

PATIENT INTERACTION:

The 2D Counseling Space

One of the challenges of telehealth is simply not being in the same room as your client� Effective counseling uses tactics such as mirroring body language, observing facial expressions and making eye contact, yet the 2D experience can mask some of these subtle cues� To help build and maintain an authentic connection during the visit, consider the following:

y Introduce yourself. Make sure the person knows whose virtual

“office” she/he just entered� Let the person know your documenting style and how she/he will be contacted if technology fails and the visit abruptly ends� y Explain your gaze. If real-time documenting during the visit has your gaze tracking away from the camera at times, let your clients know this� Affirm that you are still listening and engaged while looking away to take notes, and then return to making eye contact with the camera� y Stay obviously engaged. Gentle ways of affirming you are actively listening to your client may not be as readily perceived over video� Keep an engaged face, exaggerate body language and facial expressions, and give encouraging verbal cues (such as “Yes” or “Go on”) to show your client you are listening� y Play to various learning styles.

Keep your client engaged by utilizing various teaching tools�

Inflect your voice (auditory)� Use the share-screen function to share colorful images (visual)� The genuine human connection of the counseling setting can be such a gift for client and provider alike� Take time to go through the checklist before your visits, and whether your client is one mile or 1,000 miles away, get ready to truly connect with your client through the screen�

PRE-TELEHEALTH VISIT CHECKLIST:

 Am I dressed professionally?  Is my background clean, plain and free of distracting items?  Is my face well-lit?  Are my computer settings adjusted appropriately?  Have I tested the tech?  Do I have props, images or handouts ready to show or share?  Once the visit starts, does the patient know who I am, how I am documenting, and how I will contact the person after the visit?

Krista Fedorchak is a registered dietitian and privatepractice business owner offering Christian faithbased insights into caring for body and soul alike� Her favorite screenfree activities are writing letters, chopping veggies and going for leisurely walks with her husband�