Are you thinking of adding telehealth to your practice as a dietitian? Wondering how your communication with patients will change when counseling them over the phone or internet instead of face-to-face in your office? Well, as an RD and certified diabetes educator who has been working in telehealth for more than a year now, I have some helpful tips to share with you.
The truth is that the use of telehealth in health care professions, including dietetics, is becoming the wave of the future. Of course, not all in-person visits can be replaced by phone and video counseling sessions, but there certainly is a large market for remote dietary counseling. Let’s face it: Our patients are busy, and some have limited mobility. So offering them the option to have an appointment in the comfort of their own home can be attractive to both clients and RDs. This can increase attendance and timeliness of counseling sessions and afford more frequent contact, all of which can lead to better compliance with their treatment plan.
If you decide to add remote counseling services to your practice, you’ll need to make some modifications and consider the following:
- Just like in-office visits, you must have a quiet, private place to conduct your counseling sessions, and you should encourage patients to do the same. This minimizes distractions and enhances patient privacy. Using a headset during phone calls or internet-based counseling can improve your ability to hear patients and reduce background noise. Avoid using a speakerphone, as this can be intimidating to clients and risk breaching privacy.
- Keep in mind that the visual component of counseling, such as facial expressions and body language, will be absent if you’re using the phone to communicate. Therefore, active listening is key; paying attention to verbal cues such as tone of voice, hesitations, and pauses will be more important to connect with and understand the client. When counseling via video conferencing, you may be able to retain some of the visual cues but will have to focus and concentrate more intently to pick up on them. Fortunately, using motivational interviewing techniques still can be quite successful when counseling remotely. Open communication, active and reflective listening, exploring ambivalence and confidence about change, asking open-ended questions, and having a client-focused agenda all can be done via phone or video.
- To make your remote counseling appointments effective, have an agenda (created and agreed upon by the client and yourself) and a set time frame for the appointments. Send reminders via phone or secure e-mail to encourage visit compliance, and have a missed appointment policy in place.
- Finally, make sure you do things legally and professionally. Use secure e-mail and HIPAA-compliant software (such as VSee or SecureVideo) when offering telehealth services; look into your state and local laws to ensure you’re following the laws for telehealth counseling, and obtain any required licenses. Be sure to get malpractice insurance that includes coverage for telehealth. Also be aware that many health insurance plans don’t cover telehealth yet, so patients often must pay out of pocket.
Despite the transitions and challenges involved with entering the world of remote nutrition counseling, it’s a very exciting emerging field that can offer numerous benefits to your patients and yourself as a practitioner.
— Marie Feldman, RD, CDE, CHC, has been a registered dietitian for almost 18 years and a certified diabetes educator for eight of them. In addition to counseling patients via a telehealth company, she author of the cookbook The Big Book of Diabetic Recipes (released January 2016) and has a nutrition and recipe blog Nourish You Delicious.