We know that “distracted doctoring” can negatively affect patient safety and inhibit open communication. Similar risks can also occur when the patient is distracted—a situation that may be more likely to occur during a telehealth visit.
Distracted patient behaviors can affect the practitioner’s ability to establish rapport with the patient and collect information that is necessary to accurately diagnose and treat the patient’s condition. For example, the patient may not provide a complete history of the reason for the visit, thus limiting the practitioner’s ability to assess signs and symptoms. Distracted patients may also miss critical instructions, resulting in nonadherence with the treatment plan, discharge instructions, or follow-up.
Privacy becomes an additional concern during telehealth visits when the distraction involves individuals in the patient’s immediate environment. Patients may be hesitant to address sensitive health conditions within earshot of others—thus restricting the extent of the clinical discussion.
Addressing Distracted Patients
Consider the following tips for addressing and preventing patient distractions during telehealth visits:
Set technology expectations. Ask patients to shut off nonessential electronic devices (such as televisions, video game stations, and music sources) and to place smartphones on “do not disturb” or in airplane mode.
Set environmental expectations. Advise patients to attend telehealth visits from a private location, preferably at home. Ask patients to ensure that others in the home are not in the immediate vicinity and, when possible, that children and pets are supervised by someone else during the visit. If the patient is attending from a public space, offer to reschedule the visit.
Set behavioral expectations. Assess the patient’s behavior at the initiation of the visit and respond accordingly. If the patient appears to be driving, smoking, drinking alcohol or using other substances, or taking part in an unrelated physical activity (such as exercising or doing housework), discuss your concerns and use your judgment about continuing the visit.
Document distracted behavior. Describe the distraction, what the patient was asked, how the patient responded, and the result. For example, “Asked patient to excuse children to another room; she did and visit proceeded.”
The ease and comfort of attending a healthcare visit from home may result in unexpected consequences. Patients may not realize that telehealth visits are held to the same standard of care as an office visit. Practitioners must be prepared to address situations that impede the ability to provide safe and effective patient care via telehealth.
Find Additional Strategies
Visit our Telehealth Resources page, read our article “Manage Patient Distraction During Telehealth Visits,” or contact the Department of Patient Safety and Risk Management at
(800) 421-2368 or patientsafety@thedoctors.com.
The Doctor’s Advocate is published by The Doctors Company to advise and inform its members about loss prevention and insurance issues.
The guidelines suggested in this newsletter are not rules, do not constitute legal advice, and do not ensure a successful outcome. They attempt to define principles of practice for providing appropriate care. The principles are not inclusive of all proper methods of care nor exclusive of other methods reasonably directed at obtaining the same results.
The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.
The Doctor’s Advocate is published quarterly by Corporate Communications, The Doctors Company. Letters and articles, to be edited and published at the editor’s discretion, are welcome. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of The Doctors Company. Please sign your letters, and address them to the editor.