Table 4.

Best practices for a successful telemedicine visit

Telemedicine setup	Choose a telemedicine platform that: • can provide a secure, private connection • is compliant with local government regulations of telemedicine • can be easily implemented by both patients and provider
Pre-visit preparation	Prior to a telemedicine visit: • Develop a workflow to identify patients who are appropriate for telemedicine visit [vs those who need in-person evaluation] • Provide instructions to patient on how to access telemedicine platform, including tips for troubleshooting • Clinic staff may opt to perform a ‘dress rehearsal’ with patient to ensure patient can easily access telemedicine platform • Utilize electronic tools to collect history and data from patient [online questionnaire, eHealth, IBDoc, myIBDcoach]. Ideally, this can auto-populate in the electronic medical record • Clinic staff [e.g. medical assistants, nurses or others] can ‘pre-’ chart and input clinical information including IBD scores • Find a space that is quiet, private and without distractions to conduct visit • Determine if telemedicine visit must be performed by provider in a clinic space [rather than from home] in order to optimize reimbursement and meet regulatory requirements
During the visit	• Medical Assistant may ‘room’ the patient and review insurance, demographics, preferred pharmacy and perform medication reconciliation • Obtain verbal consent to perform video visit • Obtain history and limited physical examination • Complete visit, communicating follow-up plan
Addressing technology challenges	• Can mostly be avoided by pre-visit trial with medical staff and/or providing a tips sheet for troubleshooting ahead of time • Trial of alternative platform [e.g. FaceTime, WhatsApp] • If all else fails, convert to telephone visit
After the visit	• Provide electronic copy of after-visit summary. • Route prescriptions and laboratory orders electronically. Drive-through pharmacy and delivery options should be encouraged • Instruct staff to contact patient to schedule follow-up care
Documentation	• Use similar note template to in-person documentation • Use a physical exam template appropriate for video visit • Document that patient provided consent to conduct telemedicine visit • Document the modality used for the visit [e.g. real-time audio and video connection]