. 2022 Nov 7;156:668–678. doi: 10.1016/j.jpsychires.2022.10.051

Panel 2.

Practical recommendations for the implementation and use of remote consultation for people with mental health conditions in the community.

Recommendations for organisations
Provide continuous training and skills sessions to providers, including training to improve self-efficacy with diagnosing and assessing patients^a
Provide supports for staff who are burdened or struggling^a
Obtain regular feedback from providers and patients to improve remote consultations^a
Provide adequate administrative support and staff, particularly during initial stages of implementation^a
Provide the necessary software and hardware for staff working remotely^a
Offer adaptations to patients with hearing or visual impairments^a
Provide a quiet, private room in GP, local health centre or pharmacy for those living in crowded homes etc.^a
Follow up with those who have refused online care and find out the reason for refusal e.g. low digital literacy, no internet connection^a
Provide FAQs to patients and staff on common technical problems^a
Conduct a separate session for preparing patients for remote consultations^a
Make increased efforts to communicate delayed appointments to patients^a
Advocate for continued insurance coverage for remote consultations^a
Develop an automised documentation system whereby paper and electronic notes can be integrated and accessed remotely by all staff involved in a patient's care^a
Recommendations for providers
Adopt a hybrid model of care where possible, taking into account the type of consultation and patients' preferences^a
Share positive experiences with colleagues to improve buy-in^a
Schedule breaks and take regular breaks from the screen^a
Encourage patients to include their full body on screen, and emphasise the importance of this to the patient^a
Conduct special follow-up with older patients or those experiencing difficulties with remote consultations^a
Make use of online resources such as online whiteboards for therapeutic work
Offer choice of consultation format to patient and engage patient in decision-making^a
Implement contingency planning if disconnected from patient, for example, ask the patient for their location and for a call-back number at the beginning of each consultation
Utilise phone consultations for certain visits when efficiency is required e.g. medication management visits^a
Utilise virtual (inspection) physical examination (ViPE) when a physical examination is required^a
For patients at risk of suicidal thoughts, schedule future appointments to which the patient can look forward
Explain to the patients how the pathway of recovery will be addressed on remote consultations
Test the technology with a colleague before conducting the initial consultation with a patient, to reduce fears and increase efficacy^a
Be open with the patient about your insecurities with technology, if not confident, to create balance in the relationship^a
Recommendations for patients
Ask the organisation if they can offer devices and equipment temporarily, such as laptops, tablets, and Wi-Fi boosters^a
Attempt to have first meeting in-person in person to build rapport with provider
Communicate any needs or adaptations to the practice or provider^a
Conduct consultation in a quiet, private space, free of distractions where possible^a

May be generalizable to remote medical consultations.