The coronavirus pandemic has seen GP surgeries and many private clinics introduce video appointments in order to provide a service while maintaining the need for social distancing. It has proved effective and is part of the “new normal” that we are all having to learn to live with.
The Oxford Clinic is no exception to this and we are offering this service to patients in the Government’s “extremely vulnerable” category where the risk posed by a face-to-face appointment is too high. If you have never used online video conferencing before there is a learning curve as with anything new. Here are some ideas for how to improve and build your confidence.
What equipment will I need?
You will need access to the following:
- A desktop or laptop computer (Windows or Mac), an Android tablet or iPad, or a smartphone or iPhone
- A webcam (camera), speakers and microphone (these are almost always already built into laptops or mobile devices)
- A good connection to the internet (If you can watch a YouTube video, you can make a video call)
What software do I need installed?
You can use Skype, Zoom or WhatsApp for our video appointments. If don’t already have an account download the software and follow the online instructions for each app. Remember to keep a note of your user name and password.
If you haven’t used video calls before, if possible, run a test call with family or friends before you do your first video consultation to make sure you know how to adjust video and audio settings.
Let us know your user name, e-mail address and a contact phone number
Let us know your username before the appointment so that we can find you on Skype. We need an e-mail address to send you consent forms and other information beforehand. We ask for a phone number that we can contact during the video call in case of technical difficulties. If you are using a mobile phone to make the video call then a landline number would be best.
Where should I do my video consultation?
Think which room would be best. Unless you live alone, you’ll need to find a quiet, private space where you won’t be disturbed. If you don’t feel confident of privacy at home (e.g. if you’re still living with parents), consider a different place to connect from. Some people ask at work if there’s a room they can use.
Adjust the light so you can be seen clearly (e.g. face not in shadow).
Starting the video call
Many aspects of video consultations are similar to traditional face-to-face ones, but the first few seconds are very different because you need to make the technical connection. This can be daunting, but once you’re ‘in’, things will become more familiar. Here are some tips:
- You will have been given an appointment time in the usual way by the Clinic. Log in to Skype at least five minutes before and check that your video and sound is working.
- Around your appointment time you will get an invitation to join a video call from Pinar Aydemir. Click on Accept to start the call.
- If you haven’t received the invitation within 10 minutes please call the Clinic on 01229 827717. The physio may have been delayed with the previous patient, or we may have got your username wrong.
- Confirm that everything is working well. You’ll find yourself saying things like “can you hear me?” or “your face isn’t clear” or “yes I can see you”. If there’s a technical problem (e.g. you cannot see or hear each other) try these suggestions:
- Type a message to Pinar using the text-based chat window (or see if she has sent you a message).
- Wait for Pinar to contact you by telephone.
How do I pay for a video consultation?
You can either pay beforehand by calling the Clinic receptionist, or at the beginning of the video call. If you haven’t paid beforehand please have your debit or credit card ready for Pinar to take the details. We charge £30 for an initial video consultation lasting 30 minutes and £20 for follow-up sessions of 20 minutes.
If your insurance company has arranged your treatment we will invoice them directly and there is nothing to pay.
Will my consultation be private and secure?
If this is your first consultation with Pinar to ensure privacy and security she may check your date of birth, telephone number, or use another type of security question. You will have been sent a copy of our Privacy Notice and Consent Form beforehand. Pinar will confirm with you that by continuing with the call you give your consent to treatment and the Clinic retaining your personal data.
We do not record video sessions. Pinar will make written notes on your record in the normal way.
If someone has helped me set up, can I have the consultation privately?
As in a traditional face-to- face consultation, it is your choice who sits in on your consultation. Pinar will ask you if anyone else is in the room and whether you happy for them to be there. She will need to know their name and their status i.e. a relative, friend, technician. If someone has been helping you get set up, it’s quite OK to suggest that they might leave the room once you’ve been connected.
How do I communicate in a video consultation?
Research shows that once the technical aspects of set-up are completed, video consultations tend to be remarkably similar to traditional face-to-face ones. Here are some things to watch out for.
- How will the consultation start?
Once you and Pinar agree that the technology works, the main part of the consultation, usually by her saying something like “Tell me about your problem”, “How have you been since I last saw your?” or “How are you feeling?”
- How do I let Pinar know that I’m listening and doing OK?
You do not need to look directly into the camera on your computer, tablet, or phone. Looking at the screen is sufficient for the other person to know that you are engaged in the consultation.
Because webcams provide only a limited view, Pinar may not be able to see much beyond your face. It’s a good idea to tell them if things are happening out of view (e.g. “my wife has just come into the room”), so she knows what’s going on.
- How do we know whose turn it is to talk?
Sometimes it can be hard to tell whose turn it is to talk during a video consultation. This is usually due to delays in the connection. When this happens:
- Stop talking, acknowledge the problem, work out whose turn it is, and then continue. Nobody should be offended – this is just something that happens sometimes in video consultations. It’s sometimes quite funny!
- Make a comment to show you’ve noticed (e.g. “Oops, I think there’s a bit of a time lag here, let’s start again”) will help to confirm that nobody’s deliberately trying to interrupt the other.
- What happens if there’s technical interference?
- Video consultations can suffer from technical interference, e.g. due to a busy network or problems with latency (when a person’s lips move but the sound comes just a bit later). This can result in garbled talk, or blurry or frozen faces on the screen. Having a good connection and equipment helps, but otherwise there may not be much you can do to change this. Basically, some video consultations may turn out to be less fluent than a face-to-face or telephone consultation.
- You may need to repeat things or ask for clarification more often. If there’s been a technical glitch, a good way to resume the consultation is to repeat the last thing you heard (or said).
- It may help to make a comment about technical problems (e.g. “You’re breaking up a bit”).
- How do make sure I capture important information?
If Pinar is giving you potentially important information about exercises, ask her to repeat it to confirm you both have it correctly. In any case she will send you a link to the exercises by email afterwards.
How can my therapist conduct a physical examination?
People used to think that physical examinations are impossible via video link, but research shows that it is sometimes possible to do parts of a physical examination, especially with active input from the patient (and perhaps a carer or helper). Here are some tips:
- Take particular care to ensure that the room is well-lit and you are not in shadow.
- What happens if I’m asked to do an examination myself? (e.g. lift your arms above your head):
- Don’t rush.
- Ask Pinar to show as well as tell you what to do.
- Don’t worry if you don’t know the official medical names for things. If you call it “the little bit that sticks out there”, the clinician will know what you mean.
- What happens if I’m asked to do an examination myself? (e.g. lift your arms above your head):
- Can I ask someone to help me with a physical examination?
Think about how much help you want from a carer or other helper. If the examination is likely to involve holding or moving the webcam to let Pinar see a part of your body other than your face and chest, another person will almost certainly be needed to do this repositioning. If you prefer, you could ask the person to come into the room just for that part of the consultation. Once this part of the examination is complete, ask them to leave the room.
- How can I make a physical examination easier for my therapist?
Listen to feedback from Pinar as you do the examination. For example:
- She may be able to guide you to reposition the camera so as to get a better view.
- One useful trick is to reverse the camera on your webcam when you do the examination, so you see what the therapist sees.
- Pinar may ask you to adjust the lighting. For example, webcams are sensitive to over-exposure, so she may ask you to reduce the amount of light shining on you.
How does a video consultation end?
The final moments of a video consultation are usually very different from a face-to- face one. Face-to-face, Pinar might stand up and accompany you to the door before shaking hands and saying goodbye. In a video consultation, you both need to find other ways of achieving closure. Here are some ideas:
- Towards the end, Pinar will probably ask you if there’s anything else you want to cover, and suggest when your next appointment should be. This happens in much the same way as in a face-to-face consultation.
- It may be necessary to summarise or clarify things that were missed as a result of technical interference. In particular, make sure you’re clear about exercises and ask for confirmation by email if necessary.
- ‘Technical’ closure happens when you hit the ‘end this call’ link. Don’t worry if you can’t find it – Pinar will end the call herself.