The COVID-19 pandemic led to a rapid uptake of telehealth services, raising critical clinical questions and challenges for health professionals to provide optimal care for cancer patients.
We’re hearing mixed reactions—through Cancer Council’s 13 11 20 information and support line—from patients about their experiences using telehealth. While some people welcome it, others have shared anxiety, confusion and dissatisfaction with their telehealth appointments.
Julie, who is living with stage 4 lung cancer, began with face-to-face appointments that went for about an hour. Since COVID-19, she has been shifted to telehealth and most appointments have been less than ten minutes.
'"Up until the pandemic was declared my appointments were face-to-face,' Julie said. 'I found the appointments very beneficial as I was able to ask questions. My family also took the opportunity to ask questions of the specialist. All my appointments are now via telehealth with the specialist oncologist…I feel the appointments are very quick, and do not leave enough time to ask questions or process my thoughts."
Webinar: Enhancing communications skills for telehealth delivery
Cancer Council Victoria in collaboration with the Victorian Comprehensive Cancer Centre and Monash Partners Comprehensive Cancer Consortium recently presented a webinar on enhancing communication skills for telehealth delivery. View the webinar here.
The webinar was moderated by Adjunct Clinical Associate Professor Zee Wan Wong, a medical oncologist at Peninsula Health and featured panellists Kate Barber, a clinical nurse specialist at Cancer Council; Peter Martin, Professor of Communication and End of Life Care at Deakin University and Dr Rob Campbell, a general oncologist at Bendigo Health.
Practical communication tips shared by the panellists:
The importance of a pause. Clinicians commonly forget to allow for a pause for people to process information during telehealth consultations. Evidence suggests that a pause of 3-5 seconds is needed for people to clarify your comments or questions or allows other people to speak.
Slow down. The pace of a conversation should be slowed down but this is even more relevant with telehealth, particularly when providing information to the patient. Speak slowly and use non-technical language.
Explicitly express empathy. Some non-verbal cues can be lost with telehealth regardless of how good the technology is. Clinicians must make more effort to audibly express empathy when communicating with the patient.
Don’t forget to actively listen. Telehealth technology can make it easier to become distracted meaning you might be thinking of the next question you are going to ask and miss important verbal or non-verbal cues.
Ensure the patient understands what was discussed and allow time for questions. Use reflecting or clarifying questions E.g. “Does what we have just spoken about make sense to you?” At the end of the appointment get the patient to summarise what they understand and repeat it back to you E.g. “I want to be sure I explained everything clearly. Can you tell me how you are going to take this medicine?”
Smile. Don’t forget to smile- even if it’s on the phone. Patients can hear the difference and it helps build rapport.
Source: S Sabeson, D Tucker, Doctor patient communication and relationship in telehealth, MJA, 11 May 2020
Useful resources
Doctor–patient communication and relationship in telehealth (an article by Professor Sabe Sabesan and Associate Professor Danny Tucker)
Join the Telehealth Community of Practice at telehealthvictoria.org.au
Cancer Council Victoria training. Effective Cancer Communication (ECC) program provides best-practice communication skills education to health professionals. Effective communication enables supportive relationships with cancer patients and their carers. Through experiential learning with a simulated patient, participants explore and receive feedback on personal communication challenges in a safe environment. Visit www.cancervic.org.au/for-health-professionals/training-education/vcccp
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