| Safety | - Verify the patient's location/contact information at the beginning of the encounter.
- Ensure that the patient's physical and virtual environments are secure and private, including from other family/household members.
- Obtain informed consent for the visit.
- Use headphones to ensure patient confidentiality unless you are in a private space.
- Proceed according to patient comfort level; obtain consent for examinations, minimize removal of clothing, and proceed with follow-up discussions once the patient is clothed.
- During an examination, avoid personalizing language such as "[instruction for me]" or "show me your [body part]." Consider instead: "In order to help us treat you, it would be useful for me to examine the arm. Would you mind rolling up the sleeve so that I can see the rash?"
- Provide education/information on safety resources that can be accessed virtually (eg, crisis hotlines).
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| Trustworthiness and transparency | - Actively listen to the patient's concerns about their health and/or the telehealth environment.
- Alert the patient to possible ambient noises.
- Sit far enough from the screen that the patient can see your body language, which also helps to ensure the appearance of better eye contact through the camera.
- Provide the patient with time to adapt to the telehealth environment.
- Provide clear information on changes to scheduling, access, and contact process.
- Dress professionally for the visit and avoid busy, unprofessional backdrops.
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| Collaboration and mutuality | - Thank the patient for connecting with their medical team using this care modality.
- Collaboratively identify and develop an agenda for the visit.
- Partner with the patient to attain goals and mitigate treatment challenges.
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| Empowerment, voice, and choice | - Follow patient preferences regarding extent of the visit; some may prefer to just talk or test the connection for their first appointment.
- Assure the patient that they may choose to end the visit at any point.
- Allow the patient to choose the room where the visit takes place.
- Emphasize that the topic of discussion can change, even abruptly, when needed.
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| Cultural, historical, and gender issues | - Use gender-affirming language (including patient's preferred pronouns).
- Encourage/praise the patient's willingness to try this care modality.
- Consider social determinants of health during the visit (eg, housing stability, food insecurity, impact of racism).
- Be sensitive to the patient's feelings in revealing their personal space during the visit; refrain from comment about their home/living space.
- Seek ways to make telehealth accessible to those who lack devices/Internet access or need an interpreter.
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