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November 4, 2020

What do patients do during telehealth visits? (Sometimes, smoke a cigarette or drink a 'quarantini.')

Daily Briefing

    As people increasingly rely on telehealth amid the epidemic, telehealth providers in turn may notice a number of patients are partaking in some interesting behaviors for a doctor visit—such as enjoying an alcoholic beverage or updating their Facebook status, according to a new study.

    The 'digital divide' is stopping your patients from accessing telehealth. Here's how to bridge it.

    Study details

    For the study, Propeller Insights on behalf of DrFirst conducted an online survey of 1,002 U.S. adults between June 16 and June 19. They survey asked respondents about their attitudes and behaviors when it comes to telehealth services and other aspects of health care.


    According to the survey, 44% of respondents said they had used telehealth services since America's coronavirus epidemic began. Respondents reported using telehealth services for their annual checkups (38%), mental health therapy (25%), and specialists visits (21%

    However, the survey also found that many of those respondents weren't giving their telehealth visits their full attention, as 73% of male respondents and 39% of female respondents who reported using telehealth services also said they had multitasked during those visits.

    Specifically, the survey found that, of the 44% of respondents who said they had used telehealth services since the epidemic began:

    • 24.5% said they had checked their emails, surfed the web, or texted during their telehealth visits;
    • 24% said they had watched a movie, the news, or television during their telehealth visits;
    • 21% said they had used social media during their telehealth visits;
    • 21% said they had eaten a meal or snack during their telehealth visits;
    • 19% said they had played video games during their telehealth visits;
    • 18% said they had exercised during their telehealth visits;
    • 11% said they had smoked a cigarette during their telehealth visits;
    • 10% said they had driven a car during their telehealth visits; and
    • 9.4% said they had drunk a so-called "quarantini" cocktail or other alcoholic beverage during their telehealth visits.

    Nancy Stewart—an assistant professor of medicine at the University of Kansas Medical Center—told Forbes that she's noticed such behaviors during telehealth visits with her patients. In fact, she said she's had to ask patients to stop doing other tasks or to pull their cars over during the visits, so she and the patients could finish their visits without distractions. According to Stewart, most patients are receptive to the request—and they apologize.

    And Angela Weyand, an assistant professor of pediatric hematology at the University of Michigan School of Medicine, told Forbes that it's not just patients who get distracted. Weyand said she, too, can sometimes get distracted by notifications and text messages she receives while conducting video visits with patients—even when those notifications and messages relate to her work.

    "I am constantly feeling like a million things are distracting me from our conversation," she said.

    Kathryn Gordon, a licensed clinical psychologist, said she sometimes gets the urge to use the internet to search for answers to questions that she and her patients are unsure of during their telehealth visits, Forbes reports.

    Sarah Isaacs, a mental health counselor, told Forbes she's had a similar urge to search for answers or context that she could use to help her patients during their telehealth visits. "I realize this is as much about my own anxiety as theirs," she said.

    Why the atypical behavior?

    DrFirst CMO Colin Banas said patients may be more likely to engage in atypical behavior for a health care visit during a telehealth service because remote meetings and hangouts have become almost ubiquitous amid the coronavirus epidemic. "Video calls are becoming a part of our regular lives as more people are working from home, and people are getting used to multitasking during them," he said.

    However, Banas said patients should resist multitasking during their telehealth visits. "As tempting as it may be, it's important for patients to put aside distractions during a telehealth visit so they can fully engage with their healthcare provider," Banas said.

    To do so, Banas recommended that patients use a quiet and well-lit space, where they can avoid disturbances, for telehealth visits. "Set up early to make sure your internet connection, microphone, and camera are working. I also advise patients to take notes and ask questions, whether their appointment is in-person or via telehealth," he said.

    On the provider side, Banas said providers know how vital it is to focus on their patients. "Nothing is more important to a doctor than focusing on the patient, yet distractions can still be a challenge. … Doctors understand that lapses in attention can lead to errors, and are well practiced at staying in the moment with their patient."

    Weyand said she has started using a pager instead of her cell phone for work notification, because she believes patients are more understanding of her checking a device that's clearly dedicated to her work than her personal phone.

    Isaacs said she turns off all notifications on her laptop, which she uses to conduct her telehealth visits, and she tries to keep a notebook and pen in hand. "[H]aving the notebook seems to signal to me, even in my bedroom, 'OK. We're doing therapy now,'" she said.

    Overall, Gordon said, "It's not that hard to resist checking social media or other things during session, it is just that it's an automatic behavior. Taking … action … make[s] me more aware and conscious of my behaviors so that I can stop them—as does the thought of my patient feeling like I'm not listening to them or fully paying attention to what they say" (Gold, Forbes, 10/28; DrFirst release, 10/28).

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