Telehealth in the time of COVID19

Social distancing requires a lot of creativity in how we handle our day to day business, and one of those adaptations is through visits with a medical professional remotely rather than in person. But how do we help the consumer who is convinced they just do not know enough about technology?

First and foremost, find out what the expectations are from the medical professional who will be interacting with the consumer – do they need to access an app, will they be visiting a website, does it have to be live, and so on. This should not require a release of information since this will be the process for all remote calls.

If a visual visit is necessary and your consumer has a smartphone there are a few simple app options:

In the example I will discuss today, the consumer needed to log on to a website after receiving confirmation from the medical provider. He reported he was having trouble seeing the keyboard on his smartphone, so we went through the steps to get him using his home computer (note: this may not be sufficient if a visual confirmation is necessary – many laptops come equipped but if a desktop computer does not have a built-in camera a different solution may be required).

Our first step was making sure the system was on – a yellow light on the monitor indicated that the screen was active, but the tower needed to be turned on. In this instance the desktop was an HP so I could direct him to the power button in the front center of the box. Once the operating system booted I walked him through locating the Ctrl, Alt, (I recommend the bottom left two) and Del (right or top right location) buttons and instructed him how to press them simultaneously (“Press and hold Control, press and hold Alt, then press Delete and release all three together”). This brought up the password prompt. The password can present specific case-sensitive challenges: in this instance the written password was expressed with an additional capital ‘L’ but the system expected only the first ‘L’ which was an operator error by the person who recorded the password and it was only caught by another user in the home.

Once we had access to the system desktop, we had to locate the browser of choice (if one was specified by the medical provider please keep that in mind). The individual you are working with may have a preference which should be respected if possible. The icon for Mozilla Firefox (Orange circle), Google Chrome (red/green/yellow circle) or Microsoft Edge (blue ‘e’) may be in the taskbar located at the bottom of the screen, but if not they will have to find it on the desktop among the other icons. A double click with the left mouse button should open the browser for use. If they are unfamiliar with the function of a web browser I suggest looking for ‘search’ or ‘http’ near the top to help identify the address bar. A single click should put the cursor in the field for text entry and the consumer can be coached through typing the address with keyboard quadrants.

I mirrored these steps on my system so that when he successfully entered the website we could discuss the two fields that appeared on the screen, ‘Patient Name’ and ‘Check In’, and the process he could expect as part of his appointment (a call from the physician’s office first who would tell him when to check in on the computer, at which time their system would link him with his healthcare professional). He indicated his intention to practice these steps ‘a few more times’ which I strongly encouraged and let him know I would call back the next day to check in. Sure enough, at that time he reported two more successful attempts and that he felt much more confident about his ability to get the care he needed.

This was not and should not be expected to be a fast process – the call took an hour, and the consumer who was convinced he could not do it needed reminding throughout to recognize his own incremental successes. Nevertheless, his self-confidence at the end was a testament to the value of skills training by professionals who make sure no one is left behind.

 

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John Flaherty

John is an Assistive Technology Professional certified through the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA). Prior to his current work he worked as a technician in computer manufacture and was lead teacher in a private classroom in Pittsburgh

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