Telehealth is an area of growing importance in healthcare as it enables convenient patient care and follow-up at lower costs than the status quo health facility, especially for patients who live in rural areas or need follow-up between visits to manage chronic conditions. In these cases, receiving care over the phone from a qualified professional can be enormously beneficial. 

CircleLink is part of this change, with best-in-class tele-nurses who serve thousands of patients with chronic or behavioral issues each month. The work that these registered nurses do to support patients between doctors’ visits significantly improves revenues, and has been shown to reduce costs through better health outcomes

However, there is a challenge for telehealth.  Patients don’t have the same face-to-face contact with healthcare professionals. Apart from prescribed treatments, the psychological support received from direct interactions with healthcare professionals is a powerful force in fostering speedy recovery and peace of mind among patients. Conveying this psychological support over the phone, however, is more difficult than doing so in person. The key to making remote care effective is for healthcare professionals to earn the trust of these patients whom they may never meet.

Why trust matters

Building trust in a telehealth relationship is important for three reasons: First, for clinics and hospitals, trust is key to retention in chronic care management or behavioral health integration programs. Adherence has been shown to be 2.5 times higher in patients who have high levels of trust in their doctor than in those with low levels of trust (adherence rates of 43.1% and 17.5% respectively). Patients who adhere are more likely to stay with the program, meaning better revenue for the clinic or hospital.

Second, trust leads to better healthcare outcomes for the patients. The patient-clinician relationship has been shown to affect health outcomes that are both objective (such as blood pressure) and subjective (such as pain scores). A trusting relationship is not only important for making the patient feel good, but also for their physical well-being and recovery.

Finally, patients are more likely to stick with their clinician when they receive consistently outstanding service.  Feedback from CircleLink’s registered nurses illustrates this relationship vividly: 

“I spoke with our patient today, and she was very grateful for our program, says that she got a call from his [practice] office [after Circlelink RN coordinated], an appointment was set up and she is feeling much better. Says she never would have gotten in so quickly without our [CircleLink’s] call.” – Suzanne, registered nurse. 

“The patient was very happy because after 1 1/2 weeks of trying to get a script for a glucose meter, after my call to her they resolved it within a few hours [due to CircleLink RN following up with practice]. She was also appreciative of my follow up call.” – Lisa, registered nurse.

How to build trust: The Basics

Building trust requires investing in time and practice, but it’s well worthwhile. We at CircleLink have found techniques that enable new tele-nurses to adapt their existing expertise and patient experience to telephone care quickly. We’re delighted to share some of those insights below.

Right at the start of a call, it is important for the tele-nurse to introduce themselves and mention that they are calling on behalf of the patient’s specific doctor straight away. They may also mention the name of the patient’s practice. This will let the patient know that they can trust the caller, and, will make them feel more at ease. 

Next, the caller should explain that the patient’s doctor endorses the chronic care management program, and that the call was set up by the doctor in order to keep in touch between appointments. This helps the patient understand the relationship between the telehealth services on offer and the physician’s regimen that they are already familiar with. 

Once it has been established that their trusted doctor supports the patient using the telehealth service, a more in-depth conversation can begin. In the experience of our nurses, discussing medication is a productive first step, as it builds credibility with the patient. For example, the patient may wish to discuss how to manage their medication regimen, or to list any side effects they might be experiencing. By focusing conversation on these important details, it demonstrates that the telehealth nurse is a trained medical profession who understands the patient’s specific care needs.

Finally, taking the time to listen to the patient cannot be stressed enough in trust building. In our experience, allowing some silence into the conversation invites the patient to ask questions or to bring up issues that are concerning them. This is important in making the patient feel comfortable sharing more key health and lifestyle information, and to having them involved in their care. 

More Advanced Tips from CircleLink’s Tele-nurses

In addition to these basic trust-building techniques, CircleLink’s qualified tele-nurses have their own tips to share on building trust:

“First and foremost, smile and be enthusiastic about the program, the practice and the patient. You can hear a smile over the phone,” says Lisa B. RN “Get personal, and make reminders in your notes so you can refer back to spouses and names of family they live with, pets’ names, etc.” 

LeAnna, another registered nurse at CircleLink, likes to ask open ended questions like “How have you been feeling?” or “What is new with you since we spoke last?” in order to give patients space to open up that isn’t dictated by a script. She also emphasizes the importance of learning the patient’s preferred name and their preferred times to speak on the phone for their convenience.

Both LeAnna and Lisa stress the importance of being reliable and showing up to phone appointments as promised. In addition, it helps to remember that elderly people can be wary of phone scams, so LeAnna encourages the patient to call the doctor’s office and confirm her identity if they feel unsure. “I’ve found that when I do that, the next call with the patient goes extremely well, and they are appreciative of our understanding their need to get that reassurance that we are who we say we are,” she explains.

The nurses’ experiences confirm what the research has shown too: that making the patient feel heard is vital. “Listening to the patient and validating that they are being heard is important,” says LeAnna. “I want every patient to know that they have my full attention, and I care about what they are saying.”

In conclusion

Building trust with patients is key to successful telehealth programs. Both the scientific evidence and our nurses’ clinical experience backs this up. For more information about telehealth and how it can benefit both health providers and patients, requests a 1-on-1 free consultation here.