How to Stay Compliant with Telemedicine Video Visits: For Nurse Practitioners and Nurses

Nurse practitioners conducting telemedicine visits to address patient complaints remotely.

Telemedicine has revolutionized healthcare delivery, making it easier to connect with patients from anywhere. However, as nurse practitioners and nurses, ensuring compliance during video visits is not just a box to check—it's the cornerstone of safe, legal, and ethical care. Whether you’re new to telemedicine or a seasoned pro, I’m here to guide you through the essentials to ace your virtual visits with both confidence and compliance.

Start with a Warm Welcome

The first few moments of a telemedicine visit set the tone for the entire encounter. Begin with a friendly introduction, just as you would in an in-person setting. Smile, make eye contact (as much as the camera allows), and greet the patient warmly.

Here’s an example:

"Hi, I’m [Your Name], a [Your Role, e.g., Nurse Practitioner], and I’ll be working with you today. How are you doing?"

This simple gesture builds trust and rapport, essential for an effective virtual visit.

Why It’s Important to Identify Your Credentials in Your Introduction

When introducing yourself to a patient during a telemedicine visit, it’s essential to include your credentials. Doing so isn’t just a professional courtesy—it serves several critical purposes that enhance the overall quality and compliance of the visit.

First, many state telehealth regulations require providers to disclose their credentials and title to patients at the start of the visit. This ensures transparency and helps patients understand the scope of your role in their care.

Second, stating your credentials builds trust. Patients are more likely to feel confident and at ease when they know they are being cared for by a qualified professional with the appropriate training and expertise.

Lastly, including your credentials in your introduction sets a professional tone for the visit. It demonstrates your commitment to providing high-quality care while reinforcing your authority and responsibility in the patient-provider relationship.

By incorporating this step into your introductions, you not only comply with regulatory requirements but also establish a strong foundation of trust, professionalism, and confidence for the rest of the visit.

Verify the Patient’s Identity

Before diving into any medical discussions, it’s essential to confirm that you’re speaking to the correct person. Accurate patient identification is crucial for safety, maintaining compliance with HIPAA, and ensuring you’re providing care to the right individual.

While asking for two identifiers is standard, it’s even better to go a step further by collecting a third identifier when possible. Here’s how to approach it:

1. Start with Name and Date of Birth: These are the most commonly used identifiers and should always be included.

2. Add a Third Identifier: This could be the patient’s address or phone number as recorded in their medical chart.

3. Check Identification When Available: Some telemedicine platforms have the patient to upload their ID prior to the visit, which allows you to review the uploaded ID for verification during the appointment. Alternatively, if the ID was not uploaded, you can ask the patient if they have their ID handy and request them to hold it up to the camera for verification. This step helps ensure the accuracy of patient identification and enhances the overall security of the telemedicine visit.

   Please remember that the state listed on the ID does not necessarily indicate the patient’s current location. Always ask where they are physically located at the time of the visit (more on that in the next section).

This thorough approach not only enhances patient safety but also reduces the risk of miscommunication or identity errors during the telemedicine visit.

Ask Their Location—Every Time

One of the most important steps in a telemedicine visit is verifying the patient’s physical location. Why? Telemedicine laws vary by state, and you must be licensed to practice in the state where the patient is located at the time of the visit.

Ask directly:

"Can you confirm where you’re located right now?"

If the patient is outside a state where you’re licensed, you’ll need to pause the visit and provide alternative resources. This may seem inconvenient, but it’s non-negotiable for legal compliance.

Explain the Visit Structure

Patients unfamiliar with telemedicine may not know what to expect. Give them a quick overview of how the visit will unfold:

1. Review of their medical history

2. Discussion of symptoms or concerns

3. Development of a care plan

Here’s a script:

"To make the most of our time today, I’ll start by reviewing your medical history. If you’re medically qualified for this type of care, we’ll talk about your current concerns and any necessary medications or treatments."

This approach sets clear expectations and eases any anxiety.

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Obtain Verbal Consent for the Telemedicine Visit

After explaining the structure of the visit, it’s essential to secure verbal consent from the patient for the telemedicine session. While most platforms have patients complete digital telemedicine consent forms prior to the appointment, reinforcing this consent verbally adds an extra layer of clarity and transparency.

This step also gives you the opportunity to remind the patient about the unique nature of telemedicine. It’s important to explain that virtual visits have limitations compared to in-person evaluations, and patients should know they always have the option to pursue in-person care if they prefer or if their condition requires it.

Here’s how to approach it:

1. Review the Structure of the Visit: After outlining what will happen during the session (e.g., medical history review, discussion of symptoms, and care planning), transition into the consent process.

2. Acknowledge Telemedicine Limitations: Be upfront about the fact that virtual care may not always be as comprehensive as an in-person evaluation.

3. Ask for Consent to Proceed: Confirm that the patient understands this and still wants to move forward with the visit.

Example Script

"Before we begin, I want to let you know that telemedicine visits, while convenient, does have limitations compared to in-person evaluations. For instance, I may not be able to perform certain physical exams or procedures through video. That said, telemedicine is a safe and effective option for many concerns, and you always have the choice to seek in-person care if needed. Based on this information, would you still like to proceed with today’s telemedicine visit?"

Obtaining verbal consent not only aligns with best practices but also reinforces patient autonomy, ensuring they feel informed and comfortable with their care choices. It also provides you with documentation that the patient agreed to the telemedicine format after being made aware of its limitations.

Before You End the Visit: Offer Clear Next Step Instructions

Before concluding the visit, take a moment to guide your patient on the next steps. Telemedicine is often a new experience for patients, and without the in-person cues of a traditional visit, clear communication is even more important. Ensuring they know how to proceed helps maintain continuity of care and reduces confusion.

Here’s what to cover:

1. How They Can Reach You: Provide your contact details or the appropriate office number for any follow-up questions or concerns

2. What the Next Steps Are: Clarify any actions they need to take, such as filling a prescription, completing lab work, or checking their dashboard for next steps to make sure they get their treatment. You will want to make sure you find out the steps patients need to take on the telemedicine platform you are working on to assure you are informing your patient correctly.

3. Scheduling Their Next Visit: Recommend when they should check back in with you for follow-up care and provide guidance on how to schedule the appointment. Or inform them how they can request a refill for their next prescription if their treatment is long term.

4. Reinforce the Importance of Follow-Up: Highlight why staying connected is crucial to their care and how they schedule a follow up appointment or request a refill for their medication.

By ending the visit with clear instructions, you empower your patients to take charge of their health and help them feel supported even after the session ends. This extra effort makes all the difference in patient satisfaction and the success of your telemedicine practice.

Reinforce the Importance of Seeking Immediate Care When Needed

As you conclude the telemedicine visit, it’s essential to remind patients about the limitations of virtual care and the importance of seeking immediate attention for any severe symptoms or concerning side effects. While telemedicine is a valuable tool for many healthcare needs, it’s not a replacement for urgent or emergency care when time-sensitive intervention is required.

Here’s how to communicate this:

"Before we wrap up, I want to emphasize that while telemedicine is a convenient way to receive care, it does have its limitations. If you experience any severe symptoms, serious side effects, or a sudden worsening of your condition, please seek immediate attention at an urgent care clinic or emergency room. You can let me know afterward, but I want to make sure you get the care you deserve right away."

This closing reminder reinforces patient safety, encourages proactive action during emergencies, and reassures patients that their health is your top priority—even if that means seeking care beyond the telemedicine setting.

Conclusion

These are just some of my top tips for conducting a telemedicine visit in a way that ensures compliance, safety, and high-quality care for both you and your patients. By verifying patient identity, sharing your credentials, obtaining verbal consent, and reminding patients about telemedicine’s limitations, you can foster trust while delivering effective virtual care.

Remember, telemedicine laws and regulations can vary widely between states, so it’s crucial to stay informed about the specific rules in the states where you’re licensed to practice. Regularly review your state’s telemedicine regulations and your employer’s protocols to ensure you remain compliant and aligned with best practices.

By incorporating these steps into your routine, you can confidently navigate telemedicine visits while prioritizing the safety and well-being of your patients.

Stay compliant and confident with every telemedicine visit—bookmark this guide and share it with your colleagues!