Table 4

Strategies for effective virtual visits

Before the visit
 TechnologyConfirm the patient has access to and understanding of the platform used.
 TimingSchedule enough time as part of the visit (especially the initial virtual visit) so the patient has adequate time to enter the virtual visit.
 DataIdentify members of the healthcare staff to contact the patient in advance to review medications and vital signs.
During the visit
 History Adherence:
Adherence to medication regimen.
Assess for symptoms of medication.
Intolerance.
Assess for sodium/fluid restriction compliance.
Engage caregivers in the above questions if available during the virtual visit.
Symptoms:
Weight gain.
Dyspnoea.
Orthopnoea.
Bendopnoea.
Lower extremity oedema.
Abdominal bloating.
Early satiety.
 PhysicalDyspnoea with observed ambulation or speech.
Jugular venous pressure with manoeuvring camera and tangential light.
Lower extremity oedema.
After the visit
 Laboratories and other studiesHealthcare staff contacts the patient to arrange necessary laboratory examination or other studies such as echocardiogram, right heart catheterisation and cardiopulmonary exercise testing.
 InstructionsWritten instructions regarding testing and medication adjustments relayed to patient.
Review recommendations for daily weights, fluid and sodium restriction.
 Medication changes/refillsProvide 3-month supply of medications if possible to reduce trips to the pharmacy.
 Follow-upFollow-up appointments scheduled; determine if it should be in person or virtual.
 Specialist careIdentify need for virtual visits with other members of the healthcare team: pharmacists, social workers and nutritionists.
  • Strategies and tips for effective virtual visits for clinicians before, during and after the visit.

  • Adapted from Gorodeski et al.37