Below we cover some of the key areas to consider when carrying out a remote consultation.

Check the equipment you're using and that the patient can see you clearly.
Check your setting, background, appearance and privacy settings, especially if you're working from home.

Communication skills are the cornerstone of a good consultation, but there may be additional barriers when communicating remotely compared to a face-to face-consultation.
Put the patient at ease by introducing yourself and explaining how the consultation will work.
Remember to look at the camera in order to make eye contact with the patient, rather than at the screen.
Is this patient new to you or the practice or someone you already know well? If they're unfamiliar, have you reviewed the notes (including hospital records if available) and any relevant investigation results?
Does the patient have any specific concerns, and what is the purpose of their contact?

Using an unfamiliar format to consult with patients can be off putting. Don't forget basic principles of history taking and examination.
Is this a chronic condition or a new presentation?
Has there been a change in their presentation or any new symptoms?
Has the patient already been seen by a colleague either remotely or in person?
Has the patient had multiple consultations about the same matter?
What are the social circumstances and could these be relevant?
Is this a physical or mental health problem and what is the patient's emotional state?
Are there any special considerations in view of the patient's age (very young or elderly)?

Do you need to conduct a remote examination? Can you do this entirely remotely, or will you need to arrange a face-to face-consultation - for example, because you need to observe vital signs to fully assess the patient?
Do you have appropriate consent for the examination?
Is a chaperone necessary and is it possible to arrange this remotely?
Are there any red flags?
Are you in a position to exclude a serious diagnosis?
What is your differential diagnosis and have you recorded this?

At the end of the consultation, check the patient understands the plan and knows how to seek further help if needed.
Make sure you give safety netting advice, especially as you have not physically examined the patient.
Consider whether a face-to-face appointment is needed and arrange this within a suitable timescale.
Allow for the potential for uncertainty in remote consultations by making sure key points of your discussion are noted.
If a follow-up appointment is needed, arrange this for the patient before they leave (if possible).

This article originally appeared on GP Online and has been edited for publication.

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