Here’s a typical telehealth visit scenario that also addresses SDoH:
Dr. Smith: Good morning Ms. Jones, I’m so glad we were able to keep our visit today. I know how challenging it can be for you to get to our office. I remember you mentioning at our last visit the effort you made to get here by bus and given your recovery from hip surgery I thought you might appreciate this video visit to review your condition without you having to leave your house.
Ms. Jones: Thank you Dr. Smith and to your staff for helping me set up and use this technology, it certainly has made my day a lot less stressful, especially now that I don’t have to walk through my rough neighborhood to catch the bus.
Dr. Smith: I’m glad we could assist you, it’s our commitment to making access to us easier and more convenient. Since our visit today involves how your diet may be affecting your recovery, I had you meet with my nurse prior to this visit to explain why I would like you to show me to your pantry and refrigerator so we can review what food items may be slowing your recovery.
Ms. Jones takes Dr. Smith for a brief video tour of her kitchen pantry and refrigerator.
Dr. Smith: Given your diabetes and high blood pressure, I noticed that you have several boxes of pasta and rice, a bag of potatoes and one of chips, several loaves of bread, and a case of pop. I suggested at our last visit that you try to eat more vegetables and fruit and less processed foods. Were you able to purchase fresh produce at the farmer’s market as we discussed? If not, I can contact the local food bank and Meals on Wheels to make arrangements for delivery of produce and healthy food items. Are you OK with us doing that?
Ms. Jones: Yes, thank you, that would be most welcome and appreciated. Since my recent surgery, I have not been able to shop for myself and rely on my family to come by when needed. Unfortunately, their schedules do not always allow for them to drop off food. I have asked that they try and prepare some healthier meals in advance that I can freeze. My daughter suggested that she and her siblings might purchase a meal delivery plan. Do you have any recommendations?
Dr. Smith: Not off hand but I can have our nutritionist contact you to discuss how to create an appropriate meal plan and menu. We may be able to have a volunteer companion stop by to visit and help you with food preparation activities if you don’t have daily assistance.
Dr. Smith: How have you been sleeping? You mentioned that your air conditioner hasn’t been working and that you are having difficulty sleeping due to heat. Were you able to get that repaired? If not, I may be able to arrange for a repairman to stop by who is part of a local community effort to assist seniors in their homes. In the future, my staff can help arrange for transportation to my office should you need to come in-person rather than spending a few hours getting here by bus.
Ms. Jones: Thank you Dr. Smith very much for all your caring and concern. I appreciate the effort you and your staff are making on my behalf and will try to continue to follow your advice.
Dr. Smith: Before we go, I wanted to just check on your range of motion and gait. Could you please walk across the room while I watch you move. Are you experiencing any pain or discomfort?
Ms. Jones: Still some pain but much less and my stiffness seems to be less restrictive since you gave me those exercises to do everyday. I appreciated your therapist reviewing my progress and she was able to correct several exercises I was doing wrong.
Dr. Smith: Great news, please keep up your exercise, you will thank me when you can carry your grandbaby. How has your wound been doing? Are you still confident in cleaning and bandaging? If you would like a refresher, let me know and I will have a staff member contact you and your caregiver team to review.
Ms. Jones: I think I’m good for now. Thank you very much Dr. Smith, this visit really made my day.