Considerations for Providing Virtual Care
During COVID-19, it’s more important than ever to provide support to families, but in-person home visits are no longer possible in much of the country. Remote services such as virtual home visits can help fill the gap and provide valuable support.
Telehealth is the use of digital technology such as video, texting, or online content to support long-distance health services. Studies comparing in-person and telehealth models have shown they provide similar outcomes, and the following research-supported telehealth strategies may be very useful during the pandemic:
- Video calls. Many states are allowing school nurses and other support staff to use video conferencing to parents to address their needs. However, remember that while video calls are a great way to reach families, not all families will be able to take advantage, and may need support through other means.
- Texting and messaging apps. Telehealth may also use texting or messaging services, and research shows that this approach can enhance traditional home visiting programs. Texting that accompanied a home visiting program increased responsive parenting and use of recommended parenting strategies, as well as decreased incidences of children acting out and parental depression.
- Online content. Providing relevant information online can reduce some barriers to access, and can produce similar outcomes to in-person participation. Parent engagement with online content can be strengthened when providers check in with parents to reinforce ideas. Home visitors may need to adjust typical service delivery strategies to best recognize and meet the needs of families.
Other Things To Consider
- Families and home visitors need technology support. When using video conferencing, technology glitches may affect the quality of home visitors’ interactions with families. Home visiting programs should provide support to both staff and parents to troubleshoot problems. Not all families will have regular access to web-supported devices for virtual visits, so programs should provide a range of telehealth support.
- Privacy concerns during virtual visits are more important than usual. Challenging topics such as depression can be potentially amplified given that the speaker or other family members may be in close contact with an abuser who is also practicing social distancing. Home visitors must be able to communicate with other practitioners who have expertise in these difficult topics and can provide additional services to families—both of which can be done remotely.
- Good communication skills are critical when engaging with families. When using video, providers should set up equipment to allow continued eye contact. Minimize distractions such as background noise and think carefully about what is in the background.
- Provide ongoing support to parents. Providers can text to check in on parents or reinforce content between meetings. Texting to support parents can increase their overall engagement.
- It’s important to create day and time boundaries for communication with families. Since telehealth technology is available around the clock, home visitors must clearly set expectations and boundaries when they engage with families.
- Families’ needs can change day to day. Many families may lose support or services, or deal with modified services and become even more at-risk. Telehealth options are a promising opportunity to ensure that families receive vital support in this difficult time.
Most importantly, keep in mind that many states have modified requirements for telehealth, and it's imperative that school nurses and administrators stay up to date on current state laws and policies.