# Best Practice Guide for Reducing Barriers to Video Call–Based Telehealth: Modified Delphi Study Among Health Care Professionals

## TL;DR

This study provides a guide of best practices for healthcare professionals to overcome barriers in video call-based telehealth, especially during the pandemic.

## Contribution

A modified Delphi study consolidates 105 best practices for telehealth video calls from healthcare professionals' insights.

## Key findings

- 105 best practices were identified, including 20 technology-related and 85 healthcare practice-related.
- Recommendations focus on setting up telehealth environments, ensuring safety, and building trust with patients.
- Fewer practices were found for issues like lack of technology skills or hardware reliability.

## Abstract

Telehealth has grown, especially during the COVID-19 pandemic, improving access for those in remote or underserved areas. However, its implementation faces technological, practical, and interpersonal barriers.

The aim of this study was to identify and consolidate best practices for telehealth delivery, specifically for video call sessions, by synthesizing the insights of health care professionals across various disciplines.

We first identified 15 common telehealth barriers from a preceding scoping review. Subsequently, a modified Delphi method was used, involving 9 health care professionals (physiotherapists, speech and language therapists, dietitians, and midwife) with telehealth experience in qualitative interviews and 2 iterative rounds of web-based surveys to form consensus.

This study addressed 15 telehealth barriers and identified 105 best practices. Among these, 20 are technology-related and 85 concern health care practices. Emphasis was placed on setting up telehealth environments, ensuring safety, building relationships and trust, using nonmanual methods, and enhancing observation and assessment skills. Best practice recommendations for dealing with patients or caregiver skepticism or lack of telehealth-specific knowledge were developed. Further, approaches for unstable networks and privacy and IT security issues were identified. Areas with fewer best practices were the lack of technology skills or technology access, unreliability of hardware and software, increased workload, and a lack of caregiver support.

This guide of best practices serves as an actionable resource for health care providers to navigate the complexities of telehealth. Despite a small participant sample and the potential for profession-specific biases, the findings provide a foundation for improving telehealth services and inform future research for its application and education.