Proven Tips for Overcoming Communication Barriers in Telemedicine


Overcoming communication barriers in telemedicine is crucial for ensuring effective and efficient remote care. Some common barriers include patient resistance to change, technological barriers, a lack of trust in telehealth services provided, limited access to telemedicine on the patient side, along with resistance from healthcare providers. A few things may be enacted to overcome these barriers. To start, providers should take the time to explain telemedicine to their patients, including why it is being used and how it simplifies care. Telemedicine is still a fairly new construct and for patients with limited technical proficiency or those for whom English is not a first language, it can feel overwhelming at best. It is important for providers to educate patients about the technology being used in telemedicine and provide support to address any concerns or difficulties they may have. Avoid having them ‘go it alone’ because frustration can lead to a lack of trust among other things. Proactively communicating with patients about the measures taken to protect their personal information and ensure their privacy is key. Sometimes, even healthcare providers aren’t well versed on the complete benefits of telemedicine, including how it can streamline workflows and improve patient care. It’s a learning process for everyone but getting in front of it and talking about it is the first step to conquering it. 

The Vital Role of Communication in Telemedicine Care

Effective communication is the bedrock of successful telemedicine, bridging the gap between healthcare providers and patients. Telemedicine involves using various internet-connected technologies to provide clinical healthcare over safe video and audio connections. As mentioned in the introduction, establishing trust and rapport is vital to delivering sound telemedicine care. Providers should prioritize connecting with patients, as patients often remember the last thing that was said to them. It’s difficult to remember everything said during a visit, and so having technology in place that documents provider/patient exchanges, clearly outlines next steps, and retains a log of any and all communications, is vital. The more providers are trained in using telemedicine technology effectively, the greater the possibility that communication becomes seamless and efficient. Handled correctly,  telemedicine delivers:

  • Accessibility and efficiency in healthcare delivery
  • A reduction in the need for travel, providing clinical support, and overcoming geographic barriers
  • Myriad communication channels, such as video conferencing and remote monitoring, to improve patient outcomes

The Adverse Effects of Communication Barriers On Healthcare Practice

Poor communication in healthcare can have adverse effects on a healthcare practice, including:

  1. Reduced Quality of Care
    • Poor communication between healthcare providers can lead to misunderstandings and errors that negatively impact patient outcomes.
    • Communication barriers can also result in inadequate informed consent, which can lead to malpractice lawsuits.
    • Spotty communication can also lead to a reduction in the quality of care, poor patient outcomes, wasted resources, and higher healthcare costs.
  2. Patient Dissatisfaction
    • Poor communication between clinicians and patients can result in misunderstandings about medications and follow-up instructions, which can result in poor outcomes and readmissions.
    • Communication barriers can also lead to decreased adherence to treatment.
    • Patients may also lose trust in healthcare providers if communication is poor, leading to negative perceptions of a healthcare practice and even telemedicine at large. 
  3. Compromised Patient Safety
    • Poor communication can lead to various negative outcomes, including discontinuity of care and compromise of patient safety.
    • Medication errors, incorrect diagnoses, and other adverse events.

Main Types of Communication Barriers in Telemedicine

Navigating the complex landscape of telemedicine requires an understanding of the diverse communication barriers that can arise—from technological hindrances to cultural differences.

Technological Barriers

Let’s begin with technological barriers, such as a lack of user-friendly hardware or software, device deficiencies like small screens and subpar cameras, and poor digital literacy. This can dramatically hinder effective communication in telemedicine. There is also limited access to broadband coverage or low bandwidth, both of which can create challenges in telemedicine communication.

Inexperience with Technology

Inexperience with technology can be very challenging for many providers and patients. Patients who lack digital literacy may struggle to use telemedicine technology effectively. They may not understand how to navigate the software or hardware, and it is really on the healthcare provider to provide training and support to patients to overcome this.

Language and Cultural Barriers

Language and cultural differences can impede effective communication in telemedicine. Patients who do not speak the same language as the healthcare provider may struggle to understand instructions or express their concerns. Thus, healthcare providers should utilize interpreters or translation services to overcome these language barriers and ensure effective communication.

Non-Verbal Communication Limitations

Telemedicine technology reduces the presence of non-verbal communication, such as body language and facial expressions. Most of us can quickly identify an unhappy individual based on the way they are holding themselves, eye contact avoidance, and even a furrowed brow. But some of that can get lost in telehealth, which can create barriers to effective communication. Also, the lack of human contact in telemedicine can lead to depersonalization in the clinician-patient relationship, making it difficult to pick up on non-verbal cues. By recognizing and addressing these communication barriers, healthcare providers can enhance the effectiveness of telemedicine and improve patient care outcomes. By prioritizing effective communication and making small but impactful modifications, communication in patient care will be greatly improved.

Time Zone Differences

Time zone differences can make it difficult to schedule telemedicine appointments, especially when patients and healthcare providers are in different parts of the world. They can also limit the availability of healthcare providers. For instance, if a patient lives in California but has a telehealth appointment scheduled with a provider in New York, it may be tricky to align calendars with a 3-hour time difference at play. This also applies to after-hours outreach. A patient following up at the end of their work day in California might find NY doctors have already finished their day hours before.

Distractions and Environment

Auditory distractions, like background noise or distractions in the patient’s environment can interfere with effective communication during a telemedicine visit. That said, visual distractions can be equally hindering. For instance, if the provider is distracted by crying children in the patient’s background, or the patient is distracted by the provider’s staff coming in and out of frame during a visit, either or both parties may feel frustrated. Patients may feel uncomfortable discussing sensitive information or asking questions if they are concerned about their privacy during telemedicine visits. Finally, technical issues, such as poor internet connection or audio/video glitches, can disrupt communication and cause angst. Creating an environment with minimal distractions can contribute to clear and meaningful communication during telemedicine visits.

Emotional and Social Barriers

Like any relationship in life, a lack of personal connection between provider and patient can hinder effective communication. It’s hard enough to ‘connect’ in person but over the phone or in a video visit, patients may feel even less comfortable discussing sensitive topics or expressing their concerns. Cultural differences can create communication barriers when patients and healthcare providers are from different backgrounds. Patients may also have different expectations or beliefs about healthcare, which can lead to misunderstandings and miscommunication. The remote nature of a visit can intensify these issues because the benefit of body language is extricated from the equation. The stigma surrounding mental health can create communication barriers in telemedicine, especially for patients seeking mental health care. Patients may feel uncomfortable discussing their mental health over video or phone calls due to the perceived lack of privacy and confidentiality.

Strategies to Overcome Telemedicine Communication Barriers

Overcoming the aforementioned barriers requires a well-rounded approach and strategic planning. 

Implement User-Friendly Technology

Using a solution like Spruce, built from the ground up to make communication, collaboration, and connection between provider and patient a seamless experience, can make all the difference. A modern tool, such as Spruce, will enable you to streamline processes and workflows as well as increase productivity by utilizing automations and decreasing manual processes. Think of Spruce like your “communications hub”—it’s one platform to send/receive emails, calls, and faxes, talk with patients both via standard text and secure messaging, and facilitate intra-office communication with staff members. Many things can be set up to automatically happen in the background. For example, setting up a phone tree with selections such as ‘appointments’ or ‘insurance/billing’ can be very practical. These lines, upon selection, could provide additional information to your patient, making them a bit more self-sufficient and reducing the need for a call back. Your billing line, for example, could specify what insurance you take or state that you’ll provide superbills for reimbursement purposes. Putting in a ‘med refill’ selection on your tree could tell patients what they should do on their end before leaving a message with a request, i.e., calling their pharmacy to ensure they don’t already have refills on hold, or, prompting them to book an appointment first if they haven’t been seen in a specific amount of time. You can imagine just how detailed you can get when setting up the phone tree and just how much it can help relay helpful information to your established and potential patients. From call routing to features like Saved Messages and Auto Forwarding, you’ll find that barriers to communication with patients are quickly alleviated with Spruce.

Provide Technical (and Non-Technical) Support

If your patient isn’t well versed in the nuances of telemedicine and they want to connect with you, provide technical support! Some simple training and education on your in-house technology (and its benefits) will be critical to helping patients over the initial hump. Explicitly outlining the benefits of the technology will also tend to speed adoption, particularly for those resistant to change. Healthcare providers may want to consider offering extended hours or partnering with other providers in different time zones to ensure that patients have access to care when they need it.

Invest in Digital Literacy Education

Digital literacy education can help patients and healthcare providers alike improve their understanding and use of telemedicine technology. Some simple training can improve telehealth outcomes by ensuring that patients and healthcare providers are comfortable and confident in using the telemedicine technology at their disposal. Digital literacy education can also help to reduce health disparities by ensuring that all patients have access to telemedicine technology and are comfortable using it.

Offer Language Services

Healthcare providers may want to consider utilizing interpreters or translation services to overcome language and cultural barriers and ensure effective communication with patients. This can dramatically help to improve patient outcomes and satisfaction.

Encourage Open Communication

Encouraging open communication is an effective strategy to overcome barriers in telemedicine. For instance, patient-centered interviewing involves encouraging patients to share their concerns and preferences and actively listening to their responses. On the provider side, it’s critical to demonstrate empathy and compassion towards patients, creating a supportive and safe environment for communication. Finally, shared decision making means involving and collaborating with patients to make informed decisions about their care. 

Train for Non-Verbal Cues

If you are considering training for non-verbal cues, you can consider the following options:

  1. Body language training and nonverbal communication courses, which cover topics such as recognizing nonverbal expressions, understanding posture and facial expressions, and interpreting nonverbal cues. Online learning platforms like Udemy offer nonverbal communication courses that cover various aspects of nonverbal communication.
  2. Practicing awareness and observation, which can help in recognizing and interpreting nonverbal cues.

Use Secure Communication Channels

This is a fairly obvious one and something we’ve already touched on throughout this article. Patients are universally uncomfortable with the idea of their private health data getting exposed. Leveraging secure communication channels is both a relief to your patients and a major step forward for the provider when it comes to HIPAA compliance. Spruce Health delivers secure communication channels that are designed for easy HIPAA compliance and to make connecting provider and patient safe, effective, and seamless. 

Maintain Continuity of Care

Continuity of care can be a blocker both on the provider and patient side. If you have a busy practice and your patient needs to see you consistently for a chronic condition, scheduling can be problematic. Add to that, your patient prefers to see you, their chosen provider, in lieu of getting shuffled around across a busy practice. So for both sides, tapping a technology like Spruce can ensure seamless collaboration and continuity of care.

  1. Continuity of care means checking in with patients after each consultation to ensure that they are recovering. This can be managed easily in Spruce.
  2. Sharing patient information between providers can help ensure continuity of care—team collaboration is key here. Spruce enables you to work seamlessly with your entire care team even if they are not located within your physical location. With all internal communication living inside secure, cloud-based software, you are able to discuss patient information (including PHI) together with your team, quickly and efficiently. 

The Patient’s Perspective: How Communication Barriers Impact Them

Communication barriers can have a deep and lasting impact on a patient’s experience with telemedicine—from engagement to satisfaction.       

Limited Understanding

  • Communication barriers can lead to reduced understanding and engagement in telemedicine visits.
  • Patients may struggle to understand medical concepts or instructions, leading to poor outcomes and reduced satisfaction.
  • Effective communication is crucial in ensuring that patients understand their care plans.

Reduced Engagement

If a patient doesn’t feel like the communication with their provider is clear, they will check out and engagement will wane. That is why it’s critical to explain the details of a visit or follow up plan with the patient or you risk drop off, spotty scheduling, or a patient seeking treatment elsewhere.

Emotional Impact

Communication barriers can lead to increased anxiety and stress in patients because they don’t feel heard or supported. Patients may also feel uncomfortable discussing sensitive topics or expressing their concerns over video or phone calls, leading to increased anxiety and discomfort. 

Decreased Satisfaction

Feelings of satisfaction diminish when a patient doesn’t feel connected to their provider. The main culprit for dissatisfaction is often a communication gap. Overall, satisfaction can be associated with the modality of telehealth, but factors of effectiveness and efficiency are mixed. Patient satisfaction is ultimately hinged on having expectations met, including choosing the right telehealth modality for their needs/wants.  

The Healthcare Provider’s Challenge: Effects of Communication Barriers

Providers are equally affected by communication barriers, leading to potential burnout, inefficiency, and a disconnection from patients.            

Reduced Diagnostic Accuracy

Reduced diagnostic accuracy due to communication barriers in telemedicine can have a significant impact on healthcare providers. Telemedicine presents new challenges for diagnosis. Providers must learn how to address and overcome diagnostic risks when possible and determine when a virtual visit is not appropriate because the risk of diagnostic error is too high. Video visits can enhance diagnostic timeliness by removing access barriers and shortening delays in initial diagnostic evaluation, while inadequate medical history-taking can contribute to diagnostic errors.

Frustration and Burnout

Communication barriers among healthcare providers can contribute to burnout in several ways. To begin, inefficient communication skills are recognized as a strong barrier to the provision of healthcare services. When healthcare providers struggle to effectively communicate with each other, it can lead to misunderstandings, delays in care, along with errors, which can increase stress and workload, ultimately contributing to burnout. Burnout among physicians has been linked to poor patient-physician communication. When healthcare providers are burned out, they may have difficulty establishing rapport, listening attentively, and effectively conveying information to patients. This can result in decreased patient satisfaction, increased patient complaints, and further stress for the healthcare provider.

Inefficient Consultations

Health information technology, such as electronic consultations and electronic health record (EHR) systems, can lead to inefficiencies and increased administrative burden. When consultations are inefficient, healthcare providers may spend more time navigating complex systems, documenting information, and completing administrative tasks. This can add to their workload and contribute to burnout.

Limited Patient Connection

Limited patient connection can also be a communication barrier in healthcare. Patients who are unable to connect with their healthcare providers may feel neglected or ignored, which can lead to dissatisfaction and mistrust. This can be especially true for patients with limited English proficiency or those who are deaf or hard of hearing. In addition, the COVID-19 pandemic has made it more difficult for patients to connect with their healthcare providers due to lingering social distancing measures and increased use of telehealth. 

Final Thoughts

Telemedicine has proven to be an efficient way of providing quality care while minimizing physical interactions, especially during public health emergencies. However, there are still barriers that hinder the successful adoption and implementation of telehealth among healthcare providers and organizations.  If you don’t yet have a strong telemedicine solution in place, explore Spruce Health. Spruce is the #1 platform for HIPAA-compliant communication and telemedicine, enabling healthcare teams to connect seamlessly with their patients. Best yet, patients can use the Spruce app to communicate with their healthcare provider and exchange messages securely and conveniently. Spruce offers video calls, messaging, and a centralized inbox to manage patient requests and send personalized responses. Why not start with a free 14-day trial (no credit card required). 

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