The Veterans Health Administration (VHA) was an early adopter for telehealth, and in 2017, developed the Veterans Video Connect platform that is being widely used in the current pandemic. As catastrophic events are known to be highly traumatic or triggering for already traumatized individuals, the application of a trauma-informed lens to telehealth within the VHA and other health care systems has the potential to mitigate some negative impacts of the pandemic and increase patient engagement in care. This article explores the case of a veteran with post-traumatic stress disorder to illustrate how telehealth visits can be trauma-informed.
The patient was initially reluctant to try telehealth in the pandemic environment. The clinic nurse addressed his concerns about videoconferencing during a supportive phone call by sharing that the visits are not recorded, he can choose the location where he will videoconference from, and the visit can end at any point if discomfort arises. After the patient consented, he saw his primary care physician (PCP), who provided eye contact and made sure her face was well-lit. The patient was concerned about a rash on his leg, and the PCP avoided strong commands and gently asked for permission to examine it. They collaboratively discussed a care plan and involved a social worker and psychologist to help address the economic issues and anxiety that the patient was experiencing.
Although virtual physical examinations have limitations, telehealth visits may allow patients to feel empowered by choice over their surroundings, and allow for a greater portion of time to discuss the patient’s care plan. Trauma-informed telehealth offers the potential to ensure continuity of care during the COVID-19 pandemic by allowing safe and collaborative interactions between patients and health care teams.