20 Telehealth Best Practices Every Healthcare Provider Should Follow

Telehealth works best when providers treat a virtual visit as a clinical encounter that happens through a different delivery method—not as a shorter or less structured version of an office visit.

The technology matters, but it is only one part of the process.

Providers also need a clear workflow for deciding which visits belong in telehealth, preparing patients, verifying identity, protecting privacy, documenting the encounter, managing technical problems, handling follow-up, and determining when a patient needs in-person care.

The following 20 telehealth best practices focus on those operational and clinical details.

1. Decide whether telehealth is appropriate before scheduling the visit

Not every patient or appointment is a good fit for telehealth.

Before scheduling a virtual visit, consider what the provider needs to assess, whether a physical examination is necessary, whether diagnostic testing may be required, and whether the patient’s symptoms could require immediate in-person evaluation.

The decision should also account for the patient’s ability to participate effectively.

Does the patient have a suitable device?

Can the patient connect reliably?

Can the patient find a private location?

Can the provider obtain enough information through the available technology to make a safe clinical decision?

These questions should be part of the scheduling workflow rather than left entirely to the provider once the appointment begins.

For practices developing a broader virtual-care model, how telehealth is expanding access to rural healthcare provides additional context on where virtual care can improve access and where providers still need to account for clinical and operational limitations.

2. Build telehealth into the existing practice workflow

Telehealth should not operate as a completely separate process from the rest of the practice.

Scheduling, check-in, clinical intake, consent, documentation, billing, follow-up, and patient communication all need defined workflows.

The U.S. Department of Health and Human Services recommends planning for changes to scheduling, billing, check-in, appointment structure, triage, consent, and documentation when implementing telehealth.

That means a practice should map the entire virtual visit before launching it.

For example:

Appointment scheduled → patient instructions → check-in → identity verification → intake → provider visit → documentation → orders or prescriptions → follow-up → billing.

Every step should have an owner.

If nobody owns a step, the patient or provider usually ends up carrying the responsibility.

3. Give patients clear instructions before the appointment

Patients should not have to figure out the technology five minutes before seeing the provider.

Send instructions before the appointment.

Explain:

• How the patient will join
• Which device they can use
• Whether an app is required
• How they will receive the appointment link
• What to do if the connection fails
• Where the patient should sit
• Whether headphones are recommended
• What information they should have available
• Whether forms need to be completed beforehand

HHS recommends giving patients basic instructions about how they will connect, what to expect, who needs to be present, and what information they may need for the appointment.

The objective is simple: the provider should spend the visit discussing the patient’s health rather than explaining how to find the camera button.

4. Verify the patient’s identity

Identity verification remains important in a virtual encounter.

At the beginning of the appointment, confirm the patient’s identity using the practice’s established process.

Depending on the workflow, that may include confirming information such as the patient’s name, date of birth, address, or other identifying information.

Also determine whether anyone else is present.

A caregiver, family member, interpreter, trainee, or another healthcare professional may be participating.

The patient should know who is present and should consent when appropriate.

HHS recommends verifying the patient’s identity and identifying other authorized participants as part of secure telehealth delivery.

5. Confirm where the patient is located

A virtual appointment does not eliminate the importance of knowing where the patient is during the encounter.

The patient’s location can matter for clinical response, emergency planning, and applicable telehealth requirements.

Make location confirmation part of the check-in workflow.

For a routine appointment, the practice may confirm the patient’s current location at the start of the encounter.

For situations involving potential clinical deterioration, knowing the patient’s location becomes even more important.

If the provider believes the patient needs emergency assistance, the practice needs enough information to direct that response appropriately.

6. Use a secure telehealth platform

Providers should use a telehealth platform that supports appropriate privacy and security protections.

HHS advises providers to use reasonable HIPAA safeguards and a telehealth platform that meets applicable HIPAA requirements.

Security should not be treated as a separate IT issue.

It is part of the clinical workflow.

The platform should control access appropriately, protect patient information during transmission, and support secure communication.

The practice should also establish policies for device security, authentication, access, staff training, and handling privacy incidents.

For additional context on protecting healthcare information, see how HIPAA safeguards billing information in healthcare.

The same principle applies to telehealth: patient information remains protected health information even when the encounter happens remotely.

7. Protect privacy on both sides of the visit

A secure platform does not automatically create a private visit.

The provider also needs a private environment.

The patient needs one too.

Providers should conduct telehealth visits from a location where conversations cannot easily be overheard.

Patients should receive instructions to find a quiet and private location when possible.

HHS recommends using a private, enclosed room for the provider side and discussing privacy expectations with patients.

This becomes especially important for sensitive discussions.

If someone else enters the room during the appointment, the provider should know who that person is and determine whether the patient is comfortable continuing the conversation.

8. Establish a telehealth consent process

Telehealth consent requirements vary by state and by the type of care being provided.

Practices should understand the requirements that apply to their operations and document consent through their established process.

HHS notes that providers may be required to obtain informed consent and recommends documenting the consent process.

Consent workflows should be easy for both staff and patients.

The patient should understand what the virtual visit involves and what happens if telehealth is no longer appropriate during the encounter.

The practice should also know where the consent is documented.

Do not leave consent documentation scattered across emails, paper notes, and disconnected systems.

9. Prepare the patient’s clinical information before the visit

The provider should not have to spend the first several minutes of every telehealth appointment reconstructing basic patient information.

Whenever appropriate, collect relevant information before the visit.

Depending on the appointment, that can include:

• Reason for the visit
• Current symptoms
• Medication list
• Allergies
• Relevant medical history
• Home blood pressure readings
• Blood glucose readings
• Temperature
• Weight
• Other patient-generated health information

HHS recommends an intake process that can include identity verification, symptoms, medical history, and vitals when appropriate.

The information collected should match the visit type.

Do not create a longer intake form simply because the technology makes it possible.

10. Structure the virtual visit before it starts

A telehealth appointment still needs a clinical structure.

Before starting, the provider should know:

• Why the patient scheduled the visit
• What information is available
• What questions need to be answered
• What limitations the virtual format creates
• What follow-up may be required

A structured visit reduces the risk of spending too much time on administrative details and too little time on the patient’s actual concern.

The provider should also tell the patient what will happen during the visit.

For example:

“First, I want to understand what has changed. Then we’ll review your medications. After that, we’ll decide whether you need an in-person examination.”

That simple explanation gives the patient a clear framework.

11. Treat communication differently on video

Video removes some of the physical cues providers normally rely on in an office.

Eye contact can be harder.

Body language may be less visible.

Audio delays can interrupt conversations.

Patients may also hesitate to speak because they cannot tell whether the provider is ready for them to continue.

Providers should compensate deliberately.

Use clear questions.

Allow pauses.

Avoid speaking over the patient.

Check understanding.

Pay attention to changes in tone, facial expression, and engagement.

HHS recommends maintaining interactive dialogue, friendly body language, and eye contact during virtual encounters.

The goal is not to imitate an office visit perfectly.

It is to make the virtual interaction clinically effective.

12. Know the limits of a virtual physical examination

A video connection cannot reproduce every part of an in-person physical examination.

Providers need to understand what they can assess remotely and what they cannot assess reliably.

Some examinations may work reasonably well through guided observation.

Others require hands-on assessment, specialized equipment, palpation, auscultation, testing, or procedures.

When the provider cannot obtain enough information to make a safe clinical decision, the correct response is not to force the virtual visit to continue.

The provider should transition the patient to an appropriate in-person setting.

This is one of the most important telehealth best practices because convenience should never override clinical judgment.

13. Have a plan for technical problems

Every telehealth practice needs a backup plan.

Internet connections fail.

Cameras stop working.

Microphones malfunction.

Patients click the wrong link.

Audio becomes unusable.

The provider’s connection may drop.

The practice should define what happens next.

For example:

Video fails → attempt reconnection → switch to approved backup communication if clinically and legally appropriate → reschedule or transition to in-person care when necessary.

Staff should know the process before the first problem occurs.

Patients should also receive instructions about what to do when the connection fails.

HHS specifically recommends giving patients information about addressing technical problems and defining alternatives when technical issues continue.

14. Document the encounter completely

A telehealth encounter still requires appropriate clinical documentation.

The provider should document the relevant clinical information, assessment, treatment plan, orders, prescriptions, follow-up, and other information required for the encounter.

The fact that the appointment occurred virtually does not remove documentation responsibilities.

HHS identifies documentation of diagnoses, procedures, treatment, consent, and encounter notes as part of telehealth clinical standards.

The documentation should also accurately reflect the limitations of the virtual assessment when those limitations affect clinical decision-making.

If an examination could not be performed remotely, the provider should not document findings that were never actually assessed.

15. Connect telehealth documentation to the EHR

Telehealth should not create a separate documentation island.

If providers have to copy information from the telehealth platform into the EHR manually after every visit, the practice has created another administrative step.

A better workflow connects the virtual encounter with the patient’s existing record.

The provider should be able to access relevant patient information during the appointment and document the encounter within the practice’s established clinical workflow.

HHS recommends that EHR systems be easy to merge with telehealth workflows.

This is an important consideration when practices evaluate telehealth technology.

The question is not only:

“Can patients join a video call?”

It is:

“What happens to the encounter after the video call ends?”

16. Make billing part of the telehealth workflow

Billing should be planned before a practice starts delivering virtual visits.

The practice needs a process for identifying telehealth encounters, capturing the necessary information, and submitting claims according to applicable payer requirements.

Telehealth reimbursement rules can change and may differ by payer, service, location, and other factors.

Providers should therefore avoid assuming that every telehealth visit follows the same billing rules.

HHS maintains provider resources covering telehealth billing and reimbursement across Medicare, Medicaid, and private insurers.

The practice should assign responsibility for reviewing applicable requirements rather than leaving billing decisions to individual providers.

17. Give patients a clear follow-up plan

A telehealth visit should end with the same clarity as an in-person appointment.

Before ending the encounter, make sure the patient knows:

• What the provider concluded
• What the patient needs to do
• Which medications should be taken
• Whether testing is required
• When follow-up should occur
• Whether another virtual appointment is appropriate
• Whether an in-person appointment is needed
• What symptoms should prompt urgent or emergency care

A written after-visit summary can help reduce misunderstandings.

Patients should not have to remember every instruction from a short video conversation.

18. Know when to convert the visit to in-person care

Telehealth is not a commitment to complete every appointment virtually.

The provider should be willing to change the care setting when the virtual format becomes insufficient.

That may happen when:

• The patient’s symptoms worsen
• A physical examination is necessary
• Diagnostic testing is required
• The provider cannot obtain enough reliable information
• The patient cannot participate effectively
• Technical problems prevent a meaningful assessment
• The patient’s condition requires urgent evaluation

The provider should explain the reason for the change.

The decision should be based on clinical need, not on protecting the telehealth appointment metric.

HHS recommends considering whether the patient is a good candidate for telehealth and weighing the risks and benefits of an in-person visit.

19. Review the patient experience

Providers should not assume that a telehealth workflow works simply because appointments are taking place.

Review what happens during the visit.

Ask:

• Are patients able to connect?
• Are they completing forms beforehand?
• Do they understand the instructions?
• Are technical problems common?
• Are visits running longer than expected?
• Are staff spending too much time troubleshooting?
• Are patients comfortable discussing sensitive information remotely?
• Are providers able to complete adequate assessments?
• Are follow-up instructions clear?

HHS recommends collecting feedback from patients and clinical/support staff when evaluating telehealth privacy and workflow processes.

The answers can identify problems that are invisible in appointment-volume reports.

20. Train the entire practice, not only the provider

Telehealth is a practice workflow.

The physician or clinician is only one part of it.

Front-desk staff need to know how appointments are scheduled.

Clinical staff need to know how intake works.

Providers need to know how the platform and documentation workflow operate.

Billing staff need to understand the practice’s telehealth billing process.

Everyone needs to understand privacy and security responsibilities.

HHS recommends regular training and clearly defined roles for telehealth programs.

Training should include technical workflows as well as clinical and privacy procedures.

What a strong telehealth workflow looks like

A well-designed telehealth visit should feel straightforward to the patient and predictable to the practice.

The patient receives clear instructions.

The staff completes the appropriate intake.

Identity and location are confirmed.

Consent and privacy requirements are addressed.

The provider conducts the clinical assessment.

The provider determines whether telehealth remains appropriate.

The encounter is documented.

Orders, prescriptions, and follow-up are handled.

Billing information moves into the appropriate workflow.

The patient leaves knowing what happens next.

The technology should support this sequence.

It should not become the sequence.

Telehealth should fit the practice, not create another practice

The strongest telehealth programs do not treat virtual care as an isolated product.

They connect it to scheduling, patient intake, EHR documentation, billing, communication, and follow-up.

That is why the technology behind the visit matters.

mHospital’s EHRCentral includes telehealth alongside EHR and practice-management capabilities, allowing virtual care to sit within a broader practice workflow rather than functioning as a disconnected video tool.

For providers evaluating what their practice technology should handle, mHospital’s healthcare technology platform provides a broader view of the EHR, practice-management, telehealth, and related capabilities available through its ecosystem.

Final checklist for healthcare providers

Before offering a telehealth appointment, ask:

• Is this visit clinically appropriate for telehealth?
• Does the patient know how to connect?
• Has the practice established identity verification?
• Is the patient’s location confirmed?
• Has consent been handled appropriately?
• Are both sides of the visit private?
• Is the platform secure?
• Has the necessary clinical information been collected?
• Does the provider have a plan for technical failure?
• Can the provider document the encounter properly?
• Does telehealth connect with the EHR?
• Does the practice have a billing workflow?
• Does the patient know what happens after the visit?
• Does the provider know when to move the patient to in-person care?
• Does the practice review patient and staff feedback?
• Have staff received appropriate training?

If the answer to several of these questions is no, the problem may not be the telehealth appointment itself.

The problem may be the workflow surrounding it.

Telehealth works best when the clinical decision, technology, staff process, documentation, privacy controls, and follow-up plan all work together.