Telehealth has moved from being a convenience to an essential part of modern healthcare delivery. When implemented thoughtfully, it can improve access, continuity of care, and patient satisfaction—without compromising clinical quality or professionalism. The key is to approach virtual care with the same rigour you would apply in your rooms, while adapting your methods to the realities of the digital setting.
1. Choose the right patients and the right problems
Telehealth is not a one-size-fits-all solution, so best practice starts with selecting the right patient and the right clinical problem. Virtual consultations work particularly well for follow-up visits for stable chronic conditions, medication reviews and adherence checks, mental health consultations, lifestyle counselling, and health education. By contrast, acute emergencies, conditions that require a physical examination or procedure, and presentations with significant diagnostic uncertainty are typically less suitable unless you have a clear in-person back-up plan. A useful operational step is to set internal guidelines that define when telehealth is appropriate and when escalation to face-to-face care is the safer option.
2. Create a professional virtual clinical environment
Your virtual presence should reflect the same standards as your physical practice. This means consulting from a quiet, private room with a neutral background, ensuring good lighting so your face is clearly visible (ideally with the light source in front of you), and using stable internet with high-quality audio. Professional attire still matters, as it signals seriousness and helps patients feel confident in the encounter. It is also important to avoid multitasking or distractions—patients can usually tell, and trust is easily eroded in a virtual setting.
3. Prioritise privacy, confidentiality and consent
Telehealth introduces distinct privacy risks, so confidentiality and informed consent must be handled deliberately. Secure, encrypted platforms designed for healthcare are strongly preferred. At the start of each session, verify the patient’s identity and confirm their physical location, which becomes critical if an emergency arises during the call. Consent for telehealth should be explicit, discussed, and documented, alongside clear explanation of what telehealth can and cannot achieve. Both practitioner and patient should also be in private spaces to reduce the risk of accidental disclosure.
4. Adapt your communication style for virtual care
Because non-verbal cues are reduced on video and nearly absent on phone calls, communication needs to be more intentional. Speaking slightly slower and more clearly can reduce misunderstandings, especially where connection quality varies. Open-ended questions remain central to good clinical practice and help patients tell their story in a way that surfaces key details—for example: “What concerns you most about your symptoms today?” or “How is this affecting your day-to-day life?” Build in small pauses to accommodate latency and prevent people speaking over each other. It also helps to verbalise empathy more explicitly, such as: “I can see this has been difficult for you,” and to check understanding often, especially when giving instructions or explaining next steps.
5. Conduct structured and safe virtual assessments
Without hands-on examination, structure becomes your safety net. Use systematic history-taking frameworks and guide the patient to describe, demonstrate, or measure symptoms where possible—such as showing a rash on camera or reading out home blood pressure values. Where available, remote monitoring devices can add useful objective data. Always stay alert to red flags, and act decisively when they appear. If there is any doubt about safety or diagnostic clarity, it is better to arrange an in-person review than to try to “make it fit” virtually.
6. Maintain clinical documentation and continuity of care
Telehealth consultations must meet the same documentation standards as face-to-face visits. Records should clearly reflect the mode of consultation (video or phone), that consent was obtained, what clinical findings were established, and what limitations existed due to the virtual format. The management plan and follow-up instructions should be documented in a way that another clinician can easily interpret. Where a broader care team is involved, proactive communication helps prevent fragmentation and ensures continuity for the patient.
7. Be mindful of equity and accessibility
While telehealth expands access for many patients, it can unintentionally exclude others. Some people have limited internet access, low digital literacy, or challenges related to language and the need for interpreters. Others may have disabilities that affect hearing, vision, or cognition, which can make virtual care more complex. Wherever possible, offer practical support and alternatives so telehealth does not widen health disparities.
8. Commit to ongoing training and quality improvement
Telehealth is a clinical skill that improves with practice, reflection, and feedback. Regular training in telehealth etiquette and the technology you use can prevent avoidable errors and improve patient experience. Patient feedback is valuable, and periodic review of outcomes and safety events can highlight areas for improvement. Because standards and expectations continue to evolve, staying up to date with changing guidance and regulations should form part of ongoing professional development.
South African legal and ethical context
In South Africa, telehealth is governed by existing healthcare, ethical and data-protection frameworks. Practitioners providing telehealth services must be appropriately registered with the Health Professions Council of South Africa (HPCSA) and practise strictly within their registered scope. The HPCSA’s Ethical Guidelines for Good Practice in Telehealth (Booklet 10) emphasise that telehealth consultations must meet the same standard of care as in-person visits, and that practitioners remain fully accountable for their clinical decisions and outcomes. This includes obtaining and documenting explicit informed consent for telehealth, with clear discussion of limitations and risks.
Practitioners must also comply with the Protection of Personal Information Act (POPIA), ensuring that patient data is collected, stored and transmitted securely, using appropriate technological safeguards. For this reason, telehealth platforms should be encrypted and purpose-built for healthcare, and patient confidentiality must be actively protected throughout the consultation process.
Telehealth is more than traditional care delivered through a screen. It requires a purposeful shift in clinical process, communication, and risk management. By applying these best practice techniques—and aligning care with South African regulatory expectations—healthcare practitioners can help ensure telehealth remains safe, professional, patient-centred and clinically effective.