Video calling with clients

What it is

Video calling is a conversation over a live video connection: you and your client see and hear each other on a screen. Other words for the same thing are video chat and video consultation.

In care and support, it is usually an ordinary conversation at a distance: a neighbourhood team worker talks to a client who finds it hard to leave the house, or an outreach support worker has a short check-in between two home visits. There is also screen care (beeldzorg): care via a screen, where a care worker helps someone at a distance with ordinary everyday things. For people with a disability who get outreach support at home, this seems to help mainly as extra support in between, for example when a complicated letter arrives that causes stress.

Why it matters

Video calling has advantages that also apply in care and support:

• the conversation can take place in your client’s familiar surroundings;
• your client doesn’t have to travel, and doesn’t depend on transport or on help from others;
• an interpreter, an informal carer or another care worker can easily join in.

There are also disadvantages. The contact is less personal, and you can’t do everything you can do in person: a physical examination, for example, isn’t possible. For some people, video calling is also too difficult, because they have little experience with it or don’t have the equipment.

With good explanation and one practice session together, it often works with clients who have little digital experience too. But people do need to be both willing and able to use digital care.

When it works, and when it doesn’t

You decide together with your client:

• whether video calling suits your client’s question;
• whether your client wants it;
• whether your client is able to do it.

In some situations, video calling is less suitable. For care and support, these are the most important:

• When it is urgent. Then you want to see someone, or be able to act straight away.
• If your client can’t talk freely. For example in an unsafe home situation. You can’t always see someone who is listening in.
• If the technology doesn’t work and there is no help. Without a device, or without someone who helps to make the connection, the time goes on the technology.
• If language is a barrier and an interpreter can’t join in.
• If talking via a screen is too tiring, for example because of a physical disability or a mental health condition.

How to do it

1. Decide together. Ask the three questions above, and don’t fill in the answer for your client. Also say that meeting in person is still possible, and that your client can switch.

2. See what your client can already do. With a short list of questions, you can estimate how digitally skilled your client is. Do you have a computer, phone or tablet with internet? Do you use email, so I can send you a link? Do you ever use an app, and can you download one yourself? If the answer is often “no” or “with help”, plan extra explanation.

3. Use your organisation’s program. Your organisation is responsible for making sure you can communicate safely with clients, and must offer safe ways to video call for this. Don’t know which program that is, or not sure? Ask the data protection officer (in Dutch: functionaris gegevensbescherming, FG): the person in your organisation who oversees the privacy rules and gives advice. If there is no FG, your manager knows who is responsible for privacy. If the maker of the program works with client data on behalf of your organisation, there must be a data processing agreement (see The AVG (GDPR) in care and support). Care providers must also make sure their information security meets NEN 7510, the Dutch legal standard for information security in healthcare. Your FG knows which rules apply to your organisation.

4. Practise together once. Go through it once with your client, for example with a test call during a home visit. Explaining it well once is often enough, but many people also want the steps on paper. So make a small card with three steps and a picture.

5. Agree a plan B. Write down your client’s phone number, and say beforehand that you will phone if the connection drops or the picture keeps freezing. Then look together at what helps: a better place in the house, earphones, or meeting in person after all.

6. Let your client prepare. With Questions for your appointment, your client writes down beforehand what they want to say and ask. Also ask your client to find a place where they can talk in peace and freely.

7. Prepare yourself. Sit in a room of your own with a calm background, and ask colleagues or the people you live with not to come in. Test beforehand whether the sound and microphone work. Make sure there is light on your face, put the camera firmly at eye level, and use earphones if the sound is poor or echoes.

8. Start the way you start a conversation in person. Ask whether your client can see and hear you well. Ask whether anyone else is in the room, and whether your client is happy for that person to listen. Say so when you are taking notes, so your client understands why you sometimes look away.

9. Keep it clear. Choose the topics together at the start. If you share your screen, only open information about this client, because otherwise you might accidentally show someone else’s data.

10. End well. Ask your client to tell you in their own words what you agreed (the teach-back method). Then ask how the video call went, and write up the conversation as you would an ordinary conversation.

Video calling for everyone

Not everyone sees, hears or reads equally well. With these points, you take that into account in a conversation with your client:

• Choose a program that is accessible. That is a program that meets the latest version of the guidelines for accessible websites (now WCAG 2.2), at level AA. Such a program also works with just the keyboard, for example. Check this with whoever manages the program in your organisation.
• Make sure there is more than one way to join the call, for example also with an ordinary phone.
• Turn on captions if your client is hard of hearing, if the program can do this. If a sign language interpreter is taking part, make sure the interpreter is clearly visible.
• Send documents beforehand if you want to look at something together, so your client can read it at their own pace or have it read aloud.
• Test beforehand, together with your client.

Also make sure your client has somewhere to go with questions about the technology. Sometimes the maker of the program offers a helpdesk like this, and otherwise your organisation can appoint colleagues to answer questions about video calling.

Example: short things by video, money matters at a home visit

You see a client at home every two weeks, and you suggest alternating the visits with video calls. The questions about digital skills show that she has a tablet and email, but can’t download an app. You install the program together at the next home visit, and do the test call there too.

After a few calls, you look back together. Video calling suits short things. She prefers to talk about money when you visit, because sometimes there is someone in the house who doesn’t need to listen in. You agree to do it that way.

Choices you make

• Video, phone or in person. Video shows more than the phone, but is harder to set up. For a short question, a phone call is sometimes enough. For a conversation about something difficult, meeting in person is often better.
• Convenience or safety. An app your client already knows is easy. But for your organisation’s program, the agreements about working safely have already been made. If in doubt, ask your FG for advice, and don’t let convenience decide.
• Help from someone close. A grandson who sets up the connection can help a lot. But if he stays in the room, he also hears everything. Keep asking your client whether that is okay.

Points to watch

• Don’t discuss sensitive things by video if your client can’t talk freely. If you feel that someone is listening in or that your client is holding back, plan a conversation in person.
• Don’t record without asking. Doctors must tell their patient beforehand that they are recording a conversation, and ask for permission. Ask your FG how your organisation handles this.
• Keep a route without a screen open for people for whom digital care doesn’t work: see What is digital inclusion?.
• Report a data error straight away within your organisation, for example if you accidentally share your screen with another client’s data on it.

Questions

Can I video call through an ordinary app, such as an app my client already has? That depends on the agreements in your organisation. Your organisation must offer safe ways to video call, and if there aren’t any, you arrange to meet in person for conversations about the support itself. If you do use an ordinary app, discuss as little sensitive data as possible, tell your client about the privacy risks, ask for permission and check that the app sends messages encrypted. Ask your FG what is allowed where you work.

Find out more

• The AVG (GDPR) in care and support
• Privacy checklist for an app
• Choosing a digital tool for your client
• Introducing a digital tool in your team
• What is digital inclusion?