A new study has put forward outlines for the best methods of delivering healthcare through telehealth following the surge in its use during the COVID-19 pandemic.

Carried out by researchers from Boston University School of Medicine (BUSM), the study looks at applying principles of trauma-informed care in the delivery of telehealth in order to help mitigate the isolating, traumatic effects of COVID-19.

Developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) the six principles of trauma-informed care include safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice, and sensitivity to cultural, historical, and gender issues.

A practical approach to telehealth delivery

The COVID-19 pandemic is a traumatising experience for many, disproportionately impacting people who may have prior trauma exposure and mental health conditions, with social distancing measures potentially exacerbating underlying mental health conditions.

The authors looked at applying the principles of trauma-informed care in the delivery of telehealth for the first time – taking a practical, skills-based approach, including a case study.

Corresponding author Megan R. Gerber, MD, MPH, medical director of women’s health at VA Boston Healthcare System, said: “Trauma-informed care is a global, ’universal precautions’ approach to providing quality care that can be applied to all aspects of healthcare and to all patients.”

The researchers note that the trauma-informed principles being applied to virtual care during crisis has the potential to offer connection and support to trauma survivors, as well as enhance patient and clinician resilience in this time of need.

They also highlight that it is critical for clinicians to be aware that the public health approach to the pandemic may result in trauma, and re-traumatisation, for patients.

Gerber, associate professor of medicine at BUSM, added: “Clinicians have a unique opportunity during this pandemic to apply trauma-informed care principles early on and to envision how telehealth may contribute to a more meaningful care experience for all and a more equitable future for those we care for.

“Because trauma may be unseen, unmeasured, and unnamed, it is important to deliver all medical care with sensitivity to its potential presence. All clinicians have a unique opportunity in the setting of COVID-19 to apply a trauma-informed lens to our telehealth encounters which may promote connection, equity and healing-cantered engagement in care.”