Considering autistic patients in the era of telemedicine: the need for an adaptable, equitable, and compassionate approach

Sebastian CK Shaw; Lucy-Jane Davis; Mary Doherty

doi:10.3399/BJGPO.2021.0174

Article Figures & Data

Tables

View popup

Table 1. Our recommendations for autistic patients

Reasonable adjustment	Rationale
Facilitate access
Patient notes should be flagged with autistic diagnosis and any specific strategies that will help for consulting	By being aware of strategies that are helpful in consulting with each patient from the outset, the clinical and supporting administrative team are better placed to offer care to their autistic patients.
Allow autistic patients to request the most accessible type of appointment for them to reduce barriers to access.	Some may not cope with telephone calls or video calls, and this may foster inequitable care.
Offer online booking	Some may not cope with telephone calls to make the booking for the appointment.
If face-to-face, offer the first or last appointment — preferably the first if a clinic is likely to run late.	Some may find the busy waiting room environment challenging and in some surgeries it will be quieter at particular times of the day.
Offer longer or double appointments.	Autistic patients may need a longer appointment because of specific social communication needs.
If remote, offer clearly defined appointment times — not a half day.	This allows autistic patients to prepare for the appointment and ensure they are in an environment which facilitates their engagement.
During c onsultation
Ask the patient if they have any communication needs for you to consider at the beginning.	Autistic patients may have a variety of needs and requirements to facilitate their communication/consultation.
Consider lowering the threshold for face-to-face appointments in any triage process.	Some may find interoception challenging and thus ‘present’ in unexpected ways, which may require physical examination.
You may also wish to consider: Allowing for extra processing time between questions. Avoiding rephrasing questions unless asked to. Using clear, unambiguous language. Adding extra checks of understanding. Developing phrases which let a patient know when a question has been adequately answered and using these to help structure the consultation.
Following appointment
Use text messages to summarise information and safety-net.	This can help to ensure effective communication of key outcomes.