Telehealth Tips: Weight, Height and Physical Exam

There is no weight or height for this visit. What can I do?

Check if child had them measured recently. In some cases, these could be obtained at home, but that may be stressful for families. Use your clinical judgement to determine if these are needed, but remind families to avoid regularly weighing children at home. Learn if the child seems to be growing along previous trajectories.

ASK: Is your child growing out of their clothes?

Even if you don’t have height and weight measurements, you can still counsel about healthy behaviors that are good for everyone.
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There is a weight and a height for this visit. How do I talk to the family about it?

Obtain permission to discuss the child’s weight.

ASK: Would you like to talk about your child's weight? Do you have any concerns about it?

Avoid discussing specific weight and BMI values to help minimize weight stigma. Focus on encouraging healthy behaviors instead.

What about the physical exam?

Performing an exam with telehealth visits is challenging, but the history can help you evaluate for obesity-related conditions, for example, acanthosis nigricans or obstructive sleep apnea.

ASK: Does your child have any dark areas or lines in their skin (like neck, armpits, groin area)?

ASK: Does your child snore or wake up from sleep gasping for air? Do they seem tired during the day?

When documenting your visit, acknowledge the limitations of obtaining an exam during telehealth visits.

TIPS AND RESOURCES

For telephone visits:

Note the allotted visit length and set an agenda together.

For video visits:

Make sure to have a neutral background and good lighting.

Resource:

Check out the US Department of Health and Human Services (HHS) Telehealth website for updated guidance.