Actually remote healing doesn't require hand signs it only requires the intial hand sign ram and after that in ever instance its been used the user is free to do other things and doesn't need to maintain the ram sign at all.
this is what she was doing in that picture.
Clap Hands
This is more of an initiation of a technique rather than a hand seal where the user simply claps their hands together as exemplified when Naruto Uzumaki for example summons chakra or is breaking genjutsu. The hand seal sequence for powerful summoning kinjutsu like the Summoning: Impure World Reincarnation and the Dead Demon Consuming Seal end with this motion;
similarly, Jiraiya prepares to enter Sage Mode (summoning Shima and Fukasaku) b
y performing this motion and sustaining it, Hashirama uses it to enter Sage Mode as well, Gaara uses it for Quicksand Waterfall Flow at his fight against Kimimaro. It is also used to perform the Chibaku Tensei technique. Once the seal sequence completed, the user's hands are held in this position until the desired effect is achieved.
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