The Basics of Telehealth Assessment and Treatment: Difference between revisions
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# Rationale if a referral is necessary | # Rationale if a referral is necessary | ||
# identifying a support network of seniors or experts in the field who can advice and assist at any stafge required. This channel needs to be active and the clinicians must be able to contact , as an when necessary | # identifying a support network of seniors or experts in the field who can advice and assist at any stafge required. This channel needs to be active and the clinicians must be able to contact , as an when necessary | ||
# The contact details | # The contact details shouldn't be kept confidential, it would even be recommended to get seperate lines and contact ids for this purpose, after the consultation the numbers must be deleted or stored only i the official records<ref>Chartered Society of Physiotherapy. Telephone Guidance from Musculoskeletal Practise. Avaialable from: https://www.csp.org.uk/news/coronavirus/remote-service-delivery-options/telephone-guidance-msk-practice</ref> | ||
Always maintain the records of the patients | Always maintain the records of the patients | ||
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== | == Key points to keep in mind: == | ||
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|- | |- | ||
|Before the Consultation | |Before the Consultation | ||
|Consider a pre call questionnaire (Self rating like in case of VAS or Body chart) | | | ||
Ask the client if they would like a partner or family member to be present during the consultation | * Consider a pre call questionnaire (Self rating like in case of VAS or Body chart) | ||
* Ask the client if they would like a partner or family member to be present during the consultation | |||
Schedule the consultation based on whom you need to see on a priority basis([[Clinical triaging considertain telehealth|clinical triaging in telehealth]]) | * Schedule the consultation based on whom you need to see on a priority basis([[Clinical triaging considertain telehealth|clinical triaging in telehealth]]) | ||
* Confirm if a video graphic consultation is clinically appropriate Use a room that is private and well lit | |||
Confirm if a video graphic consultation is clinically appropriate | * Make sure the patients phone number is ready, in case the video graphic link gives trouble | ||
Use a room that is private and well lit | * Keep the patients clinical records ready and preferably on another screen | ||
* Prior to the session test the technology , if it is works as its supposed to. | |||
Make sure the patients phone number is ready, in case the video graphic link gives trouble | |||
Keep the patients clinical records ready and preferably on another screen | |||
Prior to the session test the technology , if it is works as its supposed to. | |||
|- | |- | ||
|Start of the consultation | |Start of the consultation | ||
|Always initiate the consultation by calling the patient | | | ||
Check the connectivity and clarity by asking the subject of he/ can see or hear. | * Always initiate the consultation by calling the patient | ||
* Check the connectivity and clarity by asking the subject of he/ can see or hear. | |||
* A formal introduction to the patient is a must | |||
* A verbal consent must be taken from the client before the commencement of the assessment procedures | |||
* It is always better to look at the camera for the client to make eye contact and restore the subjects faith in you | |||
* In case there are other consultants in the room they need to be introduced to the client | |||
|- | |||
|The consultation | |||
| | |||
* Maintain written records as you would for a face-to -face consultation. | |||
* Be aware that the video communication is slightly different in comparison to their | |||
* In case you are preoccupied, making notes or reading medical records, let the patient know | |||
|- | |||
|Closing the consultaion | |||
| | |||
* Summarize key points, incase something went wrong technically this would really help | |||
* Clarify any doubts the patient might have | |||
* Confirm i the patient is happy with the video method of telehealth | |||
* Remind the client not to stop his routine medication in case of any co morbidities present | |||
* Say goodbye and close the call | |||
|- | |||
|After the consultation | |||
| | |||
* Update the records | |||
* Schedule referrals or follow up appointments | |||
* Make sure the exercises, if promised in the form of an email are sent | |||
* Prompt follow up email needs to be sent, summarizing the necessary features of the teleconsultation | |||
* Face to face appointments in case necessary must be scheduled<ref>Specialty guides for patient management during the coronavirus pandemic. Clinical guide for the management of remote consultations and remote working in secondary care during the coronavirus pandemic. NHS Report number: 001559 [27/03/2020]</ref> | |||
|} | |||
== The process: == | |||
Begining: | |||
Perform a brief visual assessment ( Is the patient distressed, gauge his ability to proceed with the assessment) | |||
Understand the purpose of the consultation (assessment, medical records for leave, reassurance, referral etc) | |||
Check the medical records, for the presence of high risk status or [[red flags]] or co morbidities (diabetes, steroids, pregnancy, chemotherapy, chronic kidney disease, etc) | |||
Taking a history: | |||
Remote examination | |||
tests | |||
Clinical Descision making: | |||
Treatment plan | |||
Patient guide: | |||
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Revision as of 19:26, 13 May 2020
Recommendations to clinicians:[edit | edit source]
- Exclude all reg flags
- Identify patients who may need face- to face assessment
- Rationale if a referral is necessary
- identifying a support network of seniors or experts in the field who can advice and assist at any stafge required. This channel needs to be active and the clinicians must be able to contact , as an when necessary
- The contact details shouldn't be kept confidential, it would even be recommended to get seperate lines and contact ids for this purpose, after the consultation the numbers must be deleted or stored only i the official records[1]
Always maintain the records of the patients
Reduce the amount of identifiable patient details that you share digitally
Assessment needs:
Empowerment of the patient
Individually tailored
Not recommended to assess:[edit | edit source]
Assessing high risk patient or patients with potentially high risk conditions
Patients with internal examination including any pelvic area examination
Coniditions or comorbidities affecting the ability to us technology including delusion, anxieties about using tecnology
Deaf and dumb individuals, may be difficulat , however the use of assitive technolgy may aid the process
Key points to keep in mind:[edit | edit source]
Before the Consultation |
|
Start of the consultation |
|
The consultation |
|
Closing the consultaion |
|
After the consultation |
|
The process:[edit | edit source]
Begining:
Perform a brief visual assessment ( Is the patient distressed, gauge his ability to proceed with the assessment)
Understand the purpose of the consultation (assessment, medical records for leave, reassurance, referral etc)
Check the medical records, for the presence of high risk status or red flags or co morbidities (diabetes, steroids, pregnancy, chemotherapy, chronic kidney disease, etc)
Taking a history:
Remote examination
tests
Clinical Descision making:
Treatment plan
Patient guide:
:
- ↑ Chartered Society of Physiotherapy. Telephone Guidance from Musculoskeletal Practise. Avaialable from: https://www.csp.org.uk/news/coronavirus/remote-service-delivery-options/telephone-guidance-msk-practice
- ↑ Specialty guides for patient management during the coronavirus pandemic. Clinical guide for the management of remote consultations and remote working in secondary care during the coronavirus pandemic. NHS Report number: 001559 [27/03/2020]