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Conducting a Telehealth Session

Conducting a Telehealth Session. On the day. Make sure in advance that: All appointments have been confirmed All written material and test results are collated and ready A “do not disturb sign” at hand The patient has received information on Telehealth consultation

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Conducting a Telehealth Session

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  1. Conducting a Telehealth Session

  2. On the day • Make sure in advance that: • All appointments have been confirmed • All written material and test results are collated and ready • A “do not disturb sign” at hand • The patient has received information on Telehealth consultation • The patient has given consent (verbal or written) • The room and equipment are set up – enough chairs, camera angle and sound tested • You know how you will take notes

  3. The View through the Camera • You need an appropriate field of view: wide enough to show all the people and close enough so the view can see faces clearly • Chair placement • Camera placement • Zoom • Ensure people fill the screen not the surrounding room

  4. Lighting and Contrast • The room needs to be well lit. Normal room lighting will often do. • If extra light is needed, bounce light off the wall onto the patient and clinician. • Don’t shine it in their faces. Good lighting Too dark due to back light Too bright Uneven lighting

  5. Lighting and Contrast (continued) • Contrast between a patient’s complexion and clothing colour might affect the clarity of pictures. • White clothes/dark skin or black clothes white skin - might be difficult to see facial features. Sit the patient closer to the camera. • Simple backgrounds and plain clothes require less bandwidth to transmit. Three good examples of plain backgrounds and clothing

  6. Sound • Microphones aren’t good at filtering out sounds (fan, air conditioning, traffic) • Don’t rustle papers near the microphone • Speak clearly and at reasonable volume and ask the person at the other end if the volume is right • Remember the need for privacy

  7. Getting organised for the consultation • Have the patient in the room and ready 10 minutes early • Check: • The camera angle and chair placement – consider if eye contact is appropriate for your patient – make sure the specialist knows what is appropriate • Any patient worries related to the room or screen image (address these) • Any other worries - discuss and address • The video quality and lighting

  8. Doing the consultation • The technology • The technology is working nicely – all checked at the beginning • Picture of patient and clinician on screen? Check view occasionally • The people • Confirm you have the right person on the other end. They need to confirm that you are the right person • Introductions • One person at a time – proceed as usual • Short time delay • Body language – less obvious over video

  9. Doing the consultation (continued) • Physical examination • The clinician with the patient will need to do this – best discussed before the session begins • Develop protocols for particular types of consultations • Around 10% of Telehealth consultations need an a follow up due to the limitations of ability to do physical examinations • Finishing up • Make sure you both know who is doing what – tests, scripts, follow-up

  10. Doing the consultation (continued) • Feeling awkward • May feel quite “intense” due to extra concentration required • Might be disconcerting seeing yourself on-screen. (Also for the patient.) • Practice with friends/family/colleagues on Skype to begin with • Remember that patients are generally very positive about their Telehealth consultations (higher than clinicians). The patient is probably feeling better than you about it.

  11. After the consultation • Patient evaluation • It is important to find out how the patient felt about the session – use a standard form to allow comparison between responses over time and to compare to other patient’s experiences.

  12. After the consultation (continued) • Billing and follow-up • Bill the patient in the same way as for any other service • Next appointment? • Prescriptions? • Tests?

  13. Trouble shooting • Two common problems are: • Failure to get started • Poor quality picture or sound or call failure Solutions: • Check everything is plugged in – cables connected • Try restarting • Use a speaker phone for the sound to improve overall picture and sound quality • Adjust the frame rate down to about 12 per second

  14. An example of a video consultation http://www.rrmeo.com/misc_files/acrrm/acrrm_video/morayfield_consult.mp4

  15. Questions and discussion

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