Conducting a Telehealth Session. On the day Make sure in advance that: All appointments have been...
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Transcript of Conducting a Telehealth Session. On the day Make sure in advance that: All appointments have been...
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
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
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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
The View through the Camera
3
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
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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
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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
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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
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Doing the consultationThe 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 video8
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
9
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.
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After the consultationPatient 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.
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After the consultation (continued)
Billing and follow-up
Bill the patient in the same way as for any other service
Next appointment?
Prescriptions?
Tests?
Trouble shooting
Two common problems are:
1. Failure to get started
2. 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
13
http://www.rrmeo.com/misc_files/acrrm/acrrm_video/morayfield_consult.mp4
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An example of a video consultation
Questions and discussion
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