Category Archives: Services by clinical field

Reference Documents

PROGRAM GUIDE

Guide for the Diabetic Retinopathy Screening Program in the Cree Region – Classified by user role (imager or nurse).

  • Role – Imager

Imager Training Manual for Diabetic Retinopathy (Part 1)
Imager Training Manual for Diabetic Retinopathy (Part 2)
Imager Job Description
Consent Form
Clinical Data Form
Visual Acuity Assessment
Material Required
Competencies Evaluation
Clinical and Administrative Process
Validation Sheet
Screening Results Report
Letter to participants

  • Role – Nurse

Nurse Training Manual for Diabetic Retinopathy
Nurse Job Description
Collective Order
Intraocular Pressure Measurement
Eye Drop Administration
Competencies Evaluation
Clinical and Administrative Process
Consent Form
Clinical Data Form
Visual Acuity Assessment
Screening Results Report
Letter to Participants

POWER POINT PRESENTATION

Power Point : Diabetic Retinopathy Screening Program in the Cree Region of James Bay of Quebec with D. Lededer MD

USEFUL COMMUNICATION TOOLS

Les documents suivants sont uniquement disponible en anglais.

Teleconsultation in the Provider Site

In addition to procedures regarding the criteria to be applied to the requesting and provider sites for accessing telehealth services (details available in procedure 6.1 of the text version of the Policies and Procedures), given below are the teleconsultation activities in the provider site.

Accepting a teleconsultation request

The designated person at the provider site or at the CECoT must:

  • Check the eligibility of the request based on the basket of services provided by each specialty.
  • Check that nothing is missing in the file. Contact the person in charge of the request in case of any missing details.
  • Contact the specialist to accept or reject the request.
  • Contact the requesting site and the CECoT to confirm the date and time of the teleconsultation.

If you have any questions or require additional information, please contact the CECoT.

Planning the teleconsultation

Once the teleconsultation date is confirmed, the designated official in the provider site must:

  • Book the following in his site:
    • The videoconferencing room (the room should ensure privacy).
    • Videoconferencing equipment including clinical devices required for consultation, like the electronic stethoscope.
  • Check that the staff required for conducting the teleconsultation (technical staff, administrative staff and/or health care professional) is available, as specified in the prerequisites of each clinical field.
  • Ensure that these people know how to properly use the equipment, applications and devices. If not, then contact the CECoT for a training session before the teleconsultation.
  • Fill up the videoconferencing request form.
  • Notify the requesting site and the CECoT in case of cancellation.
  • Confirm the opening of a file locally after accepting the request.

If you have any questions or require additional information, please contact the CECoT.

Holding the teleconsultation

  • Ensure that the designated official in the institution installs the required videoconferencing equipment and medical devices (e.g. handheld camera, electronic stethoscope and other devices) and make sure that everything is working properly.
  • Introduce the staff of the provider site to the requesting site.
  • Explain the teleconsultation proceedings to the patient and participants.
  • Provide local participants with the other guidelines regarding teleconsultation etiquette.

If you have any questions or require additional information, please contact the CECoT.

Conclusion of the teleconsultation

  • Prepare the teleconsultation report and ensure that it is sent to the requesting site, preferably via the Internet, or by fax if the network is down.
  • Print the report and store it in the paper or computerized file of the patient.

If you have any questions or require additional information, please contact the CECoT.

Accepting a teleconsultation request

TELECONSULTATION IN THE PROVIDER SITE

In addition to procedures regarding the criteria to be applied to the requesting and provider sites for accessing telehealth services (details available in procedure 6.1 of the text version of the Policies and Procedures), given below are the teleconsultation activities in the provider site.

Accepting a teleconsultation request

The designated person at the provider site or at the CECoT must:

  • Check the eligibility of the request based on the basket of services provided by each specialty.
  • Check that nothing is missing in the file. Contact the person in charge of the request in case of any missing details.
  • Contact the specialist to accept or reject the request.
  • Contact the requesting site and the CECoT to confirm the date and time of the teleconsultation.

If you have any questions or require additional information, please contact the CECoT.

Conclusion of the teleconsultation

TELECONSULTATION IN THE REQUESTING SITE

Given below is a list of teleconsultation activities in the requesting site. Mapping that summarize these actions can be found in the Policies and Procedures Section.

Conclusion of the teleconsultation

  • Print the report and ensure the follow-up with the attending physician. The responsibility for ensuring follow-ups and patient management lies with the requesting physician except in certain situations that should be specified when implementing the service.
  • When the health professional from the provider site sends the teleconsultation report, store it in the paper or computerized file of the patient.
  • Complete the satisfaction questionnaires:
    • submit the questionnaires to the patient and health care professional;
    • collect them, if possible;
    • send the duly completed questionnaires to the CECoT by fax, email or post.

If you have any questions (or wish to obtain a copy of an above document), please contact the CECoT.

Holding the teleconsultation

TELECONSULTATION IN THE REQUESTING SITE

Given below is a list of teleconsultation activities in the requesting site. Mapping that summarize these actions can be found in the Policies and Procedures Section.

Holding the teleconsultation

On the day of the teleconsultation, before the clinical activity begins:

  • Install the required videoconferencing equipment and medical devices and make sure that everything is working properly.
  • Greet the patient and o explain the teleconsultation proceedings to him; o help him to familiarize himself with the equipment and its functioning;
    • ensure that he has read the pamphlet meant for him;
    • check if he has received answers to all his questions;
    • inform or remind him that he has the right to terminate the telehealth session at any time during its course;
    • get him to sign the teleconsultation consent form, if this is not already done.
  • Keep in mind the etiquette and helpful tips regarding telehealth and provide local participants with the other guidelines for facilitating the session.

If you have any questions, please contact the CECoT.

Workflow

The following workflow is generic. It introduces the various participants involved in the teleconsultation. The roles and responsibilities of the requesting and provider sites are described below (avalaible in French only).

img-clinical-flow-generic

Teleconsultation in the requesting site

Given below is a list of teleconsultation activities in the requesting site. Mapping that summarize these actions can be found in the Policies and Procedures Section.

Teleconsultation request

For referring a patient to telehealth:

  • Make sure the request is eligible based on the type of services provided in telehealth.
  • The health care professional is in charge of providing complete explanations and answering any question or concern of the patient, relative and/or guardian. A pamphlet on telehealth is available for the patient.
  • Get the health care professional to sign the patient consent form for teleconsultation.
  • If the session is recorded, get the corresponding consent form signed.
  • Provide the desirable information before the telehealth activity, based on each type of consultation.
  • Fill up the web-based clinical request.
  • Send the request to the physician at the provider site if he is known. If not, forward it to the CECoT.

In case the network is down:

  • In situations of emergency, call or fill up the AH-226 DT medical consultation form (a dynamic electronic version of this form is available on the MSSS website) and fax it to the physician.
  • For elective cases, fill up the web-based clinical request once the network is restored.

If you have any questions (or wish to obtain a copy of an above document), please contact the CECoT.

Planning the teleconsultation

You will receive a confirmation date from the CECoT. Once you have obtained it, you must:

  • Book the following in your facility:
    • a videoconferencing room, ensuring that the room guarantees privacy;
    • videoconferencing equipment including clinical devices required for consultation, based on the specialty.
  • Check that the staff required for conducting the teleconsultation is available, as specified in the prerequisites of each clinical field.
  • Ensure that the participating staff (including the health care professional) knows how to properly use the videoconferencing equipment and medical devices. If not, then contact the CECoT for a training session before the teleconsultation.
  • Fill up the videoconferencing request form.
  • Confirm the date and time of the appointment to the patient.
  • In case of cancellation, notify the provider site and the CECoT (and the patient, if need be) as soon as possible.

If you have any questions, please contact the CECoT.

Holding the teleconsultation

On the day of the teleconsultation, before the clinical activity begins:

  • Install the required videoconferencing equipment and medical devices and make sure that everything is working properly.
  • Greet the patient and o explain the teleconsultation proceedings to him; to help him to familiarize himself with the equipment and its functioning;
    • ensure that he has read the pamphlet meant for him;
    • check if he has received answers to all his questions;
    • inform or remind him that he has the right to terminate the telehealth session at any time during its course;
    • get him to sign the teleconsultation consent form, if this is not already done.
  • Keep in mind the etiquette and helpful tips regarding telehealth and provide local participants with the other guidelines for facilitating the session.

If you have any questions, please contact the CECoT.

Conclusion of the teleconsultation

  • Print the report and ensure the follow-up with the attending physician. The responsibility for ensuring follow-ups and patient management lies with the requesting physician except in certain situations that should be specified when implementing the service.
  • When the health professional from the provider site sends the teleconsultation report, store it in the paper or computerized file of the patient.
  • Complete the satisfaction questionnaires:
    • submit the questionnaires to the patient and health care professional;
    • collect them, if possible;
    • send the duly completed questionnaires to the CECoT by fax, email or post.

If you have any questions (or wish to obtain a copy of an above document), please contact the CECoT.

Access to the Request

You require a user name and password to access the request. Here is a step-by-step description of the entire process:

  • Contact the CECoT to indicate your interest in using the request and obtaining information.
  • Define your user profile by reviewing the various profile definitions.
  • Fill up the form (available at the CECoT) corresponding to your profile and send it to the CECoT.
  • Once your profile is approved, a member of the CECoT team will contact you and provide you with your user name and password.
  • Training via videoconference is required in order to use the web request. To do this, check the online training schedules. A training module and a demo version of the request are also provided to familiarize you with the process.
  • A clinical coordinator is on hand to assist you when you first use the request, so as to complete your training.

If you have any questions, please contact the CECoT.

Important points regarding the request

Health Insurance Card (RAMQ):

  • Ensure that the card is valid to avoid rejection of the consultation request (refer to the RAMQ process regarding invalid cards on their website and ensure prompt treatment).
  • Verify the accuracy of demographic data and information linked to the card. Inaccuracies in the data may lead to a delay in assigning a file number at the provider site and thereby postpone the consultation process by the medical specialist.

Identification:

  • Clearly identify the physician or group of physicians at the provider site to whom the request will be sent.
  • Specify the name or file number of the patient on the attachments so that it will be easier to trace the documents.

Follow-up:

  • The responsibility for following up the teleconsultations with the patients or health professionals lies with the requesting site.

Prescription:

  • The patient’s attending physician at the requesting site must produce the prescription and fax it (since electronic prescriptions are not yet recognized in the healthcare system in Quebec).

Emergency:

  • As electronic clinical requests are used for teleconsultations in elective mode, contact the physician directly by phone in case of emergency.

Overview

The advantages of a web-based clinical request include:

  • Automation of teleconsultation from the creation of the request to the production and transmission of the report to the requesting site.
  • Secure transmission of personal information on the RITM network.
  • Transmission of relevant information required to carry out the teleconsultation.
  • Facilitation of work (e.g. mandatory fields are denoted by a red star).
  • Option of attaching documents (previous consultations, test results, etc.) to help the physician at the provider site prepare for the teleconsultation.

EXISTING CLINICAL FORMS

  • Cardiology
  • Dermatology
  • Respiratory medicine
  • Women’s health
  • Mental health
  • Generic (for referring a patient to telehealth in all other specialties not listed above)

Specialty forms include the clinical information required for the provision of quality service. The maximum amount of clinical information about the patient’s condition should be provided on the request form or on a document attached to it. Failure to include certain details may result in rejection of the request by the physician at the provider site.

The procedure for accessing the web-based clinical request can be found easily in all the sections of this website at the bottom of the page.

Helpful Tips

  • As regards the place of the teleconsultation:
    • Teleconsultation should take place in a room that is private and that meets certain physical criteria required to ensure the transmission quality of images during the videoconferencing session.
    • To safeguard privacy during a teleconsultation, it is advisable to put up a notice outside the room in question that a teleconsultation session is in progress there.
    • The videoconferencing room should ideally be ready and the system should be plugged in 30 minutes before the time of the teleconsultation.
  • As regards the patient and other participants:
    • It should be ensured that the patient has read the leaflet that explains, among other things, telehealth services in videoconferencing.
    • One should verify whether the patient has received answers to all his questions.
    • Technical adjustments may be required because of visual and hearing deficits, especially in the case of older patients, so that teleconsultation sessions run smoothly. From the start of the consultation, the patient should be able to see and hear clearly.
    • All the people present at the requesting and provider sites should be introduced. At the beginning of the meeting, the cameras in both the sites should display all the participants on the screen by scanning the room. The patient has the right to prevent other people from attending the teleconsultation, unless his condition demands their presence.
    • Other relevant guidelines regarding teleconsultation should be given as follows:
      • Wait for a few seconds before speaking and after having spoken to avoid any interference.
      • Do not handle papers, pencils or other objects close to the microphone.
      • Look at the camera on the videoconferencing device (and not the screen) when talking.
    • The patient should be notified about the outcome of the teleconsultation and his follow-up.

Helpful tips for teleconsultation can be obtained by clicking on the right link.