Category Archives: A Teleconsultation Proceeding

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.

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.

Responsibility at the technical support level

The objective of incident management is to restore the normal operation of services as quickly as possible and to minimize the negative impact on activities.

Incidents can be separated into two groups: minor incidents and major incidents

To ensure optimal technical support to RUIS McGill users who face a technical problem with videoconferencing equipment, the latter should immediately contact the coordinator of teleconsultation activities who acts as a liaison between users and the CECoT technical support.

Level 1

The main activities are as follows:

  • Receiving requests for assistance by phone with a single entry point (CECoT).
  • Attaching the unique identification code of the request number to the assistance requests.
  • Performing a first level diagnosis to determine the source of the problem.
  • Assigning requests to second level resources if the problem could not be solved.
  • Doing follow-ups to ensure that all requests are processed.
  • Preparing follow-up reports.

Level 2

In case of non-resolution of a first level diagnosis, the telehealth business analyst of the MUHC IT department will take over the assistance request. He will carry out more detailed checks within the RITM network in collaboration with partners like SOGIQUE or suppliers if required.

Level 3

In case of general failure (non-resolution of the problem), the telehealth business analyst of the MUHC IT department will coordinate the required technical resources of external partners (suppliers, SOGIQUE, TCR, institution) until the problem is finally resolved. This could require a change in the IP address programming code, and even the replacement of components.

 

Important points

1. Minor incidents – The allocation of human resources to various minor incidents is ensured by technical staff that is remotely supported by the event coordinators of the CECoT.

2. Major incidents – The allocation of human resources to various major incidents is ensured both by the chief telehealth technician and the IT technician of the CECoT.

3. The IT technician of the CECoT is responsible for analyzing recurring incidents with the same symptoms (problems) and must propose remedial action.

4. A detailed report must be prepared for all major incidents. The report should include the organizational and clinical repercussions of the incident.