The Basics of Telehealth Assessment and Treatment
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 |
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Start of the consultation |
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The consultation |
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Closing the consultaion |
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After the consultation |
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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
Recommendations to the Organizers[edit | edit source]
Telehealth networks must be establishes, preferably standardized software or systems
Consulting and refereeing sites must be made available , probably like a smaller unit for immediate consultation when required
Standardized, goal oriented and time driven protocols must be in place for the efficient delivery of rehabilitation services specially in he acute phase
Continuing education and mock simulation conditions are suggested to continually train and update professionals offering services[3]
It neere means that telerehab includes one mode of communication. Infact to optimize reults and adehrence
Patient guide:[edit | edit source]
- Decide what type of a consultation you would like or need (telephone consultation works well if a video isn't necessary). Video consultations are more reassuring due to the visual feedback.
- Ensure your details last updated at the hospital are your current details (email id, phone number). locate a quite place, with good connectivity to the internet. test the device you will be using prior to the consultation. Make sure the Physical therapist has your credential details to know it is you and to respond timely. Login to the connection a few minutes prior to the consultation
- During the process of the consultation, you can look at the screen, it isn't mandatory to look at the camera as this may be difficult. Any questions that require verification can be clarified. If the connection is disrupted in between , reconnect the call
- Make sure to follow u on anything you have agreed to.
Evidences:[edit | edit source]
Stroke rehablitation:
Quality of life, Activities of daily living and upper limb function improved in the same capacity as that of face to face rehablitation. No adverse events reported with the practise of telerehablitation,
- ↑ 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]
- ↑ Blacquiere D, Lindsay MP, Foley N, Taralson C, Alcock S, Balg C, Bhogal S, Cole J, Eustace M, Gallagher P, Ghanem A. Canadian stroke best practice recommendations: Telestroke best practice guidelines update 2017. Int J Stroke. 2017 Oct;12(8):886-95.