Teledermatology consult pathway rev 2012 0411

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Teledermatology Consult Pathway

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  • This is an example of the Boston ordering menu. Each facility will have their own menu design.Some facilities will not have a separate order menu but use the consult hierarchy list instead.Prerequisite text is editable by the Clinical Applications Coordinator at each facility. The facility may edit the number of lesions that is allowed for the Teledermatology consult.
  • Here is your note from completing the Teledermatology Request Consult. It auto-fills your note into the Teledermatology Imaging Consult.
  • Option to select diagnosis from drop-down list that will be entered into the encounter for you. [Primary diagnosis] and [Add to problem list ]options are also available
  • At this point the dermatologist may fill in the headings as appropriate; encounter information should be complete other that any questions regarding service connected disability or environmental factors. Health factors have been entered with minimal information.
  • Teledermatology consult pathway rev 2012 0411

    1. 1. VHA Office Of Telehealth ServicesStore-and-Forward Boston Telehealth Training Center
    2. 2. Teledermatology Workflow Patient PCP PCP Patient Clerk or Imager Clerk or ImagerPresents to Orders Sends Patient to Presents to Receives CreatesPrimary Care Teledermatology Teledermatology Teledermatology Teledermatology appointment inClinic Request Consult Clinic Clinic Request Consult Teledermatology Clinic Imager Imager Imager Imager Imager Completes Request consult Completes Signs the Imaging Triggers Teledermatology note text encounter Teledermatology Consult updates to Request Consult Note transferred to data providing Imaging Consult pending at TeleReader reminder dialog Teledermatology Wk’ld credit Reading Site worklist template Imaging Consult for Acq Site reason for request Imager Imager Reader Reader Reader Selects Patient and Acquires Images sent Acknowledges Accesses Completes the consult in Imaging Dermatology to VistA notification of images via consult note Capture Images Imaging Teledermatology Telereader containing Imaging Consult Reader Template Reader Reader Imager & PCP PCP PCP Signs the note, Receive Views results of Follows consult Enters the encounter completing the notification of Teledermatology recommendations data, providing wk’ld Teledermatology consult Imaging Consult credit for Reading Site Imaging Consult completion 2
    3. 3. Completed by Primary Care Provider 3
    4. 4. Sample Order Menu and Prerequisite Text (YOUR FACILITY NAME) 4
    5. 5. (YOUR FACILITY NAME) 5
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    18. 18. Name, Patient Clinic LocationSSN DOB Provider Name Patient , Name SSN DOB PROVIDER, NAME PROVIDER, NAME 18
    19. 19. Name, Patient Clinic LocationSSN DOB Provider Name Provider, Name Provider, Name 19
    20. 20. Completed by Teledermatology Imager
    21. 21. Highlight consult;go to Action / Consult Results /Complete/Update Results;Select Note Title from list Date/Time Provider, Name-Title Complete template
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    35. 35. Name, Patient Clinic LocationSSN DOB Provider Name 35
    36. 36. Name, Patient Clinic LocationSSN DOB Provider Name 36
    37. 37. Name, Patient Clinic LocationSSN DOB Provider Name 37
    38. 38. Name, Patient Clinic LocationSSN DOB Provider Name PROVIDER,Name Provider, NAME 38
    39. 39. Name, Patient Clinic LocationSSN DOB Provider Name 39
    40. 40. Name, Patient Clinic LocationSSN DOB Provider Name /ES/ PROVIDER, NAME TITLE SIGNED: DATE AND TIME 40
    41. 41. Completed by Teledermatology Imager 42
    42. 42. If this message shows up, you need tosign your note from the previousconsult. Then restart the Imagerconsult. 43
    43. 43. Here is your note from completing theTeledermatology Request Consult. Itauto-fills your note into theTeledermatology Imaging Consult. 44
    44. 44. 45
    45. 45. /es/ Provider, NameTitleDate and time 46
    46. 46. Name, Patient Clinic LocationSSN DOB Provider Name Depending on your security key, you will either sign consult as the provider, or sign by policy
    47. 47. Name, Patient Clinic LocationSSN DOB Provider Name 48
    48. 48. Name, Patient Clinic LocationSSN DOB Provider Name 49
    49. 49. Name, Patient Clinic LocationSSN DOB Provider Name /ES/ PROVIDER, NAME TITLE SIGNED: DATE AND TIME 50
    50. 50. Name, Patient Clinic LocationSSN DOB Provider Name Provider, Name Provider, Name 51
    51. 51. Open Vista Imaging CaptureSelect Teledermatology consult configuration buttonSelect PatientSelect ConsultEnter date of image capture
    52. 52. PATIENT, NAME Patient, Name Patient, Name DOB SSN Sex SVC/NSC VETERANPATIENT, NAME SSN 53
    53. 53. Patient, Name Select appropriate patient from list-make sure consult number matches consult in CPRS 54
    54. 54. Patient, Name SSN Capture all images according to protocol 55
    55. 55. Recommended protocol: Use card reader (approved by Information Security and configured on computer by IT staff ) Take required images using camera with SIM card Remove card from camera and insert into card reader Drag and drop images into Vista Imaging Capture Click [Study Complete] when finished Open Vista Imaging to confirm all images were captured and imported into Vista Imaging under the correct consult and patient Remove SIM card from card reader and return to camera Delete images from SIM card
    56. 56. Dermatologist receives alert in CPRS for pending consultProcess alert and review consultOpen TeleReader applicationSelect correct patient and consult in TeleReaderHighlight consult and [LOCK] for readingReview images in Vista ImagingComplete consult report in CPRS using reminder template
    57. 57. Completed by Teledermatologist 58
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    74. 74. Name, Patient Clinic LocationSSN DOB Provider Name 75
    75. 75. Name, Patient Clinic LocationSSN DOB Provider Name 76
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    82. 82. Name, Patient Clinic LocationSSN DOB Provider Name 83
    83. 83. Name, Patient Clinic LocationSSN DOB Provider Name Provider, Name /es/ Provider, Name Title Signed: Date 84
    84. 84. (Not ideal, but gets minimal required information capturedfrom template quickly—beneficial if working remotely andconcerned about network problems causing CPRS to closeprematurely prior to template completion) 85
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    90. 90. Name, Patient Clinic LocationSSN DOB Provider Name At this point the dermatologist may fill in the headings as appropriate; encounter information should be complete other that any questions regarding service connected disability or environmental factors. Health factors have been entered with minimal information. 91
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    92. 92. PCP and Imager receive alertregarding completed consultViewing results for Interfacility (IFC) consults: Consult tab / Action / Consult Tracking / Display Results
    93. 93. Follow up by Primary Care Clinic and/or Dermatology Clinicaccording to recommendations of TeleDermatologist
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