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Teledermatology consult pathway rev 2012 0411

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Teledermatology consult pathway rev 2012 0411

  1. 1. VHA Office Of Telehealth Services Store-and-Forward Boston Telehealth Training Center
  2. 2. Teledermatology Workflow Patient PCP PCP Patient Clerk or Imager Clerk or Imager Presents to Orders Sends Patient to Presents to Receives Creates Primary Care Teledermatology Teledermatology Teledermatology Teledermatology appointment in Clinic 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 Location SSN DOB Provider Name Patient , Name SSN DOB PROVIDER, NAME PROVIDER, NAME 18
  19. 19. Name, Patient Clinic Location SSN 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 Location SSN DOB Provider Name 35
  36. 36. Name, Patient Clinic Location SSN DOB Provider Name 36
  37. 37. Name, Patient Clinic Location SSN DOB Provider Name 37
  38. 38. Name, Patient Clinic Location SSN DOB Provider Name PROVIDER,Name Provider, NAME 38
  39. 39. Name, Patient Clinic Location SSN DOB Provider Name 39
  40. 40. Name, Patient Clinic Location SSN 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 to sign your note from the previous consult. Then restart the Imager consult. 43
  43. 43. Here is your note from completing the Teledermatology Request Consult. It auto-fills your note into the Teledermatology Imaging Consult. 44
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  45. 45. /es/ Provider, Name Title Date and time 46
  46. 46. Name, Patient Clinic Location SSN 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 Location SSN DOB Provider Name 48
  48. 48. Name, Patient Clinic Location SSN DOB Provider Name 49
  49. 49. Name, Patient Clinic Location SSN DOB Provider Name /ES/ PROVIDER, NAME TITLE SIGNED: DATE AND TIME 50
  50. 50. Name, Patient Clinic Location SSN 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 VETERAN PATIENT, 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 Location SSN DOB Provider Name 75
  75. 75. Name, Patient Clinic Location SSN DOB Provider Name 76
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  82. 82. Name, Patient Clinic Location SSN DOB Provider Name 83
  83. 83. Name, Patient Clinic Location SSN DOB Provider Name Provider, Name /es/ Provider, Name Title Signed: Date 84
  84. 84. (Not ideal, but gets minimal required information captured from template quickly—beneficial if working remotely and concerned about network problems causing CPRS to close prematurely prior to template completion) 85
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  90. 90. Name, Patient Clinic Location SSN 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 alert regarding 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 Clinic according to recommendations of TeleDermatologist
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Editor's Notes

  • 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.
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