1.
VHA Office Of Telehealth Services
Store-and-Forward Boston Telehealth
Training Center

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.
Completed by Primary Care Provider
3

4.
Sample Order Menu and Prerequisite Text
(YOUR FACILITY NAME)
4

5.
(YOUR FACILITY NAME)
5

6.
6

7.
7

8.
8

9.
9

10.
10

11.
11

12.
12

13.
13

14.
14

15.
15

16.
16

17.
17

18.
Name, Patient Clinic Location
SSN DOB Provider Name
Patient , Name
SSN DOB
PROVIDER, NAME
PROVIDER, NAME
18

19.
Name, Patient Clinic Location
SSN DOB Provider Name
Provider, Name Provider, Name
19

20.
Completed by Teledermatology Imager

21.
Highlight consult;
go to Action / Consult Results /
Complete/Update Results;
Select Note Title from list
Date/Time
Provider, Name-Title
Complete template

22.
22

23.
23

24.
24

25.
25

26.
26

27.
27

28.
28

29.
29

30.
30

31.
31

32.
32

33.
33

34.
34

35.
Name, Patient Clinic Location
SSN DOB Provider Name
35

36.
Name, Patient Clinic Location
SSN DOB Provider Name
36

37.
Name, Patient Clinic Location
SSN DOB Provider Name
37

38.
Name, Patient Clinic Location
SSN DOB Provider Name
PROVIDER,Name
Provider, NAME
38

39.
Name, Patient Clinic Location
SSN DOB Provider Name
39

40.
Name, Patient Clinic Location
SSN DOB Provider Name
/ES/ PROVIDER, NAME
TITLE
SIGNED: DATE AND TIME
40

41.
Completed by Teledermatology Imager
42

42.
If this message shows up, you need to
sign your note from the previous
consult. Then restart the Imager
consult.
43

43.
Here is your note from completing the
Teledermatology Request Consult. It
auto-fills your note into the
Teledermatology Imaging Consult.
44

44.
45

45.
/es/ Provider, Name
Title
Date and time
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.
Name, Patient Clinic Location
SSN DOB Provider Name
48

48.
Name, Patient Clinic Location
SSN DOB Provider Name
49

49.
Name, Patient Clinic Location
SSN DOB Provider Name
/ES/ PROVIDER, NAME
TITLE
SIGNED: DATE AND TIME
50

50.
Name, Patient Clinic Location
SSN DOB Provider Name
Provider, Name Provider, Name
51

51.
Open Vista Imaging Capture
Select Teledermatology consult configuration button
Select Patient
Select Consult
Enter date of image capture

52.
PATIENT, NAME
Patient, Name
Patient, Name DOB SSN Sex SVC/NSC VETERAN
PATIENT, NAME SSN 53

53.
Patient, Name
Select appropriate patient
from list-make sure consult
number matches consult in
CPRS
54

54.
Patient, Name SSN
Capture all images according to protocol
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.
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.
Completed by Teledermatologist
58

58.
59

59.
60

60.
61

61.
62

62.
63

63.
64

64.
65

65.
66

66.
67

67.
68

68.
69

69.
70

70.
71

71.
72

72.
73

73.
74

74.
Name, Patient Clinic Location
SSN DOB Provider Name
75

75.
Name, Patient Clinic Location
SSN DOB Provider Name
76

76.
77

77.
78

78.
79

79.
80

80.
81

81.
82

82.
Name, Patient Clinic Location
SSN DOB Provider Name
83

83.
Name, Patient Clinic Location
SSN DOB Provider Name
Provider, Name
/es/ Provider, Name
Title
Signed: Date
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

85.
86

86.
87

87.
88

88.
89

89.
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

91.
92

92.
PCP and Imager receive alert
regarding completed consult
Viewing results for Interfacility (IFC) consults:
Consult tab / Action / Consult Tracking / Display Results

93.
Follow up by Primary Care Clinic
and/or
Dermatology Clinic
according to recommendations
of TeleDermatologist

94.
95