Utah Telehealth Network (UTN)

Maintains master calendar of clinics and videoconferencing.
Give a copy of the signed Informed Consent for Telehealth Consultations form to the consulting practitioner prior to the patient exam. Place another copy in the Telemedicine Outreach Program files.
Set up video-conferencing equipment and be available to provide technical assistance as needed.
Maintain a log of each telemedicine session.

Telehealth Site Coordinator:

Work with the Telehealth Network Coordinator to maintain current schedule.
Provide a copy of the complete clinic schedule to the Telehealth Network Coordinator and to the Consulting Practitioners.
Verify the final patient schedule with the Telehealth Network Coordinator in advance of the clinic or session.
Inform the Telehealth Network Coordinator and Consulting Practitioners of any schedule changes or cancellations.
Fax the signed copy of Informed Consent for Telehealth Consultations form to the Telehealth Network Coordinator prior to the patient exam.
Provide pertinent patient care records to the consulting practitioner prior to the telehealth exam. Examples are; lab results, height and weight, food intake records, growth charts, diagnostic studies, etc.
Set up and maintain proper functioning of the video-conferencing equipment and be available to provide technical assistance as needed.

Date and time of appointment.
Names and professions of Presenting and Consulting Practitioners.
Address and room number(s) where telehealth consultation will take place.
Name and telephone number of a contact person for questions or appointment changes.

Verify that the patient has a valid informed consent form on file.
(The form is considered valid if it has been signed within the previous two years).
Pull pertinent information that is needed for the consultation and fax to the consultant.

For new telehealth patients, give patient The Telehealth Patient Information sheet and the Informed Consent for Telehealth Consultations form. Review the Telehealth Patient Information sheet and the Informed Consent for Telehealth Consultations form with the patient, answer any questions they may have, and obtain the appropriate signatures.
Place the original in the patient's file and fax a copy to the Telehealth Network Coordinator. For returning telehealth patients, verify that there is a valid informed consent form on file (The form is considered valid if it has been signed within the previous two years).

Necessary medical supplies and equipment
Medical peripherals (zoom camera and otoscope) are connected and working properly.

Introduce the patient and consulting practitioner to each other.
Give (or have the patient give) a brief patient health history or health update to the consulting practitioner including the primary patient complaint.
Make it clear to the patient that you are their advocate and that you and the consultant work as a healthcare team to provide them the best possible care.
Follow the consultants verbal and standing orders.
Document verbal orders received from the consulting practitioner regarding any tests or clinical procedures that need to be done.
Comply with your facility's Infection Control Policies and Procedures when presenting patients.
Always maintain patient confidentiality.
Schedule next telehealth consultation if necessary.
Allow time afterwards to discuss the patient visit with the consulting practitioner.

Follow up with the patient orders. Order any lab tests, etc., and forward them to the consultant.
Clean the examination room and equipment after each patient visit, following your facility's Infection Control Policies and Procedures. Also refer to 1.8 Caring for the Telehealth Equipment.

Verify that a signed Informed Consent for Telehealth Consultations form has been obtained.
Review with the presenter what is needed for a successful exam, such as:
- Medical peripherals - zoom camera, otoscope, document camera.
- Necessary supplies and equipment
- Age-appropriate assessment tools.

Ask the presenter to obtain the patient's verbal permission, if needed, to allow additional personnel, such as other nurses, residents, etc., to be present during the exam. Introduce these people to the patient. Document that the patient's permission was given.
Ask the presenter to obtain the patient's written permission, if video recording is to occur.

Conduct patient exam.
Discuss with presenter and patient whether patient requires further telehealth consultations, and clearly summarize the conclusions of the discussion.