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Tips for Telehealth

This page is in development and more resources will be added soon.

Technology considerations:

  • Familiarise yourself with the telehealth platform and its functions.
  • Consider having 2 screens (phone, laptop/computer, tablet)
  • Troubleshoot technical issues before your first visit (ensure the app is downloaded and functioning). Check sound and webcam if possible before visit.  Can try calling a friend using another app like Messenger or Face Time
  • Ensure all your devices are charged and have the chargers handy in case your battery drains
  • Close other apps/programs prior to visit to improve speed/connectivity
  • Platform specific issues: 
    • Some platforms enable you to take stills and include them in the patients record.  
    • Consider using a virtual background with your hospital logo or design. Web-around backgrounds can be attached to your chair as well. 
    • Some platforms allow invite functions to allow for multidisciplinary clinics or having other members of care team be present.
    • Learn the different functions such as locking the visit (to ensure privacy).
    • Learn the difference between leaving the waiting room vs exiting the waiting room.
    • Learn how to record the consultation in the electronic medical record.
  • You may need to switch views during visit (normal view vs 'selfie'/front camera view). Sometimes you can show them the medical record by switching views from your second device.
  • Think through logistics of camera set up how to get the best views of each part of the body
  • Be prepared for issues to arise. Have a phone number for the family in case the video doesn’t function so that you can at least have a telephone check-in. 

Preparing the family for telehealth clinics:

  • Send the weblink and instructions to the family beforehand.
    • Include a copy of the consent which will be taken verbally.
    • Include pictures of the V-pGALS manouvres for the examination portion of the visit.
  • Advise that likely to take 45-60 minute follow up appointment.
  • Advise that consent will be verbal and taken at the start of the consultation.
  • Children don’t have to be present/participate in the history portion of the visit.
  • Request family to prepare by finding a quiet space where their internet is good, with good lighting and adequate room where the child can walk around (where the child can walk at least 5 feet in one direction), to be seen on the camera and also sit on the floor.
  • Have family be ready and prepared 10 minutes before time.
  • Have child wear a t-shirt, preferably sleeveless, and shorts (no socks or shoes).
  • If feasible have chair available for patient to sit on and have a sofa or bed or table close where the child can be watched lying down for knee and hip range of motion. 
  • Bring medications to the room where they are doing telehealth.
  • Have any laboratory tests and imaging ready for review. 
  • With younger children play ‘Simon Says’ or ‘Follow the Leader’.
  • Have family email pictures ahead of time to a dedicated email: resolution to visualise rashes is much better through pictures than the video screen.
  • If family is using a tablet or phone with both a “selfie” and a more traditional view-finder camera, use the selfie side for the history and then switch to the view-finder side for portions of the physical exam. 
  • Instruct the family to hold phone overhead to visualize certain joints (like hands and knees, especially). Have the parent hold the tablet or phone sothat you can see the entire child as they walk, etc.
  • Have someone else present / available for at least part of the visit (even if patient>18 years old) to hold device during examination.
  • Creativity can be used for physical examination tools:
    • Ask families to utilize a tape measure to evaluate muscle atrophy, jaw excursion and patient height.
    • Families should use at-home scales to measure a current weight.
    • Families can count heart rate and respirations over one minute, or can tap out a patient’s heart beat for the examiner to hear.
    • Smartwatch and smartphone data can be reviewed to determine a patient’s activity level, such as number of steps in a day and heart rate data.

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