Teladoc Physician Training Module 6 | 2012 All material proprietary and confidential. Presented by Teladoc, Inc. Module 6: Performing a Medical Consultation 1. Prepare for the Consult 2. Perform the Consult 3. End the Consult All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult Note: You may only perform a consult on a patient who is registered with Teladoc. If a patient requests that you treat his/her child/friend who is not a registered member, you may not continue the consult. • • Explain to the patient that you cannot perform a consult for an unregistered patient or one who has not completed a medical history. Cancel the consult and ask the member to obtain assistance from 1.800.Teladoc so that the correct patient is scheduled. 3 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult Sample home page displaying the consult queue: 4 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Locking a Patient By locking the patient, you are indicating that you are able to serve them within 10 minutes of clicking the “Lock” button. Click “Lock”. Select the patient whose timestamp is closet to expiring. Timestamps are highlighted in Orange or Red and indicate the patient is close to reaching the guaranteed call back time. Do not lock the patient to “claim the consult” and then walk away to take care of other business. This action delays the patient from medical care, creates delays on the application, and prevents other doctors who are available from helping the patient. 5 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Home Page 6 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Alerts and QA Issues This displays any allergies listed in the patient’s health history questionnaire, as well as immunization information for pediatric patients. This section will remain open during the consult in case any new allergic reactions needed to be added. This area displays issues noted by the QA Physician. Information will display when a patient has either: • been submitted as a “problem patient” by a consulting physician • his/her account has been randomly placed under review by the site 7 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Past Consults and Rx This area displays a history of consultations that have taken place for this patient. This is VERY important information and helps you conduct an accurate consultation with the patient. This area displays current medications provided by the patient as well as any prescriptions ordered during past consults. 8 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Problems and Social History This displays medical history provided by the patient on the health history questionnaire. Answers will display as “Yes” if the patient entered as past history or “Current” if a current condition. This area displays answers to the social questions on the health history questionnaire. 9 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Encounters and Family History This area displays any previous visit or hospitalization information provided by the patient. This area displays family history provided by the patient on the health history questionnaire. 10 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Healthcare Providers and Labs This area displays the patient’s physicians and associated specialties. This area displays lab results provided by the patient. 11 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Claims and Image Attachments This area displays reported claims data for patient when possible. This area displays images that the patient would have sent in. 12 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Preview and Call Step 1 Review the entire record thoroughly before getting the patient on the phone (Preview Screen). Be sure to check each box in the bottom of each session. Step 2 Dial *67 (to block your number from being broadcast) and the patient’s primary number indicated on the preview screen. 13 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for Consult: Patient Can’t be Reached First and Second Attempt Leave the following message if this is a first or second attempt to reach the patient: Third Attempt Leave the following message if this is the third attempt to reach the patient: “This is Dr. ______ from Teladoc. You requested a consult. Because I have been unable to reach you at the number you provided, I am required to place you back on the waiting list. Your call back guarantee will start over and another attempt will be made to reach you. If we are unable to reach you after three attempts, your request will be cancelled without a charge. Thank You.” “This is Dr. ______ from Teladoc. You requested a consult. We have made three attempts to reach you at this number you provided. We are required to cancel your request. If you would still like to use our service, please logon and request a new consult or call 1800TELADOC. Thank You.” 14 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Preview and Call This section is for any notes you need to make about reaching the patient. Click “Continue” if you reach the patient. Patient’s primary and secondary phone number. If the patient can not be reached, please choose an option from the dropdown menu. 15 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Verify the Patient Verify the patient’s name and that they have provided you with a true and complete medical history. Verify the patient’s date of birth. Once the patient is verified, hit “Continue”. 16 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Minors When giving consults involving minors, you are required to speak with a parent/guardian or authorized consenter authorized on the account. This person’s name is noted on the consult page and will be noted appropriately in the scripting. 17 All material proprietary and confidential. Presented by Teladoc, Inc. Prepare for the Consult: Medicine Teladoc encourages evidence based medicine by: • Embedding hyperlinks such as AMA and WebMD • Implementing antibiotic programs: • • AWARE (aware.md) CDC GET SMART (cdc.gov/getsmart) This should not supersede your judgment. 18 All material proprietary and confidential. Presented by Teladoc, Inc. Module 6: Performing a Medical Consultation 1. Prepare for the Consult 2. Perform the Consult 3. End the Consult All material proprietary and confidential. Presented by Teladoc, Inc. Perform the Consult: Complaint and Symptoms In the Symptoms search box, type in the first few letters of the symptom and select from the drop down box. Once entered, click “Add”. The symptoms added will display in the listing underneath the search box. Added Symptoms. Click “Confirm” to advance. Using the drop down box, choose the chief complaint. Consults should be limited to one overall chief complaint. If the patient begins offering multiple complaints, politely ask the patient to state the primary reason for the call and/or refer the patient to seek in-person care. 20 All material proprietary and confidential. Presented by Teladoc, Inc. Perform the Consult: SOAP Notes This is the area for you to add your notes relative to this consult. Please be precise and accurate with your documentation. These medical records are portable, meaning the patient can request a copy or have these records sent to their PCP. Please make sure to keep the notes professional and to the point. Information that is in this section will be used for future consults that this patient has. 21 All material proprietary and confidential. Presented by Teladoc, Inc. Perform the Consult: Diagnosis In the Diagnosis search box, type the first couple of letters of the diagnosis and select from the drop down box. Once entered, click “Add”. The diagnosis added will be displayed. Click “Confirm” to advance to the next screen. 22 All material proprietary and confidential. Presented by Teladoc, Inc. Perform the Consult: Add a Prescription If you are wanting to add a prescription, click “Yes” and then click “Add Prescription”. If no prescription is necessary, click “No” and then click “Continue”. 23 All material proprietary and confidential. Presented by Teladoc, Inc. Perform the Consult: Follow Up You are required to recommend follow-up instructions to the patient. Read the selected statement to the patient as you are filling in the recommendations. 24 All material proprietary and confidential. Presented by Teladoc, Inc. Module 6: Performing a Medical Consultation 1. Prepare for the Consult 2. Perform the Consult 3. End the Consult All material proprietary and confidential. Presented by Teladoc, Inc. End the Consult If you did not complete required data, a message in red bold text will display telling exactly what was missed. Review what has been entered, and if the records are finished, click “Complete” to finish the consult. You will then be returned to the Home page. 26 All material proprietary and confidential. Presented by Teladoc, Inc. Contact us: Amy McKay Clinical Director (214) 302-5205 amckay@teladoc.com Boyd Harbour Physician Recruiter (214) 302-5228 bharbour@teladoc.com © 2012 Teladoc, Inc. All right reserved. Teladoc and the Teladoc logo are registered trademarks of Teladoc, Inc. and may not be used without written permission. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. Teladoc phone consultations are available 24 hours, 7 days a week while video consultations are available during the hours of 7am to 9pm, 7 days a week. All material proprietary and confidential. Presented by Teladoc, Inc.