Build Your Practice Contents

Telemedicine Directory 2

Clinical Protocols 8

Establish Your Practice 14

Clinical Consultation 16

Communicating Your Practice 18

Telemedicine Directory

The OTN telemedicine directory provides members with easy access to telemedicine consultants, programs and sites. It’s a secure place to promote, coordinate and manage services offered through Telemedicine.

Searching the Directory

To access the telemedicine directory, click on the Directory link from within the OTNhub. From here you’ll be able to make searches by person, site name, specialty and place. If you are not sure of a name, you can use the first three characters to maximize your search results.

Searching the Directory

You can further narrow your searches by utilizing the filter features. For instance, you can choose to search for only people who are physicians and are accepting Videoconferencing referrals.

You can also filter results based on information associated with a Profile and/or a Location. To view the filter options, please click the Show Filters link. This brings up an option box where you filter people based on profile, profession, specialty, location, accepting referrals and wait times. Furthermore, you can search by place using variables such as the types of peripherals supported as well as specific site information. You can select one or multiple filters when narrowing your search results. Click anywhere on the browser screen to view your search results.

Site Finder Tool

The Directory site finder tool enables you to initiate a proximity search.

For instance, if you enter a full or partial address the directory displays a Google map identifying OTN sites located near the address provided. This is a great tool when determining if a site is convenient and suitable for a patient.

Google Map Location

In many cases, if you just type the location, city or town name when initiating a search,

the directory will automatically display an embedded google map of the location. Simply

click the link to view a full map view including your search results. You can further

narrow your search by clicking the filters link.

When you rollover a specific marker, you can view a sites address and get directions

instantly. When you click the title of interest, the profile screen appears that includes

key information such as the services and programs offered, the clinical protocols,

coordinator contact information as well as resources available at the site.

Viewing Other Profiles

To view the profile page, please click on the profile link of interest. A person or site’s profile details contains demographic and contact information about the person or site as well as information about the telemedicine services they are involved with. The action buttons appear on the profile depending on the OTN services that the member is registered for.

Action Buttons

The action buttons include: adding a person to your favorites in the OTNhub (star & plus), starting a videoconference call (camera), submitting an eConsult (speech bubble) and printing a hardcopy of the profile details (printer icon).

Updating Your Profile

Building and updating your profile in the directory helps you manage your Telemedicine

practice the way you want, while giving referring physicians greater access to your

specialized areas of practice. Your profile provides vital information about the services

you offer, including specialized areas of practice, protocols and relevant referral and

scheduling instructions. Keeping an up-to-date profile in the Telemedicine Directory

helps you advertise, coordinate and manage the services you offer via telemedicine. To

update your profile, click your user name in the far right corner of the top banner. Select

the My Directory Profile link from the drop-down menu. Your Profile Details screen will

appear. If you need to make any alterations to your profile, click the Edit Profile button

at the top of the screen. After you’ve updated your profile always click the save button to

validate the changes made.

For further documentation on the Telemedicine Directory, please visit the Help section

at tm.otn.ca

1

www.otn.ca

Te lemedicine’s Leader

What is a Telemedicine Clinical Protocol?

A clinical protocol provides an overview of your telemedicine service offering including the types of patients you will see, the process of scheduling/referring, any documentation required, and your expectations regarding the telemedicine equipment and etiquette for the session.

• Decreasing the number of inappropriate referrals: f/u vs new etc.

• Outlining referral process, including any information necessary for the referral to be accepted

• Scheduling procedures: patients, patient sites and OTN systems

• Identifying any patient preparation/information necessary prior to the consult

• Identifying the skill set necessary to present the patient

• Providing a list of what medical peripheral devices and/or supplies you will need for the exam, for example patient exam camera, electronic stethoscope, otoscope, measuring tape, reflex hammer, etc

• Indicating how and when diagnostic imaging should be completed prior to consult

• Specifying any special equipment positioning requirements (both telemedicine equipment and clinical equipment) or furniture arrangements.

Clinical Protocols

Advantages of Having a Clinical Protocol

Tips for Creating a Clinical Protocol

1. You can do it yourself or have your admin staff do it – here is a link to the clinical protocol template as well as a guide for completing the template (this will also be in the PDF guidebook)

2. Here are some example clinical protocols (RMs to identify good links that exist in the Telemedicine Directory)

3. It is a good idea to develop and include a patient assessment record or data form as part of the Telemedicine clinical protocol (this is a patient information sheet) – here is an example

4. People to consult for help: an existing Telemedicine Coordinator at your site, or your Regional Manager

CONSULTANT CONTACT INFORMATION & PRIMARY PRACTICE LOCATION Name: The Consultant’s preferred abbreviation, given name or forename,

and family name or surname. Organization: The organization name where the physician’s primary office is

located. LHIN: The unique identification number of the Local Health Integration

Network (LHIN) where the consultant’s primary office is located (a number between 01 and 14, inclusive).

Street Address: The street name and civic number of the physician’s primary office. Floor/Suite: The unit, floor, suite, or apartment number of the physician’s primary

office. City: The city name where the physician’s primary office is located. Province: The province name where the physician’s primary office is located. Postal Code: The postal code of the physician’s primary office. Country: The country name where the physician’s primary office is located. Phone Number: The 10-digit office telephone number of the physician’s primary

office. Eg. 555-555-5555 x123 Fax Number: The 10-digit fax number of the physician’s primary office. Primary e-mail Address: The physician’s email address for receiving telemedicine-related or

OTN communications. Alternate Phone Number: If available, a secondary 10-digit telephone number for the

physician. TELEMEDICINE PRACTICE INFORMATION Physician: If yes, the consultant is a medical doctor.

If no, the consultant is another type of health care provider. For example, a nurse practitioner.

Credentials: The professional certifications, registrations, license, and degrees held by the consultant. Eg. MD, FRCPC, MHSc, etc.

Primary Service: The main area of expertise for which the consultant offers telemedicine services. For example, a physician’s primary service could be Anesthesiology, Anatomical Pathology, Cardiac Surgery, etc. A non-physician’s primary service could be Psychology, Nursing, Radiotherapy, etc.

Secondary Service: The secondary area of expertise for which the consultant offers telemedicine services.

Other Service: Additional area of expertise for which the consultant offers telemedicine services.

Specialized Areas of Practice:

Languages and other abilities, services, or specific conditions treated. Eg. Service in French, manage Diabetes patients, etc.

SCHEDULING, REFERRAL AND CLINICAL INFORMATION Referrals: Identifies whether the physician accepts:

- Both initial and follow-up telemedicine referrals - Only follow-up telemedicine referrals - Initial in-person referral with follow-up telemedicine referrals - N/A will be selected if you have other instructions to be put into the Scheduling and Referral Instructions box

Catchment Area Serviced:

The geographical district(s) from which the physician will accept patients\clients. Eg. All of Ontario or LHIN 2 (south west Ontario).

Scheduling and Referral Instructions:

Follow these instructions to make an OTN telemedicine referral or schedule a telemedicine appointment with the physician. Eg. Use the OTN referral form. All Referrals will be faxed to the Telemedicine contact fax number below. Call the TM contact for inquiries regarding this intake process.

Clinical Protocol and Forms:

Links to OTN-posted procedural documents and forms for use by patient sites to help them properly prepare for and conduct a clinical session with this physician (Maximum 3 forms or protocols)

Support and Resources Required at Patient Site:

Information and instructions about the physician’s specific support or resource requirements for participant sites. Eg. the physician requires that a nurse be present during all clinical consultations which involve a patient.

Telemedicine Clinic: Indicates whether the physician sets a regular block of time aside to provide patient care via telemedicine. Patients are usually seen back-to-back as in an in office clinic.

Clinic Availability Dates/Times:

The dates and times of the consultant clinic.

Average Wait Time: Average wait time for a telemedicine appointment 0-30 days 1-3 months 3-6 months > 6 months

Uses NCompass Scheduling:

The level of use of Ncompass to schedule telemedicine events: self-service, assisted, or full-service scheduling.

CONSULTANT’S TELEMEDICINE CONTACT PERSON (CAN HAVE MORE THAN 1) Telemedicine Contact Person 1 Name: The telemedicine contact person’s preferred abbreviation, given

name or forename, and family name or surname. Title: The telemedicine contact’s job title. Phone Number: The telemedicine contact’s 10-digit office telephone number. Fax Number: The telemedicine contact’s 10-digit office fax number. Telemedicine Contact Person 2 Name: The telemedicine contact person’s preferred abbreviation, given

name or forename, and family name or surname. Title: The telemedicine contact’s job title. Phone Number: The telemedicine contact’s 10-digit office telephone number. Fax Number: The telemedicine contact’s 10-digit office fax number. ------------------------------------------------------------------------------------------------------------------------------- FOR OTN OFFICE USE ONLY: Publish To Profile: Pending Comments: Pending account registration and consent

CONSULTANT CONTACT INFORMATION & PRIMARY PRACTICE LOCATION Name: Organization: LHIN: Choose an item. Street Address: Floor/Suite: City: Province: Postal Code: Country: Phone Number: Fax Number: Primary e-mail Address: Alternate Phone Number: TELEMEDICINE PRACTICE INFORMATION Physician: Choose an item. Credentials: Primary Service: Secondary Service: Other Service: Specialized Areas of Practice:

SCHEDULING, REFERRAL AND CLINICAL INFORMATION Referrals: Choose an item. Catchment Area Serviced:

Scheduling and Referral Instructions:

Clinical Protocol and Forms 1:

Clinical Protocol and Forms 2:

Clinical Protocol and Forms 3:

Support and Resources Required at Patient Site:

Telemedicine Clinic: Choose an item. Clinic Availability Dates/Times:

Average Wait Time: Choose an item. Uses NCompass Scheduling:

Choose an item.

CONSULTANT’S TELEMEDICINE CONTACT PERSON (CAN HAVE MORE THAN 1) Telemedicine Contact Person 1 Name: Title: Phone Number: Fax Number: Telemedicine Contact Person 2 Name: Title: Phone Number: Fax Number: ------------------------------------------------------------------------------------------------------------------------------- FOR OTN OFFICE USE ONLY: Publish To Profile: Pending Comments: Pending account registration and consent

1

www.otn.ca

Te lemedicine’s Leader

Overview

In addition to the logistical details of setting up a telemedicine practice, it is important to consider several key elements when developing a telemedicine porgram. Here are five items that are important to determine prior to the first patient appointment.

Determine the Client Population

• Telemedicine appointments can be booked as follow-ups for current patients.

• In order to grow the patient base, new patients can have their initial consultation via telemedicine.

• Contractual relationships with specific sites or programs can be fulfilled via telemedicine, thereby limiting costly travel.

Identify How Referrals will be Received

• Modify referral forms to include and advertise telemedicine services.

• Determine what additional tests or information are required in order to conduct an efficient telemedicine consultation.

• Recognize and outline the timelines that are necessary for the information to be at the consultant site prior to the telemedicine event.

Determine Patient Support for Telemedicine Consultations

• A family support person may be sufficient for your telemedicine service.

• If a health care provider is required, identify if a speicific skill-set is needed (e.g. Rheumatology needs either an OT or PT to conduct an appropriate joint assessment.

• Ensure your telemedicine clinical protocol is up to date and identifies the requirements for patient support.

Establishing Your Telemedicine Practice

Tips for Developing a Telemedicine Program

2

www.otn.ca

Te lemedicine’s Leader

Establishing Your Telemedicine Practice

Tips for Developing a Telemedicine ProgramEstablish the Scheduling Structure for Clinics• Clinics could be “one offs” that fit into the existing schedule as required.

• Clinics can be scheduled in blocks with one specific site.

• Clinics can be blocked to multiple sites one after another.

Identify a Support Person for the Telemedicine Program• Outline their job duties and role (scheduling clinics, verifiying appointments, supporting patients

during telemedicine events, etc).

• Identify training requirements (for both the support person and the consultant).

1

www.otn.ca

Te lemedicine’s Leader

OverviewIt is important to identify the key steps involved in facilitating a successful telemedicine appointment. These are typically divided into three main sections: pre-consultation, during the consultation and after the consultation.

1. Verify that the patient appointment is scheduled in Ncompass.

2. Ensure the consultant has the patient referral form.

3. Ensure the consultant has the patient chart and any relevant test results.

4. If consultant is using a room-based system, they should have the event ID, site number and global address (GAB) of the patient site in order to place the call.

5. If consultant is using personal videoconferencing, they should locate the event in their calendar in the Telemedicine Centre in order to place the call.

6. Always verify the date and time of the telemedicine appointment.

7. Hang a “Private: Telemedicine Session in Progress” sign on the door, or ensure the consultant has a private area for the telemedicine appointment.

8. Turn on the videoconference system.

9. Have all appropriate phone and fax numbers available (e.g. Patient site, OTN Service Desk).

Clinical Consultations

Pre-Consultation

During the Consultation1. Unmute the microphone and introduce everyone in the room. Obtain the patient’s date of birth for verification purposes.

2. The patient site should use the presets to frame the patient, or allow the consultant to use far end control to frame the patient.

3. Obtain the fax number for the patient’s pharmacy if a prescription is required.

4. Arrange any follow-up lab work through a consultant note that goes back to the patient’s primary physician.

5. End the call and shut down the system or place it on the privacy preset.

After the Consultation1. Arrange any follow-up appointment for the patient.

2. Remove the privacy sign from the door.

1

www.otn.ca

Te lemedicine’s Leader

Tip 1: Send information letter to referring sites• Create and send an Information Letter to your referrers detailing your telemedicine

program and process for referring.

• There is an example of an information letter on page 3 of this booklet.

Tip 2: Create a clinical protocol• Create your clinical protocol and distribute it to those that have expressed

interest.

• Please see the module on clinical protocols for more information.

Tip 3: Include telemedicine on your referral sheet• Incorporate a telemedicine option into your existing referral sheet.

• This could be an extra bullet point or a tick box.

Top 10 Communication Strategies

Communicating Your Telemedicine Practice

Tip 4: Promote your program to telemedicine coordinators• Promote your telemedicine program at OTN’s monthly Telemedicine

Coordinator meetings .

• Promote your services in OTN Update, a bi-monthly newsletter for Telemedicine Coordinators .

• Contact marketing@otn.ca for more information.

Tip 5: Self-refer your telemedicine appointments• Your own patients are an excellent resource with which to promote and grow

your service.

• Self-refer follow up appointments to occur via telemedicine.

2

www.otn.ca

Te lemedicine’s Leader

Tip 6: Create a poster or pamphlet for use in your office space• Create a poster that you can hang in your waiting area to promote your telemedicine

practice.

• Design a pamphlet that you could hand out to your patients.

• There are examples of posters and pamphlets in pages 4 and 5 of this booklet.

Tip 7: Create your profile in the OTN Telemedicine Directory• Post your profile on the OTN Consultant Directory.

• Please refer to module 2 in the “Set Up Your Practice’ section for more details on how to create your profile and how to access the telemedicine directory.

Tip 8: Use your local news media• Local news media (television, radio, newspaper) are always an option to

promote new and exciting innovative health care practices.

• Contact marketing@otn.ca if you would like assistance in engaging your local news media or to advertise successes or milestones of your telemedicine practice.

Top 10 Communication Strategies

Communicating Your Telemedicine Practice

Tip 10: Use Ncompass to schedule your appointments• Take advantage of OTN’s self-scheduling software (Ncompass) to allow your

administrative staff to coordinate and book your telemedicine appointments.

• This will make the process easy and efficient to set up your new telemedicine service with other health care teams and providers.

Tip 9: Engage your OTN Regional Manager• Work with your OTN Regional Manager to find partnerships and provide your

service to areas that are in need.

• This is especially useful if you are accepting new patients.

• If you do not know your OTN Regional Manager, call us at 1-866-454-6861 and select option 3 or email: information@otn.ca to find out more..