[Jaemie Katipunan]

The case I participated is the concussion case study. I was the patient that was playing soccer and hit the goal post and wanted to see if I had a concussion. A neurologist could be involved if the injury involved loss of consciousness. A CT scan can be the technology that could be used with this case if symptoms did not resolve within a certain time period.

Here is a link to the zoom video: https://drive.google.com/file/d/1xVaMvmtzy1Vyyi6rJPyleaW2MXmTEiyc/view?usp=sharing

Telehealth Etiquette Checklist
Group #: 2
Patient Case: Concussion

As you view each version of a video consultation, please critique how well the clinicians demonstrate interpersonal skills using this checklist of 12 Critical Behaviors. For each critical behavior, three to five competencies that support the behavior are listed. Indicate the rating from 1 to 5 that you think applies best about the performance of each Critical Behavior using the following response scale:
1 = very poor performance; 2 = poor performance; 3 = fair performance; 4 = good performance;
5 = very good performance.

You can also add Coaching Comments at the end that you might say to the clinician.

Critical Behavior
Competency
1. Orientation
Explained expectations for the televisit ü Expressed positive views of telecare
Checked for cultural/regional differences ü Introduced self
Explained role on the health care team
Rating: 4

2. Verbal Clarity
Used clear language
Avoids or explains abbreviations and technical language ü Clarified unclear statements as needed
Rating: 5

3. Active Listening
Used repetition and summarizing to reinforce information
Specifically invited questions
Checked for clear understanding of what the patient was saying
Avoided interrupting patient
Rating: 5

4. Patient-Focused
Explored problem impact in the patient’s life
Allowed the patient to set the pace for the consultation
Used adequate open-ended follow up questions to obtain a view of the whole health
problem
Rating: 5

5. Tone of Voice
Friendly
Softened tone when conveying emotional content
Used appropriate vocal volume and rate for patient understanding
Rating: 5

6. Eye Contact
Made eye contact before speaking
Appropriate length to enhance patient comfort ü Stayed visually attentive
Rating: 5

7. Other Body Language
Open posture- arms uncrossed (neutral/positive)
Appropriate and engaging facial expressions
Kept position facing patient/camera and unobscured
Limited distracting movements or note-taking
Appeared comfortable in the virtual environment
Rating: 5

8. Empathy
Conveyed empathy nonverbally
Showed openness to patient’s emotions
Showed acceptance of patient’s emotions
Responded to patient’s nonverbal indicators of emotional state
Used silences to facilitate the patient’s expression of thoughts and feelings
Rating: 5

9. Rapport
Created rapport
Encouraged patient to express self
Showed interest in the patient as a person
Rating: 5

10. Respect
Acknowledged patient’s coping efforts
Accepted legitimacy of patient’s views and feelings; is not judgmental
Rating: 5

11. Therapeutic Alliance
Responded to patient with emotional vs. informational comments, appropriately ü Collaborated with decision-making
Offered partnership
Dealt with embarrassing topics sensitively
Rating: 5

12. Environment
Limited background noise or distractions ü Explained role of any others present
Explained setting
Assured privacy of patient consultation
Rating: 4

Overall Rating
Coaching comments: 5
Rebecca did a great job on the telehealth meeting as a provider. She touched on most of the proper etiquette for a telehealth meeting.

Please provide your general feedback on using the checklist here.
The checklist was helpful in knowing the characteristics on how to conduct an appropriate telehealth meeting.

Telehealth Exam/Education Rubric
Group #: 2
Patient Case: Concussion

1. Identifies reason for the visit; Check
2. Confirms that patient agrees with the reason for the visit and accepts; Check
that it is delivered by telehealth; Check
3. Obtains history of symptoms or situation; Check
4. Obtains approaches/treatments patient has taken to address the issue; Check
5. Conducts an appropriate physical using equipment at home, and/or other individuals to assist or provides telehealth education using appropriate learning style; Check
6. Discusses findings/Overview of education; Check
7. Develop plan (follow-up, referral, medication, etc.); Check
8. Determines patient’s understanding of plan/education; Check
9. Determines how patient will get information on the visit (email,
portal, secure text, etc.); Check

Check

Total (1 point each) 9/9

[Jaemie Katipunan]

As a PNP, the telehealth model I would select is videoconferencing because you can talk and see the patient live. The type of equipment I would use for videoconferencing is a computer, tablet, or smartphone that has access to video and a microphone. The type of population I will see is pediatrics and a healthcare issue I would address is health and wellness, such as healthy eating habits and exercise. My role is to promote the benefits of telehealth and to reach patients and families that may not have access to a physical physician’s office or does not have the time to go to the office. In order to evaluate the program, I would need to collect data in health outcomes, the value of the healthcare delivery, and patient and provider experience. HIPAA, consent to telehealth, online prescriptions, and state/federal guidelines are the legal considerations I would address. I would like other interdisciplinary members, such as physicians, OT, PT, ST, mental health, and social work, to be involved so that we can work as a team. There are protocols I would develop when using telehealth, such as contacting patients, obtaining consents, preparing for the telehealth videoconference, understanding the state/federal guidelines, and following up with the patient. Verbal or written consent would be the ways I would obtain consent.

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