[Nikole Mihill]

I was the provider meeting with a parent and baby for a follow up g-tube placement appointment. It was easier than I thought to conduct the appointment. I used the parent for information and assistance with the physical assessment. It would have been helpful to have a dietician with us because we discussed feeds, growth, and nutrition. I would of liked to have a peripheral stethoscope so that I could listen for bowel sounds to make sure I could hear them. I just asked mom about eating and pooping instead and was satisfied with her answers.

[Nikole Mihill]

Telehealth Model you would select and why (Store & forward, videoconferencing, RPM, mHEALTH, a combination)
The neonatal population would benefit from a combination of videoconferencing, store & forward, remote patient monitoring, and mHEALTH.
A combination of telehealth models would be a great for follow up appointments for Neonatal Intensive Care Unit (NICU) graduates. Many NICU babies leave the NICU but still require care from several
different specialties. For their safety NICU graduates should stay home as much as possible and not be out in the public or around crowds because they are fragile and immunocompromised. Depending
upon the baby’s comorbidities these babies could attend several follow up appointments a week. These appointments put the NICU graduate at risk, with remote patient monitoring and store & forward
some or most of these appointments could be done from the safety of their home. Having peripherals, smart phone, applications, and remote monitors, these specialties can continuously monitor the
patient and determine if they need to see the patient in person or if telehealth was sufficient.

The type equipment you would use (RPM, Store & Forward, mHealth, Videoconferencing, or a combination)
Peripherals- Stethoscope, scale, cardiac monitor, pulse oximetry, ultrasound, videoconferencing

The type population/healthcare issue you would address
Follow up appointment s for NICU graduates.

Your role in the program
Neonatal Nurse Practitioner in the NICU who follows up with NICU graduates as needed post discharge.

What you would evaluate about the program
I would evaluate if the telehealth models are working for the patient and for the provider. Determine if there is a need for change or improvements.

Legal considerations you would address
Informed consent from responsible caregiver, go by state laws regarding consents, and use HIPPA compliant platforms.

Other professions that you would like to involve
Cardiology
Dermatology
Pulmonology
Dietician
Gastrointestinal
Pediatric Surgery
Neurology
Durable medical equipment companies
Home health agencies
Pediatrician

Protocols you would develop
Ensure the equipment utilized would be HIPPA compliant, emergency protocols, a list of available telehealth providers, family education on telehealth, monitoring, and peripherals. To have
everything set up and tested prior to appointment. A protocol for when the patient must be seen in person.

How would you Consent the patient
Email consent to patient or upload the consent to the patient portal. Confirm with patient and check chart at the beginning of appointment.

[Nikole Mihill]

Diabetes Case Evaluation (Provider Haley Harger)
Telehealth Etiquette Checklist
Orientation 5
Verbal clarity 5
Active Listening 5
Patient-Focused 5
Tone of voice 5
Eye Contact 5
Other Body Language 5
Empathy 5
Rapport 5
Respect 5
Therapeutic Alliance 5
Environment 5

Telehealth Exam/ Education Rubric
1. 1
2. 1
3. 1
4. 1
5. 1
6. 1
7. 1
8. 1
9. 1
Total= 9

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