[Rebecca Waters]

The case I participated in was the developmental assessment case study. I was a mother of an ex-NICU baby that was living in a rural setting and had concerns about my child’s development. I was reaching out to a developmental NP for evaluation. Since the concerns that I brought up in the visit were mostly physical, PT/OT involvement or referral could be beneficial. A list of providers could have been suggested for follow-up. Using video recording could have been beneficial in this situation so that the provider could see exactly how limited the infant was when evaluating physical development. Videos of the infant trying to crawl or stand would better enable the provider to see how limited or advanced the infant is in development.

Link to the zoom video:

Telehealth Etiquette Checklist

Group #: 3

Patient Case: Developmental Assessment

1. Orientation
Rating: 5
2. Verbal Clarity
Rating: 5
3. Active Listening
Rating: 5
4. Patient-Focused
Rating: 5
5. Tone of Voice
Rating: 5
6. Eye Contact
Rating: 5
7. Other Body Language
Rating: 5
8. Empathy
Rating: 5
9. Rapport
Rating: 5
10. Respect
Rating: 5
11. Therapeutic Alliance
Rating: 5
12. Environment
Rating: 4

Overall Rating: 5

Coaching comments:
Emily did an amazing job of connecting with me as the pt even though we were remote. I could tell she was actively listening and discussed the benefits of using telehealth appointments, especially for this pt who lives in a rural area with limited access to in-person visits.

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

[Rebecca Waters]

Telehealth model:
I would like to set up a telehealth platform that would provide newborn visits to new parents. Many times new parents do not want to bring their newborns into the pediatrician’s office and possibly expose them to different germs which places them at risk for infection. By offering telehealth options for these visits, the parents and newborn could stay in the safety and comfortability of their own home while still allowing a PNP to check in on them and assess how the baby is adjusting.

Equipment:
A device with video streaming capabilities would be needed on both ends. This could be either a laptop, smartphone, or tablet. Video access would need to be available so the PNP could see the infant and assess for things such as possibly jaundice coloring. Store and forward capability would also be beneficial to have access to the patient’s chart in the future for other providers. A scale would also be needed for parents to weigh and report weight gain in the infant.

Type of population:
Infants, primarily newborns

Roll in the program:
Provider of the care as a PNP

Outcome evaluations:
Increased access to care for newborn infants whose parents don’t have convenient
access to care.
Decreased newborn infection/illness rates.
Increase in patient/parent’s care satisfaction.

Legal considerations:
HIPPA

Other professionals:
To begin it would just require the PNP, but if it is successful, then it could be expanded to include other specialists for the infant such as PT/OT/Speech, cardiology, pulmonology, and neuro.

Protocols:
There would be a set list of things I would need the parent to check and report to me at the beginning of each visit. This could include, weight, head circumference, height, and temp. This set of vitals would be necessary to ensure the patient is not in any acute distress and is growing well. I would also instill protocols on how to immediately get the patents and infant to a care facility should I believe immediate in person medical care was needed.

Consent:
I would require the written consent of the parent to conduct newborn/infant appointments through telehealth prior to treating. I would obtain this consent verbally over the phone with a witness. This consent would be good for one year and then need to be obtained again.

[Rebecca Waters]

Telehealth model:
I would like to set up a telehealth platform that would provide newborn visits to new parents. Many times new parents do not want to bring their newborns into the pediatrician’s office and possibly expose them to different germs which places them at risk for infection. By offering telehealth options for these visits, the parents and newborn could stay in the safety and comfortability of their own home while still allowing a PNP to check in on them and assess how the baby is adjusting.

Equipment:
A device with video streaming capabilities would be needed on both ends. This could be either a laptop, smartphone, or tablet. Video access would need to be available so the PNP could see the infant and assess for things such as possibly jaundice coloring. Store and forward capability would also be beneficial to have access to the patient’s chart in the future for other providers. A scale would also be needed for parents to weigh and report weight gain in the infant.

Type of population:
Infants, primarily newborns

Roll in the program:
Provider of the care as a PNP

Outcome evaluations:
Increased access to care for newborn infants whose parents don’t have convenient
access to care.
Decreased newborn infection/illness rates.
Increase in patient/parent’s care satisfaction.

Legal considerations:
HIPPA

Other professionals:
To begin it would just require the PNP, but if it is successful, then it could be expanded to include other specialists for the infant such as PT/OT/Speech, cardiology, pulmonology, and neuro.

Protocols:
There would be a set list of things I would need the parent to check and report to me at the beginning of each visit. This could include, weight, head circumference, height, and temp. This set of vitals would be necessary to ensure the patient is not in any acute distress and is growing well. I would also instill protocols on how to immediately get the patents and infant to a care facility should I believe immediate in person medical care was needed.

Consent:
I would require the written consent of the parent to conduct newborn/infant appointments through telehealth prior to treating. I would obtain this consent verbally over the phone with a witness. This consent would be good for one year and then need to be obtained again.

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