Telehealth consultations

Published: 30/05/2020

Safe and confidential telehealth consultations

  Phone calls

• Individuals requesting information - Confirm name, job title, department, organisation and telephone number

Record all the information in the notes

Consultations

• Prior to the consultation - ensure you have access to the patient’s available medical records
• Introduce yourself to the patient – “Hello this is … from the Hospital/ Community team/ GP surgery.”
• Confirm the patient’s name and date of birth
• Exclude any red flags
• Record the date and time of the call
• Record the consultation in the patient notes

(e-Learning for Healthcare, 2020a; NHS Health Education Thames Valley, 2016; Car and Sheikh, 2003

Leaving a voicemail / answer phone message

• Need to find a balance between confidentiality and protecting the patient’s health
• Consider:
• Nature and urgency of the contact
• Medium used to contact the patient

Ø  Mobile phone voice message is more likely to be received by the intended recipient

Ø  Landline voice message could be picked up by other members of the household

(Information Governance Alliance, 2019)

• Example of a voicemail message: “This is the Hospital/ Community Team / Surgery calling. Please call me back on ….”

Video conferencing

Prior to the consultation

• Ensure you have access to the patient’s available medical records

During the consultation

• Confirm the patient’s name and date of birth
• Confirm their telephone number in-case the video link fails
• Take consent for the video consultation
• Introduce everyone in the room (even those off camera) and ask the patient to do the same (or confirm they are alone)

Ø  For example: Physio says “I am in a shared room with other physiotherapists, but I am the only person who can hear this call.”

•        Record the consultation in the patient notes

(Greenhalgh et al, 2020)

Record keeping

Best practice checklist

•         Produce contemporaneous records
•         Information is complete
•         Save records in a secure place with is easy to find
•         The record complies with procedures (both local and organisational)
•         Do not duplicate existing records (in your setting)

(e-Learning for Healthcare, 2020b)

Electronic records

Paper records

Records password protected       Entries dated and timed (using a 24-hour clock, e.g. 13:00)      Deletions and alterations should be dated and timed       If there is a delay in documenting the encounter, record “delayed entry” and the date and time of the encounter      Advanced decisions to refuse treatment, consent and resuscitation decisions must be clearly recorded (Information Governance Alliance, 2016)

Records should be legible  Entries dated and timed (using a 24-hour clock, e.g. 13:00) Entries signed, print your name and designation  Deletions and alterations should be countersigned, dated and timed Each page of the records should contain the patient’s name, date of birth, NHS number and page number Advanced decisions to refuse treatment, consent and resuscitation decisions must be clearly recorded (Information Governance Alliance, 2016)

Reference list

Car, J. and Sheikh, A. (2003) ‘Telephone consultations’, BMJ, [Online] Available at: https://www.bmj.com/content/326/7396/966. (Accessed: 10 May 2020).

e-Learning for Healthcare (2020a) Data Security Awareness Level 1: Data Breaches. Available at: https://portal.e-lfh.org.uk/LearningContent/Launch/544107. (Accessed: 2 May 2020).

e-Learning for Healthcare (2020b) Data Security Awareness Level 1: Good record keeping. Available at: https://portal.e-lfh.org.uk/LearningContent/Launch/544107. (Accessed: 2 May 2020).

Greenhalgh, T., Morrison, C. and Koh Choon Huat, G. (2020) ‘Video consultations: a guide for practice’. British Journal of General Practice [Online] Available at: https://bjgplife.com/2020/03/18/video-consultations-guide-for-practice/. (Accessed: 27 April 2020).

Information Governance Alliance (2016) Records Management Code for Practice for Health and Social Care 2016. [pdf] Available at: https://digital.nhs.uk/data-and-information/looking-after-information/data-security-and-information-governance/codes-of-practice-for-handling-information-in-health-and-care/records-management-code-of-practice-for-health-and-social-care-2016. (Accessed: 14 May 2020).

Information Governance Alliance (2018) NHS: Communication with patients. [pdf] Available at: https://utv.uea.ac.uk/View.aspx?id=50742~5f~xixBbLDmGF. (Accessed: 14 May 2020).

NHS Health Education Thames Valley (2016) Telephone consulting. [pdf] Available at:  http://www.oxforddeanery.nhs.uk/pdf/GP_Telephone_1.pdf. (Accessed: 10 May 2020).