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APPD Virtual Cafe for Fellowship Program Directors
Hayley Gans
Hi everyone, please feel free to use chat to ask answers and make comments and I will monitor and make sure topics are passed onto the speakers.
Katherine Steingass
we have been on observing most of the fellows' new patient evals in part due to billing on attending time. Fellows have actually appreciated this as we have been able to provide more specific feedback than we would have otherwise
Erica Lawson
Our fellows have also told me that they like having attendings join for the whole visit — they are getting more feedback on their history taking that they would for in-person visits.
Debra Boyer
Katherine- I agree that would be ideal. My issue is that our attending precept 2-4 fellows at one time so you can’t be on lal the calls for all that time
Jennifer Kesselheim
I’m wondering if any of the panelists have had to think about patient confidentiality differently using telemedicine? It is hard to know who else is around a parent in the home, or during virtual rounds, but is just not visible on the camera. Sometimes I worry about Telehealth causing challenges to privacy in new ways that are hard for the physicians to manage…any advice on that?
Shanna Kralovic
Our institution is using doxy.me. Are others using it and how many callers have you been able to have on it successfully?
Shanna Kralovic
it does not seem that successful
Cynthia Holland-Hall
Hard for an adolescent to say “no” to the confidentiality question if parent is there
Debra Boyer
I. Have found pre-gaming really helpful and efficient. You can do a lot of teaching then
Ada Fenick
Yes. We try to run the list with the residents ahead of time to troubleshoot plans. We also have our VRA (virtual rooming assistant) on the call if possible as s/he can do some of the trouble-shooting when they call the patient…
Debra Boyer
what is a VRA? What kind of person is it?
Pnina Weiss
Virtual rooming asst
Ada Fenick
usually MA or RN
Debra Boyer
what do they actually do
Pnina Weiss
For us, call patient ahead of time to make sure that they are available and can get on telemedicine visit
Katherine Steingass
we use Skype IM to communicate with the fellows during the visit which allows more real-time coaching without faculty needing to speak in front of the family. It also helps to have a group chat to coordinate if faculty is supervising more than 1 fellow at a time.
Ada Fenick
They check the patient in, make sure they understand the tech, check over the med list, review allergies...
Debra Boyer
wow. I want aa VRA
Zarela Molle Rios
Billing could be an issue if the organization - depending on the location - mandates to do billing according to face to face time with the attending ---- any comments
Uma Phatak
They can also ask the family for patient weight etc if needed.
Pnina Weiss
Do you mean for the telehealth visit? We can bill based on time or complexity.
Ada Fenick
I have billing comments. Perhaps after the video
Debra Boyer
Very cool
Debra Boyer
Zarela Molle Rios
thank you
Debra Boyer
We should consider a multi center study on fellow telehealth?
Debra Boyer
orr did Pnina say that SPIN is doing this
Jennifer Kesselheim
Next virtual cafe re: fellowship is for residents applying this fall! July 8 at 4pm ET.