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.

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

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.

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

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?

Our institution is using doxy.me. Are others using it and how many callers have you been able to have on it successfully?

it does not seem that successful

Hard for an adolescent to say “no” to the confidentiality question if parent is there

I. Have found pre-gaming really helpful and efficient. You can do a lot of teaching then

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…

what is a VRA? What kind of person is it?

Virtual rooming asst

usually MA or RN

what do they actually do

For us, call patient ahead of time to make sure that they are available and can get on telemedicine visit

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.

They check the patient in, make sure they understand the tech, check over the med list, review allergies...

wow. I want aa VRA

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

They can also ask the family for patient weight etc if needed.

Do you mean for the telehealth visit? We can bill based on time or complexity.

I have billing comments. Perhaps after the video

Very cool

thanks

thank you

We should consider a multi center study on fellow telehealth?

orr did Pnina say that SPIN is doing this

Next virtual cafe re: fellowship is for residents applying this fall! July 8 at 4pm ET.