ROJoson TPORs

ROJoson's TPORs (Thoughts, Perceptions, Opinions, and Recommendations), Insights, Reflections, and Reactions on ROJoson Telemedical Consultation

I officially started ROJoson Telemedical Consultation on March 17, 2020.

I accepted telemedical consultations in Facebook Messenger and cellphone on March 17 and 18, 2020 while I was still refining the policies and procedures of my ROJoson Telemedical Consultation.

I set a telemedical consultation appointment for March 19, 2020 using the policies and procedures that I created for ROJoson Telemedical Consultation.

DC - 1000H

MS - 1100H

JG - 1200H

MM - 1230H

Only 2 pushed through as JG canceled because she said she already consulted another physician and MM cancelled as she was busy in her work as a Metrobanker.

I will report on what transpired today.

IT WAS TEDIOUS AND EXHAUSTING!!! MORE TEDIOUS AND EXHAUSTING THAN MY FACE-TO-FACE MEDICAL CONSULTATION.

Factors:

Getting use to the online technology by both patients and myself. Encountered some glitches in the online technology but optimistic I will overcome this.

Areas to improve:

Google Hangouts

Ask patients to sign in to their Google account.

Ask them to click on the Google Apps icon.

Ask them to click on the Hangouts icon.

On my part, after opening the Hangouts page, send invite (type email address) and then wait.

NOTE only chat or conversations (not video) can be archived.

Take a screen shot of patient and myself to document that a ROJoson Telemedical Consultation took place.

Scanning of Previous or Old Medical Records

In the second patient, scanned copies of old medical records were not readily available (have to look for them). Have to make sure before the consultation, patients have scanned all previous medical records. To save time on consultation.

Samples;

Physical Examination - Telephysical examination

Has to center / focus the laptop or ipad video on the patient's lesion - needs constant adjustment - recommend using laptop or desktop computer.

Hard to point for instructions.

Measuring size of lesions

Options:

1. Tape measures

2. Coin (2.5cm)

Recording of physical examination:

Ask patient and relatives to have cellphone camera to document things that I need - both using still and video pictures.

Do not rely on the camera of the laptop. Difficult to document through screenshots.

Those who did not respond or confirm appointment date - DO NOT WAIT FOR THEM ANYMORE.

HAVE TO CONFIRM THROUGH SMS.

HAVE TO EMPHASIZE THIS.

Explanations, Discussions and Medical Recordings

Medical recordings have to be done after the Telemedical Consultation proper so as not to prolong the online consultation time.

Tedious on my part but needed to be done.

Medical recordings to be emailed to patient. Hopefully, probably at times, I can do the medical recording during the Telemedical Consultation time.

Medical recordings should document what I told the patient, what were agreed upon, etc.

This should be acknowledged in email.

Laboratory requests / prescriptions

These have to be done after the telemedical consultation

The activities in the Telemedical Consultation does not stop at the end with the video chat. I, as the physician, will still have to document everything in the tele-interactions - particularly the medical recordings and the physical examination picture findings. I still have to prepare laboratory requests and prescriptions to be emailed to the patient. A 15-to 20 minutes in face-to-face medical consultations will end up to be one hour in telemedical consultations or even more (including the post-video chat activities and responsibilities that I have to do.

Feedback:

DC - Appreciate having this Telemedical Consultation, especially during this time. It alleviated a lot of the worries while waiting for actual physical appointment to be set.