Telemedicine, TeleHealth, Virtual Healthcare Visit, Electronic Visit, EVisit, Telemedicine Musculoskeletal Evaluation

  • Definitions
  1. Telemedicine
    1. Telecommunications (voice, video) to provide off-site health services to patients
  • Preparations
  1. Employ a HIPAA compliant mode of communication
  2. Use Test Patients first before using in practice
  3. Employ the patient's home devices for Vital Signs
    1. Portable oximeter provides Heart Rate and Oxygen Saturation
    2. Smart watch provides Heart Rate (or teach a patient how to check their pulse)
    3. Weight scale
    4. Peak Flow meter
  • Technique
  1. Set expectations and goals for visit at the start of the encounter
  2. Maintain Bedside Manner while online
    1. Making eye contact with the patient requires the provider to look at the camera
    2. Maintain a pleasant speaking voice
  3. Clear verbal communication is key
    1. Social cues and body language are often hidden when communicating online
  • Exam
  • Upper Extremity Telemedicine
  • Exam
  • Lower Extremity Telemedicine
  • Imaging
  1. Decision rules may help guide who needs further evaluation with imaging
    1. Consider obtaining imaging followed by in person follow-up exam on same day
  • Management
  1. Exercise caution in underevaluating patients virtually
    1. Red flag findings should prompt in person evaluation
  2. Home care online instructions
    1. Telemedicine evaluations may direct online resources (e.g. rehabilitation Exercises)
  • References