Policy

It is the policy of the facility to permit the use of telemedicine technology for after-hours care. The medical provider must be licensed in the State of New York and shall be credentialed and privileged at the healthcare facility for which the clinical telemedicine encounter is being conducted.

The assessment and treatment of a patient via telemedicine technology will not deviate from the standard of care applicable to a face to face assessment and treatment of a patient.

All documentation of telemedicine services will be documented in accordance with applicable standards of practice and policies and procedures.

Procedure

1. Staff shall be trained and able to properly operate all video conferencing equipment and medical peripheral devices to ensure safe and competent operation of the equipment for clinical encounters. 
2. Nursing staff will obtain the patient’s vital signs and notifies the nursing supervisor upon recognizing a medical event/change in condition of the patient.
3. Nursing Supervisor/designee will submit a case to Heartbeat Health physician that provides preliminary information about the patient and observed condition. 
4. Nursing Supervisor/designee will document the patient assessment and the notification of the medical provider.
5. Nursing Supervisor will inform the patient about the telemedicine visit and obtains written consent. Nursing Supervisor will explain to the patient what will occur during a clinical encounter to prepare them for their experience. The patient has the right to refuse to participate in the telemedicine encounter.
6. Nurse will initiate the telemedicine visit using the equipment on the portable cart and brings to the bedside of the patient.
7. Nursing staff shall ensure patient privacy and confidentiality of information. 
8. Medical provider will facilitates the visit using the telemedicine equipment which may or may not include medical peripheral devices, such as an electronic stethoscope or specialty cameras should the medical provider need them during the examination
9. Medical provider will discuss the plan of care with the patient/nursing staff and will document the evaluation and appropriate treatments in the EMR.
10. Nursing staff will implement treatment orders and follow up with the medical provider as needed.
11. If a hospital transfer is necessary, the medical provider will communicate with the emergency department directly.
12. The Medical provider will communicate with the primacy care physician, as necessary.
13. Nursing supervisor will log the encounter on the tracker for follow up of care issues.

Note:

911 should be used for life threatening emergency such as cardiac or respiratory arrest, unresponsiveness or profuse bleeding.

Responsibility

The Medical Director shall be responsible to ensure compliance to this policy.