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RCORP - Rural Center of Excellence on SUD Prevention

Telemedicine: Preparation and Workflow

Office-based telemedicine 
  • Patient arrives at office/community hospital and checks in at recommended time (at least 15 minutes before start of telemedicine visit). 

  • Nurse or medical assistant (if medication does not need to be administered by injection) trained in telemedicine brings patient to room with telemedicine cart or computer equipped for patient visit. 

  • Nurse/MA collects urine sample, checks temperature of sample, and submits it to lab. 

  • Nurse/MA initiates telehealth visit and stays with patient during visit in case of questions. 

  • Provider starts visit from remote location and meets with patient. 

  • Provider documents visit (may be needed at patient site as well, if billing is done separately). 

  • Scheduling of subsequent appointment. 

  • Provider sends prescription to pharmacy at end of visit when follow-up interval is discussed. 

Home-based telemedicine 
  • Program coordinator/staff member in practice counsels patient on how to use Zoom Professional or other HIPAA-approved platform from their smart phone or computer. 

  • Patient is informed about how payment/copays for telehealth appointments work. 

  • Patient is advised to finding private setting for appointments. 

  • Patient learns about downloading application, installing updates, and arriving in virtual waiting room in advance; has opportunity to practice. 

  • Staff are available to update patient if provider is running more than 10 minutes late. (Patient should remain logged in.) 

  • Provider starts visit from remote location and meets with patient. 

  • Provider documents visit and schedules follow-up with patient. 

  • Provider sends prescription to pharmacy and sends requisition for subsequent urinalysis to lab. 

  • Note: Since nurse/MA cannot check temperature of urine sample when visit is not in person, home-based telemedicine should be used only for very stable patients. 

General tips 
  • Provider “locks” meeting after patient joins (precaution against “Zoom bombing”). 

  • Provider has patient’s phone number and can switch to phone visit if technical/internet issues occur. 

  • Recommended: Provider schedules follow-up appointment with patient during visit.