Telehealth

• Can be administered by anyone
  • No degree required
• Anything
  • No restriction on services
    • Order a taxi
    • Enter data
    • Review medications
    • Provide a health call
  • Any Tech
    • No restrictions on how communication
      • Fax
      • Phone
      • App
      • Video
• Restricted from the practice of medicine!

Telemedicine

Medicine

• When someone who has a license
  • makes a diagnosis
  • performs a treatment.

Tele

• Varies by state
• Usually a video based encounter
  • Most states require you get paid for the service.
    • Phone calls generally do not require billing
• Provider with a Webcam with a Patient

What needs to be done to do Telemedicine

• Patient registers a complaint
  • First Paragraph: FARCOLDER
    • Frequency
    • Associated symptoms
    • Radiation
    • Character
    • Onset
    • Location
    • Duration
    • Exacerbation Factors
    • Relieving factors
  • Differential Diagnosis
    • Based on patterns, reduce long list to Short list of probabilities
  • Second Paragraph
    • List of questions that increase or decrease probability of Differential Diagnosis
    • Review of systems (ROS) that change probability
    • Should also include
      • Past medical history
      • Surgical history
      • Family history
      • Social history
      • Allergies
      • Meds
  • Repeat Differential Diagnosis
  • Physical Exam
    • Tier 1
      • Same exam for every patient every time
        • Varies between medical providers
        • Pediatrician not the same as neurologist
    • Tier 2
      • Based on 2nd Differential
  • Labs
    • Tier 1
    • Tier 2

Physical Exam

• In above outline, everything can be done remote without “Telemedicine”
• 13:00 out of 30