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What are the Pros and Cons to telehealth?
How will you approach and perform a telehealth assessment?
What are the limits to telehealth?
What is the difference between the provider's need for a successful telehealth visit versus the Patient's perspective?
Telehealth offers significant benefits for healthcare access and efficiency, but it also presents challenges regarding technology, equity, and the completeness of the physical exam. A successful telehealth interaction requires balancing the needs of the provider for effective diagnosis with the patient's desire for convenience and quality care.Telehealth offers significant benefits for healthcare access and efficiency, but it also presents challenges regarding technology, equity, and the completeness of the physical exam. A successful telehealth interaction requires balancing the needs of the provider for effective diagnosis with the patient's desire for convenience and quality care.
Performing a telehealth assessment requires substituting traditional hands-on techniques with heightened observation, clear instruction, and technology use.
Preparation and Environment: Ensure the technology (audio, video, lighting) is functional and secure (HIPAA-compliant platform). The patient should be in a quiet, private, well-lit space.
Subjective Data Collection (History): This is the most critical part of the telehealth visit. Conduct a thorough, focused interview regarding the Chief Complaint (CC) and History of Present Illness (HPI).
Visual Inspection (Objective Data): Observe the patient's general appearance (e.g., hygiene, distress, skin color), affect, speech, and respiratory effort. Use the video feed to assess specific areas (e.g., rash, swelling) and ask the patient to use their device's zoom feature.
"Hands-on" Substitution (Patient-Assisted Exam): Instruct the patient or a nearby caregiver on how to perform simple, diagnostic maneuvers:
Palpation: Directing the patient to press gently on a specific area of pain and describe the tenderness.
Neurological: Asking the patient to perform range-of-motion movements, check pupils with a flashlight, or test grip strength.