I. GENERAL PROJECT BACKGROUND/PARTICIPANTS |
B. Patient Demographics |
A. Relationship -- HSC and Remote Site |
C. TC Participants |
Relationship -- Formal |
TC Participants -- HSC |
Relationship -- Personal |
TC Participants -- Remote Site |
Prior Familiarity
|
Remote Site Participant Expertise
|
Trust
|
Remote Site Training
|
B. HSC Specialty |
|
C. Physical/Plant Description of Remote Site |
VI. TELCONSULTATION SESSIONS |
Remote Site Resource Issues |
A. TC Session Scheduling |
|
TC Frequency |
II. HEALTH CARE DELIVERY PROBLEM |
TC Session Length |
A. Health Care Complexity |
B. TC Session Description |
Diagnosis |
TC Session Process |
Treatment |
|
Disease Quirks |
VII. PROJECT IMPACT |
|
A. TC suitability -- What Could/ Not Be Done |
III. PROJECT INITIATION (when/why started) |
HSC Provider/Patient Connection -- Psychological Patient Acceptance |
A. Date Project Started |
B. TC Outcomes -- Examples |
B. Project Startup |
TC Outcomes -- (Before /After) |
Initial Activities |
TC Outcomes -- Failures |
Barriers to Startup |
TC Outcomes -- Readmittance |
C. Need to Project |
C. Access to Care -- Overall |
|
Access to Care -- Project Volume |
IV. INFORMATION TECHNOLOGY (IT) CONFIGURATION |
Access to Care -- TC Efficiency |
A. IT Equipment |
D. Cost of Care -- Overall |
IT Location |
Cost of Care -- Project Financing |
IT Description |
Cost of Care -- Reimbursement |
B. User Perceptions |
E. Quality of Care -- Overall |
IT Training |
Quality of Care -- Reputation |
IT Ease-Of-Use |
Quality of Care -- Referral Patterns |
IT Reliability/Problems |
Quality of Care -- Local Expertise |
IT Sufficiency |
|
Local IT Support Availability/Expertise |
VIII. PROJECT FUTURE |
|
A. Future -- Issues to Be Resolved |
V. TELCONSULTATION (TC) PROJECT BACKGROUND |
|
A. TC Project Purpose |
|
Frequency of Activites (non-TC) |
|