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Sample Allergy and Immunology Telehealth Workflow

Telehealth (TH) visits may be conducted on site or at a remote location (check your company and state requirements). Regulations regarding interstate telehealth activities vary from state to state. Be sure you know the regulations for your state and the state where the patient is located at the time of the telehealth visit. The patient’s state of residence is not controlling, it is where the patient is located at the time of the visit that matters.

•    Patient calls for TH appointment or requests a TH appointment on the portal
  o    Practice has an algorithm for permitting TH appointments
  o    Physician approval (or optional based on staff training)
•    Two days before the TH appointment the patient receives a text or phone call reminding them to complete the pre-visit online interval history forms
•    The day before the TH appointment staff contacts the patient
  o    Updates medication and allergy lists
  o    Confirms that online forms have been completed
  o    Confirms that the patient has the virtual platform link and is able to access it
•    On the day of the visit,
  o    The patient logs on to the virtual platform a few minutes before the scheduled visit time
  o    The standard visit template is loaded into the EMR
  o    The practitioner (physician or APP) opens the visit template
  o    A text document (TextEdit in Mac, Wordpad in PC) is opened for note-taking (optional) or
  o    A notepad is available for manual note-taking
  o    The practitioner joins the patient in the virtual room
- Two devices, one for the Webcam/Telehealth portal and a second device for charting makes the visit go much smoother by eliminating toggling and enhancing the visual relationship of the visit.
  o    The practitioner performs the TH visit
  o    Visit information is captured using an EMR template or partly into the EMR and partly using electronic or paper notes
  o    Immediate post-visit practitioner activities
- Prescriptions are written (may be done by staff based on instructions depending on the level of staff support)
- Patient specific instructions are recorded
- Asthma action plans, Food Allergy Action Plans and other patient-specific forms are completed
- Handouts and other educational materials are ordered
- Laboratory or other testing is ordered
- The electronic superbill is completed
- Follow up plans are entered
  o     Immediate post-visit staff activities (Medical Assistant or Nurse)
- Instructions, handouts, educational materials and treatment plan forms are assembled and emailed to the patient through the patient portal
- Prescriptions sent electronically (may be done by provider or staff depending on the level of staff support)
- Orders for procedures, laboratory or other testing are completed
- Superbill charges are processed
  o     Deferred post-visit provider activities
- Review/complete history, physical exam, medical decision making, and plan documentation
- Generate post-visit correspondence as indicated (Depending on your EMR, correspondence templates capture information from the visit note before or after the note is signed.)
- Complete and Sign the visit note
These links are for research only. They are not endorsed by the American Academy of Allergy, Asthma & Immunology (AAAAI).