Complex primary care
Priorities/Considerations:
Care coordination needs/care gaps
- Ask about family’s goal(s) for their child. Does the care plan address the family’s stated goal?
- Address family concerns first at each visit
- Review all care gaps: vaccines, subspecialty/therapy follow-up, recommended diagnostic imaging, scheduled labs, or other needed surveillance
Durable medical equipment (DME)/supply needs
- Unique opportunity to view home set-up of equipment
- Ask if family has medication or supply needs
Communication across multi-disciplinary teams
- Utilize opportunity for shared visit across teams. Can other team members virtually join the visit? (ie nurse care manager, social worker, parent mentor, dietician)
Social complexity/family coping
- Universal social screening, prior to or during visit
- Provide local resources if applicable
Home health services
- If home health nurse is present in the home during the Telehealth visit, and family finds it helpful or requests, you may obtain update from home health nurse.
Tips for virtual physical exam:
- Ask family in advance to have child in loose clothing for ease of parent to help during exam, flashlight (or other bright light such as cell phone light) if pupil exam is needed or additional light is needed to visualize portion of exam
- Ask family to take vitals prior to your visit (if applicable: temperature, BP, weight, HR, RR, pulse ox)
- Ask family to have recent records available of other health monitoring at home (ie glucose, BP monitoring, weight checks, enteral feeds, ostomy output, etc)
- Ask family to help show you (if applicable: GT/GJ, Ostomy, Trach, Central lines)
- During visit, observe child’s behavior, neurodevelopment, level of interaction
By: Jean Chia MD
Last updated: July 2020