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) |