Telephone-Facilitated Virtual Care
Although telephone calls with patients are commonplace, they increasingly support virtual care. Telephone-facilitated assessment, follow-up, education and care planning is familiar to patients and easily supported with existing infrastructure.
A telephone encounter is suitable when in-person interaction is not required, video is not needed, and the patient’s hearing, speaking and cognition are adequate. Appointment scheduling, test result communication and health maintenance reminders are typically brief. Assessment and planning encounters can last longer and include multiple team members.
Documenting Telephone Virtual Care
Scheduled telephone encounters can be initiated, navigated and document like other virtual health appointments.
Ad hoc (not scheduled) telephone encounters should be documented with a “Telephone Encounter” visit type (created as a new encounter).
If a telephone encounter satisfies an outpatient referral, be sure to use the communication (Letter) workflow to generate an appropriate consultation or follow-up letter to the referring provider.
Telephone Encounter Types
There are many "Encounter Types" that can be selected when "Creating" a new un-scheduled encounter in Connect Care. Among these is the "Telephone Encounter" type. This can be used to help manage and document telephone-facilitated virtual care, as described above.
The same encounter type can also be used to capture information about a wide range of other patient, family or staff communications; where such information is important to include in the clinical record but is not otherwise captured in a scheduled appointment. Examples include:
Summary of secure email or secure messaging exchanges with a patient (where this is not already documented in the MyAHS Connect portal), pharmacist or other healthcare provider (where not already documented in In-Basket).
Summary of a communication found in another information system, such as Alberta Netcare or MyHealth Records.
Connect Care ambulatory care clinics can take advantage of automated appointment reminders for patients with upcoming outpatient, day surgery, therapy or investigation visits. The automated telephone system was implemented in January 2020 and integrated with the clinical information system to support appointments from February 2020 forward.
Automated telephone reminders are sent to patients' preferred number 3-5 days (depending upon weekend) prior to their next appointment. One call covers all appointments on a single day.
Messages are left when possible if the call is not answered.
Calls go out Monday-Saturday 10:00-19:00 with no calls on Sundays or holidays.
Patients can confirm, cancel or request a rescheduled appointment using keypad responses.
Patient instructions and other important appointment information continues to be sent via mail or MyAHS Connect.
At present, English alone is supported.
The interactive telephone "script" works for most outpatient settings. Some custom scripts are applied for specific contexts (e.g., mental health, public health, etc.) and, in future, other customizations may become possible.
Standard scripts are updated with any relevant pandemic response instructions or reminders.
Connect Care clinic managers (operations-medical dyad) are provided information about automated appointment telephone reminders. Clinic opt-out is possible, but discouraged. One telephone reminder approach should be adopted department-wide; ultimately organization-wide. Individual patient opt-out remains possible once the automated telephone reminder system is implemented.
A clinic request to opt-out of automated telephone reminders must come from the relevant department manager or leader and recorded as a ticket submission through the Connect Care Concierge.
It is important that clinic or medical office support staff understand how to manage the automated reminder system through scheduling workflows (see tip sheet below) and for physicians to know whether their clinic has chosen a reminder workflow, prepared staff and communicated to patients (e.g. posters). The physician can then reinforce this service when patients ask about appointment preparations.
Patients can register a preference to receive reminders via direct staff-to-patient or staff-to-proxy. In time, they may also indicate a preference for text or email reminders (in the works). The patient's telephone, email and text locations approved for clinical communication are solicited (and validated) at all registration and check-in workflows.
Patients who sign up for MyAHS Connect can receive appointment reminders via the patient portal. They can also control their communication preferences from within the portal. Clinics that enable MyAHS Connect self-scheduling can additionally offer patients the ability to manage all confirmations, cancellations and scheduling requests via that interface.
Physicians do not have the ability to change patient preferences. This must be done by support staff trained in appointment workflows.
If an entire department (clinic) wishes to opt-out of automated telephone reminders, submit a Help Desk Ticket stating "Opt out of Auto Reminder phone calls for [DEPT NAME]".
Tip: Auto-Appointment Reminder Calls (for support staff but good skim for physicians to understand how patient preferences work)
Support: Connect Care Help Concierge (for opt-out and configuration requests)
Resource: Automated Reminder Scripts (for examples of possible customizations)
Contact: Auto-Appointment Call Scripts (ConnectCareOperations.PatientAccess@ahs.ca)