Remote Prescribing Flashcards
Describe the CONSULT guide which can be used to determine if a remote consultation is appropriate.
Consider:
- Is video call clinically required?
- Is a phone sufficient?
- Does px have capacity to participate?
- Is remote consultation of any benefit?
Organise:
- What software or hardware is required?
- Is connection stable and appropriate?
Necessary:
- Have I got the necessary information to hand?
- Do I need any additional paperwork or information?
- Do you have consultation open?
Start:
- Identity check
- Location
- Call back methods
- Check
- Acknowledge
- Inform
Undertake:
- Use usual structural process (ICE, Hx taking)
- Consider if appropriate in the moment.
- Regular check ins.
Listen:
- Px preferences
and Terminate:
- Check understanding of consultation.
- Ask px they would like you to clarify any points during consultation.
- Also ask if px is happy for remote consultations.
- Make px aware where you are ending the call and wait for them disconnect first.
Describe the PACE mnemonic that can be used when dealing with challenges emotions during a remote consultation.
Probe - discover what the issue is
Alert - try to progress if px is shouting.
Challenge - state terms of consultation
Escalate - following through on your statement.
Describe the remote prescribing high level principles.
1: Make px safety the first priority.
2: Understand how to identify vulnerable px and how to protect them.
3: Tell px your name, role and professional reg details.
4: Explain you can only Rx if it’s safe to do so.
5: Obtain informed consent.
6:Undertake an adequate clinical assessment and access medical records or test results where necessary.
7: Give px info about options available to them including declining tx.
8: Make appropriate arrangement for after care.
9: Keep notes that fully explain and justify decisions made.
10: Stay up to date with relevant training, support and guidance when consulting in a remote context.
What are the pitfalls of remote prescribing?
Delayed/missed diagnosis
Over or under px investigation
Increased clinician burden to make judgements remotely.
Reduction in therapeutic relationship between px and clinicians.
Missed opportunities to identify subtle cues during face-to-face consultations.
What are the benefits of remote prescribing?
Saves px time
Reducing need to travel.
Px who are digitally literate and happy to consult remotely.
Px groups who experience difficulty in social interaction.
Px may find it easier to explain the symptoms using online consultation tools or explain embarrassing problems in a remote prescribing setting.
What are the challenges of remote consultations?
Delivering personalised care = difficult
Health inequalities
Workload
