Training Telehealth 101 An introduction to telehealth equipment and processes. Objectives: Gain understanding of telehealth and its benefits. Provide information on Scheduling and Service Desk processes Introduce the equipment involved in a telehealth event Give hands on practice with the equipment What is Telehealth? Telehealth is the use of information and communication technology to link people to health care expertise at a distance. A secure, high-speed video link is used to connect a patient to health care professionals at another site in the province, in the country or around the world. The patient and care provider are able to see, hear and talk to one another in real time on a television monitor within their local health care facility. Telehealth also encompasses health related education programs and administrative support for rural health authorities. Benefits of using Telehealth: Improved access to specialized services that may not be available in every community Saves the patient and the healthcare system the time, money and risks associated with travel Allows for access to care while remaining close to family, friends and community supports at a time when added emotional and physical help may be needed Reduces the hardship and inconvenience of being away from work and home Provides access to continuing education for health care professionals Reduces administrative costs in relation to travel for rural health authorities Types of Telehealth Events Clinical Clinical events encompass a wide scope of activities. Generally, they refer to a range of client care. For example, clinical services may include the following: Specialist Consultations Follow-up appointments Client Teaching Case Conferencing Discharge Planning Education Examples of education events include Continuing Medical Education (CME), Continuing Nursing Education (CNE), and weekly Grand Rounds offered by the University of Manitoba which allow rural based health professionals to remain in their communities while
continuing their professional development. MBTelehealth can also link outside of Manitoba for National and International events however, additional charges will apply. Administrative - Administrative events are held for the purposes of conducting meetings and interviews. Holding these types of events using telehealth reduces travel time for regional administrators and increases their ability to participate in multiple meetings in the province regardless of distance. Some examples of administrative users for the network include regional, provincial and national health programs. Televisitation - A televisitation is an event where a patient, who is on an extended stay in hospital, connects to a family member(s) in their home community. Connection Types Point-to-Point One site connecting to another Multi-Point 3 or more sites connected via MBTelehealth s multi-point control unit (MCU). Out-of-Province Involves connecting to a site in another province or outside of the MBTelehealth network. These connections can be either point-to-point or multi-point however charges may apply. Scheduling a Telehealth Event: All telehealth events are booked through a centralized scheduling desk. Requests are submitted using Clinical Booking Forms (CBF) for anything involving a patients and Non-Clinical Booking Forms (NCBF) for anything education or administration related. The CBF must be faxed (not emailed) because it contains patient information and can be sent to 204-975-7787. The NCBF can be faxed to the same number or emailed to schedule@mbtelehealth.ca. Once submitted, the MBTelehealth Network Schedulers (schedulers) will respond to your request within 48 hours of receipt. To contact the schedulers regarding your request call 204-975-7714 or 1-866-667-9891 and select option 2. All requests must be received before noon on the day prior to the date requested however the earlier your request is submitted, the better the chances are that the requested site(s) will be available. Contact the schedulers for all event modifications and cancellations unless they are same day changes. For same day changes, contact the MBTelehealth Service Desk to ensure that all participants are notified of the change to the event. MBTelehealth Service Desk The MBTelehealth Service Desk provides real time support for telehealth events. They can be contacted at 204-975-7714 or 1-866-667-9891 option 1 to provide assistance with anything related to your telehealth event. Service Desk Hours are Monday to Thursday 0730-2100 and Friday 0730-1730.
Telehealth Equipment Camera A high-quality imaging device used to transmit near end images to the far end site Codec The central part of the videoconferencing equipment. The main task of the codec is the compression of outgoing video, audio and data, the decompression of the incoming information and the transmission of this information between endpoints. Screen/Monitor Displays images from the near and far end sites as determined by the codec Remote Control Used to place calls, adjust the volume, navigate screens and select options. It controls all functions of the videoconference equipment Router When connected to an MBTelehealth drop, the Router provides a secure connection back to the MBTelehealth network Camera Codec Screen/Monitor Remote Control Router Cart Cart Allows the equipment to be mobile and therefore be utilized in multiple locations within a facility Microphone (not shown) Is an input device used to send audio to the far end site through the codec Connecting the Equipment: Connecting telehealth equipment involves plugging in a power cable and an ethernet cable (see image below). The power cable is plugged into a standard power outlet and the ethernet cable is plugged into a computer drop that is configured for use on the MBTelehealth network. These drops will be identified by labels (often MBT or telehealth); once you have those two cables connected you can turn on your videoconference equipment. Ethernet cable Note: Some units are connected to a power bar and some have a power button that controls the entire unit. Make sure the router, codec and monitor are all turned on before trying to make a connection.
Video Source Buttons The video source buttons on your remote control allow you to display images from video conference peripherals such as patient cameras, document cameras and laptops. The main camera button refers to the camera on top of the codec and is the default video source. You access the peripherals by pressing the corresponding video source buttons. For more information on video conference peripherals, see the Additional Telehealth Training opportunities listing on page 6. Mute The mic off button on the remote control is used to mute your microphone so that other sites cannot hear what is being said at your site. Most telehealth equipment is set to auto answer with the mic turned off; this means that your microphone will automatically turn off when someone connects to your equipment. This ensures that they are not able to dial in and listen to a conversation without a person at the near end site being aware. When your microphone is muted, you will see an icon on the monitor similar to this one: Pressing the mic off button will toggle the microphone on and off. Make sure your site is on mute before making a call and while receiving presentations; turn the mute off when you are ready to be heard. Camera Presets Camera presets are predetermined camera positions which are useful when images from different camera positions are to be viewed by the far end site. They are set up prior to the start of a telehealth event and are used to switch camera positions without having to manually move the camera. MBTelehealth has 3 standard presets: 1. Sign The first preset is of a sign with the site name. This is an off screen camera view that allows users to move about the room without being on camera and identifies the sites that are connected. The equipment should always be set to the sign preset before connecting to an event. 2. Participant (Patient, Provider, Presenter) This preset is a close up view of the person or persons involved in the event. Whether it is the patient, provider or a presenter, when setting this preset, you want to ensure that the far sites are able see the person clearly. 3. Room Part of video conference etiquette includes making the sites you are connected to aware of everyone involved in the event. By setting a preset of the entire room, you can easily identify everyone in attendance and then switch back to preset number 2 as necessary. This preset is also helpful for question and answer periods. Note: See the cheat sheet included with your equipment for camera preset instructions specific to your videoconference unit.
Layout The layout button controls a picture in picture image of what you are sending to the far end site. There are five options for the location of the image; all four corners of monitor and turned off. You move through these options by pressing the layout button repeatedly. It is recommended that you always press the layout button after connecting to ensure you are constantly aware of what you are sending to the far end site. Selfview The selfview button is used to swap near end and far end images on your monitor. When you have a picture in picture view of yourself on screen and then press the selfview button, you will see that the near end image will appear in the big window and the far end image will appear in the smaller window. This is helpful for presentations where you have other people attending in the same room and also when using a patient camera so you can view the image you are sending to the far site more easily. Press the selfview button again to switch back to regular view. Connect/Disconnect Once you ve booked your point-to-point event with scheduling, connecting to another MBTelehealth site is as simple as pressing the Phone Book button and then scrolling through the listing until you find the site you are scheduled to connect to. You can quickly skip to the site you are looking for using the corresponding number key on the remote control. For example, if you are looking for Pine Falls, press #7 on the remote to skip to the P section of the phone book. Once you find the site, press the green Connect button to place the call; press the red Disconnect button to end the call once your event is finished. For out of province connections, you will be given a dial in number which you enter by pressing the green Connect button and then typing in the number using the buttons on the remote control. You will need to enter the prefix 86 in front of the number in order for it to work. Far End Note: Incoming calls will be automatically answered with the microphone turned off. Taking Far End Camera Control allows you to move the camera at the far end site as well as control their video sources and presets during Point-to-Point connections. Before taking far end camera control, always request permission and explain why you are taking control. You may need to take far end camera control if: There is an unskilled operator at the far end. The operator requests that you take control. If the operator isn t able to facilitate the event at their end. During Multi-Point events, Far End control allows you to change how the far end sites are displayed on your monitor. As discussed in Connection Types, Multi-Point events are set up
using voice activation to control the display by default. Pressing the Far End button and then the up arrow allows you to toggle through the screen layouts shown below: Voice Activation 4 Site Split 10 Site Split 6 Site Split Pressing the Far End button again will turn off Far End control Additional Telehealth Training Opportunities Now that you have completed Telehealth 101, please register for additional telehealth training sessions as identified below or contact the MBTelehealth Training Coordinator to make arrangements to meet your individual training needs. Telehealth 201 Builds on the knowledge gained in Telehealth 101 with additional information on connecting and using peripheral devices such as Patient Cameras, Document Cameras and Laptops Telehealth Trouble Shooting - For users who would like to take their telehealth knowledge to the next level; this training session provides you with the tools and abilities to troubleshoot some of the more common connection problems including laptop connections. Telehealth Networking For the advanced user who wants to know exactly how things work; this training session will give you a look into how a telehealth network operates. Note: These sessions must be taken in the order listed above and registration is limited How to register: Book a telehealth compatible room at your local facility then email the MBTelehealth Training Coordinator at jmacdonald@mbtelehealth.ca to be added to the session. Identify the date, time and session you wish to attend and include your site, room, and contact information so you can be contacted to confirm your registration. Additional Training Topics: Topic specific and individual training is also available at a user s request. Email your request for a specific topic to the MBTelehealth Training Coordinator at jmacdonald@mbtelehealth.ca and you will be contacted to make the necessary arrangements. MBTelehealth Training Coordinator Jason Macdonald 204-399-6807 jmacdonald@mbtelehealth.ca www.mbtelehealth.ca
Test Your Knowledge 1. Which of the following statements regarding telehealth is false? a) Telehealth is the use of use of information and communication technology to link people to health care expertise at a distance b) Telehealth is an individual patient's medical record in digital format. c) Telehealth allows for improved access to specialized services that may not be available in every community d) Telehealth encompasses health related education programs and administrative support for rural health authorities. 2. Select the option that accurately lists the four types of telehealth events: a) Clinical, Point-to-Point, Administrative, and Education b) Administrative, Multi-Point, Televisitation, and Clinical c) Clinical, Administrative, Education, and Televisitation d) Education, Administration, Point-to-Point and Out-of-Province 3. Which of the following statements regarding scheduling a telehealth event is false? a) Non-Clinical booking forms are used for education and administrative requests b) Clinical booking requests are to be emailed to schedule@mbtelehealth.ca c) Non-Clinical requests can be faxed or emailed to the MBTelehealth Network Schedulers d) Clinical booking forms are to be used for any event involving a patient 4. Which of the following statements regarding telehealth equipment is false? a) The camera is a high-quality imaging device used to transmit audio to the far end site b) The codec allows for the compression of outgoing video, audio and data, and the decompression of the incoming information and the transmission of this information between endpoints c) The remote controls all functions of the videoconference equipment d) The monitor Displays images from the near and far end sites 5. Select the option that lists the standardized MBTelehealth presets in the proper order: a) Room, Sign, Patient b) Participant, Physician, Sign c) Sign, Participant, Room d) Sign, Physician, Room 6. Far end control allows a user to: a) Control the camera at the far end site during a point-to-point event b) Mute the microphone at the far end site c) Change the screen layout during a multi-point event d) Both a & c