Telemedicine. The procedure for preparing and conducting teleconsultation

Appendix # 2

to the Order of LOCB

No. 648A dated December 29, 2017

The procedure for preparing and conducting a teleconsultation.

1) The decision on the need for telemedicine consultation is made by the attending physician together with the head of the department and the deputy chief physician for medical work. The attending physician determines the availability of indications for referring his patient to a medical commission in the form of a remote (telemedicine) consultation by a specialist (specialists) of the health care institution, on the basis of which the telemedicine center was created;

2) It is necessary to obtain informed voluntary consent of the patient for a consultation (telemedicine council) with a reflection in the medical history of the medical organization sending the application. If it is impossible to independently express the will of the patient, the question of holding a consultation is decided by the council of the medical organization sending the application.

3) If it is necessary to conduct a telemedicine consultation with a patient in a planned manner, the attending physician draws up a referral for a telemedicine consultation (Appendix No. 1), signs an informed voluntary consent to conduct a telemedicine consultation (Appendix No. 2) and sends them to the telemedicine center by fax (fax 8 4742 314047). The head of the department and the deputy chief physician by profile must get acquainted with all the documents transmitted for teleconsultation (they endorse the fact of familiarization with their signature in the epicrisis);

4) The registrar of the telemedicine center accepts a referral for a telemedicine consultation, informed voluntary consent to conduct a telemedicine consultation and transfers them to the head of the telemedicine center (TMC);

5) The head of the goods and materials center informs the deputy chief physician for the profile and the head of the department about the received application to agree on the time of the consultation;

6) The head of the department appoints a consultant doctor;

The time of the consultation and the full name of the specialist of the State Healthcare Institution "LOCB" appointed for the consultation shall be agreed upon after studying the medical documents within three working days, if necessary - urgently. Telemedicine consultation is carried out at the appointed time in the equipped auditorium of the telemedicine center on the one hand and in the equipped auditorium of the telemedicine center on the other hand. Information about the patient is reported by the attending physician, the consultant physician of the telemedicine center enters the information into the patient's outpatient card according to the protocol (Appendix No. 3). With the informed consent of the patient, a demonstration of the patient is possible. During the consultation, the attending physician provides examination data, which can be additionally interpreted by the consultant physician, which is recorded in the outpatient card;

7) If it is necessary to conduct a telemedicine consultation for a patient urgently, information about this case is transmitted from the region's MO by telephone:

- during working hours - to the head of the department of the Ministry of Defense, in need of consultation, to the head of the corresponding department of the State Medical Institution "LOCB" or to the deputy chief physician for the profile:

8-960-156-21-17 or 314-020, 314-520, 307-836, 307-837 (for cardiac patients);

8-960-156-21-41 or 337-021, 314-524 (for patients with a neurological profile);

8-960-156-21-41 or 337-316, 314-034 (for neurosurgical patients);

314-600 or 314-593, 316-285 (for surgical patients);

314-023 (for patients with a therapeutic profile);

- outside of working hours - by the specialist on duty of the Ministry of Defense on the above-mentioned phone numbers to the specialist on duty at the Regional Clinical Hospital for the disease profile of the consulted patient.

8) Based on the results of the telemedicine consultation, the consultant doctor draws up the conclusion of the telemedicine consultation, which indicates the diagnosis and recommendations for patient management. The conclusion is sent by facsimile to the health care institution that sent the application for the telemedicine consultation, and the questionnaire is sent to the telemedicine center where the telemedicine consultation was held. The appointments formulated in the conclusion of the telemedicine consultation are of a recommendatory nature.

9) If necessary, the tactics of patient management are agreed with the deputy chief physician for medical work (responsible surgeon on duty).

Annex 1

APPLICATION of a medical organization from "_" ___ 201

to conduct telemedicine consultations (consultations) at the State Healthcare Institution "LOCB"

Medical organization (______________________________________

Branch (______________________)

Patient (s) XX, age, sex m / f No. of medical history (To comply with Federal Law 152 "On personal data", instead of full name, indicate the unique identification number of the patient, No. of medical history)

I ask for a telemedicine consultation with a doctor - __________. Preliminary diagnosis: ............................................... ...............

Appendix: an extract from the medical history or outpatient card.

Deputy chief physician, full name (or person in charge)
Attending physician Full name

Contact phone numbers (including mobile), email address and full name of the doctor who will represent the patient at the consultation (for feedback).

Appendix # 2

INFORMED VOLUNTARY CONSENT OF THE PATIENT for telemedicine consultation

1. I, the undersigned, ________________________________________

(Full name of the patient / legal representative (parents, adoptive parents, guardians) I hereby confirm that in accordance with clause 5 of article 19 of the Federal Law of 21.11.2011 No. 323-FZ "On the basics of protecting the health of citizens in the Russian Federation », According to my will, in a form accessible to me, informed about the need for telemedicine consultation regarding:

a) my illness ___________________________________________

b) ________________________________________________________________________

(Full name of a minor under 15 years of age, incapacitated) represented by me on

based on ____________________________________________________

(name and details of the title document, by whom, when issued)

1. I received full and comprehensive explanations, including comprehensive answers to my questions about the conditions, goals and objectives of telemedicine consultation.
2. Voluntarily in accordance with Art. 20 of the Federal Law of 21.11.2011 No. 323-FZ "On the Fundamentals of Health Protection of Citizens in the Russian Federation" I give my consent to conduct a telemedicine consultation for me (or the person I represent).
3. I understand the need for telemedicine consultation, I am aware of the risk associated with possible information leakage.
4. I am aware that the conclusions obtained as a result of the telemedicine consultation will be of a recommendatory nature, and that the further management of the case of my illness will be carried out according to the decisions of my attending physician.
5. I have no objection to the transfer of data about my illness, recording of telemedicine consultation on electronic media and demonstration to persons with medical education - exclusively for medical, scientific or educational purposes, taking into account the preservation of medical secrecy.
6. I certify that I have read the text of my informed consent to telemedicine consultation, I understand the purpose of this document, the explanations received are clear and I am satisfied.

"___" ___________ 20__ ___________________ / _________________________ /

(signature of the patient or his (transcript of the signature)

legal representative)

This document has been drawn up

(attending physician, head of the medical department, another specialist,

directly involved in the examination and treatment)

based on the results of preliminary informing of the patient (legal representative) about the state of his health (health of the person represented)

"____" __________ 20___ ______________________ / _____________________ /

(signature) (decryption of signature)
If the patient, for some reason, cannot sign this document with his own hand,
this document is certified by two signatures of medical workers of the healthcare facility.
"___" __________ 20___ ________________ '/ ______________________ /

(signature) (decryption of signature)

"___" __________ 20___ ________________ / ______________________ /

(signature) (decryption of signature

Appendix No. 3

Telemedicine consultation protocol

No. ____