Entrustable Professional Activities

LG9: Virtual care

Learning Goal 9

Virtual care

Provide virtual care for dermatology patients or virtual dermatology advice to referrers

This activity requires the ability to:

  • triage referrals, and assess whether virtual care is appropriate for each patient
  • prepare for virtual consultations with patients and for delivering virtual advice to other health professionals, navigating suitable technology platforms
  • provide patient-centred and culturally competent telehealth consultations to patients, or provide virtual advice to referrers
  • complete appointment follow-up actions
  • evaluate patients’ or other health professionals experience of virtual care or advice
  • document and communicate consultations or virtual advice provided

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • triage inpatient and outpatient referrals, and provide virtual advice to referrers
  • locate and verify patient information and records before virtual consultations
  • apply the same clinical care standards, policies, guidelines, and directives that apply to in-person consultations
  • share succinct virtual advice and clinical communication with other relevant health professionals, such as general practitioners, in a timely manner following virtual patient interactions

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • seek advice regarding whether virtual advice is appropriate when necessary

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • discuss with patients, families, whānau, and/or carers how virtual care can support their health needs, and the limitations of virtual health care
  • obtain patients’ consent to use virtual communication methods
  • establish a rapport with telehealth participants
  • negotiate collaboratively, and agree on management plans
  • use a communication style designed to compensate for connectivity issues, including asking participants to repeat their understanding
  • produce a consultation report for referring clinicians

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • select virtual modalities that reflect clinical standards and guidelines
  • only offer virtual care when and where it is clinically and culturally safe
  • use approved devices and secure platforms to ensure safety and privacy

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • obtain consent where appropriate, and document this along with the consultation notes in medical records
  • recognise the limitations of virtual care

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • apply an educational approach to allow patients and local health professionals to continue with ongoing care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • seek out learning in how to apply virtual care to day-to-day practice

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • report on patients’ feedback of virtual consultations

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • maintain knowledge of the literature around the differences between virtual and in-person interactions

Cultural safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • consider patients’ cultural and social background when deciding whether virtual care is appropriate
  • use professional interpreters, health advocates, or family or community members to assist in communication with patients, and understand the potential limitations of each
  • acknowledge patients’ beliefs and values, and how these might impact on health
  • incorporate Māori views on health, including the four cornerstones of the Māori health model known as te whare tapa whā
  • liaise with cultural advisors about the appropriateness of providing virtual care
  • assess patients’ comfort level with technology, based on their culture and past experiences

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • collect patient information privately in the same way one would for an in-person consultation
  • send and record patient information on a secure network

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • clarify with patients whether their virtual consultation has been satisfactory and met their care needs
  • respect patients’ privacy and safety during consultations, as if they are attending an in-person consultation

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • consider a range of factors when determining whether virtual care is appropriate, including the complexity of care required and patients’ personal circumstances, such as the ability of whānau, family, and/or carers to attend
  • identify situations where in-person care is the most appropriate option
  • assess patients’ access to technology and local support services
  • select an appropriate setting for the consultation, such as a private space
  • assess patients’ level of health and digital literacy before and during the consultation
  • consider and plan how prescriptions will be provided to patients
  • devise and implement back-up plans in the event of technological issues

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • recognise, manage, and overcome the inherent limitations of virtual care, and ensure adequate access to in person care

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • advocate for patients’ access to appropriate hardware to support virtual care needs
  • advocate for service models that better meet the needs of patients receiving virtual care
  • advocate for support for patients to attend in person when virtual care is not appropriate