Last week, we talked about how primary care providers can use telemedicine for care coordination -- and looked at a simple workflow for getting a consult or asking a question.

Today, we want to look at how "specialists" can organize their workflow to ensure ease and efficiency in answering questions.

Whether you are a primary care provider or a specialist, you will sometimes be requesting a consult, and sometimes be providing a consult. The advantage of a platform that supports true healthcare collaboration is that the "help" can go two ways, or multiple ways, in a single case.

The workflow is always up to you, but here are some guidelines for when you respond, consult, or answer.

A step-by-step workflow for providing a consult via telemedicine:

• Make sure you understand the question.
  If you are not sure what the question is, then ask a question back. Ask for clarification. Mostly, being a specialist means knowing what to ask and letting the patient provide the answer. Do so with respect. What is obvious and easy for you in your field is probably not obvious and easy for someone in another field. Indeed, you yourself may soon be off your turf and need help.
• Add your own data, be concise, be focused.
  While we have become used to the four page referral letter -- because we bill based on how many elements or how many domains we provide -- most data is not pertinent and too much information decreases precision.
• Help the requestor be the judge and jury.
  The requestor knows the whole picture more than you. Ask the requestor to get other specialty help. For example: an open fracture with marginal skin loss, or a case of white-coat hypertension shockingly found by you the night before the patient's surgery. If you did not receive follow-up, ask for it. Otherwise, skeletons in the closet are there when they don’t need to be.
• Consult with the team to get a consensus.
  Before you bring tablets down from your lofty mountain, make sure there aren't other opinions you should gather. As a specialist, I have to remind myself that my opinion is not final and there might be some other aspect to the problem that I might not see. By engaging in discussion, my opinion becomes more valuable. We need to move on from the four page referral letter and its unidirectional pronouncements.
  Sometimes, you just have to see the patient. 
• Don’t be afraid to ask, but don’t ask just ask to avoid thinking. There is a human and financial cost to seeing you.

Medical collaboration doesn't only happen in hospitals. Read our Quick Guide for collaboration tips from across industries: