Teleneuro workflow

[hd84]

Hello
For those who do teleneurology, what's your workflow like.

I have to contact the unit secretary who then calls the rn, who then finds out where the teleneurology computer is, and then i call them again to find out if the computer is in the room.

Sometimes I have to call them 2 to 3 times to ensure that they place the computer has been wheeled into the patient room.

Then often there's nobody to assist the exam while I do the teleneuro consult. So I either ask the patient to call somebody in or I call them unit secretary again to send an rn in.

Then I repeat this process for each patient.



It basically takes double the time to do a teleconsult than it would have to just see them in person.

How do you make rounding more efficient ?

Do you make an assigned appointment during the day where the RN will be ready with the teleneuro computer in the room?

Do you have an assigned "rounding nurse/tech" to wheel the telecomputer into each room while you round.

Thanks.

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[Neurogeneral]

Hello
For those who do teleneurology, what's your workflow like.

I have to contact the unit secretary who then calls the rn, who then finds out where the teleneurology computer is, and then i call them again to find out if the computer is in the room.

Sometimes I have to call them 2 to 3 times to ensure that they place the computer has been wheeled into the patient room.

Then often there's nobody to assist the exam while I do the teleneuro consult. So I either ask the patient to call somebody in or I call them unit secretary again to send an rn in.

Then I repeat this process for each patient.



It basically takes double the time to do a teleconsult than it would have to just see them in person.

How do you make rounding more efficient ?

Do you make an assigned appointment during the day where the RN will be ready with the teleneuro computer in the room?

Do you have an assigned "rounding nurse/tech" to wheel the telecomputer into each room while you round.

Thanks.

I don’t have experience in this yet but I will be doing a non-acute teleneurology rounding job starting in June.

The workflow is supposed to be very efficient cause many telemedicine companies pay at least a base hourly rate and they obviously want you to see as many patients as possible during your shift. I have been told that a designated nurse is supposed to take you from patient to patient on the census at a designated time.

 

[hd84]

I don’t have experience in this yet but I will be doing a non-acute teleneurology rounding job starting in June.

The workflow is supposed to be very efficient cause many telemedicine companies pay at least a base hourly rate and they obviously want you to see as many patients as possible during your shift. I have been told that a designated nurse is supposed to take you from patient to patient on the census at a designated time.

A designated nurse[ or nurses aide/tech] makes sense,


Recently, I covered a hospital for teleneuro, there were 15 pts which means I had to make a minimum of 15 different phone calls to actually get staff to move the telecart into the pt room.
Most of the time there is no RN in the room, it's hard to reach the RN as they're probably understaffed n busy.

Plus they leave the unit unplugged so the power runs out!

A designated one person to call to wheel the telecart around would be great.

 

[Hockeyfan23]

These sound like odd set ups. Recently started doing teleneuro full time in October with one of the larger companies. I love it so far. I do a hybrid model so half the month I take stroke call then the other half I do rounding. Usually it is 3-5 hospitals during the day but just depends on the volumes at each. My numbers are usually 30-35 patients per day. It is a very well organized machine. I learn the order and general times to round for all sites. I know the patient list and have sign out ahead of time If they’re new patients. When it is time to round I log onto the designated cart and there is a dedicated RN or manager to walk with me the entire rounds. They stay with me the entire time and can assist with exam if needed, find the RN for that patient if needed, etc. They will give me time in between patients if I need to finish documenting or look up imaging, labs, etc. once I’m done rounding I usually let our team know an eta when I’ll be heading to the next place. It’s a busy day but a pretty relaxing process. I think so far I’ve only had one site that didn’t really have a designated person for the day because the manager called in sick that day so that was a lil frustrating but definitely not the norm. Hope this helps.

 

[hd84]

These sound like odd set ups. Recently started doing teleneuro full time in October with one of the larger companies. I love it so far. I do a hybrid model so half the month I take stroke call then the other half I do rounding. Usually it is 3-5 hospitals during the day but just depends on the volumes at each. My numbers are usually 30-35 patients per day. It is a very well organized machine. I learn the order and general times to round for all sites. I know the patient list and have sign out ahead of time If they’re new patients. When it is time to round I log onto the designated cart and there is a dedicated RN or manager to walk with me the entire rounds. They stay with me the entire time and can assist with exam if needed, find the RN for that patient if needed, etc. They will give me time in between patients if I need to finish documenting or look up imaging, labs, etc. once I’m done rounding I usually let our team know an eta when I’ll be heading to the next place. It’s a busy day but a pretty relaxing process. I think so far I’ve only had one site that didn’t really have a designated person for the day because the manager called in sick that day so that was a lil frustrating but definitely not the norm. Hope this helps.

Thanks

Is this designated person to help you round, employed by the teleneurology company or employed by the hospital that you're seeing patients in?


If employed by the hospital, did the hospital just use one of their existing RNs or did they have to hire someone new as a " teleneurology nurse "

 

[Hockeyfan23]

They are hospital employees and just people who are designated to walk us for that day. Typically it’s a unit manager or someone at that level. Just depends on the day but it’s not something I have to organize.

 

[ProReduction]

These sound like odd set ups. Recently started doing teleneuro full time in October with one of the larger companies. I love it so far. I do a hybrid model so half the month I take stroke call then the other half I do rounding. Usually it is 3-5 hospitals during the day but just depends on the volumes at each. My numbers are usually 30-35 patients per day. It is a very well organized machine. I learn the order and general times to round for all sites. I know the patient list and have sign out ahead of time If they’re new patients. When it is time to round I log onto the designated cart and there is a dedicated RN or manager to walk with me the entire rounds. They stay with me the entire time and can assist with exam if needed, find the RN for that patient if needed, etc. They will give me time in between patients if I need to finish documenting or look up imaging, labs, etc. once I’m done rounding I usually let our team know an eta when I’ll be heading to the next place. It’s a busy day but a pretty relaxing process. I think so far I’ve only had one site that didn’t really have a designated person for the day because the manager called in sick that day so that was a lil frustrating but definitely not the norm. Hope this helps.

Please tell us that the company is paying you at least $5,000 pre-tax per day to see 30-35 per day

 

[Hockeyfan23]

Not necessarily that much. I would say u can get to the $2700-3000 range. You have to keep in mind it is far easier and faster doing tele rounding than in person. Plus there is no call after rounding. I’m usually done with everything by 3-4 o’clock in the afternoon.

 

[deathmerchant]

Please tell us that the company is paying you at least $5,000 pre-tax per day to see 30-35 per day

For inpatient rounding most companies are paying $100-140 per new patient and $70-80 for f/u. Slightly higher rates for Telestroke calls.

 

[ProReduction]

I've been doing Tele since 2017 continuously. I've got > 10,000 TeleNeuro consults under my belt, majority emergency but also some inpatient routine. I've never heard of rates this low before. If you are making less than $100 per consult ($3000 per day max and min 30 pts), then you are severely underpaid. My average per consult pay is approximately $200. In 5 years of doing this, I've never seen an inpatient new routine consult for less than $250. $70-80 per follow-up is well below market rate, unless there is some sub-market that has organized to pay new Neurology residency grads half of what us seasoned TeleNeuro people know are the standard rates. I think this is what has happened. We have zero new grads in my groups. None of the providers in my groups would do Tele for the rates you all quote.

Also, I quit doing inpatient routines because rounding in that Tele setting is much less efficient than in-person rounding. As the OP stated, it can take hours to see a small number of patients because the local facilities do not prioritize Tele providers.

 

[deathmerchant]

I've been doing Tele since 2017 continuously. I've got > 10,000 TeleNeuro consults under my belt, majority emergency but also some inpatient routine. I've never heard of rates this low before. If you are making less than $100 per consult ($3000 per day max and min 30 pts), then you are severely underpaid. My average per consult pay is approximately $200. In 5 years of doing this, I've never seen an inpatient new routine consult for less than $250. $70-80 per follow-up is well below market rate, unless there is some sub-market that has organized to pay new Neurology residency grads half of what us seasoned TeleNeuro people know are the standard rates. I think this is what has happened. We have zero new grads in my groups. None of the providers in my groups would do Tele for the rates you all quote.

Also, I quit doing inpatient routines because rounding in that Tele setting is much less efficient than in-person rounding. As the OP stated, it can take hours to see a small number of patients because the local facilities do not prioritize Tele providers.

Yea maybe these are the new rates. I've talked with most of the top companies and the maximum I got was $50 per RVU. So an acute stroke would be around $190 bucks and a f/u around $70; but that company didn't have a good support system/softwares. Night coverage was slightly more.
For 30 patients/day like Hockeyfan above @ avg $200/patient; 26 weeks/year, that comes to be around $1.1 million- doesn't sound right to me. Haven't heard those numbers before.

 

[forchinet121]

Not necessarily that much. I would say u can get to the $2700-3000 range. You have to keep in mind it is far easier and faster doing tele rounding than in person. Plus there is no call after rounding. I’m usually done with everything by 3-4 o’clock in the afternoon.

Done at 4 but what time do u start?

 

[Hockeyfan23]

Usually 730 or so. Depends on how many patients and sites. The above stated numbers are good but are you limited in the amount of patients and sites ? The bigger companies I feel give you unlimited business where these “better” numbers places may only get you 6 consults per day or something like that.