The COVID-19 pandemic has become the new normal for the foreseeable future and podiatry practices must look to adapting in order to better serve the needs of their patients and minimise the risk of COVID-19 infection on their premises to both healthcare staff and patients.

Telemedicine is one of the medical advances that allow for patients to consult with their podiatrist virtually without the need for face-to-face interaction. This form of consultation has proven very effective in several ways:

• Pre-assessment of conditions allows podiatrist to categorize the patients problem, offer appropriate advice where in clinic treatment is not required and ensure appropriate appointment timings are given to time sensitive conditions swiftly.
• Follow up appointments where no treatment is required to check on a patients condition, progress or status of patient.
• To offer advice for minor ailments or concerns pertaining to treatments, wound care or medication management. This is essential for post-operative procedure follow up.
• Offer remote counselling of conditions and assessment the mental health of the patient while undergoing treatment remotely.

Flowchart  (suggest adding arrows / bubbles around this next section)

• Patient contacts clinic via call / email after finding podiatrist/clinic profile online / social media platform / newspaper. Please ensure a disclaimer is visible and clear indicating that patient should seek immediate care from hospital setting for worsening pain and conditions if the teleconsultation cannot be provided in a timely manner.  
• Counter or clinic staff contact patient via text / call / email to fix online appointment with podiatrist within 6 hours of enquiry. Ensure all details are correct and up to date for the teleconsultation (NRIC, condition details, phone number).
• Pre-payment of consultation is advised to patient clearly and payment taken via paylah, paynow and bank transfer.
• Podiatrist time blocked off for 30 minutes teleconsultation. Relevant photos and videos requested from patient to be sent to secure clinic phone and podiatrist doing teleconsultation updated, previous medical notes made available for podiatrist.
• Patient and podiatrist join the consultation based on the meeting ID (zoom) or phone number provided at the appointed time. Consultation starts using the agreed secure online network (skype, zoom, whatsapp call). Recording of consultation is not necessary but may be carried out, patient must be informed at beginning of call if they are being recorded.
• Podiatrist starts the required consultation, assessment, diagnosis and treatment or next steps of patient.
• Clinical notes must be written during or shortly after the teleconsultation and input into in clinic notes system of the clinic, start to finish time must be included.
• Podiatrist advises if further assessment is required (in-clinic) or if any future follow-up appointment via teleconsultation is required and how this will be scheduled. It is suggested that the patient is reconnected to the clinical staff either on the same call or via a follow up call / email / text shortly after the teleconsultation.
• If patient requires face to face assessment and treatment, they should be attended to accordingly and within a reasonable time frame.
• If patient can be adequately treated via telemedicine and no face to face is deemed necessary at this time then it is recommended that the patient is then scheduled for a follow up teleconsultation appointment in either 1,3, or 5 days following the call. 

Key benefits of including telemedicine in your practice:

• Faster care delivery
• More affordable care
• More accessible care
• Reduced risk of infection
• Improved chronic disease management and patient outcomes
• New revenue streams for practitioners
• Reduced costs of clinical operation
• Reduce loss of revenue during times of pandemic or economic downturn