This Teleconsultation (TC) clinical practice guideline (CPG) is intended for use by deployed U.S. healthcare providers who are working in contingency settings outside of established Military Treatment Facilities (MTFs) and includes care of Military Working Dogs (MWDs). TC is a subset of Telemedicine (TM) or Virtual Health (VH). TM and VH are synonymous terms that refer to the overall delivery of healthcare using communications technology, usually directly to a patient with video visits. In contrast, local caregivers (LCs) who need guidance to best manage a casualty with available resources and within operational constraints use TC (sometime referred to as an eConsult) to obtain it from remote experts (REs) not physically present with the casualty. Care teams may use a variety of communications technologies to conduct TC including asynchronous solutions like text messaging, email, and web portals and synchronous solutions like chat, phone calls, and video teleconferencing. Importantly, any TM, including TC, is governed by U.S. privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA).

Operational virtual health (OVH), which supports TC for deployed providers, is a collection of solutions (versus a single integrated technology platform) that have evolved over time and require specific knowledge, skills, and abilities (KSAs) for most efficient and effective use. This CPG provides this information and will be updated as the OVH system continues to evolve.

This guideline focuses on TC instead of TM because most casualties are managed by a deployed medical provider or buddy aid and, given current OVH solutions, it is more consistently available in operational settings. It is a guideline and is not intended to define a standard of care. Every deployed healthcare professional (HCP) and/or local caregiver (LC) making use of this guideline is responsible for evaluating the appropriateness of applying it in the settings of any context.

When available and used appropriately, TC is a critical enabler of better casualty care. It has been demonstrated to enhance care quality, reduce lost duty time, optimize evacuation decisions, reduce evacuation costs, and improve casualty outcome1-6 but it is NOT a substitution for the deployment of necessary medical support, resources, and evacuation capabilities.

If you are a clinician expert and wish to provide TC as a RE, please contact the OVH Program Manager at the Virtual Medical Center (VMC) by sending an email from a DoD user account to dod.advisor-office@health.mil. ADVISOR is ADvanced VIrtual Support for OpeRational Forces.