Using the Alethea Mobile Applications

1) Taking Photos Using the Otoscope / Endoscope

_{The digital endoscope can be used to perform an examination of the ear canal / tympanic membrane, or the anterior nasal cavity.}

_{The digital endoscope is not to be used for examinations / imaging of the oral cavity. Please use the mobile rear facing camera for these examinations. The otoscope can only be used on the Android App and Online Portal, not the iOS App.}

To take a photo using the Alethea mobile app and digital otoscope / endoscope, first open the mobile app, and prepare your endoscope. Our endoscopes are compatible with Welch Allyn adult otoscope tips. Firmly press a tip onto the end of your endoscope. Ensure the tip is tightly fixed to the device, and there is no wiggling or movement of the tip:

Next, plug the endoscope into your mobile device. You may receive a notification asking you to use the camera. Select “OK”:

Next, open the camera using the icon on the top right of your screen:

Before beginning your examination, check the orientation of your otoscope to ensure you are using it with the right side up. Consider looking at the text on you app screen to test your orientation.
Next, select the camera icon on the bottom right of your screen to begin taking a photo:

You can now begin either your ear or anterior nasal cavity examination. It is typically not necessary to pull on the pinna to see a clear image of the eardrum. You will need to gently navigate the curve of the ear canal to see a clear image. When performing an anterior nasal exam, gently insert the front of your endoscope tip into the nasal cavity.
To record an image, tap the large white button on your app screen. You will feel a gentle buzz to confirm that your image has been recorded

Once you have completed imaging, ensure you properly clean / sanitize your endoscope. Remove and dispose of the tip. If there is any debris on the endoscope, rinse the body of the device under running water before drying, and sanitize with an alcohol wipe. Use an alcohol wipe or CaviWipe to clean your mobile device.
To record a video using the otoscope, select the video camera button on the bottom left of your screen:

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Tap the red button to begin and finish recording.

2) Taking Photos and Videos Using the Phone Camera on Android

The rear facing camera can be used to take photos and videos of the oral cavity, dermatology conditions, and to record movement patterns.

To take a photo using the rear facing camera, first open the Alethea App. To turn on the rear facing camera, tap the camera icon on the right hand side of your screen:

Next, select “Camera”:

You will be brought to the camera screen. You can use your fingers on the touch screen and “Pinch to Zoom” in and out. You can also tap to focus.

To record an image, tap the large circular button on your app screen:

To save the image, tap the blue circle with the check mark:

To skip saving the photo and take another, tap the white back arrow icon:

To record a video, select the “Camera Video” icon when entering the camera:

Tap the red button to begin and finish recording.
Tap the blue circle with the check mark to save the video:

To skip saving the photo and take another, tap the white back arrow icon:

To clean your mobile device after use, use an alcohol wipe or CaviWipe.

3) Taking Photos and Videos Using the Phone Camera on iOS

The rear facing camera can be used to take photos and videos of the oral cavity, dermatology conditions, and to record movement patterns.

To take a photo using the rear facing camera, first open the Alethea App. To turn on the rear facing camera, tap the camera icon on the right hand side of your screen:

Next, select “Photo”:

You will be brought to the camera screen. You can use your fingers on the touch screen and “Pinch to Zoom” in and out. You can also tap to focus.
Turn the flash on and off by tapping the lightning bolt icon on the top right of your screen:

To record an image, tap the large circular button on your app screen.
To take a video, tap “Video”:

You can pinch to zoom and tap to focus.
Use the lightning bolt icon on the top right of your screen to turn your flash on and off:

Tap the red button to start and stop taking a video. Your video will automatically save.

4) Reviewing Images, Videos, and Accessing the AI

To review your images, videos and access the AI, tap the left menu bar on your home eConsult screen:

Tap “Gallery” to view your images:

Your image gallery will be organized by date. Any photos taken on the Alethea Mobile Device will also automatically appear in the online portal. You can also now search by image tags and notes that you have attached onto your image: (More on this to come)

Upload any other files/photos to the gallery by clicking “Upload Files” and tapping to upload:

Delete photos from your library by clicking the "Select" button before selecting any images, and then clicking "Delete Selected":

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To search for images, tap “Show Search”:

You can search by date, and by tags and notes you have added to images. Tap “Search” to continue, and “Clear Search” to remove the search terms. Tap “Hide Search” to view the gallery without search terms:

When you click on an image in the gallery, you can access Alethea's AI prediction by selecting the subsite from the from the dropdown menu:

You can delete the photo by tapping on the trash icon at the bottom of the image screen:

You can add tags and notes to your images by tapping the "Pencil" icon:

As noted above, you can now search your image gallery by these tags and notes. Click the save icon to finish:

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5) Sending an eConsult

eConsults can be sent through the mobile app, or the online portal.

The eConsult screen will be the default screen on your mobile app. If you are not at the default screen, open the left menu bar and tap “eConsult”:

Use the drop down menu under “Referring Physician” to select the clinic you will be sending the consult from:

Use the following drop down menus to select the Specialty, Subsite, and Specialist for your eConsult:

Complete the required fields in the eConsult form. The required patient information fields are the patient’s province of residence, PHN, patient first and last name, and the date of birth.
If you include the patient email, you can tap the “Send eConsult copy to patient” check box to send the patient a copy of their eConsult. This will be sent the next day, and will be automatically billed for as a patient communication by Alethea for Alethea Plus users:

Complete the “Other Information” fields to complete your consult. The “Question for Consultant” field is required.
Tap “Open Gallery” to choose one or multiple images or videos from your library to include in your consult:

Upload any additional files you would like to include in the “Other Attachments” section of the form.
Tap “Submit” to send your eConsult.
You can expect to receive a response from the specialist within 24-48 hours in your Secure Messaging Inbox of the Alethea Online Portal or Mobile App.

6) Review your eConsult Responses in Secure Messaging

To access your secure messaging centre, tap, “Secure Messaging” on your left menu bar:

You can move your eConsults to archived by checking the box on the left of the line item, and then clicking “archive” at the top of your inbox:

You can search for consults by PHN, Patient First Name, Patient Last Name, Subsite, and Specialty by tapping “Add Search Term” and using the drop-down menu:

Remove search terms by tapping the “minus” sign beside the search function:

Unread messages in your inbox will be marked with a teal dot on the right hand side:

When you click on a line item in secure messaging, you can see the full details of the eConsult you sent:

You can mark the consult as unread or archive using the options at the top of your screen:

If you would like to share an eConsult with your MOA or other staff, you can use the “Forward” button at the top of your eConsult and use the drop down menu to select “To MOA”:

You will then see a pop-up menu asking you to enter an email address, and any notes you would like to include:

The recipient will receive a notification in their inbox, letting them know that they have received a secure message from you. They will be prompted to either create or sign-in to their Alethea.Care account to view the message.
To forward your consult to a different specialist, use the forward drop down menu to select “To Specialist”:

You will then be asked to confirm which specialist you would like to forward the eConsult to. This new specialist will respond with their advice within 24-48 hours:

Use the left arrow at the top of your screen to head back to your inbox, or the right arrow to view the specialist's response. You can also swipe left/right on the screen to do this. You can reply to eConsults with follow-up questions using the messaging box at the bottom of the specialist response page:

ATTENTION: Every Alethea Plus user who sends a new message within secure messaging will have the message submitted for billing.

If you send multiple messages on the same day for the same patient, or a follow-up message for an eConsult from the same day, only the initial consult or or first message for that day will be accepted for billing.

Each time you send an eConsult, receive a secure message, or send a secure message back to the specialist, there will be a corresponding eFax sent to your fax number on file (as long as you have this feature turned on in your user profile).

7) Sending and Reviewing Patient Forms

You can securely send patient forms using the “forms” tool in the mobile app. To access the forms tool, click “forms” on your left menu bar:

If you practice at multiple clinics, you can us the drop-down menu to select the clinic that you would like to send the form from:

Once on the forms page, you will select a form that you would like to send from the drop down menu. You can also preview the form before sending it to your patient(s):

After a form is chosen, you will then input the patient data - the PHN and the email for your patient. You can add as many patients as required by tapping the plus sign:

If you would like to delay sending the form, there is a check box to do so - the form will be sent at 7:00AM the following morning (For example: if you are filling out this information on a Monday evening, and would like to delay the form, it will be delivered at 7:00 AM Tuesday morning:

Hit send! the patient will receive an email directing them to the Alethea.Care Portal where they can fill out the form and it will automatically be returned to you upon completion. An eFax of the form will also be sent to your clinic as long as you have your eFax settings turned on in your profile.
To review your completed forms, head to “Patient Messages” in your left menu bar. You can access all your past Patient Messages and Form responses here:

At the top of your screen, you will see the folders for “Inbox”, “Sent”, and “Archive”:

Your “Inbox” will show responses to the secure forms you have sent out.
Your “Sent” folder will show the secure messages you have sent, and forms you have sent but your patient has not replied to.
Your “Archive” folder will contain any messages you have moved into that folder.
In your patient messaging centre, messages you have read will appear with a grey highlight. Unread form responses or messages you have marked as unread will be marked with a green dot on the right hand side:

Messages and forms will be marked as “delivered” when they have been received by the patient. Forms will be marked as “Response Received” when the patient has successfully completed the form.
To find older messages, we have made it easy to search based off of patient email, PHN, message type, and subject by tapping “Add Search Term” and using the drop-down menus:

To read the contents of a message / form, simply click on the message.
On this page you will see all information received from the form you sent to your patient:

Using the top menu bar, from left to right, you can mark messages as unread, move to inbox (if not in inbox already), forward, archive, and open any additional attachments.
You can show / hide the additional details about your message by tapping the small arrow under the top menu bar:

You can also export the PDF by tapping the “Square / Arrow” icon on the message body:

Use the back arrow at the top of your screen to return to the messaging folder you were last in.

8) Sending and Reviewing One-Way Patient Messages

To access our One-Way Messaging service, click “One-Way Messaging” on the left menu bar:

If you are practicing at multiple clinics, use the drop-down menu at the top of your screen to select which clinic you would like to send your message from:

You will then input the patient data - the PHN and the email for your patient:

If you would like to delay sending the message, there is a check box to do so - the email will be sent at 7:00AM the following morning (For example: if you are filling out this information on a Monday evening, and would like to delay the message, it will be delivered at 7:00 AM Tuesday morning:

Next you can add information to the subject line, “Secure message from Dr. ________: [any text you wish to add]
Below, write your message. You can add any information you would like the patient to have, as well as attach any documents your patient requires.
Lastly, you can alter the personal signature at the bottom of your message to include any information you would like.
Hit send! the patient will receive an email directing them to the Alethea.Care Portal where they can read the message you have sent.

**It is important to note that this communication is a one-way message, and if the patient has any follow up questions they will have to phone the clinic or any contact information you have provided them directly.

To review the one-way messages you have sent, head to “Patient Messaging” in your left menu bar. You can access all your past Patient Messages and Form responses here:

At the top of your screen, you will see the folders for “Inbox”, “Sent” and “Archive”

Your “Inbox” will show responses to the secure forms you have sent out.
Your “Sent” folder will show the secure messages you have sent, and forms you have sent but your patient has not replied to.
Your “Archive” folder will contain any messages you have moved into that folder.
In your patient messaging centre, messages you have read will appear with a grey highlight. Unread form responses or messages you have marked as unread will be marked with a green dot on the right hand side:

Messages and forms will be marked as “delivered” when they have been received by the patient.
To find older messages in any of your folders, we have made it easy to search based off of patient email, PHN, message type, and subject by tapping “Add Search Term”:

To read the contents of a message, simply click on the message in your inbox and you will be taken to the body of the message or form response:

Using the top menu bar, from left to right, you can mark messages as unread, move to your inbox (if not in inbox already), forward, archive, and open any additional attachments.
You can show / hide the additional details about your message by tapping the small arrow under the top menu bar:

You can also export the PDF by tapping the “Square / Arrow” icon on the message body:

Tap the back arrow at the top of your screen to return to the folder you were most recently in.

9) Accessing the Reference Journal

The reference journal provides access to a series of images, characteristics, and treatment advice for conditions that can be predicted through the AI support tool.

To access the reference journal, tap "References" in your left menu bar.
The Reference pages will be listed at the top of your screen. Click the relevant specialty/subsite to review the images:

Using the Alethea Mobile Applications