After the transport team has arrived at the referring facility, received a medical handoff, and performed a preliminary evaluation of the patient, they often need to communicate with one or more people at the receiving hospital These calls involve clinical review, patient disposition, scheduling of studies, need for consultants, and other logistical issues The ability to conference in various participants, such as specialty physicians, charge nurses, and bedside nurses, can greatly enhance the information flow, logistics, and care coordination of the patient Such calls are often best facilitated through a communication center Use of telemedicine technologies (photos, videos, etc.), in a Health Insurance Portability and Accountability Act (HIPAA) compliant fashion, may be quite helpful for the providers to ensure appropriate management En route to the receiving hospital, it may be necessary for the transport team to contact the medical control physician either for advice or because the patient’s medical condition has changed Reliable communications are especially important at this point in the transport The team should be equipped with redundant communication systems to ensure that a reliable means of communication is always available These could include cellular technology, radio communication systems, and satellite phones where necessary Additional technologies, including web-based communications and global positioning systems, may improve communication and logistics capabilities Of course, the transport control physician should always be immediately accessible to the transport team After arrival at the receiving hospital, the transport team is responsible for ensuring an efficient, informative, and seamless transition of care to the accepting provider team Adequate communication and information flow must take place to fully inform the inpatient team of the patient’s disease process and care to date Complete documentation, written in a clear, concise fashion, is mandatory A formal “time out” for a handoff is a technique that programs have found to be understood by providers, and useful in standardizing and focusing the transition of care Anything less than a complete medical transfer of information and a seamless transition from referral physician, to the transport team, to the receiving clinicians, is a disservice to the patient and a source of potential liability It is important to remember that transport communications may have medical– legal ramifications The most important of these involves the giving of medical advice and the assumption of legal responsibility for patient management When giving or receiving management advice by telephone, both parties should remember that the transport control physician is often unable to see and is always unable to examine the child in question Therefore, his or her advice should be