Spotting scope and general setup
Before digiscoping, I attach my spotting scope to my tripod and my digital camera to my scope via the camera adapter. I then carry this set up with me out in the field, that way if an opportunity for a photograph arises, I'm already set up - seconds can be vital.
Rather than having to take the camera out of the adapter, I prefer focusing the spotting scope on to the subject with the digital camera already attached, therefore using the monitor of the camera to judge when the subject is in correct focus.
I recommend using the focus lock on your camera (usually pressing the shutter release halfway) before taking the picture, that way you can fine tune the scope focus before taking the shot.
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