Telemedicine: just what the doctor ordered!

What if your child needed subspecialty pediatric care and you lived over 100 miles away from any big medical center?  What would you do?  Well, I’m guessing you’d drive those 100+ miles and do whatever it is you needed to do, however often you needed to do it, so that your child would get the care she needed.

But shouldn’t there be an easier way in today’s technology?

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Good news.  There is.  We call it “telemedicine.” It’s when clinicians are able to provide direct healthcare to patients – remotely – using groundbreaking technology that helps facilitate a physical examination and communicate the assessment and findings of the exam. I’d like to note that telemedicine is not intended to REPLACE patient-doctor care, rather to supplement it in some pretty stellar ways. 

So you could drive to your local pediatric urgent care office and get your child an electrocardiogram and have vital signs and a physical examination performed. Then that information could be sent directly to the pediatric cardiology specialist 100+ miles away, who could apply their expertise to your child real time.  Swell. That’s telemedicine.

Here’s another example:

Imagine you live in a rural area (or maybe you already do), where, unlike many metropolitan areas, the local docs close down at 5PM. It’s 8:30PM and you’ve got a killer sore throat. You’re also a parent, so naturally, you never truly take a sick day. Your doctor is unavailable beyond regular office hours, and the nearest ER is a good 45 minutes away. You’re in pain. All you’ve got is the mall. And what good is the mall when you’re feeling sick?

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In this scene, a doctor who is far away can see right into the child’s ear with the otoscope hooked up to a computer monitor, and make a visual assessment along with the necessary vitals taken by the nurse.

I’ll tell you.

Now imagine inside the mall, there is a little storefront or a private kiosk where you can walk in and get private care with the help of a nurse or medical assistant, working with a (real, live, credentialed, practicing) doctor through a television screen and a microphone. The nurse or medical assistant will take your vitals, swab your throat, and use telemedicine tools to show the doctor – in real time – what your throat looks like.  These tools exist and they are amazing. The doctor can see right down your throat with a camera and identify the problem. In the meantime, your rapid strep test results have come up positive. The doctor then reviews your vitals, the strep test results, and what he/she has seen on the camera. The doctor gives you instructions for care at home, submits an electronic prescription to your local pharmacy, and sends you on your way (maybe even with a lollipop, if you’re a good patient). Your primary care doctor also gets an electronic copy of all your data AND a picture of your throat.  Charming. BOOM. Done.

The technology is INCREDIBLE!

I’ll admit that I don’t think I could initially be classified into the “early adopter” category.  I’m the physician who smiles broadly when I see that coffee cup meme that says, “Don’t confuse your Google search with my medical degree” and in truth I applauded loudly when the Journal of the American Medical Association (JAMA) reported recently that “internet medicine” cannot replace your physician.  #TrueStory.  BUT…telemedicine can combine the good parts of both of these worlds—convenient, accurate and accessible plus physician oversight and the human touch.

It’s already happening in many arenas.

cicu_telemed3I saw a report on TV where some surgeons in the US were coaching their Middle Eastern colleagues on surgical techniques in real time, using video and virtual instruments to guide them.  The engineering of biomedical robotics is accomplishing some amazing stuff already.  Breakthroughs are happening every single day. I’m not sure I can ever give up the traditional doctor-patient setup of a face-to-face interaction, and I hope and doubt that we will ever abandon that as our gold standard.  That being said, I was recently sent an image of a child’s eardrum as an example of this emerging technology. I’m here to bear witness to the fact that it was an order of magnitude better and higher quality than the tiny image I see from my own squinting eye while trying to catch a quick glimpse in a moving 13 month old.  I’m now looking forward to seeing what the visions are to make the most of this emerging field in medicine.  I think it’s going to do a lot of good.  And I’m determined to be part of it.

So what do YOU think of telemedicine?

http://www.pmpediatrics.com/dear-dr-christina/