Telemedicine: Improving efficiency and outcomes
Safa P. Farzin, MD | 03.04.13
Telemedicine allows a physician and patient to see and talk to each other without being in the same location.
Telemedicine is a new option to improve efficiency and outcomes for services when time or availability to reach a patient is important. It is a system that works between two computers to allow a physician and patient to see and talk to each other without being in the same location, much like video chat.
Telemedicine can be used for patient care such as emergent treatment of stroke patients with Tele-Stroke, evaluation of patients at long-term care facilities and urgent care centers known as, Tele-Triage, as well as monitoring of critically ill patients known in Tele-ICU. This advanced form of treatment provides improved quality and efficiency of care, better availability of specialists, and wide spread critical care in geographies that do not have specialty services.
With advancements in technology like telemedicine, stroke cases in which the time it takes for a neurologist to join a care team can affect the patient's chances of a positive outcome. While neurologists are always on-call they spend critical time in transport. When stroke alerts are initiated from multiple sites, even more time is wasted with the duplication of efforts in a critical time. In many cases there is a three-hour window from the onset of a stroke to intervention to deliver common treatments, including travel to the hospital. Many times, the three hour window has passed by the time the patient is evaluated.
When a stroke is suspected, protocol dictates that the patient should be transported to a stroke center. This may mean a helicopter flight or other costly transportation. If a neurologist performs an assessment using telemedicine at the point of admission, patients that do not need stroke care are not transported benefiting the patient and the payer, and patients who do need stroke care can be treated promptly.
Different than Tele-Stroke, Tele-Triage works by putting small portable devices at first access locations like urgent care, walk-in clinics and pharmacies. The camera has the ability to “call” the Tele-Triage center staffed by a physician, nurse, or appropriate clinical person. When patients arrive at the urgent care center or other location with a health issue that may need more care than can be provided on-site, such as a burn or wound or serious infection, they can access the Tele-Triage Desk at the host hospital and determine a course of action in the coordination of patient care.
In many cases, the availability of Intensivist physicians that specialize in critical care may be required to cover several hospitals. Indications are that outcomes are better when an intensivist is involved. The use of telemedicine has made this possible.
Telemedicine provides a mechanism that allows these limited resources to be in remote or in multiple places at the same time. This application requires that all the information needed by the doctors is provided in all supported locations and that the specialists and the remote doctors are connected by processes and operate as a unit providing better coordinated, quality care to patients.
Written by Safa P. Farzin, MD,
Associate Chief Medical Officer & Director of Critical Care at PinnacleHealth
Tell us: Have you used telemedicine to communicate with your health care provider? How has it benefitted you and improved your care? Please leave a comment below.