I am a concierge pediatrician. That means I do house calls. I also give phone advice, communicate with clients via email, and I do telemedicine visits. What's that, you say? What's a telemedicine visit? You are not alone in asking. It is one of the more common questions I am asked.
Telemedicine is the use of a computer screen to do a patient visit. This is similar to Skype, but through a secure portal. It is most commonly used in Intensive Care units and for rural medicine. It is a way to link patients with doctors who are geographically distant. (The wonderful thing is, no one is really distant in the age of the internet). Information from an ICU monitor can be transmitted around the world to the physician who is the best in that field. In rural areas, it is used to link patients with a chronic illnesses to their specialists. They also use it for monitoring chronic conditions. It follows HIPAA and AMA rules and regulations, so it is completely legal.
That's cool and all, you say. Then you point out that I don't practice in an ICU or in a rural area. You want to know how this is going to help a typical urban mom with a sick child. That is an excellent point. Sometimes, you need to call the doctor in the middle of the night. You might reach a physician, but you are more likely to reach an Advise Nurse or an answering service. If you get a physician, she may tell you that she cannot fix your problem over the phone. It needs a higher level of service. She gives you the option of waiting until morning to call for an appointment, or going to the emergency department.
This is where I swoop in and save the day! Or night, as the case may be. Often, that higher level of care can be managed through a telemedicine visit. With the magic of the digital age, I can get a much better idea of how sick your child really is. Sometimes. all I need to do is see the child through the computer screen. Other times, I am looking for something specific, such as pink eye or a rash. Once this is done, I can give you more specific information. I can tell you if that visit the next day is necessary. Often, I can tell you that ER visit is not necessary. Occasionally, I can send out a prescription.
You're looking at me as if that example isn't enough information. Okay, try this one. You wake your child for school, and he has a fever and a sore throat. He was fine last night. Now what? Do you send him to school? Do you take him to the doctor's office? No. You call me and we do a telemedicine visit. I am able to determine that he needs a rapid strep test. A requisition is electronically sent to the lab in your neighborhood. You run by the lab, and results are sent to me within the hour. I can then tell you whether or not it is safe or advisable to send him to school.
It takes much less time to manage an illness via telemedicine than through a traditional office visit. Yes, the office physician may have a lab in his building. He may even be able to perform the strep test in his office. However, you still have to sit in a waiting room with other people who are ill. You may only have to wait a few minutes for your appointment. You may have to wait an hour. If it is flu season, you may not be able to get a same-day appointment with your provider. Your child may have to be seen by someone they've never met. Telemedicine is quick, convenient and offers continuity of care.
Not everything can, or should be handled via telemedicine. Please let your provider help in that decision as to when to do a telemedicine visit versus an onsite visit. You wouldn't want her to miss an important diagnosis.
I hope this has given you a more concrete idea of telemedicine and what it can do. It is more than phone advice, yet less than a face to face visit. It has different uses in different settings. It can sometimes, but not always, replace an office visit. It is quick, convenient and safe.
Dr Nan N
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home
See this post as a video:
http://www.youtube.com/user/personalmedicinetv#p/a/u/0/xZZ0psXHpdQ
http://firesidepediatrics.com
http://personalmedicine.com
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