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Saving Lives with Telemedicine

By Judd E. Hollander, MD, Advisory Council Member, American Board of Telehealth; Associate Dean, Strategic Health Initiatives, Kimmel Medical College; Professor and Vice Chair of Finance and Healthcare Enterprises, Department of Emergency Medicine; Thomas Jefferson University; Philadelphia, Pennsylvania

I can’t treat every illness as a telemedicine provider, but I can save a patient’s life.

For more than 5 years, I have practiced telemedicine as part of the team that introduced this modality of care at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania. We initially introduced telemedicine through in-person training for 600 people in many small group sessions for our 3 hospital system. With subsequent mergers and growth to 14 hospitals, we transitioned from in-classroom training to remote training. With the pandemic, our remote training allowed us to rapidly train the remainder of providers in our system to use telemedicine.

This alignment for remote patient care prepared our providers and patients for the sudden reliance on telemedicine due to the pandemic.  As the pandemic became reality, we were able to deliver high quality care to Covid-19 patients as well as the larger group of patients with chronic medical problems; we took care of 70 percent of our patients who had planned scheduled visits and delivered 90 percent of those visits via telemedicine.

From my perspective as an emergency physician, patients reap the benefits of telemedicine because they receive care when and where they need it. Here are some examples.

Timing
One of my colleagues treated a patient with severe symptoms of a heart attack a few hours after she reached out to her primary care physician. Still waiting for a return call, she checked in through our JeffConnect on-demand telehealth service. Within minutes of this interaction, she was in an ambulance and headed for evaluation at our hospital.

Decision Makers
Emergency physicians make and adjust decisions with the information at-hand. My colleagues and I decide how best to proceed at that moment in the encounter.

Not every on-demand telemedicine call requires an immediate trip to the hospital. Using video, I can show a patient how to clean and bandage a cut on his finger and recommend a visit his physician or an urgent care center the next morning for further treatment.

Tie breakers
We often act as tie breakers for families with opposing opinions or questions on the care for their loved one. For example, one parent was comfortable going to bed while the other stays up with a teenager nearly comatose presumably from drinking. Another person calls after someone fainted twice for no apparent reason. The caregiver can’t find a pulse. Both of these patients need immediate care, a diagnosis based on symptoms gathered from questioning and video examination but neither would have received that care at the hospital, if they had not done the telemedicine visit.

Training
Physician training improves the telehealth experience for provider and patient. As with any major change in the workplace, telehealth ranks for many as a new care delivery mechanism with unfamiliar tools that clinicians must learn how to use.

The doctors throughout the country are at many different stages in their careers, each with its own challenges overcome through experience and training in telehealth. As they learn clinical judgment, young physicians depend on the patient in front of them for diagnosis. Telemedicine takes that crutch away. Mid-career doctors have confidence, but telehealth requires they change the method of care delivery. And older clinicians may not be at all familiar with telemedicine.

ABT as the next step in telehealth education
Clinicians need training to learn how to use telemedicine and administrators to understand why doctors and nurses use telemedicine. As a member of the Advisory Council for the American Board of Telehealth, I collaborate with other recognized telehealth experts to share our collective telemedicine experiences to help design the telehealth certificate courses.

The ABT Telehealth CORE Concepts Certificate Program and upcoming certificate courses offer that training with a standardized approach to educate the clinical and administrative workforce.

Find out more about the ABT Telehealth Certificate Program

Published on May 19, 2021