Telemedicine


I was catching up with a friend of mine earlier in the day who happened to have her very first telemedicine consultation with her primary care physician today.   So out of curiosity, I ask her how was her experience and what was her opinion on telemedicine in comparison to her regular office visit?

She reported that it was more convenient as now there was no huge wait time like while visiting the doctor’s practice and a person didn’t need to be physically present at the office to see the doctor; but when rating the personal connection during the visit, she said office visit was better.

So what went wrong with this new mode of consultation called as Telemedicine?

During the conversation, the doctor was almost all the time occupied with computer entering data into it and failed on the facetime and eye contact that we are used to and so much expect.

Why does this matter?  Patients need this eye contact from their physicians while they are trying to explain their health issues to get assurance that their concerns are being heard. When this personal connection is lost, the patient feels like their issues are not heard and the patient is not confident or content with the treatment plan given to them without making any reassuring eye contact.

Is it a healthy practice? Definitely not. As disconnection would lead to the patient not being able to engage with their providers with confidence which results in loss of comfort and care.

The patient feels the doctor is more involved in filling their EHR documentation than listening to what the patient has to say.

EHR documentation takes a major chunk of a physician’s time in a practice, but what is the point in having the best documentation when patient engagement is lost?

Let us say if the doctor gives the full facetime and does the reporting after the visit or at the end of the day, will the provider be able to recollect the relevant and vital information from the visit to be fed into the EHR?

Vital signs recording and blood work, what happens to this? – Do come to our office to get this done. Next question would be then why need this telemedicine consult?

There are apps available for recording the vitals of a patient, but these come at a price where the question would be whether the patient would have to pay for it or is covered under patient’s medical insurance?

My friend’s virtual visit with her physician lasted 25 minutes and there was a co-pay of $75 charged to her credit card.  So, are people ready to pay this price for a virtual visit???

  • How long is it going to take for Telemedicine to change into an acceptable healthcare practice model?
  • How successful is it going to be in long run?
  • Will adaptation change on what can be expected?

Medical Scribing


EHR documentation had put Medical Doctors into a state of not able to focus on their patients if they do it in the examination room or taking excess hours to work on reports which puts them into unwanted stress of working extra hours after seeing the patients.

Dicta scribe: The doctor could dictate what he wants to be typed into the EHR and an assistant could complete it latter on, final reviewed by the doctor once report done and signed off . This could be either in a live process or done as a recorded dictation.

Data Scribe: Data send to the scribe in a hard copy as filled by the doctors while seeing the patients and this could be final sent to a scribe to put in the details to the relevant fields in the EMR which could be latter final reviewed by the doctor and closed.

Live Scribe: No dictation nor data transferred but a live scribe will be listening to the “Doctor/ Patient” conversation and will do the reports. This would require certain comprehensive capability for the scribe to understand the session between the Doctor/ patient to pick exactly what would be required for the EHR.

Conclusion: Scribing could take the typing burden out of the hands of the doctors. It does requires the doctors to do final review of the reports done before they final sign it for it to be considered as a meaningful use.