Telemedicine and the Emergency Physician by Kevin Klauer, DO
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KEY POINTS AND RECOMMENDATIONS
1. Telemedicine is here and growing at a rapid pace.
2. The role of telemedicine in stroke management is well established and is expanding.
3. Mobile stroke units are the latest, and very expensive, fad. Their overall impact is unclear, although those who own these units have published support for this practice.
4. Many emergency departments are using telemedicine, particularly smaller and more rural EDs.
5. Intensivists have published papers concluding that telemedicine enhances care.
6. Telepsychiatry is rapidly growing and may impact on the ED in a favorable way, reducing the boarding of psychiatric patients.
7. Teledermatology is feasible in the ED setting, and provides enhanced diagnosis which is almost as good as a face-to-face visit. Video conferencing is superior to still pictures alone.
8. Virtual urgent care is rapidly growing and will most likely reduce the number of non-urgent ED visits.
9. Most of the world has mobile phones.
10. Smartphones have been shown to be useful in the diagnosis of multiple diseases, either alone or with special attachments.
11. Smoking cessation programs that include texting have been shown to be more effective than the cessation program without texting.
12. Home monitoring combined with smart phone technology will continue to revolutionize ongoing patient care.
13. The big giants: Amazon, Apple, Google, and Microsoft will have a major impact on the practice of medicine.
14. Wearable monitors on discharged ED patients can identify arrhythmias, some of which are quite significant.
15. The future will be different than the present. Particularly if payment issues are addressed.
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