Telemedicine Can Greatly Improve Emergency Care

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Telemedicine can Greatly Improve Emergency Care A recent study discusses how an innovative digital health program at NewYork-Presbyterian Hospital has transformed emergency telemedicine. www.medicaltranscriptionservicecompany.com

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Recent studies reveal that the number of emergency department visits continues to rise across the nation despite the passage of the Affordable Care Act (ACA).

Emergency room medical transcription services help promote improved patient care by ensuring accurate and timely emergency department (ED) medical records to meet American College of Emergency Physicians (ACEP) guidelines. However, a study published in the International Journal of Emergency Medicine in July 2017 highlighted the need to develop innovative solutions to ensure high quality and efficient care to meet the rising demand for emergency medical services. The answer lies in telemedicine, say the researchers. They discuss a case study which showed that telemedicine has the potential to transform emergency care.

Benefits of Telemedicine According to the American Telemedicine Association, there are about 200 active telemedicine networks with over 50 percent of US hospitals currently using some form of telemedicine. The interest in digital health care is growing due to the many benefits that it offers:

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Telemedicine improves access to healthcare services for patients in distant locations and rural areas.

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Many patients prefer telemedicine as it reduces travel time and related stresses.

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Virtual healthcare has been also found to be cost-effective for the management of chronic conditions and has led to fewer or shorter hospital stays.

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Studies have shown that the quality of telemedicine services is on par with care provided in face-to-face consultations, with greater patient satisfaction and outcomes for mental health and ICU care.

Telemedicine in Emergency Medical Care The role of telemedicine in the field of emergency medical care related to the use real-time audio or video transmissions by practitioners to provide information, advice and orders for diagnostic and treatment interventions between a distant site

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(such as a healthcare facility, ambulance, ship, airplane, or rescue location) and an emergency department (ED) or its telecommunication hub. Telemedicine allows physicians to evaluate patients and their diagnostic results, track ongoing clinical interventions, and interact with the patient’s on-site clinicians. The availability of high resolution video and electronic health records (EHRs) make it easier for physicians to provide quality services remotely. Patients have also become adept in using digital technology to interact with healthcare professionals.

New York-Presbyterian Hospital is a leading provider of inpatient, ambulatory, and preventive care across all specialties. The hospital receives more than 2 million visits annually, including more than 310,000 emergency department visits. The New York based researchers discussed a comprehensive enterprise-wide digital health

program

launched

by

NewYork-Presbyterian

Hospital

and

Columbia

University Medical Center in 2016. The program features the first mobile stroke unit on the East Coast and one of the first emergency department-based Telehealth Express Care Service in the United States. These innovative programs have significantly improved the delivery of care by one of the nation’s largest academic healthcare systems. 

Innovative Mobile Stroke Unit:

New York-Presbyterian’s

innovative

telestroke program involved the creation of a Mobile Stroke Treatment Unit (MSTU). The first of its kind on the East Coast, this specialized emergency vehicle is equipped with CT imaging capability, has a neurologist onboard, and is dispatched by the New York City 911 System via the FDNY directly to a patient showing signs of a stroke. The MSTU also has medications for diagnosing and treating strokes, allowing the team to administer the right drugs as soon as the condition is diagnosed. 

First of its kind ED-based Telehealth Express Care Service: To create digital emergency department capability, NewYork-Presbyterian and Weill Cornell Medicine launched the first ED-based Telehealth Express Care Service. This program covers patients with minor complaints (such as wound

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checks, upper respiratory infections, contusions, suture removals, and simple rashes) arriving at the EDs of New York-Presbyterian/Weill Cornell Medical Center and New York Presbyterian/Lower Manhattan Hospital. They are offered the option of a virtual visit through real-time video interactions with a board certified Weill Cornell attending physician. The patient is triaged and undergoes medical screening before the virtual visit is initiated. The virtual visit takes place in a private room with a webcam/monitor. After the consult, the patient is discharged with printed discharge instructions. This system makes things extremely convenient for patients: -

There is no additional waiting period or checkout process.

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While an ED visit for low acuity patients typically takes 2 to 2.5 hours, the entire Telehealth Express Care Service process is completed in approximately 35–40 minutes from arrival to discharge.

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Each patient receives a follow-up call from the hospital’s nurses to answer any questions they may have post discharge.

The researchers reported that as of June 2017, approximately 2800 patients benefited from this service and their patient experience scores have been in the 99th percentile. They however stressed that maintaining high standards and quality of care was necessary for these innovative telemedicine systems to succeed.

ACEP stresses Importance of Proper Documentation of Telemedicine Services The ACEP emphasizes that provider documentation of the patient encounter should meet the same standards as a conventional office encounter. Providers need to maintain a complete and legible electronic medical record (EMR) that is available to the patient and other medical providers as needed. Medical transcription outsourcing can help with this. A reliable service provider can ensure that telehealth documentation meets ACEP recommendations, which includes: -

A reliable medical history -- past medical history, history of present illness, review of systems, current medications and allergies, if applicable.

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An appropriate and adequate exam to determine a diagnosis or underlying condition. The technology used must be sufficient to allow an exam similar to that in a face-to-face consult.

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A treatment plan inclusive of discussion with the patient about various treatment modalities and the risks and benefits of any recommended options.

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Clinical impression or diagnosis based on the information obtained.

An experienced emergency room medical transcription service company can help physicians maintain complete and legible medical records for access by patients and other medical providers as needed.

The ACEP also notes that providers should maintain privacy and confidentiality required under HIPAA while delivering ED telemedicine services. This includes assuring that their equipment and technology are up-to-date and secure. Physicians should maintain the required standards of care and ensure proper follow-up and referrals if required.

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