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Medical Consultations With Webcams Extremely Successful
AgaveNectar writes "Doctors are far from being early adopters, so they have just gotten around to publishing a report that webcams help immensely with making the right decision when someone shows up to a rural emergency room suffering from a stroke. Using clot-destroying medications like Alteplase is really risky, and it should only be given in acute cases. In a study of 222 patients, rural ER doctors consulted with faraway stroke specialists. They made the right decision 98 percent of the time when the expert examined the patient with a webcam, and only 82 percent of the time when they just talked to each other on the phone. Perhaps this report will finally convince the medical community that telemedicine is important."
Now, at last, medical care can be outsourced to low-wage countries.
Will my privacy be protected, as per HIPAA, when then they stream video of me lying in a hospital bed, being less than articulate, across the interwebs?
But not because of this.
The problem is that this is not really a good demonstration of the efficacy of telemedicine, because they picked a treatment for which there is a marginal benefit for a very small proportion of people. In order to get thrombolytics for stroke, you have to meet a certain set of criteria that in my experience few meet: no recent trauma or surgery, normal blood pressure, no history of stroke in the past 3 months (or hemorrhagic stroke ever), no current ulcer disease, no diabetic retinopathy, no seizures, deficit is more than minor but not too major, certain onset of symptoms in under 3 hours (and it will take an hour to get you imaged and blood tests done after you get to the ER), and a lot more.
In addition, if we give you thrombolytics for your stroke (and you are an ideal candidate) you get a 13% greater chance to recover with minimal or no deficit, but you have a 7% greater chance of your stroke getting phenomenally worse by becoming a hemorrhagic stroke which more often than not leave you dead or in a permanent vegetative state (in addition to all the other problems you can get from being completely incapable of clotting for a good 24 hours.)
What they should do is demonstrate this where it could be really useful: with a NP or PA way off in the hinterlands or in underdeveloped countries. But that isn't snazzy, doesn't pay well, and drug companies that sell gazillion dollars a pop medicines don't sponsor it.
Google Stroke View
rewriting history since 2109
...Pay-per-view gynecology.
Could be worse though. ER tech, "This guy says he slipped and fell on a fusili statue. Here: take a look."
__ Someday, but not this morning, I'll finally learn to use the preview button.
Except the ones who are dead.
I would like to see a study comparing patient's success rates at self-diagnosis with google vs. a doctor's diagnosis success rate. Every time I've had to go to the doctor lately I've successfully diagnosed myself with the internet and known the treatment before I went, only to pay $120 for a doctor to look at me for 5 minutes and say what I had already guessed.
We didn't have a medical consultation, but yo mama gave me one hell of an anatomy lesson!
Medtronic, Boston Scientific and St. Jude Medical have systems that monitor patient's implantable cardiac defibrillators and cardiac resynchronizers. I work for one of these companies and let me tell you, the data that's gathered and the way it's helping patients is amazing.
"There are no facts, only interpretations." --Friedrich Nietzsche.
They made the right decision 98 percent of the time when the expert examined the patient with a webcam, and only 82 percent of the time when they just talked to each other on the phone. Perhaps this report will finally convince the medical community that telemedicine is important.
82% ought to be good enough for everyone.
Fact: Everything I say is fiction.
Then above you said :I'm not sure that I call transmission of digital information 'telemedicine' but we use remote radiology all the time since we are too rural to afford a full time radiologist.
I'll call them up and tell them that Portland, Oregon is officially considered a "low wage country". I bet they will be surprised!
It has been reported in the Economist and in other business magazines that there's a trend in electronically sending X-rays and other data via the internet to docs in India for review and diagnosis. They then just email back there answers.
For one; it's much much cheaper. Two, there's time difference. So, when or if you do a night shift in the ER, where do you send those X-Rays? Is that Portland radiologist or another still working at 2:00AM?
I've worked on the technology at McKesson/HBOC - 8 years ago.
I have not read the article.
That being said, a 98% accuracy sounds like it's as good as the gold standard (Gold standards are almost never 100% accurate). I find that hard to believe, and therefore find the results suspect.
Help! I'm a slashdot refugee.
The mods here just have a strict anti-"yo mama" jokes stance. Seriously, lighten up.
Also, declaring your post "insightful" automatically voids it as insightful. It's like a guy who goes around telling people he's cool. Don't be that guy.
I've used webcams for breast examinations for years.
I'm amazed that nobody has noticed that this means that webcams have passed the Turing test.
as long as your doc isn't Bill Frist
and University of Arizona, it's been going strong for years.
Si vis pacem, para bellum! For evil to succeed good men need only do nothing!
Trust me, many doctors are already convinced that telemedicine is important. The problem is that very few payment models have been sorted out. Until the insurance companies and the government (Medicare, VA, etc) figure out how they are going to pay the assisting doctor/therapist/etc for their time, we're not going to see a lot of telemedicine.
Hey, I saw that episode of House too!
"Perhaps this report will finally convince the medical community that telemedicine is important."
I wouldn't count on it. Interns still work insane hours in emergency rooms, sometimes making life-and-death decisions under circumstances that would get a long-haul trucker's license yanked for failing to obey hours-of-driving laws.
Why would this be different?
I've calculated my velocity with such exquisite precision that I have no idea where I am.
Parts of it already are....like interpreting tests, reading medical imaging output, writing the reports, etc.
It's a big deal from the standpoint that the contractors that are typing in the results and interpreting your medical diagnostics are not regulated by US law nor subject to the the US HIPPA medical privacy rules -- since they don't have to have privacy safeguards, their services can be offered due to lower overhead in procedures and safeguards as well as lower labor costs. I'm sure having an 'expert on call' would be much cheaper if on call from other continents.
Taking samples is something that isn't likely to be outsourced overseas any time soon. But remote surgery? Trans-atlantic surgery was done via remote 7 years ago.....
I was involved with tele-radiology back in the mid-Ninties, when I worked for one of the small companies trying to pioneer that particular subset of this field, RADMAN/Radiology Management Systems. That company isn't even in business any longer.