In my previous post I wrote on the need for training for doctors who are on call.
Well now I want to turn that post on it’s head.
The problem with being on call is that when you take a call from the hospital you deal with an incomplete dataset. The dataset is mostly incomplete because hearing a description about a patient simply isn’t the same as seeing the patient yourself, taking the history yourself and examining them yourself. Sometimes what might seem straight forward decisions might be the wrong decisions simply because the gut feelings that come from the experience of seeing the patient first-hand is taken away.
There have been some limited forays into breaking down the barriers between the ED and the remote physician. ECGs can be transmitted to smart phones (I even knew a cardiologist who had a fax machine in his car for the same purpose). Blood results and radiology can be viewed over the web. But this still doesn’t bring the patient to the doctor.
This can now change with the advent of remote presence devices (RPD). The simplest explanation is that this is a drone or telemedicine robot. A RPD system consists of a remotely controllable mobile display screen and camera linked back wirelessly to the control station of a remote operator. The control station could be a desktop computer, a tablet or a smartphone. The operator (the on call doctor) can pilot the robot to the bedside of the patient and conduct a virtual consultation, perhaps with the assistance of a nurse, junior doctor or physician assistant to perform hands-on tasks like holding a stethoscope to the patient’s chest. The doctor and patient will be able to to talk to each other and see each other.
The bottom-line is that the on call scenario goes from the doctor on the end of the phone thinking “I’m not really sure how sick that patient is” to the doctor on the end of a video link seeing the patient and thinking “they don’t look right…..lets do x, y & z”.
Setting up a system might be less than a quarter of a salary for a junior doctor and the ROI is having the experienced doctor making decisions based on actually seeing the patient even if they aren’t in the building.