Reviewing scans with patient in the ER

An ER physician contacted me recently at 1230 AM because an aquaintance of his, who also was a patient in the ER, had some unusual visual event earlier in the day and a somewhat confusing interpretation of CT/MRI.  The ER physician was logged into Google Talk from his desktop, identified as the “ER Physicians Desktop 1” in my list.

He sent me quick text message noting that even though my “status” was “asleep-urgent only”, that in fact this was an urgent question. I texted him back to ask for the medical record number so I could take a look at the scans.  I sent the ER doc a link to my home page that directs him to click/connect into my virtual consult room. He does so, and within 30 seconds he is online.  The patient had no neurologic deficits at the time, was fully conversant, and could provide some additional details himself.

We roll the cart into the patients room to not only get added history, but to show the patient the scans, come up with a care plan, and ask about any questions or clarification. We were able to reassure all involved of the probably nature of the issue, the reason for getting some added tests, the risks of any interventions and what to expect over the next few days.

Then a brief note is entered into the hospital’s electronic online medical record (or could have been in an office based electronic record if  needed, or ones own document repository)….

Then used Snagit to grab a copy of the notes and images, delete or cover over any names or identifying info, and send a copy as a secure email attachment to the nurse practitioner who will pick up the case in the morning on daily rounds.


About Andrew Barbash, MD

Neurology Telemedicine affiliated with Specialists on Call Virtual Care Services

Posted on May 19, 2011, in Case Studies in Virtual Care, Virtual Care. Bookmark the permalink. Leave a comment.

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