Avera E-Care

[Vandalia]

I don't believe this has been posted before. A Washington Post article on Avera E-Care. "The most remote emergency room"

Think teleradiology morphing to tele-icu morphing to tele-emergency medicine.

I am reluctant to make prophecies about the future of emergency medicine, since I have seen enough to know that 99% of those turn out to be false, but I would be very surprised if this did not become a significant part of the landscape. At least for critical access locations. Why pay to have a NP/PA on-site 24/7 when you can get a BC EM physician when you want and essentially don't pay for downtime? (Yes, there is a fixed fee but the number's quoted work out to minimal coverage.)

As a disclaimer, I have no affiliation with these companies in any way whatsoever. Except for the fact that I proposed something similar to this about 2 am on a boring night about 25 years ago...

(The article may be subscription, but there are a number of free views a month, I believe.)

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[gamerEMdoc]

Yeah, I think telemedicine really has the potential to change the future of medicine. Not just EM. Much of primary care could be done without ever going to the doctors office. So many visits to EDs could be headed off by a telemedicine visit, or at least triaged to an appropriate facility. I don't know exactly how this will be implemented, but I definitely think telehealth will play a part in the future of health care delivery.

 

[EctopicFetus]

Yeah, I think telemedicine really has the potential to change the future of medicine. Not just EM. Much of primary care could be done without ever going to the doctors office. So many visits to EDs could be headed off by a telemedicine visit, or at least triaged to an appropriate facility. I don't know exactly how this will be implemented, but I definitely think telehealth will play a part in the future of health care delivery.

It needs a lot more improvement but yes there is a chance. Im not believing it will make a major difference. who goes to the hospital / doctor. Overall it is the old and sick. Neither of those groups are gonna trust their care to a "computer". I am a naysayer. I think it will be like urgent care. Adds costs but no value.

 

[alpinism]

They mentioned in the article that they care for 300 cardiac patients a month from 179 hospitals. If you do the math that means on average these hospitals are seeing less than 2 patients a month.

Do people here really think we should have emergency rooms in places that see 1 cardiac patient every 2 weeks?

 

[RustedFox]

At my one job site (A "freestanding" ED), they recently instituted a "Virtual registration person". Now, instead of a human being coming to take your insurance card and register you - you hold your cards up to a tablet and there's a little window with a person working remotely to guide you thru the process.

The nurses hate it.
The patients hate it.
The doctors hate it.
The remote workers hate it.

 

[thegenius]

All of this time and energy spent on trying to optimize a terrible health care system. It's understandable - but futile.

Someone a few days ago posted an article from the Atlantic? One of the best reads ever on the topic of our health care system. In my opinion (and I know everyone is dying to hear it ), the health care system won't measurably change at all until 1) people start paying for their health care and not with insurance or via taxes (i.e. govt) and 2) we start a massive education program teaching people about their health and making it more a priority to stay healthy. That alone will eliminate a large percentage of the useless doctor visits each year. We over diagnosis, over treat, and patients will want everything in medicine if someone else pays for it.

Telemedicine will be another niche thing that will help a few people here and there, make a little bit of money here and there.

Why is it that we accept selling WATER (an essential chemical for life) for profit but we make health care either free or to damn expensive for everybody? What the hell is wrong with our country?

 

[TooMuchResearch]

I did this at a car rental place last year. I thought it was just a computer, there was no line, so I tried it. There was a man in that computer. Same thing, held up my license to the camera, etc. PITA. And that was for a car rental.

At my one job site (A "freestanding" ED), they recently instituted a "Virtual registration person". Now, instead of a human being coming to take your insurance card and register you - you hold your cards up to a tablet and there's a little window with a person working remotely to guide you thru the process.

The nurses hate it.
The patients hate it.
The doctors hate it.
The remote workers hate it.

 

[emergentmd]

I guess this can screw new docs but man, would I love a job where I can sit in my pajamas with a cup of coffee in hand

 

[Dr Mantis Toboggan]

we have a telepsychiatrist who always wears a scrub top when we communicate with the iPad. Pretty sure he’s in his home office.

I guess this can screw new docs but man, would I love a job where I can sit in my pajamas with a cup of coffee in hand

 

[deleted109597]

I guess this can screw new docs but man, would I love a job where I can sit in my pajamas with a cup of coffee in hand

I already do that. You don't carry coffee around at work?

 

[Fox800]

I already do that. You don't carry coffee around at work?

I mean, hell, I brought my French press and my own coffee to work the past few shifts so I don't have to drink the hospital Folgers. Just use the hot water tap on the coffee machine and let 'er rip.

Helps that I was seeing like 1-2 patients at a time, though.

 

[thegenius]

we have a telepsychiatrist who always wears a scrub top when we communicate with the iPad. Pretty sure he’s in his home office.

One of our telepsychiatrists works from Greece. He's actually quite good and I'm grateful when he helps us out.

 

[TooMuchResearch]

We have a telepsych service at one place, but their recommendations are bat**** crazy, so I won't consult them anymore.

One of our telepsychiatrists works from Greece. He's actually quite good and I'm grateful when he helps us out.

 

[austintr]

I rotated at a rural ED seeing ~10 pts/day and they use this specific company's service. It's really interesting, because the ED I was at is staffed largely by NPs with a family med boarded physician on duty 1 day/week.

The NPs would consult Avera on anything with any real degree of acuity, and you could tell the doc on the other side was just bored as hell. The NPs also had to consult with them when they were transferring a patient due to some EMTALA thing I guess, and they were like "uh, sure, sounds like they should see Ortho".

It was kind of sad seeing these EM boarded docs getting consulted on (what seemed to me as a lowly M3) extremely straightforward pathology and management. The conversations were rarely anything more than "yeah, I'd order a CT" or "seems like the epistaxis is posterior, might as well ship it to a town with an ENT".