By Dr. Jean-Paul Dym
As telemedicine has taken hold as a primary care channel amid the global pandemic, many physicians and patients first saw it as a temporary solution. Now, almost six months into the “new normal”, it’s clear that we won’t see a post-COVID world anytime soon and the massive healthcare shifts towards technology adoption will not be short-lived. The immense benefits of remote care are abundantly clear to physicians and patients alike, sparking the telemedicine revolution.
Although telemedicine may feel like it came out of nowhere, it’s grown steadily behind the scenes in recent years. In fact, patient adoption of telemedicine at the beginning of 2020 was up 33% over last year. Some healthcare providers, on the other hand, hesitated to implement unfamiliar tech-powered processes with the exception of certain specialties, like radiology, which has led the telemedicine charge for years.
Successful Telemedicine Starts with the Right Equipment
Mass telemedicine adoption came about much more quickly than expected and felt jarring for many physicians unaccustomed to working remotely. The initial shock quickly dissipated as physicians experienced the major benefits of telemedicine – speed, accuracy and efficiency to name a few – in their day-to-day. Many were surprised to not only discover that they can successfully work from home, but that their productivity increased and burnout diminished.
Radiologists identified the efficiencies of telemedicine well before the remote work boom. Having worked as a teleradiologist for over 10 years, I find that an optimized home office is a must-have, including standing desks, programmable mice and keyboards, and ergonomic chairs. Functional workstations make a world of difference, and physicians will never realize the benefits of telemedicine if they’re working with the wrong tools.
Given how fast the rush to home offices happened, it’s not surprising that physicians are operating on suboptimal devices without the ergonomics or environment needed. Even in radiology, which has a major leg up on telemedicine adoption, it can take time to determine which state-of-the-art tools outweigh others. For example, although many gaming mice are used for radiology, some of the most expensive and programmable mice may be missing key features that less expensive mice may have which enable them to actually function more efficiently. The chair and desk that a radiologist uses is another fine example. Just because it’s an electric standing desk doesn’t mean it’s a useful tool. The most expensive executive office chairs also may be missing features which would improve the radiologist reading experience. It’s time for the health sector to take a pause and consider what is needed for telemedicine to work in the long run, and teleradiology is a prominent example of how other practices can experience the full benefits of remote care.
The Next Frontier of Healthcare Will Improve Quality of Care
When I decided to transition from traditional radiology to teleradiology, my mentor strongly discouraged me, saying that the practice was frowned upon and seen as “not real”. After seeing the life-saving impacts of telemedicine firsthand, I quickly realized how inaccurate my mentor was. One of my first cases was a pediatric brain tumor in North Dakota where the onsite general radiologist was having a difficult time pinpointing a diagnosis. With my background in neuroradiology and the ability to gather second opinions on my analysis through a network of teleradiologists, we were able to quickly diagnose the child and provide immediate and potentially life-saving counsel to the physician onsite. In just a matter of minutes, we greatly improved the quality of care by democratizing access to subspecialists for residents in rural communities. This is just one example of the power of telemedicine – think about the impact that improved access and quality of care could have if amplified across the entire healthcare ecosystem in the U.S.
When discussing the power of technology in healthcare, it’s important to dispel the notion that telemedicine is a lesser or detached form of care. In medical school, the relationship between doctor, patient and student is often presented as the heart of medicine, conditioning physicians and patients to see in-person care as higher quality. This is captured in this painting that I have in my home office.
Yet this fundamental principle of patient care is also why adoption of telemedicine has been an uphill battle. What we see now with cutting-edge telemedicine is that the triad is now a quad with the availability of AI the combination of physicians and advanced technology working together to further minimize human error. Utilizing data and AI to pinpoint diagnoses and areas of immediate need allows physicians to address ailments faster and more accurately. As proof, a subtle finding on a chest CT can be further classified with a risk assessment of COVID not only based on the imaging characteristics, but on the patient’s unique characteristics too. I recently read a chest CT with a faint area of ground glass opacity (a finding which is now correlated with COVID). The ER physician thought COVID would be unlikely, but after she dove deeper into the patient’s history and recent activities, the suspicion was further raised and testing proved the patient to be positive for the infection.
With the pandemic top-of-mind, people are more acutely aware of their health and plans of care. People are using phrases like “chest xray” or “CT chest” due to COVID more than ever before, and are starting to have an early understanding of their differences. Though patients already appreciate the convenience of telemedicine, providers must prioritize transparency and direct communication for it to be seen as the same, or higher quality, as in-person care. A parent can show a rash online to a covering pediatrician within minutes of sitting down in front of a computer. One could argue that telemedicine actually fosters more of the heart of medicine taught in schools, as patients now have more direct involvement in their care.
Healthcare will not revert back to a pre-pandemic state now that physicians and patients have experienced the efficiencies and benefits of telemedicine firsthand. The telemedicine revolution is only just beginning and will change the future of healthcare for the better.
About Dr. Jean-Paul Dym
Dr. Jean-Paul (J.P.) Dym is medical director of Nines Radiology, overseeing the clinical practice and the relationships with Nines healthcare provider clients. J.P. graduated from Georgetown Medical School, completed his residency at Lenox Hill Hospital in NYC and also a neuroradiology fellowship at Yale School of Medicine.