Page 25 - Part 1 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

the neurologist requested the presence of the emergency

physician and the daughter at the bedside to discuss the

plan for care. At 5:53 PM the stroke neurologist reviewed

the observations and recommended the administration of

tPA. The spoke emergency department initiated tPA at

6:09 PM. The hub stroke neurologist dictated a

consultation and faxed it to the spoke center emergency

department.

Other specialty services (both doctor-to-patient and doctor-to-
doctor) that can be delivered at a distance include triage, urgent

evaluation, transfer decisions, supervision of care by non-physician
providers, consultation, second opinions and shared decision

making.

Teleradiology

One of the most widely embraced services in the field of
healthcare at a distance is the remote reading of medical images.

This practice is intuitively appealing; however, it has also

sometimes been seriously disruptive to pre-existing professional
and financial relationships. When the procedure does not require

direct patient contact, it should not make any difference whether
the data file is reviewed five feet or 5,000 miles away. The provider

is dealing purely with information, which is independent of

location. Teleradiology removes barriers of time, distance and
expertise. It reduces response time after-hours. It allows smaller

hospitals and groups to maintain adequate coverage around the
clock. It allows efficient access to qualified radiologists and sub-

specialty experts by facilities that cannot afford to provide this

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