Telemedicine (Rochester, NY) on Discovery Channel

January 3, 2012

IMPs, Thu & Debra,I am just getting started with Telemedicine, but so far I like the flexibility. (It is also nice to be able to go to work in your slippers….LOL.) We have not expanded to having providers from out of the state yet, but when this happens, it will be the ideal job for those who want to add extra hours but want to work remotely. It is definitely different to see tympanic membranes through a digital picture or listen to lung sounds through a wave file. It is not a job that everyone would like, but I think it will expand our ability to help those in underserved areas. I also envision Telemedicine helping those who are IMPs to see patients out of our area. There is a technician at the location where the patient arrives and they collect the data to enter into the computer, pictures etc. and the provider can see the patient through Skype and then the documentation is done in TeleAtrics, which is a web-based record. There are two sites….one for pediatrics and one for geriatrics (or adults). I envision IMPs someday, once Telemedicine takes off and is more mainstream, having their patients arrive at a Telemedicine site in their area where a technician can collect the exam data (vitals, pictures etc) and then the provider can see the patient over skype or be telephone for the interview. Technicians can collect ROS information but it must be confirmed by the provider as the techs are not licensed but trained to collect what information the provider will need. A real virtual visit cannot be done unless an exam can be completed. There are “virtual visits” that can be done but there is no means to collect vital signs and do an exam and just talking to the patient is really no different than doing a phone visit (IMHO). Some situations where the patient just needs a follow up on clarification of how to use a new medication etc. may not require an exam, but to evaluate the efficacy and side effects of the medication, for example, would require an exam. So until we have a means to collect this data, such as with Telemedicine, there are limitations to what can be done as a virtual visit. As Telemedicine progresses I see a world of opportunity opening up for health care providers and patients everywhere. One provider can cover multiple sites and the scheduler makes it a planned visit, so the provider knows when the patients will be “arriving” for their visit. The program that I work for was included in a special documentary that the Discovery Channel did from across the nation. Markwick is the other Family NP that I work with and she is the Director of the Adult Telemedicine program. Here is the link……http://link.brightcove.com/services/player/bcpid1280283152001 Tammy Tammy L. McGarvey, MSN, RN, FNP-BCBoard Certified Family Nurse Practitioner

January 3, 2012

so ok jean.. we are even.

sarcasm for sarcasm.

but in the light of a happy new year, im thinking about this a little bit more.

i think with how the culture likes quick and easy solutions telemedicine has the

capacity to kill IMPs. yes, KILL the IMPs.

now i know that telemedicine works in farflung places in teaching rural docs or

other countries how to do surgery... mind you i have been helped by this. but

here? what are we doing to ourselves?

our patients already lament no eye contact because we have to type things into

this stupid laptop im using to post this message and to do the emr records.

where has real medicine gone to? we are not elevating this and using it to its

most apropo use.

not good medicine. sorry jean, much as i like you, im with brady on this one.

grace

> > > >

> > > > IMPs, Thu & Debra,

> > > >

> > > > I am just getting started with Telemedicine, but so far I like the

> > > > flexibility. (It is also nice to be able to go to work in your

> > > > slippers..LOL.) We have not expanded to having providers from out of

> > the

> > > > state yet, but when this happens, it will be the ideal job for those

> > who

> > > > want to add extra hours but want to work remotely. It is definitely

> > > > different to see tympanic membranes through a digital picture or

> > listen to

> > > > lung sounds through a wave file. It is not a job that everyone would

> > like,

> > > > but I think it will expand our ability to help those in underserved

> > areas.

> > >

> > > >

> > > > I also envision Telemedicine helping those who are IMPs to see patients

> > > out

> > > > of our area. There is a technician at the location where the patient

> > > > arrives and they collect the data to enter into the computer, pictures

> > > etc.

> > > > and the provider can see the patient through Skype and then the

> > > > documentation is done in TeleAtrics, which is a web-based record. There

> > > are

> > > > two sites..one for pediatrics and one for geriatrics (or adults).

> > > >

> > > > I envision IMPs someday, once Telemedicine takes off and is more

> > > mainstream,

> > > > having their patients arrive at a Telemedicine site in their area

> > where a

> > > > technician can collect the exam data (vitals, pictures etc) and then

> > the

> > > > provider can see the patient over skype or be telephone for the

> > interview.

> > > > Technicians can collect ROS information but it must be confirmed by the

> > > > provider as the techs are not licensed but trained to collect what

> > > > information the provider will need.

> > > >

> > > > A real virtual visit cannot be done unless an exam can be completed.

> > There

> > > > are " virtual visits " that can be done but there is no means to collect

> > > vital

> > > > signs and do an exam and just talking to the patient is really no

> > > different

> > > > than doing a phone visit (IMHO). Some situations where the patient just

> > > > needs a follow up on clarification of how to use a new medication etc.

> > may

> > > > not require an exam, but to evaluate the efficacy and side effects of

> > the

> > > > medication, for example, would require an exam. So until we have a

> > means

> > > to

> > > > collect this data, such as with Telemedicine, there are limitations to

> > > what

> > > > can be done as a virtual visit. As Telemedicine progresses I see a

> > world

> > > of

> > > > opportunity opening up for health care providers and patients

> > everywhere.

> > > > One provider can cover multiple sites and the scheduler makes it a

> > planned

> > > > visit, so the provider knows when the patients will be " arriving " for

> > > their

> > > > visit.

> > > >

> > > > The program that I work for was included in a special documentary that

> > the

> > > > Discovery Channel did from across the nation. Markwick is the

> > other

> > > > Family NP that I work with and she is the Director of the Adult

> > > Telemedicine

> > > > program.

> > > >

> > > > Here is the link..

> > > >

> > > > http://link.brightcove.com/services/player/bcpid1280283152001

> > > >

> > > > Tammy

> > > >

> > > > Tammy L. McGarvey, MSN, RN, FNP-BC

> > > >

> > > > Board Certified Family Nurse Practitioner

> > > >

> > >

> > > --

> > >

> > > MD

> > >

> > > ph fax

> > >

> >

>

> --

>

> MD

>

> ph fax

>

January 3, 2012

aw grace IMPS would be great at telemedicine Just integrate it in Imps are nimble we can add it in and be way ahead of the Big guysPatients will love us even more:)Michele Eads was doin wav files of coughs yrs ago(I have no idea what a wav is/how you do it ) and I may not be doin anyhtin gin 10min my lap top is growling and squeaking!

Jean

so ok jean.. we are even.

sarcasm for sarcasm.

but in the light of a happy new year, im thinking about this a little bit more. i think with how the culture likes quick and easy solutions telemedicine has the capacity to kill IMPs. yes, KILL the IMPs.

now i know that telemedicine works in farflung places in teaching rural docs or other countries how to do surgery... mind you i have been helped by this. but here? what are we doing to ourselves?

our patients already lament no eye contact because we have to type things into this stupid laptop im using to post this message and to do the emr records. where has real medicine gone to? we are not elevating this and using it to its most apropo use.

not good medicine. sorry jean, much as i like you, im with brady on this one.

grace

> > > >

> > > > IMPs, Thu & Debra,

> > > >

> > > > I am just getting started with Telemedicine, but so far I like the

> > > > flexibility. (It is also nice to be able to go to work in your

> > > > slippers..LOL.) We have not expanded to having providers from out of

> > the

> > > > state yet, but when this happens, it will be the ideal job for those

> > who

> > > > want to add extra hours but want to work remotely. It is definitely

> > > > different to see tympanic membranes through a digital picture or

> > listen to

> > > > lung sounds through a wave file. It is not a job that everyone would

> > like,

> > > > but I think it will expand our ability to help those in underserved

> > areas.

> > >

> > > >

> > > > I also envision Telemedicine helping those who are IMPs to see patients

> > > out

> > > > of our area. There is a technician at the location where the patient

> > > > arrives and they collect the data to enter into the computer, pictures

> > > etc.

> > > > and the provider can see the patient through Skype and then the

> > > > documentation is done in TeleAtrics, which is a web-based record. There

> > > are

> > > > two sites..one for pediatrics and one for geriatrics (or adults).

> > > >

> > > > I envision IMPs someday, once Telemedicine takes off and is more

> > > mainstream,

> > > > having their patients arrive at a Telemedicine site in their area

> > where a

> > > > technician can collect the exam data (vitals, pictures etc) and then

> > the

> > > > provider can see the patient over skype or be telephone for the

> > interview.

> > > > Technicians can collect ROS information but it must be confirmed by the

> > > > provider as the techs are not licensed but trained to collect what

> > > > information the provider will need.

> > > >

> > > > A real virtual visit cannot be done unless an exam can be completed.

> > There

> > > > are " virtual visits " that can be done but there is no means to collect

> > > vital

> > > > signs and do an exam and just talking to the patient is really no

> > > different

> > > > than doing a phone visit (IMHO). Some situations where the patient just

> > > > needs a follow up on clarification of how to use a new medication etc.

> > may

> > > > not require an exam, but to evaluate the efficacy and side effects of

> > the

> > > > medication, for example, would require an exam. So until we have a

> > means

> > > to

> > > > collect this data, such as with Telemedicine, there are limitations to

> > > what

> > > > can be done as a virtual visit. As Telemedicine progresses I see a

> > world

> > > of

> > > > opportunity opening up for health care providers and patients

> > everywhere.

> > > > One provider can cover multiple sites and the scheduler makes it a

> > planned

> > > > visit, so the provider knows when the patients will be " arriving " for

> > > their

> > > > visit.

> > > >

> > > > The program that I work for was included in a special documentary that

> > the

> > > > Discovery Channel did from across the nation. Markwick is the

> > other

> > > > Family NP that I work with and she is the Director of the Adult

> > > Telemedicine

> > > > program.

> > > >

> > > > Here is the link..

> > > >

> > > > http://link.brightcove.com/services/player/bcpid1280283152001

> > > >

> > > > Tammy

> > > >

> > > > Tammy L. McGarvey, MSN, RN, FNP-BC

> > > >

> > > > Board Certified Family Nurse Practitioner

> > > >

> > >

> > > --

> > >

> > > MD

> > >

> > > ph fax

> > >

> >

>

> --

>

> MD

>

> ph fax

>

-- MD ph fax

January 3, 2012

I find offering Phone Visits to

my patients as an option (along with Office and Virtual Visits) works well.

This is with established pts, mind you. I want to foster a continuous healing

relationship with my pts, and that doesn’t have to be exclusively through

face-to-face encounters, IMO. I try to be flexible and meet my pts needs and

preferences in various encounter forms when appropriate.

Eads, MD

Pinnacle Family Medicine

Colorado Springs, CO

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On Behalf Of Jean

Antonucci

Sent: Tuesday, January 03, 2012 1:41 PM

To:

Subject: Re: Re: Telemedicine (Rochester, NY) on

Discovery Channel

aw grace

IMPS would be great at telemedicine

Just integrate it in Imps are nimble we can add

it in and be way ahead of the Big guys

Patients will love us even more:)

Michele Eads was doin wav files of coughs yrs ago(I have no idea what a wav

is/how you do it ) and I may not be doin anyhtin gin 10min my lap top is

growling and squeaking!

Jean

so ok jean.. we are even.

sarcasm for sarcasm.

but in the light of a happy new year, im thinking about this a little bit more.

i think with how the culture likes quick and easy solutions telemedicine has

the capacity to kill IMPs. yes, KILL the IMPs.

now i know that telemedicine works in farflung places in teaching rural docs or

other countries how to do surgery... mind you i have been helped by this. but

here? what are we doing to ourselves?

our patients already lament no eye contact because we have to type things into

this stupid laptop im using to post this message and to do the emr records.

where has real medicine gone to? we are not elevating this and using it to its

most apropo use.

not good medicine. sorry jean, much as i like you, im with brady on this one.

grace

> > > >

> > > > IMPs, Thu & Debra,

> > > >

> > > > I am just getting started with Telemedicine, but so far I

like the

> > > > flexibility. (It is also nice to be able to go to work in

your

> > > > slippers..LOL.) We have not expanded to having providers

from out of

> > the

> > > > state yet, but when this happens, it will be the ideal job

for those

> > who

> > > > want to add extra hours but want to work remotely. It is

definitely

> > > > different to see tympanic membranes through a digital

picture or

> > listen to

> > > > lung sounds through a wave file. It is not a job that

everyone would

> > like,

> > > > but I think it will expand our ability to help those in

underserved

> > areas.

> > >

> > > >

> > > > I also envision Telemedicine helping those who are IMPs to

see patients

> > > out

> > > > of our area. There is a technician at the location where

the patient

> > > > arrives and they collect the data to enter into the

computer, pictures

> > > etc.

> > > > and the provider can see the patient through Skype and then

the

> > > > documentation is done in TeleAtrics, which is a web-based

record. There

> > > are

> > > > two sites..one for pediatrics and one for geriatrics (or

adults).

> > > >

> > > > I envision IMPs someday, once Telemedicine takes off and is

more

> > > mainstream,

> > > > having their patients arrive at a Telemedicine site in

their area

> > where a

> > > > technician can collect the exam data (vitals, pictures etc)

and then

> > the

> > > > provider can see the patient over skype or be telephone for

the

> > interview.

> > > > Technicians can collect ROS information but it must be

confirmed by the

> > > > provider as the techs are not licensed but trained to

collect what

> > > > information the provider will need.

> > > >

> > > > A real virtual visit cannot be done unless an exam can be

completed.

> > There

> > > > are " virtual visits " that can be done but there is

no means to collect

> > > vital

> > > > signs and do an exam and just talking to the patient is

really no

> > > different

> > > > than doing a phone visit (IMHO). Some situations where the

patient just

> > > > needs a follow up on clarification of how to use a new

medication etc.

> > may

> > > > not require an exam, but to evaluate the efficacy and side

effects of

> > the

> > > > medication, for example, would require an exam. So until we

have a

> > means

> > > to

> > > > collect this data, such as with Telemedicine, there are

limitations to

> > > what

> > > > can be done as a virtual visit. As Telemedicine progresses

I see a

> > world

> > > of

> > > > opportunity opening up for health care providers and

patients

> > everywhere.

> > > > One provider can cover multiple sites and the scheduler

makes it a

> > planned

> > > > visit, so the provider knows when the patients will be

" arriving " for

> > > their

> > > > visit.

> > > >

> > > > The program that I work for was included in a special documentary

that

> > the

> > > > Discovery Channel did from across the nation.

Markwick is the

> > other

> > > > Family NP that I work with and she is the Director of the

Adult

> > > Telemedicine

> > > > program.

> > > >

> > > > Here is the link..

> > > >

> > > > http://link.brightcove.com/services/player/bcpid1280283152001

> > > >

> > > > Tammy

> > > >

> > > > Tammy L. McGarvey, MSN, RN, FNP-BC

> > > >

> > > > Board Certified Family Nurse Practitioner

> > > >

> > >

> > > --

> > >

> > > MD

> > >

> > > ph

fax

> > >

> >

>

> --

>

> MD

>

> ph fax

>

--

MD

ph fax

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