I was not the telemedicine person on call, but needed to evaluate a patient. This was a sick lady who I opted not to send back to the hospital on Saturday, but wanted to give her a chance at the SNF. When the nurse called me on Sunday with concerns about her escalating discomfort and knowing her labs had remained abnormal, I needed to make a decision about transfer or not.
Since I was still torn with the decision making, I decided at the spur of the moment to use telemedicine to get a sense of how the patient appeared. I was lucky to have a good and smart nurse at Heritage (Kathy) who I had been communicating with several times over the weekend. In less than 5 minutes she got the cart ready and I was able to talk to the patient and (luckily) her daughter who was in the room. I brought them both up to speed with concerns and jointly made the decision to transfer patient back to the hospital. It turns out it was the right decision as she is currently being treated for an abdominal abscess.
Although telemedicine did not prevent a readmit in this case, it helped me with valuable decision making and most of all helped with good patient care.
Sangeeta Rana, MD, MPH