From a New England Journal of Medicine article (March 11, 2020):
A central strategy for health care surge control is “forward triage” — the sorting of patients before they arrive in the emergency department (ED). Direct-to-consumer (or on-demand) telemedicine, a 21st-century approach to forward triage that allows patients to be efficiently screened, is both patient-centered and conducive to self-quarantine, and it protects patients, clinicians, and the community from exposure.
It can allow physicians and patients to communicate 24/7, using smartphones or webcam-enabled computers. Respiratory symptoms — which may be early signs of Covid-19 — are among the conditions most commonly evaluated with this approach. Health care providers can easily obtain detailed travel and exposure histories. Automated screening algorithms can be built into the intake process, and local epidemiologic information can be used to standardize screening and practice patterns across providers.
More than 50 U.S. health systems already have such programs. Jefferson Health, Mount Sinai, Kaiser Permanente, Cleveland Clinic, and Providence, for example, all leverage telehealth technology to allow clinicians to see patients who are at home. Systems lacking such programs can outsource similar services to physicians and support staff provided by Teladoc Health or American Well. At present, the major barrier to large-scale telemedical screening for SARS-CoV-2, the novel coronavirus causing Covid-19, is coordination of testing. As the availability of testing sites expands, local systems that can test appropriate patients while minimizing exposure — using dedicated office space, tents, or in-car testing — will need to be developed and integrated into telemedicine workflows.
“Life begins at 55, the age at which I published my first book,” he wrote in “From Eros to Gaia,” one of the collections of his writings that appeared while he was a professor of physics at the Institute for Advanced Study — an august position for someone who finished school without a Ph.D. The lack of a doctorate was a badge of honor, he said. With his slew of honorary degrees and a fellowship in the Royal Society, people called him Dr. Dyson anyway.
Amazon’s virtual medical clinic that offers in-person follow-ups is now available to Amazon employees in Seattle.
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This small device may change how doctors identify and manage patients with atrial fibrillation, an irregular heart rhythm that increases risk of stroke.
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