Clinical Services

ePoster Presentation

(EP-121) Remote Evaluation and Management of Outpatients at Clinics Using "Tmv" Telemedicine System-Initial Experience

Sunday, April 23
4:35 PM - 4:50 PM
Location: Experience Zone - ePosters

Objectives
While telemedicine technology is being utilized in a variety of locations and formats in increasing fashion, there is a decided lack of data on its utility and cost analysis in the most common setting for providing healthcare: outpatient primary care clinics. This report details the first experience of evaluation and management of consecutive, self-referred, walk-in patients at two free standing out-patient retail clinics, equipped with telemedicine technology.

Methods
In order to generate original data to validate this new concept in providing healthcare, retail clinics were constructed in compliance with regulations in Bucks County Pennsylvania. They were equipped with Telemedventure (tmv)'s proprietary telemedicine system at two local Wal-Mart stores with brand name SmartCareDoc. The sites were staffed by registered nurses. At the time of the visits, licensed healthcare providers were at remote locations in USA, Europe, or Asia. The open architecture system provides ability to perform continuous audio/visual interaction between patient and physician; to examine patients in real time using stethoscope, pen camera (for skin, mucosa, and ENT exam), single lead ECG, pulse oximetry, as well as vital signs (blood pressure, heart rate, respiratory rate, weight, height, and temperature); complete documentation of the visit in electronic medical records; ordering prescriptions and tests; forwarding records to physicians; generation of billing information; and providing access to patient portal.

Results
During clinic operations from 6/2012 to 8/2013, total of 605 walk-in self-referred, self-paying patients (ages 2-84 years) were treated successfully, without any safety related incidents, or any follow up medical-legal issues. Primary diagnoses were consistent with those in typical out-patient clinics: majority were related to respiratory tract, chest pain, hypertension, urinary tract, skin, back pain, headache amongst others, and also included well visits, clearance for school, sports, work, and driving. Three patients with more acute problems were referred to the local emergency room for further management. Independent survey showed 98% patient satisfaction with the service. The clinic also received high grades for use of technology, convenience, and low cost.

Conclusion
Our report clearly demonstrates that it is possible to provide high quality out-patient evaluation and management of common primary care issues at free standing retail clinic settings by healthcare providers from remote locations using tmv's SmartCareDoc telemedicine system in a safe and convenient fashion. This model is not limited by availability of providers in the immediate area, therefore, can be replicated in many locations as determined by the need of any community. Also based on this information, further studies of this system for utility in other locations and populations, its use for consultative services, and analysis of cost benefits for follow-up evaluations of chronic conditions are warranted.

Ankur N. Patel

PGY 1
Kingsbrook Jewish Medical Center

Ankur N. Patel, MD is a PGY-1 medical resident at Kingsbrook Jewish Medical Center (Brooklyn, NY) in the Internal Medicine Residency program.
He received his MD from University College Dublin in Dublin, Ireland (official degree granted: MB, BCh, BAO).
He was also awarded a MS from Drexel University College of Medicine in Philadelphia, Pennsylvania, preceded by a BS from Haverford College in Haverford, Pennsylvania.

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Rajnikant S. Shah

President and CEO Telemedventures
St Mary Physicians Group

President and CEO of TelemedVentures

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Mrugesh B. Patel

Interventional cardiology
St Mary Physicians Group

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Larry R. Kaiser

President and CEO, Temple University Health System
Temple University

Dean, The Lewis Kats School of Medicine at Temple University

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(EP-121) Remote Evaluation and Management of Outpatients at Clinics Using "Tmv" Telemedicine System-Initial Experience



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