Can telemedicine replace face-to-face intervention?
Telemedicine is starting to be considered by some as an ideal treatment modality for coronavirus social distancing. However, what happens when true medical concerns don’t present well over a video monitor?
Let’s look at a recent comp case involving a police officer with cardiac issues who was scheduled to attend a follow-up appointment with his physician arranged by Krystina, a Genex field case manager assigned to the case. A few days later, however, Krystina received a call from the physician’s office that the appointment was being changed from an in-person to telemedicine visit due to COVID-19 precautions.
Since the officer had recently been hospitalized for shortness of breath and atrial fibrillation, the field case manager was concerned he wouldn’t receive the thorough follow-up he needed if the physician observed him remotely. Instead, Krystina intervened and called the cardiologist on his cell phone to discuss her concerns and convince him to keep the in-person visit.
The day of the appointment, Krystina immediately observed that the officer appeared short of breath upon arriving to the doctor’s office. In reviewing his hospital records, she also noted a significant decrease in cardiac output and mentioned both issues to the physician during the appointment. An EKG was performed, and the results showed the officer was still experiencing atrial fibrillation.
The cardiologist determined that a cardioversion — a medical procedure that restores normal heart rhythm through use of electrodes — needed to be performed. He scheduled the officer for an urgent procedure the next day. The cardiologist thanked Krystina for being so proactive in scheduling the in-person visit, as the arrhythmia was considered life threatening and if a telemedicine visit had been conducted as scheduled, it “would have been disastrous” for the officer.
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